Choi, Sung Won;Won, Dong Chul;Lim, Young Kook;Hong, Yong Taek;Kim, Hoon Nam
Archives of Craniofacial Surgery
/
v.10
no.2
/
pp.120-126
/
2009
Purpose: Autogenous cartilage is generally first choice in rhinoplasty because of its biocompatibility and resistance to infection. On the other hand, allogeneous cartilage graft might preferred over an autogenous graft to avoid additional donor site scars, morbidity and lengthened operating time. Allogenous costal cartilage ($Tutoplast^{(R)}$) not only have the advantage of averting donor site morbidity but also are resistant to infection, resembling autogenous cartilage graft. We report here a technique for rhinoplasty by using allogenous costal cartilage graft. Methods: Through open rhinoplastic approach, alar cartilage is released from upper lateral cartilage and relocated caudally. After relocation of alar cartilage, allogenous costal cartilage is immobilized by nonabsorbable suture material at caudal aspect of septal cartilage. Caudal end of allogenous costal cartilage is sutured between medial crura of alar cartilage. Tip projection is improved by using interdormal suture, transdormal suture and shield-shape cartilage graft which is harvested from concha Results: No significant resorption and infection was detected in any of patients. Aesthetic and functional results were satisfactory. Conclusion: The low incidence of major complication and versatility of allogeneous costal cartilage graft make safe and reliable source of cartilage graft in rhinoplasty.
The purpose of this study was to analyze the effect of orthopedic forces on the craniofacial complex utilizing the three kinds of the head gear. (high pull head gear, straight pull head gear, cervical pull head gear) For this study, the teeth and alveolar bone and palate were reproduced from birefringent materials and other parts of craniofacial complex were coated with birefringent material on the model. The effect of orthopedic forces on the craniofacial complex was analyzed by photoelastic method using transmission polariscope and reflection polariscope. The results were as follows. 1. The cervical pull head gear had the greatest tipping effect on the maxillary molars and high pull head gear had the least tipping effect. 2. In areas stressed, the cervical pull head gear stressed the greatest degree. 3. Only cervical pull head gear produced stress at the zygomaticofrontal suture and the posterior region of palate. 4. The straight pull head gear and high pull head gear produced stress at just inferior to the anterior nasal spine. 5. The cervical pull head gear and straight pull head gear produced tensile stress at the fronto-maxillary suture. 6. The pterygoid plates of the sphenoid bone, the zygomatic arches, the junction of the maxilla with the lacrimal and ethmoid bone, and the maxillary molars were affected by three types of head gear.
Ahn, Seong Jun;Kim, Bu Hwan;Song, Moo Ho;Kang, Suk Woong;Oh, Kwan Taek;Yoo, Seong Ho
Journal of Korean Foot and Ankle Society
/
v.17
no.3
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pp.220-224
/
2013
Purpose: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, it could lead to skin irritation and medial pain after the surgery. The purpose of this paper was to report our clinical and radiographic results with transarticular fixation of Akin osteotomy for the treatment of patients with hallux valgus after resection of the medial protrusion of base of the proximal phalanx. Materials and Methods: Our study is subject to 34 cases of 30 patients who went through proximal phalanx medial corticectomy among patients undergone both hallux valgus surgery and Akin osteotomy at our institution from March 2006 to March 2012. In all cases, we used absorbable suture material through the articular surface for Akin osteotomy after resection of the medial protrusion in proximal phalanx. Radiographs were reviewed to assess the union and displacement of osteotomy site at the time of postoperative 6 months. The clinical results were assessed by using AOFAS score and complication such as skin irritation and pain. Results: AOFAS score was improved from average 44 points(36-58), before operation and average 87 points(74-96), 12 months after operation. In two cases, partial union was suspected in radiological perspective, however, complete union on the osteotomy site was observed in all cases, 12 months after the operation. No patients was dissatisfied with pain, joint discomfort, skin irritation and inflammation from the knot. Conclusion: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, We have good results by transarticular fixation of Akin osteotomy using absorbable suture material.
Problems of composite tissue transfer commonly arise when a single indispensable recipient vessel receives the graft vssel, and the graft vessel must be sutured in end-to-side fashion so as not todisturb the vascularity of the recipient vessel. The triangular flap in the recipient vessel wall gives an intact endothelial surface when the flow of blood stream is presented and may reduce the chance of anastomosis. We selected mature Wistar rats weighing over 450 grams to compare the conventional longitudinal slit from the triangular flap in the recipient carotid artery over bloood pressure and blood flow when the donor carotid artery was anastomosed in end-to-side fashion. In 30 minutes after anastomosis, maximum blood pressure measured in the donor carotid arterial side when the recipient arterial wall was fasioned with the longitudinal slit was recorded 114 mmHg and with the triangular flap 100mmHg. Minimum blood pressure with the longitudinal slit was 98mmHg and with the triangular flap 88mmHg. The amount of blood collected for 30 seconds in the conventional longitudinal slit was 1.18mg and in the triangular flap 0.78mg. Histology study in 30 minutes, the conventional longitudinal slit demonstrated the more hemorrhagic features around the suture material compared to that of the triangular. flap and, in the 7th day, the conventional longitudinal slit demonstrated the more prominent granulomatous reactions and vascular proliferations around the suture material compared to that of the triangular flap.
Kim, Bo-Hyun;Hwang, In-Sung;Yun, Tae-Bong;Byun, Jae-Yong
Journal of the Korean Arthroscopy Society
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v.8
no.1
/
pp.1-8
/
2004
Purpose: This study examined clinical cure and patients' satisfaction degrees by factors influencing surgical operation results, after arthroscopic inside to out repair as a nonabsorbable suture material, in case of meniscal rupture. Materials and Methods: Materials were 110 cases of 95 patients who could make paces for over 12 months from August 1999 to June 2002. Results were evaluated by clinical cure and subjective satisfaction degrees. This study, concerning those results, analyzed age, term from taking pictures to taking surgical operation, rupture section, rupture length, rupture types, lesion of articular-cartilage, and effects of anterior cruciate ligament operation accompanied. Results: 84 cases(76%) were clinically cured, 98 cases(89%) were subjectively satisfied. In case of accompanying anterior cruciate ligament rupture, and in case that rupture length was below 2 cm, rates of clinical cure and patients subjective satisfaction were significantly high. In case of complex or degenerative rupture, patients satisfaction rates were higher when comparing with clinical cure rates. Conclusion: Various sutures are possible as well as available in case of arthroscopic meniscal inside to out repair using nonabsorbable suture material. It can be concluded that patients age is not absolte consideration in determining the suture of meniscus. In cases of complex rupture, degenerative rupture, ruptures companied by joint-cartilage injuries, considerate consideratin need be paid to choose patients and operations.
Many kinds of membrane have been used for the guided bone regeneration (GBR) technique. However, most membranes do not fulfill all requirements for the ideal membrane for the GBR technique. Among them, collagen membrane has been most widely used. However, its high price and weak tensile strength in wet condition are limitations for wide clinical application. Synthetic polymers have also been used for the GBR technique. Recently, silk based membrane has been considered as a membrane for the GBR technique. Despite many promising preclinical data for use of a silk membrane, clinical data regarding the silk membrane has been limited. However, silk based material has been used clinically as vessel-tie material and an electrospun silk membrane was applied successfully to patients. No adverse effect related to the silk suture has been reported. Considering that silk membrane can be provided to patients at a cheap price, its clinical application should be encouraged.
A female Green iguana (Iguana iguana) was brought to the small animal clinic in Hannover Veterinary school because of anorexia and convulsion. Two months ago, the owner bought two iguanas, one female and one male and had to take a female to the one of local small animal clinic because she, born in 19931 didn't eat well and showed the tremor of the legs. The veterinarian suspected it to have a calcium deficiency and gave an injection of calcium and vitamin D3. But still during the last two months, the female iguana did only eat some lettuce while the other male ate lettuce, fruits and commercial cat-food ($Whiskas^{\circledR}$, Effem, Verden). It was not possible to evaluate the rations of these different "food-components". They are kept in the terrarium with water container. By palpation of the abdomen, hard thing like stone was palpated in the mid-region. The blood test wasn't carried out because of the difficulties of getting blood and because of her bad condition. It was firmly diagnosed as cystic calculus through radiography. Since the animal is in shock state already, the prognosis after surgery was bad. It was assumed to be too late to expect its surviving with the surgery carried out or without it. Cystotomy was performed in the cranial ventral paramedian incision in order to preserve the large ventral abdominal vein in the linen alba region. After two stay sutures ("holding suture" ) with 5-0 polyglactin 910 ($Vicryl^{\circledR}, Ethicon$) on the bladder, cystotomy was carried out and the stone inside was removed. Then, the bladder was closed in one-layer sutures. The abdomen was closed in simple interrupted suture with same material after the instillation of 10 ml saline solution into the abdominal cavity. The cystic calculus was in a size of $5.8{\times} 5.O{\times} 3.5 cm$. The analysis of the stone was carried out in two ways which are the infrared spectroscopy of the stone and quick analysis by $Merckognost^{\circledR}$(Diagnostica Merck, Merck). In the result of the infrared spectroscopy, the stone wee composed of 10% ammonium urate and 90% dihydrated uric acid. This iguana wasn't able to survive.n't able to survive.
From February 1988 to December 1990, 42 patients underwent so called REV operation for pulmonary stenosis or atresia with or without anomalies of ventriculoarterial connection and truncus arteriosus. The principles of operative technique are mobilization of pulmonary arterial tree beyond the pericardial reflection, transection of pulmonary trunk between the pulmonary ventricle and pulmonary artery, suture of distal pulmonary arterial stump to the upper margin of Pulmonary ventriculotomy site with absorbable suture, and anterior patch with 0.625% glutaraldehyde fixed autologous pericardium with monocusp inside it. Age at operation ranged 3-156months [mean 41.8 month] with twelve of whom infants. Operative indications were pulmonary atresia, with ventricular septal defect[16], and pulmonary stenosis with double outlet right ventricle[8], with ventricular septal defect[16], with double outlet right ventricle[8], with complete transposition of the great arteries[8], with corrected transposition of the great arteries[6], with Fallot`s tetralogy[3], and truncus arteriosus[1]. There were six hospital deaths[14%] and no late death. Twenty-four of 36 survivals were followed up more than 12 months with good clinical results. Postoperative angiocardiogram was performed in fifteen patients. Hemodynamically, two patents had residual pressure gradients along the pulmonary outflow tract, one patient showed severe pulmonary regurgitation; morphologically, there were six significant stenosis of left pulmonary arterial tree, two of whom showed significant pressure gradients. Our present experience with REV operation suggests that this technique make it possible to perform anatomic repair in a wide variety of congenital anomalies of abnormal ventriculoarterial connection associated with pulmonary outflow tract obstruction without using the prosthetic material, even in infants, with relatively low mortality and morbidity.
A 4-year-old, weighing 7.6 kg, castrated male, Pug presented with ingestion of gastric cavity foreign body. Physical examination revealed panting, retching and hyper-salivation. Blood chemistry and complete blood cell count were normal, but hypophosphatemia was observed. An abdominal radiograph revealed the foreign body (FB), round shape and 2 cm length, at the pyloric region of stomach. A thoracic radiograph revealed an incidental metal FB, 3.5 cm length, at the cranial portion of the diaphragm. An upper gastrointestinal endoscopy was performed to remove the FB in the stomach and then a peach-pit was removed. However the metal FB was not found in the esophagus therefore a lateral thoracotomy was performed. A right lateral thoracotomy through the $7^{th}$ intercostal space was accomplished to expose the right caudal lung lobe. After open the thoracic cavity, foreign body was not observed by gross evaluation and caudal lung lobe was attached to the diaphragm. The FB was identified inside the lung lobe and surrounded by granulation tissue. The metal FB (sewing needle) was removed with blunt dissection and incised lung lobe was sutured using absorbable suture material PDS 4-0 with interrupted suture. A thoracotomy tube was inserted into the thoracic cavity during surgery. Patient's respiration became stable after surgery. A chest tube was removed 3 days after surgery. No complications were noted and the dog was discharged 4 days after surgery. In small animal, foreign body ingestion is a common reason for emergency. After ingestion of the FB, perforation through the esophagus and migration to inside the lung lobe is not common in small animals. In this case, thoracic metal FB was identified incidentally and removal of a thoracic FB with thoracotomy was performed successfully.
Objectives: To investigate the effect of absorbable suture on surgically-induced corneal astigmatism in 3.0-mm sclera tunnel cataract surgeries. Methods: Medical records of patients who underwent phacoemulsification cataract surgery using a 3.0-mm sclera tunnel incision made by a single surgeon were reviewed. Uncorrected distant visual acuity, corneal astigmatism and surgically-induced astigmatism were measured in 56 patients' eyes that underwent sclera tunnel cataract surgery with absorbable sutures (sutured group) and in 23 patients' eyes without sutures (unsutured group). Uncorrected visual acuity, intraocular pressure, slit lamp examination, and automated keratometry were evaluated preoperatively and at 3 days, 2 weeks, 4 weeks, and 8 weeks after cataract operation. Results: There were no significant differences in preoperative average uncorrected distant visual acuity of the two groups (sutured group: $0.79{\pm}0.64$, unsutured group: $0.68{\pm}0.72$, P = 0.145). Corneal astigmatism measured using keratometry in the sutured and unsutured group at postoperative day 3 were $2.27{\pm}2.12D$ versus $0.83{\pm}0.55D$ at (P < 0.001), a difference which had disappeared after 4 weeks. Surgically induced astigmatism using the Holladay and Vector methods showed similar outcomes, suggesting that the sutured group exhibited higher astigmatism compared with the unsutured group until 2 weeks post-surgery. Conclusions: TPatients undergoing scleral tunnel cataract surgery with absorbable sutures have greater surgically induced astigmatism, especially in the early postoperative period, compared with those without sutures. However, this surgically induced astigmatism due to absorbable sutures in scleral tunnel cataract surgery is temporary and disappears at 4 weeks post-surgery.
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