• Asian Spine Journal
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• 제12권6호
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• pp.1085-1091
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• 2018

Study Design: Case-control. Purpose: To determine optimal cut-off value for body mass index (BMI) in predicting surgical success in patients with lumbar spinal canal stenosis (LSCS). Overview of Literature: BMI is an essential variable in the assessment of patients with LSCS. Methods: We conducted a prospective study with obese and non-obese LSCS surgical patients and analyzed data on age, sex, duration of symptoms, walking distance, morphologic grade of stenosis, BMI, postoperative complications, and functional disability. Obesity was defined as BMI of ${\geq}30kg/m^2$. Patients completed the Oswestry Disability Index (ODI) questionnaire before surgery and 2 years after surgery. Surgical success was defined as ${\geq}30%$ improvement from the baseline ODI score. Receiver operating characteristic (ROC) analysis was used to estimate the optimal cut-off values of BMI to predict surgical success. In addition, correlation was assessed between BMI and stenosis grade based on morphology as defined by Schizas and colleague in total, 189 patients were eligible to enter the study. Results: Mean age of patients was $61.5{\pm}9.6years$. Mean follow-up was $36{\pm}12months$. Most patients (88.4%) were classified with grades C (severe stenosis) and D (extreme stenosis). Post-surgical success was 85.7% at the 2-year follow-up. A weak correlation was observed between morphologic grade of stenosis and BMI. Rates of postoperative complications were similar between patients who were obese and those who were non-obese. Both cohorts had similar degree of improvement in the ODI at the 2-year followup. However, patients who were non-obese presented significantly higher surgical success than those who were obese. In ROC curve analysis, a cut-off value of ${\leq}29.1kg/m^2$ for BMI in patients with LSCS was suggestive of surgical success, with 81.1% sensitivity and 82.2% specificity (area under the curve, 0.857; 95% confidence interval, 0.788-0.927). Conclusion: This study showed that the BMI can be considered a parameter for predicting surgical success in patients with LSCS and can be useful in clinical practice.

• Journal of Periodontal and Implant Science
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• 제45권6호
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• pp.210-215
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• 2015

Purpose: The aim of this retrospective study was to investigate the cumulative success rate, the implant survival rate, and the occurrence of biological complications in implants supporting full-arch immediately loaded rehabilitations supported by upright and tilted implants. Methods: The clinical records and periapical radiographs of patients who attended follow-up visits were collected, and information was recorded regarding marginal bone loss resorption, the occurrence of peri-implant infectious diseases, and the implant survival rate. Implants were classified as successful or not successful according to two distinct classifications for implant success. Results: A total of 53 maxillary and mandibular restorations including 212 implants were analysed, of which 56 implants were studied over the full five-year follow-up period. After five years, the cumulative success rate was 76.04% according to the Misch classification and 56.34% according to the Albrektsson classification. The cumulative implant survival rate was 100%, although one implant was found to be affected by peri-implantitis at the second follow-up visit. Conclusions: The cumulative success rate of the implants dropped over time, corresponding to the progression of marginal bone resorption. The prevalence of peri-implantitis was very low, and the implant survival rate was not found to be related to the cumulative success rate.

• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.615-621
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• 2022

Various treatments for trigeminal neuralgia (TN) are known to yield initial satisfactory results; however, the surgical treatment has excellent long-term outcomes and a low recurrence rate. Surgical treatment addresses the challenge of vascular compression, which accounts for 85% of the causes of TN. As for surgical treatment for TN, microvascular decompression (MVD) has become the surgical treatment of choice after Peter J. Jannetta reported the results of MVD surgery in 1996. Since then, many studies have reported a success rate of over 90% for the initial surgical treatment. Most MVDs aim to separate (decompress) the culprit vessel from the trigeminal nerve. To increase the success rate of surgery, accurate indications for MVD and management of the offender vessels without complications are critical. In addition, if there is no vascular compression, partial sensory rhizotomy or internal neurolysis can be performed to improve surgical outcomes.

• Korean Journal of Ophthalmology
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• 제32권6호
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• pp.483-487
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• 2018

Purpose: To compare the characteristics and surgical outcomes in patients with tenacious proximal fusion (TPF) and high accommodative convergence/accommodation ratio (AC/A) types of intermittent exotropia. Methods: This study retrospectively enrolled 40 patients with intermittent exotropia, 23 with TPF and 17 with high AC/A. Binocular function was evaluated by Worth's 4-dot test. Patients underwent lateral rectus recession, and surgical outcomes were compared. Surgical success was defined as less than ${\pm}10$ prism diopters (PD) at 12 months postoperatively. Results: The proportion of diplopia at near, evaluated by Worth's 4-dot test, was significantly higher in patients with high AC/A than in those with TPF (35.3% vs. 4.3%, p = 0.029). The mean preoperative angles of deviation in TPF and high AC/A types were $28.3{\pm}4.4$ and $28.8{\pm}4.5PD$ at distances, and $14.7{\pm}4.2$ and $15.1{\pm}4.1PD$ at near. Twelve months after surgery, the mean angles of deviation in TPF and high AC/A types were $2.9{\pm}9.8$ and $1.2{\pm}9.6PD$, respectively, at distance and $1.7{\pm}7.7$ and $-1.3{\pm}11.3PD$ at near. The surgical success rates were similar in the TPF and high AC/A types (74.0% vs. 64.7%). Five (21.7%) patients with TPF and 2 (11.8%) with high AC/A type experienced recurrence, with consecutive esotropia occurring in 1 (4.3%) patient with TPF and 4 (23.5%) patients with high AC/A. Conclusions: The proportion of diplopia at near was higher in patients with high AC/A type than in those with TPF intermittent exotropia. However, the surgical success rates were not significantly different between the types.

• 한국임상수의학회지
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• 제25권6호
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• pp.529-532
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• 2008

The object of this study was to evaluate the durations from onset of neurological sign until surgery and regaining of the deep pain perception (DPP) after decompression as prognostic indicators for the outcome of decompression surgery in dogs with thoracolumbar intervertebral disc disease (IVDD). The compression lesions in the thoracolumbar vertebrae were localized by plain radiograph, computed tomography and neurological examination in 28 dogs with hindlimb paralysis. The follow up was carried out for 6 months after laminectomy. During the follow up, regaining DPP and walking ability were evaluated. Improvement to normal or paretic gait after surgery was judged as success of the surgical treatment.The success rate of surgical treatment was 70 % (7 out of 10 dogs) when surgical intervention was carried out within 24 hours but 38.9 % (7 out of 18) over 24 hours (P<0.05). The success rate of surgical treatment was 87.5 % (14 out of 16 dogs) when DDP was regained within 5 weeks after surgery but there was 0 % (0 out of 12 dogs) when DDP was not regained within 5 weeks after surgery (P<0.05). Other parameters such as compression rate in CT scan and laminectomy methods did not related with the success of the surgery. These results suggested that the time of surgery after onset and duration of regaining of DPP after decompression were useful parameter to predict the success of surgical treatment for thoracolumbar disc herniation in dogs.

• Journal of Yeungnam Medical Science
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• 제21권1호
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• pp.12-22
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• 2004

The management of coincident glaucoma and cataract is not only a common clinical challenge but also an important research topic in the ophthalmic surgical field. The purpose of this article is to compare the different surgical options on the basis of their achievable postoperative intraocular pressure (IOP) control, success rates, and complication rates reported in the related literature, and to give advice on how to manage typical situations of patients with both glaucoma and cataract. Main topics were focused on indications and rationale of 3 surgical options (only cataract surgery first and later trabeculectomy, only trabeculectomy first and later cataract surgery, or simultaneous combined surgery). Modern clear corneal cataract extraction techniques resulted in a modest intermediate-term reduction of IOP and has considerably improved the success rates of combined glaucoma and cataract surgery. It also enabled future trabeculectomy to be successfully performed at a later date if necessary. Trabeculectomy alone achieved better IOP regulation than phacotrabeculectomy (combined surgery), but subsequent cataract surgery may compromise preexisting filtering bleb. Combined surgery augmented with mitomycin C achieved a lower IOP than combined surgery alone but had a higher complication rate. In conclusion, the choice of the preferred surgical method should be determined according to the target pressure, the amount of glaucomatous damage, and the grade of visual disturbance caused by the cataract. Phacotrabeculectomy with adjunctive mitomycin C offers visual improvement and achieves the best IOP lowering of all types of combined glaucoma and cataract surgery currently used but is associated with potentially sight-threatening complications.

• Journal of Korean Dental Science
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• 제5권2호
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• pp.54-59
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• 2012

Purpose: The purpose of this study was to evaluate the prognosis (clinical outcomes) of one-stage flapless implant surgery based on success and survival rate and marginal alveolar bone loss. Materials and Methods: Ninety dental implants were placed according flapless surgical procedure in forty-one patients at Hospital between April 2004 and May 2009. The mean age of the patients was 54, and the patients were comprised of 24 men and 17 women. Each patient was investigated radiographically and clinically being with average follow up 49.7 period. Result: Average healing period is 4.45 month (maxilla: 5.31 month, mandible: 3.20 month) after installation and survival rate is 95.7% in this period. The survival rate and success rate at 1 year after function (prosthodontics setting) are 92.4% and 88.0%. At final observation, the survival rate and success rate are 90.2% (maxilla: 89.1%, mandible: 92.9%) and 84.8% (maxilla: 82.8%, mandible: 89.3%). The mean residual alveolar bone resorption at 1-year after function and final observation are 0.8 mm and 1.07 mm. Conclusion: Our study suggest that if appropriate surgical technique with proper patients selection, flapless implants surgery is predictable simple and safety technique.

• Journal of Korean Dental Science
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• 제3권2호
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• pp.12-19
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• 2010

Despite the latest advancement made in its techniques and devices/apparatuses and the resulting rising expectation in the field of dental surgery, apicoectomy performed in the molar teeth remains a technical challenge and lacks evidence substantiated by long-term follow-up studies. This study sought to investigate the treatment outcomes and post-operative success rate in the root-end resected molar teeth accompanied by a high level of surgical risks due to their close proximity to the mandibular canal and maxillary sinus. A total of 68 patients who received treatment at Livingwell Dental Hospital between 2004 and 2010 and underwent apical surgery in the maxillary or mandibular molar area were enrolled in this study. A total of 160 roots collected from 75 molar teeth were subjected to surgical endodontic treatment and subsequently evaluated clinically as well as radiographically. Based on the results of the study, the clinical success rate was found to be 78.8% in cases involving radiological healing. Likewise, 90.7% of the roots recorded a robust clinical survival rate, but with incomplete healing as shown by radiography. The results indicate that the apical procedure involving molar teeth is a prognosis-friendly method that promises positive outcomes and higher success rate based on long-term follow-up observations.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.126-135
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• 2002

신생혈관녹내장에 대한 MMC 섬유주절제술의 효과와 그 예후에 영향을 미치는 요인에 대해 알아보고자 하였다. 신생혈관녹내장으로 진단하고 MMC 섬유주절제술을 시행한 55명, 62안을 대상으로 의무기록을 후향적으로 조사하였다. 수술 성공 여부의 기준은 술후 안압하강제 사용에 관계없이 술후 최종 안압이 21 mmHg이하이며 시력상실이 없는 경우를 성공으로 판정하였고, 술전 시력이 광각이상의 환자에서 광각이 소실된 경우와 광각무인 환자에서 안구위축이 발생한 경우 및 안압하강을 위해 추가적 녹내장수술을 시행한 경우는 수술실패로 판정하였다. 평균 $23.9{\pm}16.2$개월의 추적 관찰 후 전체 62안 중 37안(60%)이 수술성공으로 판정되었다. Kaplan-Meier 생존분석을 이용한 수술 후 6개월, 12개월, 24개월, 36개월의 누적 수술성공률은 각각 85%, 71%, 57%, 52%이었다. 당뇨망막병증이 있는 경우가 다른 원인을 가진 경우보다 수술성공률이 더 높았고(p=0.005), 범망막광응고술을 시행한 경우에서 시행하지 않은 경우보다 수술성공률이 더 높았다(p=0.015). 하지만, 범망막광응고술의 시행여부는 Cox proportional hazard regression 분석법에 의해 섬유주절제술 실패의 의미있는 위험인자로 작용하지는 않았다. 결론적으로 신생혈관녹내장은 원인질환이 당뇨망막병증의 경우 MMC를 사용한 섬유주절제술의 예후가 다른 원인질환에 의한 경우보다 양호하였으며, MMC를 이용한 섬유주절제술이 방수유출장치삽입술이나 모양체광응고술에 앞서 일차적 수술로 유용하다고 생각한다.

• Korean Journal of Radiology
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• 제25권1호
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• pp.55-61
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• 2024

Objective: This study aimed to evaluate the safety and efficacy of intranodal lymphangiography and thoracic duct embolization (TDE) for chyle leakage (CL) after thyroid surgery. Materials and Methods: Fourteen patients who underwent intranodal lymphangiography and TDE for CL after thyroid surgery were included in this retrospective study. Among the 14 patients, 13 underwent bilateral total thyroidectomy with neck dissection (central compartment neck dissection [CCND], n = 13; left modified radical neck dissection (MRND), n = 11; bilateral MRND, n = 2), and one patient underwent left hemithyroidectomy with CCND. Ten patients (76.9%) had high-output CL (> 500 mL/d). Before the procedure, surgical intervention was attempted in three patients (thoracic duct ligation, n = 1; lymphatic leakage site ligation, n = 2). Lymphangiographic findings, technical and clinical successes, and complications were analyzed. Technical success was defined as the successful embolization of the thoracic duct after access to the lymphatic duct via the transabdominal route. Clinical success was defined as the resolution of CL or surgical drain removal. Results: On lymphangiography, ethiodized oil leakage near the surgical bed was identified in 12 of 14 patients (85.7%). The technical success rate of TDE was 78.6% (11/14). Transabdominal antegrade access was not feasible due to the inability to visualize the identifiable cisterna chyli or a prominent lumbar lymphatic duct. Among patients who underwent a technically successful TDE, the clinical success rate was 90.1% (10/11). The median time from the procedure to drain removal was 3 days (with a range of 1-13 days) for the 13 patients who underwent surgical drainage. No CL recurrence was observed during the follow-up period (ranging from 2-44 months; median, 8 months). There were no complications, except for one case of chylothorax that developed after TDE. Conclusion: TDE appears to be a safe and effective minimally invasive treatment option for CL after thyroid surgery, with acceptable technical and clinical success rates.