• Title/Summary/Keyword: 수술후 교정치료

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Delayed Primary Repair of Esophageal Rupture (식도천공 후 만기 일차 봉합술의 성적)

  • 김길동;정경영;김창수;박한기
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.46-51
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    • 1998
  • Treatment of esophageal perforation when diagnosed late remains controversial. Ten consecutive patients since 1990 were treated late(later than 24 hours) for esophageal perforation with primary repair. Four perforations were iatrogenic, 3 were spontaneous, 2 were foreign body aspiraton and 1 was trauma. The interval from perforation to operation was 116 hours in mean and 48 hours in median value. The principles of repair included (1) a local esophagomyotomy proximal and distal to the tear to expose the mucosal defect and intact mucosa beyond, (2) debridement of the mucosal defect and closure, (3) reapproximation of the muscle, and (4) adequate drainage. The repair was buttressed with parietal pleura or pericardial fat in 9 patients. Associated distal obstruction was treated with dilation and esophagomyotomy intraoperatively. There was one mortality and cause of death was massive gastric bleeding due to gastric ulcer on 33rd day after operation. Five patients had leak at the site of repair and these cases were treated completely with conservative treatment except a mortality case. In conclusion, in the absence of malignant or irreversible distal obstruction, meticulous repair of perforated esophagus and adequate drainage are preferred approach, regardless of the duration from the injury to the operation.

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Implant treatment on anterior cross-bite of a patient who had orthognathic surgery 20 years ago (20년전 악교정수술을 받았던 환자의 심한 전치부 반대교합의 해결을 위한 임플란트 치료 증례)

  • Park, Kwang Man;Leesungbok, Richard;Lee, Suk Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.3
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    • pp.245-253
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    • 2019
  • Orthognathic surgery of skeletal Class III malocclusion improves oral function and facial appearance. The greater amount of skeletal discrepancy, the greater amount of teeth movement required for decompensation, and this often causes pathological changes in periodontal tissue especially in lower anterior dentition. We made a Top-Down treatment plan with personalized analysis using Face Hunter, Plane System and ARCUS Digma II, in order to resolve severe mobility and cross-bite of lower anterior teeth for 49-year-old female patient who had undergone orthognathic surgery 20 years ago due to skeletal Class III malocclusion and mandibular prognathism. Lower anterior teeth were extracted and alveoloplasty was done. After healing of the wound, immediate loading was conducted immediately after implant placement. Final restorations were fabricated Zirconia using CAD/CAM, and inserted intraorally screw-retained type. During 6-month follow-up, no abnormal episodes of restorations were observed, and obtained satisfactorily both of functional and esthetic outcomes.

Sciatic Nerve Injury Following a Delayed Surgical Procedure for the Hamstring Muscle Avulsion from the Ischial Tuberosity - A Case Report - (슬근 좌골 결절 견열 손상의 지연 수술후 발생한 좌골신경 손상 - 증례 보고 -)

  • Kim Hui Taek;Yoo Chong Il;Yun Pyung Ju;Lee Jong Seo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.75-78
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    • 2002
  • Avulsion of the hamstring tendon from the ischial tuberosity is common in many sports, especially with younger athletes. The injury results from a sudden forceful flexion of the hip joint when the knee is extended and the hamstring muscles powerfully contracted. Early diagnosis and surgical repair with reattachment of avulsed muscles to the ischial tuberosity restore function and correct deformity. But, a delay in the diagnosis and treatment leads to a poor result functionally and clinically. Complication, such as heterotopic ossification and failure of the fixation, etc., were reported following a surgical procedure for this injury. However, sciatic nerve injury has not been reported in the literature. We report our experience of a sciatic nerve palsy after surgery that was performed three months after that the initial injury.

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Treatment strategies on Class III malocclusion based on Long term follow up study (III급 부정교합의 치료전략)

  • Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.26 no.2 s.55
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    • pp.125-139
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    • 1996
  • The author obtained some useful information for the class III treatment from long term observation on the growing patients with class III malocclusion. 8 patients were selected for this study and presentation. From these observation so far my conclusions might be as follows: First in the early correction of the anterior crossbite, considerable forward growth changes were observed in the maxilla Second, as for the growth modification of jaws by orthopedic treatment only limited effects were recognized from the long-term observation Thrid, at early age of patients with anterior crossbite, any data couldn't make me predict the stability after treatment on the long-term basis. Fortunately, however, genial angle showed a marginal possibility of it prediction. Fourth, at an advanced age/ retraction orthopedic force on the mandible and the rapid change in the mandibular position may cause some trouble in the T.M.joint. Finally, the followings are recommendable. As for the anterior crossbite, correct it early as possible, and use orthopedic force under the age of ten. Do not enter the phase II treatment directly. Just wait and observe until the growth were almost completed, focusiong on some important factors such as airway problem, tongue position, and third molar development. Of course, these factors may have some effects on the mandibular growth. for the female, at the age of around 14 years old and the male, around 17 years old, make a final decision whether the patients will continue to be treated orthodontically or surgically Thereby, (I think) the relapse and retreatment problem after treatemnt we have observed so far might be minimized. Furthermore, the active treatment time may be also reduced.

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Surgical Treatment of Bronchoesophageal Fistula Caused by a Self-Expanding Esophageal Stent (부식성 식도협착 환자에서 식도스텐트 삽입 후 발생한 기관지 식도 누공의 수술적 치료)

  • 이재익;우종수;이길수;노미숙
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.197-200
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    • 2004
  • Although the formation of fistula between esophagus and adjacent organ is a known complication of the self-expanding esophageal stent, only a few cases of surgically treated bronchoesophageal fistula have been reported. Increasing application of endoscopic stent for benign esophageal strictures increases the chance for this type of delayed complication. We experienced a case of bronchoesophageal fistula caused by esophageal stent for which we performed fistulectomy and Ivor Lewis operation simultaneously. To the best of our knowledge, this is the first report on the successful surgical treatment of this complication in Korea.

A Study on the Postoperative Stability of Hard Tissue in Orthognathic Surgery Patients Depending on the Difference of Occlusal Plane (악교정 수술시 교합평면의 차이에 따른 술후 경조직의 안정성에 관한 연구)

  • Hwang, Chung-Ju;Lim, Seon-A;Moon, Jeong-Lyon
    • The korean journal of orthodontics
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    • v.29 no.2 s.73
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    • pp.239-249
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    • 1999
  • In orthognathic surgery to obtain proper functional and esthetic form after skeletal discrepancy treatment, precise diagnosis and treatment plan are essential. Especially in two jaw surgeries that have serious upper and lower jaw problems, maxilla and mandible are arranged in three dimensions. Based on the maxillary rearrangement, mandibular sagittal and transverse positions are determined, and thus new occlusal plane is established. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane based on the architectural and structural craniofacial analysis of Delaires. The subjects of this study were 48 patients who underwent two jaw surgeries, and they were equally divided into two groups, A and B. A group was operated with ideal occlusal plane and B group was not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. ANS was lower than that of PNS for both A and B after the surgery. That is, maxilla and mandible are rotated in posterior and superior direction. 2. Significances were found between $T_2$ and $T_3$ for both A and B are HRP-Me at vortical measurements, articular angle(p<0.01), gonial angle(p<0.01), and Mn. plane angle(p<0.05) at angular measurement. Mn. plane angle is increased at HRP-Me is decreased for both A and B. 3. There is no significance in skeletal stability aster the surgery between group A and B. 4. Horizontal movements of B and Pog by surgery have statistically significant inverse correlations with horizontal relapse of B and Pog, and vertical relapse of PNS, as well as Mn. Plane angle, and gonial angle after the surgery.

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Transaxillary Minithoracotomy with Naruke Thoraco-opener in the Operative Treatments of Primary Spontaneous Pneumothorax (일차성 자연기흉에서 Naruke개흉기를 이용한 최소 액와절개술)

  • 김병호;허동명
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.648-652
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    • 1999
  • Background: Bullectomy through a transaxillary minithoracotomy have been widely used in the treatment of primary spontaneous pneumothorax. Material and Method: From September 1997 to September 1998, 22 consecutive cases of those who underwent transaxillary mini thoracotomy with Finochieto rib spreader(group F) and 24 consecutive cases with Naruke thoraco-opener(group N) at Taegu Fatima Hospital were reviewed retrospectively to compare the clinical results of transaxillary minithoracotomy with different rib spreaders in the opera tive treatments of primary spontaneous pneumothorax. Result: There were no significant differences in operative time, hospital stay, postoperative hospital stay, the duration of the indwelling chest tube, and the number of postoperative recurrences and complications in the two group. CONCLUSION This technique may be useful in the operative treatments of primary spontaneous pneumothorax.

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Repair of Postinfarction Ventricular Septal Defect on a Beating Heart -One case report (심근경색 후 심실중격렬손의 심박동 상태에서의 교정술 -1예 보고-)

  • Kim, Hyuck;Lee, Hyung-Chang;Kim, Young-Hak;Chung, Won-Sang;Kim, Kyung-Soo
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.543-545
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    • 2004
  • Postinfarction ventricular septal defect often induces cardiogenic shock and requires operative treatment early after myocardial infarction. Although the operative mortality of this disease has decreased during the past 3 decades, it is still relatively high. In this case, to prevent global myocardial ischemia, we used the technique of repair of postinfarction ventricular septal defect on a beating heart. This approach does not requir aortic cross-clamping and provides superior myocardial protection.

Surgical-Orthodontic Correction of Adult Bimaxillary Protrusion - Report of 2 cases - (성인의 상하악 치조 전돌증의 교정 - 외과적 악교정 2례 -)

  • Lee, Hee-Kyeung;Jin, Byung-Rho;Kim, Jong-Won;Lee, Jeung-Mee;Do, Kee-Yong;Park, Hui-Dae
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.127-133
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    • 1988
  • Two patients, sought treatment for chief complaints of protruding frontal tooth and desired treatment to reduce the prominance of lips, were diagnosed as bimaxillary protrusion via clinical and cephalometric analysis. The authors corrected them by combined surgical and orthodonic treatment. As pre-surgical survey, paper and cast surgery were performed and wafer and resin sprint were constructed. We performed anterior maxillary and mandibular osteotomies in first premolar site to retract the maxillary and mandibular dentoalveolar segment in order to ; 1) decrease prominance of upper and lower lips. 2) create proper lower incisor intrusion. By use of intrtamaxillary fixation, prompt oral intake was possible. We made good result of esthetic improvement and there was no evidence of relapse and any complication.

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A Case of Gastrobronchial Fistula after Esophagectomy (식도 절제술 후 발생한 위기관지 누공 1예)

  • 김현태;손국희;김영삼;김정택;백완기;김광호;윤용한
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.193-196
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    • 2004
  • Benign gastrobronchial fistula (GBF) after Ivor Lewis operation is a very rare and serious complication. We describe a patient with GBF who was successfully managed on the single-stage repair, 15 months after the Ivor Lewis operation. After the division of the GBF, the bronchial and gastric defects were closed directly. The omental flap and the pedicled 5th. intercostal muscle flap were interposed between the closed defects. The literature of this subject is reviewed and discussed.