• Title/Summary/Keyword: Anterior approach

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SURGICAL TREATMENT OF JAW CYSTS IN CHILDREN (소아의 악골내 발생한 낭종의 외과적 처치)

  • Kim, Jae-Gon;Kim, Young-Jin;Kim, Mi-Ra;Baik, Byeong-Ju
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.1
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    • pp.1-7
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    • 2001
  • The Dentigerous cyst is reported to be one of the most common lesions of the jaw. It is derived from reduced enamel epithelium that surrounds the crown of an unerupted tooth. Dentigerous cysts usually remains asymptomatic and presents as well-circumscribed radiolucencies surrounding the crown of a tooth. Most dentigerous cysts are treated by surgical enucleation or marsupialization of the cyst to allow eruption of the permanent tooth. The nasopalatine duct cysts derived from the islands of epithelium remaining after closure of the embryonic nasopalatine duct. The cyst presents as a well-circumscribed oval or heart-shaped radiolucency located in the midline of the anterior maxilla between the roots of the central incisors. Treatment is by surgical enucleation, employing a palatal approach. This report present two cases. One case was diagnosed with dentigerous cyst and treated by enucleation. 12 Months later, affected second premolar was erupted normally. The other case was diagnosed with nasopalation duct cyst. Histological examination of the enucleated cyst confirmed a nasopalatine duct cyst. There was no recurrence during follow up period.

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Conservative Treatment of Impingement Syndrome and Rotator Cuff Tear (충돌 증후군 및 회전근 개 파열의 보존적 치료)

  • Jung, Hong Jun;Jeon, In-Ho;Chun, Jae Myeung
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.79-86
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    • 2012
  • The conservative treatment for impingement and rotator cuff tear includes rest, nonsteroidal anti-inflammatory drugs (NSAIDs), local steroid injection and physiotherapy depending on the purpose to relieve the pain and inflammation, in addition, stretching exercise to recover flexibility and strengthening exercise to recover the function could be used. When these conservative treatments are divided into multiple steps, the first one contains pain relief, modification of daily activity and stretching exercise. Second step includes strengthening exercise of the anterior/posterior cuff and peri-scapular muscles and eventually. The third step includes training program to return to job, housework and hobby activities and maintain. Thus, the key of these step wise approach for the treatment of impingement and rotator cuff tear is exercise program. Understanding of various exercise program and apply to the patients properly is most important for the conservative treatment of impingement and cuff tear.

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Biomimetic Analysis on the Spider Silk Apparatus for Designing the Nanofiber-spinning Nozzle (나노섬유 방사노즐 설계를 위한 거미 실크 방적장치의 생체모사 분석)

  • Moon, Myung-Jin;Kim, Hoon;Park, Jong-Gu
    • Applied Microscopy
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    • v.42 no.2
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    • pp.67-76
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    • 2012
  • The biomimetic approach on the cuticular spinning nozzles of the major ampullate silk glands in the golden-web spider Nephila calvata has been attempted using various visualizing techniques of light and electron microscopes to improve the design of spinning nozzle for producing synthetic nanofibers spun from electrospinning apparatus. The major ampullate spigot which has the most effective nozzle system to produce nanofibers for dragline silk with high strength and elasticity is connected via the bullet type spigot on anterior spinneret with flexible terminal segment. The excretory duct which transports the liquid silk feedstock from ampulla to spigot is divided into 3 limbs by loops back on itself to form an S-shape morphology that is bundled in connective tissue. Final diameter of the nanofibers at nozzle was dramatically reduced by gradual narrowing of duct cuticle less than 10 times comparing to its original size of funnel region. Moreover, the funnel has a characteristic cuticular organization with porous microstructure which seems to be related to water removal from feedstock of silk precursors. High magnification electron micrographs also reveal the presence of the spiral grooves on the surface of the cuticular intima near the valve which presumed to reduce friction during rapid flow of liquid silk.

The Mid-term Results of Inferior Capsular Shift Procedure for Multidirectional Instability of the Shoulder (견관절 다방향 불안정성의 하방 관절낭 이동술에 대한 중간 추시 결과)

  • Rhee Yong Girl;Cho Chang Hyun;Lee Jae Hoon
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.1-9
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    • 2000
  • Purpose: To report the mid-term results of the inferior capsular shift procedure for the multidirectional instability, and to analyze whether the bilateral laxity, the generalized ligamentous laxity and the voluntary instability can influence upon the final outcome. Material and Method: We reviewed 95 patients with 96 shoulders treated by the inferior capsular shift procedure for multidirectional instability through an anterior approach. In total, 49 shoulders(51%) showed generalized ligamentous laxity, 56 shoulders(58%) bilateral laxity, and 65 shoulders(68%) voluntary subluxation. Mean follow-up was 27 months(11-60 months). Result: The final Rowe score was 75 points in patients who had had at least one of the bilateral laxity, generalized ligamentous laxity, or the voluntary subluxation and 84 points without any of these in each element. Seventy-five percent of the bilateral laxity and 87% of the unilateral instability continued to function well without any pain and instability postoperatively. Those with a voluntary(74%), those with an involuntary instability(83%), those with a generalized ligamentous laxity(73%) and without laxity(84%) could do well a daily living activity without instability Eighty-six percent who had had the voluntary instability was eliminated completely the voluntability. Eighty-four percent of the patients stated that they were subjectively satisfied with the status of their shoulder. Nine shoulders(9.4%) had recurrence of symptomatic and disabling instability and theses patients had had at least voluntary instability preoperatively. Seven patients(7.3%) suffered from the stiff shoulder after the inferior capsular shift procedure. Conclusion: The inferior capsular shift procedure in multidirectional instability provided satisfactory results both in objective and subjective terms. Nonetheless, a patient who has a bilateral laxity, a generalized ligamentous laxity or a voluntary instability could be expected less favorable results compared to those with neither of these. A careful selection of the inferior capsular shift procedure for the multidirectional instability is needed before surgery. But our results suggests that a voluntary instability is not always poor candidate for the inferior capsular shift procedure.

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The Results of Surgical Treatment of Comminuted Fractures of Distal humerus (원위 상완골 분쇄 골절의 수술적 치료 결과)

  • Cho Nam-Su;Park Sung-Woo;Jung Ki-Yoen;Rhee Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.97-104
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    • 2005
  • Purpose: To report the results of surgical treatment of comminuted fractures of distal humerus and to identify factors that affect the results. Materials and Methods: Thirty-two patients who were treated with open reduction and internal fixation for comminuted fracture of distal humerus were enrolled. According to the AO classification, A2.3 was 1 case, A3.2, 2 cases, A3.3, 8 cases, B1.3, 1 case, B2.3, 1 case, C2.2, 5 cases, C2.3, 4 cases, C3.2, 3 cases and C3.3, 7 cases. As fixation technique, 17 cases were fixed by double plates, 4 cases by only K-wires, 4 cases by only screws, 3 cases by K-wires and screws and 4 cases by one plate and screws. The mean age at the time of the operation was 49 years(range, $19{\sim}77$ years). The mean follow-up period was 16 months(range, $8{\sim}51$ months). Results: At the last follow-up, the mean maximum flexion was $116.4^{\circ}\;(range,\;85{\sim}140^{\circ})$ and the mean loss of terminal extension was $11.8^{\circ}\;(range,\;0{\sim}40^{\circ})$. The average Mayo elbow performance score was $91.4^{\circ}\;(range,\;55{\sim}100^{\circ})$. Overall 29 cases(91%) showed good to excellent results. The mean range of motion of extraarticular and intraarticular fracture group was $105.5^{\circ}\;(range,\;65{\sim}140^{\circ})$ and $104^{\circ}\;(range,\;55{\sim}140^{\circ})$, respectively. The average elbow score of both groups was$93^{\circ}\;(range,\;70{\sim}100^{\circ})$ and $90.7^{\circ}\;(range,\;55{\sim}100^{\circ})$. Over 90% showed more than good results. 30 cases(94%) showed complete bony union but two cases, nonunion. One case of the nonunion cases underwent replating with bone graft as revision surgery and total elbow arthroplasty was performed in the other case. At the last follow-up, 27 patients(84.4%) showed subjective satisfaction. Conclusion: Open reduction and internal fixation with appropriate surgical technique for comminuted fractures of distal humerus showed good results, which were not affected by age at the time of operation, fixation methods and anterior transposition of the ulnar nerve. Transolecranon approach may be considered as good choice for intraarticular comminuted fractures of distal humerus.

Changes of Regional Homogeneity and Amplitude of Low Frequency Fluctuation on Resting-State Induced by Acupuncture (침자극에 의한 안정성 네트워크 변화를 관찰하기 위한 Regional Homogeneity와 Amplitude of Low Frequency Fluctuation의 변화 비교: fMRI연구)

  • Yeo, Sujung
    • Korean Journal of Acupuncture
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    • v.30 no.3
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    • pp.161-170
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    • 2013
  • Objectives : Our study aimed to investigate the sustained effects of sham (SHAM) and verum acupuncture (ACUP) into the post-stimulus resting state. Methods : In contrast to previous studies, in order to define the changes in resting state induced by acupuncture, changes were evaluated with a multi-method approach by using regional homogeneity (ReHo) and amplitude of low frequency fluctuation (ALFF). Twelve healthy participants received SHAM and ACUP stimulation right GB34 (Yanglingquan) and the neural changes between post- and pre-stimulation were detected. Results : The following results were found; in both ReHo and ALFF, the significant foci of; left and right middle frontal gyrus, left medial frontal gyrus, left superior frontal gyrus, and right posterior cingulate cortex, areas that are known as a default mode network, showed increased connectivity. In addition, in ReHo, but not in ALFF, brain activation changes in the insula, anterior cingulate cortex, and the thalamus, which are associated with acupuncture pain modulation, were found. Conclusions : In this study, results obtained by using ReHo and ALFF, showed that acupuncture can modulate the post-stimulus resting state and that ReHo, but not ALFF, can also detect the neural changes that were induced by the acupuncture stimulations. Although more future studies with ReHo and ALFF will be needed before any firm conclusions can be drawn, our study shows that particularly ReHo could be an interesting method for future clinical neuroimaging studies on acupuncture.

Video-assisted Thoracoscopic Surgery for Mediastinal Lesions (종격동 질환의 비디오 흉강경 수술)

  • 김연수;김광택;손호성;김일현;이인성;김형묵;김학제
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.40-45
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    • 1998
  • Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.

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Efficacy of Ilizarov External Fixation and Autologous Bone Grafting for Performing Arthrodesis on the Ankle Arthropathy with Risk Factors (불유합의 위험 인자를 가진 족관절 병변에 시행한 족관절 유합술로서 Ilizarov 외고정 기구 장착술 및 자가골 이식술의 유용성)

  • Lee, Yong-Sik;Nam, Il-Hyun;Lee, Tae-Hun;Ahn, Gil-Yeong;Lee, Yeong-Hyeon;Lee, Hee-Hyung;Hwang, Sung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.189-195
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    • 2019
  • Purpose: The aim of this study is to evaluate if the Ilizarov external fixation procedure with axial compression can help to obtain fusion across the ankle joint in patients with a high risk of nonunion. Materials and Methods: From January 2006 to December 2015, the study reviewed 17 patients who underwent ankle arthropathy with a high risk of nonunion and who underwent ankle fusion using the Ilizarov external fixator with axial compression and auto bone grafting. After the lateral surface of the ankle joint was exposed through a lateral trans-fibular approach, massive removal of the articular cartilage and excision of any loose or avascular bone were done. With the cortical bone harvested from the pelvis as corticocancellous bone blocks, we inserted the two cortical blocks longitudinally into the anterior and posterior part of the free ankle space from lateral to medial to make the rectangular chamber to fill the cancellous bones. After the Ilizarov external fixator was equipped, we tightened the frame by 5 mm to compress the bone graft space. We accessed the American Orthopaedic Foot and Ankle Society (AOFAS) AnkleHindfoot score both preoperatively and postoperatively. Results: The average age at the time of operation was 63.4 years (range, 47~78 years). The mean frame time was 17.4 weeks (range, 15~23 weeks). The average follow-up period was 3.7 years (range, 2~6 years). Osseous fusion was obtained in 15 patients (88.2%). There were two stable pseudarthroses among the rheumatoid arthritis patients, and we continued their follow-up. The mean AOFAS AnkleHindfoot score improved from 48.5 to 73.7 points. Conclusion: Ankle arthrodesis using the Ilizarov external fixation with axial compression and auto bone grafting on the ankle arthropathy that had difficult conditions to achieve union is considered one of the useful methods with a correspondingly low incidence of complications.

Orthodontic treatment of an ankylosed tooth; application of single tooth osteotomy and alveolar bone distraction osteogenesis (유착치의 교정치료; 골절단술과 치조골 신장술의 적용)

  • Kim, Yong-Il;Kim, Seong-Sik;Son, Woo-Sung;Park, Soo-Byung
    • The korean journal of orthodontics
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    • v.39 no.3
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    • pp.185-198
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    • 2009
  • Tooth anklylosis is defined as the adhesion state of alveolar bone to dentin or cementum. Trauma, disturbed metabolic disease, and congenital disease have been given as etiologic factors. Complications of tooth ankylosis are tipping of the neighboring teeth, space loss, and supraeruption of the opposing teeth. Particularly if dental ankylosis occurs in maxillary incisors of a growing child, the ankylosed tooth can not move vertically with subsequent disturbance in vertical growth of the alveolar process. With an appropriate treatment approach, an esthetic condition must be achieved especially in the maxillary anterior region. In this report, two cases are presented which were treated by the surgical repositioning method. One is treated by alveolar bone distraction osteogenesis which used a tooth-borne type distraction device and the other by single tooth osteotomy.

Three cases of primary mediastinal Nonseminomatous germ cell tumors (원발성 종격동 비정상피종성 생식세포종 3예)

  • Lee, Soon Il;Yong, Suk Joong;Song, Kwang Seon;Shin, Kye Chul;Yang, Kyung Moo;Cho, Mee Yon;Lim, Hyung Rae;Yoo, Kwang Ha;Cho, Hwa Sang;Yoo, Jong Kil;Song, Jong Oh
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.1008-1018
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    • 1996
  • Primary mediastinal nonseminomatous germ cell tumor is extremely rare. Apart from rarity and large size, mediastinal germ cell tumors show striking similarity to testicular tumors in age, incidence, and tumor type. The symptoms associated with these tumors are related mainly to size, invasion of neighboring structures, and distant metastases. Tissue diagnosis is obtained by biopsy of the primary lesion or by biopsy of metastatic sites. Tumors often present with advanced bulky disease, which are unresectable. So these tumors require an aggressive multidisciplinary approach to management. Optimal management includes aggressive surgical debulking and early use of cisplatin-bleomycin-based combination chemotherapy. Serial biomarker measurements permit early recognition of recwrence and improved timing of surgical intervention. The prognosis for mediastinal germ cell tumors is poor, not only because they are far advanced at the time of diagnosis but also because some of the tumors-such as embryonal carcinomas, choriocarcinomas, and endodermal sinus tumors-are very aggressive. In these cases, we present three young male patients with large mass on anterior mediastinum. Tissue diagnosis was obtained by primary lesion biopsy. All patients received surgical debulking and combination chemotherapy and experienced a brief response and eventually had relapses. We report these cases with a review of literatures.

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