• Title/Summary/Keyword: primary closure

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An epidemiologic study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Pusan National University Hospital (부산대학교병원 교정과에 내원한 구순구개열 환자들에 대한 역학조사)

  • Son Woo-Sung;Baek Jae-Ho;Lee Won-Chul
    • Korean Journal of Cleft Lip And Palate
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    • v.5 no.1
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    • pp.43-58
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    • 2002
  • A General survey on the cleft lip and/or palate patients in Pusan National University Hospital was done. The conclusions were as follow. 1. In gender ratio, male was higher than female. 2. In the cleft type, unilateral cleft lip and palate, cleft lip and alveolus, and bilateral cleft lip and palate in higher ratio order. Left unilateral cleft lip and palate was higher than right in ratio. 3. In first hospital visiting age for dental treatment, the group from 6 years old to 12 years old was most and in that the age group for attending elementary school (about 7-8 years old) showed especially higher ratio. The large majority of patient were born in 1980's and lived in Pusan metropolitan city, KyungSangNamDo. Especially, most of them lived in the neighboring Held of Pusan National University Hospital. 4. Class III skeletal pattern and Angle's Class III molar relationship was most prevalent. Angle's Class II molar relationship showed relative higher ratio because tooth loss and malposition. 5. Primary lip closure in 3 months, secondary lip closure in 6-7 years old, palatal closure in 12-16 months and bone graft in 8-10 years old were operated mostly. Rhinoplasty and scar revision were operated in too early age so the need of infantile orthopedics must be considered. 6. Maxillary expansion and protraction were operated mostly in 8-11 years old but operating in primary dentition must be considered. 7. Tooth alignment were started mostly in mixed dentition and consideration about prosthodontic treatment and retention will be need. 8. In tooth anomaly, tooth malformation and missing were most prevalent.

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Anterior maxillary defect reconstruction with a staged bilateral rotated palatal graft

  • Jung, Gyu-Un;Pang, Eun-Kyoung;Park, Chang-Joo
    • Journal of Periodontal and Implant Science
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    • v.44 no.3
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    • pp.147-155
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    • 2014
  • Purpose: In the anterior maxilla, hard and soft tissue augmentations are sometimes required to meet esthetic and functional demands. In such cases, primary soft tissue closure after bone grafting procedures is indispensable for a successful outcome. This report describes a simple method for soft tissue coverage of a guided bone regeneration (GBR) site using the double-rotated palatal subepithelial connective tissue graft (RPSCTG) technique for a maxillary anterior defect. Methods: We present a 60-year-old man with a defect in the anterior maxilla requiring hard and soft tissue augmentations. The bone graft materials were filled above the alveolar defect and a titanium-reinforced nonresorbable membrane was placed to cover the graft materials. We used the RPSCTG technique to achieve primary soft tissue closure over the graft materials and the barrier membrane. Additional soft tissue augmentation using a contralateral RPSCTG and membrane removal were simultaneously performed 7 weeks after the stage 1 surgery to establish more abundant soft tissue architecture. Results: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppuration were not observed in the donor or recipient sites after the stage 2 surgery. These procedures enhanced the alveolar ridge volume, increased the amount of keratinized tissue, and improved the esthetic profile for restorative treatment. Conclusions: The use of RPSCTG could assist the soft tissue closure of the GBR sites because it provides sufficient soft tissue thickness, an ample vascular supply, protection of anatomical structures, and patient comfort. The treatment outcome was acceptable, despite membrane exposure, and the RPSCTG allowed for vitalization and harmonization with the recipient tissue.

Distance of insertion points in a mattress suture from the wound margin for ideal primary closure in alveolar mucosa: an in vitro experimental study

  • Lee, Won-Ho;Kuchler, Ulrike;Cha, Jae-Kook;Stavropoulos, Andreas;Lee, Jung-Seok
    • Journal of Periodontal and Implant Science
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    • v.51 no.3
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    • pp.189-198
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    • 2021
  • Purpose: This study was conducted to determine how the distance of the near insertion points in a vertical mattress suture from the wound margin influences the pattern of primary closure in an in vitro experimental model. Methods: Pairs of 180 porcine gingival and alveolar mucosa samples were harvested from 90 pig jaws and fixed to a specially designed model. A vertical mattress suture was performed with the near insertion point at 3 different distances from the wound margin (1-, 3-, and 5-mm) on both the gingival and mucosal samples (6 groups; n=30 for each group). The margin discrepancy and the presence of epithelium between the wound margins were measured on histologic slides. Results: The margin discrepancy decreased significantly as the near insertion point became closer to the wound margin both in mucosal tissue (0.241±0.169 mm, 0.945±0.497 mm, and 1.306±0.773 mm for the 1-, 3-, and 5-mm groups, respectively) and in gingival tissue (0.373±0.304 mm, 0.698±0.431 mm, and 0.713±0.691 mm, respectively). The frequency of complications of wound margin adaptation reduced as the distance of the near insertion point from the wound margin decreased both in the mucosal and gingival tissues. Conclusions: Placing the near insertion point close to the wound margin enhances the precision of wound margin approximation/adaptation using a vertical mattress suture.

Low incidence of maxillary hypoplasia in isolated cleft palate

  • Azouz, Vitali;Ng, Marilyn;Patel, Niyant;Murthy, Ananth S.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.8.1-8.5
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    • 2020
  • Background: The cause of maxillary growth restriction in patients with cleft lip and palate remains controversial. While studies have investigated the effects surgical technique and timing have on maxillary growth, few focus on patients with isolated cleft palate (ICP). The purpose of this study was to determine the impact palate repair and its associated complications may have on maxillary growth. Methods: A retrospective chart review of ICP patients who underwent palatoplasty from 1962 to 1999 at Akron Children's Hospital was performed. Patient demographics, Veau type, age at primary repair, closure technique, presence of fistula or velopharyngeal insufficiency (VPI), number of palatal operations, maxillary hypoplasia (MH) frequency, and follow-up were recorded. Exclusion criteria included patients with cleft lip, submucous cleft, or syndromes. Results: Twenty-nine non-syndromic ICP patients were identified; 62% (n = 18) had Veau type 1 and 38% (n = 11) had Veau type 2. All patients underwent 2-flap or Furlow palatoplasty with mobilization of mucoperiosteal flaps. Vomerine flaps were used in all Veau 2 cleft palate closures. Palatoplasty was performed at a mean age of 19.9 ± 8.2 months. Average follow-up was 209 ± 66.5 months. The rate of VPI was 59% (n = 17) and the rate of oronasal fistula was 14% (n = 4). Conclusions: There was a low incidence of MH despite complications after initial palate closure. Our results seem to suggest that age at palate closure, type of cleft palate, and type of surgical technique may not be associated with MH. Additionally, subsequent procedures and complications after primary palatoplasty such as VPI and palatal fistula may not restrict maxillary growth.

Bronchial Artery Embolization of Massive Hemoptysis -2 cases- (대량 객혈에 대한 기관지동맥 색전술 -치험 2례-)

  • 강경훈
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.1117-1123
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    • 1988
  • Prolapse of the aortic valve is the main cause of insufficiency of the aortic valve as a complication of ventricular septal defect. Aortic insufficiency gets worse by the progress of prolapse of aortic valve due to lack of support of the valve and the hemodynamic effect of blood flow through the ventricular septal defect. This produces typical clinical picture, that may be serious and threatening when it is untreated. Type and timing for the surgical treatment of the ventricular septal defect with aortic insufficiency is considered. Among 113 ventricular septal defect, 9 patients of ventricular septal defect with associated aortic insufficiency were experienced from June. 1983 to June 1988 at the Department of Thoracic and Cardiovascular Surgery, Chon-Buk University Hospital. Male was 6 patients and female was 3 patients. Ages were from 7 years to 24years. 5 patients were from 10 to 19 years age. 3 patients were below 10 years age. The ratio of pulmonary blood flow to systemic f low [Qp/Qs] was 1.53 and in pulmonary vascular resistance, normal or slight increase was 7 patients, moderate 1 patient, and severe 1 patient. Ventricular septal defect was subpulmonic in 5 patients and infracristal in 4 patients. Prolapse of right coronary cusp was 7 patients, right and non coronary cusp 1 patient and non coronary cusp 1 patient. Teflon patch closure of ventricular septal defect was undertaken in 3 patients and primary closure in 1 patient. Among the 4 patients of defect closure alone, one patient performed valve replacement 7 months later due to progressive regurgitation and cardiac failure and the result was good. The other 3 patients were good result. Closure of ventricular septal defect and aortic valvuloplasty performed in 4 patients. 2 patients of these required valve replacement for the sudden intractable cardiac failure and died due to low cardiac output. The cause of intractable cardiac failure was tearing of repaired valve at the fixed site. The other 2 patients were good result. Closure of ventricular septal defect and valve replacement performed in 1 patient with good result.

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Vacuum Assisted Closure Therapy in Snake Bite Wound: Preliminary Report (독사 교상 환자에서의 음압요법: 예비보고)

  • Song, Woo-Jin;Choi, Hwan-Jun;Kang, Sang-Gue
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.121-126
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    • 2011
  • Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

Alveolar ridge preservation using granulation tissue for esthetic implant restoration on maxillary anterior tooth (상악 전치부의 심미적 임플란트 수복을 위한 육아 조직(Granulation tissue)을 이용한 치조제 보존술)

  • Lee Chang Kyun
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.1
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    • pp.16-22
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    • 2023
  • Esthetic factors are very important in the success of maxillary anterior implant restoration. However, achieving esthetic results is difficult, especially in cases where periodontitis has resulted in severe alveolar bone loss. In the case of maxillary anterior teeth, the alveolar ridge resorption that begins immediately after tooth extraction interferes with the esthetic implant restoration. Therefore immediate implant placement can be performed to minimize the alveolar ridge resorption. However, in severe bone loss cases, immediate implant placement could result in esthetic failure, and this result might cause irreparable problems. We can also perform alveolar ridge preservation and then place implants later. On JCP published in 2019, there is the consensus of European academy of periodontology on the extraction socket management and the timing of implant placement. This consensus states that alveolar ridge preservation should be considered when there is severe labial bone loss in an esthetically important area such as maxillary anterior region. On performing the alveolar ridge preservation, we cannot obtain the primary wound closure, so secondary wound healing is induced with open membrane technique or soft tissue grafting should be performed for primary wound closure. However, the secondary wound healing can have a negative impact on bone regeneration, and soft tissue grafting such as FGG or CT graft can be burdensome for both patients and dentists. On the other hand, by using the granulation tissue in the extraction socket, primary closure can be achieved without soft tissue grafting. Also some studies have shown that granulation tissue in periodontal defects contains stem cells that may help in tissue regeneration. Based on this, implant restorations were performed on maxillary anterior teeth with severe alveolar bone loss by alveolar ridge preservation using granulation tissue. In spite of the severe bone defect of the extraction socket, relatively esthetic results could be obtained in implant restorations.

Utilization of Permanent Site Data for Accuracy Improvement in GPS Surveying - At the Subset Area of Jinan-Gun - (GPS 측량의 정확도 향상을 위한 상시관측 데이터의 활용 - 진안군 일부 지역에 있어서 -)

  • 김상철;안기원;이효성;신석효
    • Proceedings of the Korean Society of Surveying, Geodesy, Photogrammetry, and Cartography Conference
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    • 2003.10a
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    • pp.61-64
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    • 2003
  • This study attempts to analyze both the mis-closures between triangulation points of 3 and 4 glade and permanent sites data, and accuracy of according as change the number of utilized GPS permanent sites and base lines for improvement of the accuracy in GPS surveying using permanent sites data. The result of this study show that the mis-closure between the two points and Jeonju/Chungju/Sangju/Daegu stations of NGI(National Geography Institute) are 0.0051 m, 0.0361 m, 0.0039 m and 0.0198 m respectively. It indicated that the mis-closures were less than the allowed values in the primary/secondary control point specification for GPS surveying, a mis-closure less than 30 mm for the distance less than 30 km and a mis-closure less than 1 PPM${\times}$D(km) for the distance greater than 30 km. Jinan 11 of actual surveying point for the base line 21.4911 km in Jeonju permanent site and 87.8156 km in Sangju permanent site, northing and easting for planimetric errors of Jinan 11 are 0.0120 m and 0.0113 m, northing and easting for planimetric errors of Jinan 12 are 0.0122 m and 0.0115 m.

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ANALYSIS OF RAYLEIGH-BENARD NATURAL CONVECTION (Rayleigh-Benard 자연대류 유동 해석)

  • Choi, Seok-Ki;Kim, Seong-O
    • Journal of computational fluids engineering
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    • v.13 no.3
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    • pp.62-68
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    • 2008
  • This paper reports briefly on the computational results of a turbulent Rayleigh-Benard convection with the elliptic-blending second-moment closure (EBM). The primary emphasis of the study is placed on an investigation of accuracy and numerical stability of the elliptic-blending second-moment closure for the turbulent Rayleigh-Benard convection. The turbulent heat fluxes in this study are treated by the algebraic flux model with the temperature variance and molecular dissipation rate of turbulent heat flux. The model is applied to the prediction of the turbulent Rayleigh-Benard convection for Rayleigh numbers ranging from Ra=$2{\times}10^6$ to Ra=$10^9$ and the computed results are compared with the previous experimental correlations, T-RANS and LES results. The predicted cell-averaged Nusselt number follows the correlation by Peng et al.(2006) (Nu=$0.162Ra^{0.286}$) in the 'soft' convective turbulence region ($2{\times}10^6{\leq}Ra{\leq}4{\times}10^7$) and it follows the experimental correlation by Niemela et al. (2000) (N=$0.124Ra^{0.309}$) in the 'hard' convective turbulence region ($10^8{\leq}Ra{\leq}10^9$) within 5% accuracy. This results show that the elliptic-blending second-moment closure with an algebraic flux model predicts very accurately the Rayleigh-Benard convection.

Operative results of coarctation of the aorta associated with ventricular defect (심실중격결손을 동반한 대동맥교약증의 수술성적)

  • Seo, Dong-Man;Park, Yeong-Gwan;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.620-624
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    • 1984
  • The optimal surgical management of the coarctation of the aorta associated with ventricular septal defect is still debated. Sixteen patients with the coarctation of the aorta and VSD were operated upon between November, 1980 and September 1984 at Seoul National University Hospital. They were 11 males and 5 females. All presented between 5 months and 11.5 years of age [mean= 5.5 years]. Presenting symptoms were congestive heart failure in 11 [69%], cyanosis on crying in 3 [19%], and frequent upper respiratory infection in 2 [13%]. In all cases two-stage operation was applied except one in which one stage procedure was taken. Resection and end-to-end anastomosis was used in 3, Dacron graft in 5, Gortex graft in 1, and left subclavian flap angioplasty in 4. Remaining two were missed on the operating table before correction of the coarctation of the aorta. Overall operative death in repair of the coarctation of the aorta were 3[20%]. Among the 12 survivors after repair of the coarctation of the aorta, 4 required patch closure of VSD, 2 required primary closure, 2 showed spontaneous closure [17%], one [8%] showed decrease in its size, 3 were under observation. It might be safe to approach the coarctation of aorta plus VSD with initial repair of the coarctation of the aorta without banding of main pulmonary artery and later management of VSD as usual manner in simple VSD.

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