• 제목/요약/키워드: Apical surgery

검색결과 134건 처리시간 0.032초

Novel Resectable Myocardial Model Using Hybrid Three-Dimensional Printing and Silicone Molding for Mock Myectomy for Apical Hypertrophic Cardiomyopathy

  • Wooil Kim;Minje Lim;You Joung Jang;Hyun Jung Koo;Joon-Won Kang;Sung-Ho Jung;Dong Hyun Yang
    • Korean Journal of Radiology
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    • 제22권7호
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    • pp.1054-1065
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    • 2021
  • Objective: We implemented a novel resectable myocardial model for mock myectomy using a hybrid method of three-dimensional (3D) printing and silicone molding for patients with apical hypertrophic cardiomyopathy (ApHCM). Materials and Methods: From January 2019 through May 2020, 3D models from three patients with ApHCM were generated using the end-diastolic cardiac CT phase image. After computer-aided designing of measures to prevent structural deformation during silicone injection into molding, 3D printing was performed to reproduce anatomic details and molds for the left ventricular (LV) myocardial mass. We compared the myocardial thickness of each cardiac segment and the LV myocardial mass and cavity volumes between the myocardial model images and cardiac CT images. The surgeon performed mock surgery, and we compared the volume and weight of the resected silicone and myocardium. Results: During the mock surgery, the surgeon could determine an ideal site for the incision and the optimal extent of myocardial resection. The mean differences in the measured myocardial thickness of the model (0.3, 1.0, 6.9, and 7.3 mm in the basal, midventricular, apical segments, and apex, respectively) and volume of the LV myocardial mass and chamber (36.9 mL and 14.8 mL, 2.9 mL and -9.4 mL, and 6.0 mL and -3.0 mL in basal, mid-ventricular and apical segments, respectively) were consistent with cardiac CT. The volume and weight of the resected silicone were similar to those of the resected myocardium (6 mL [6.2 g] of silicone and 5 mL [5.3 g] of the myocardium in patient 2; 12 mL [12.5 g] of silicone and 11.2 mL [11.8 g] of the myocardium in patient 3). Conclusion: Our 3D model created using hybrid 3D printing and silicone molding may be useful for determining the extent of surgery and planning surgery guided by a rehearsal platform for ApHCM.

Lid technique을 활용하여 치근단 수술에서 역충전을 시행한 증례 보고 (Retrograde filling with Lid technique in periapical surgery: case report)

  • 이윤주;조경모;박세희;이윤;김진우
    • 구강회복응용과학지
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    • 제39권1호
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    • pp.45-51
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    • 2023
  • 치근단 수술의 성공 여부는 적절한 역충전 재료와 충전 기법을 선택하여 근단부를 밀폐하는 데 달려있다. 역충전 재료는 확실한 밀폐를 제공하고 양호한 치유를 얻기 위하여 여러가지 물리화학적 특성들이 요구되는데 현재까지 MTA는 기존의 재료들이 가지지 못한 전례없는 우수한 장점을 갖추어 역충전 재료의 gold standard로써 사용되어 왔다. 그러나 이러한 MTA도 경화시간이 길고 조작이 어렵다는 단점이 있어 최근에는 이러한 단점을 개선한 premixed putty type bioceramic material이 개발되었다. 또한 이러한 재료를 활용하여 역충전 와동을 효율적으로 충전하기 위한 'Lid technique'이 함께 제안되었다. 본 증례 보고는 치근단 수술에서 premixed putty type material과 Lid technique을 활용한 증례에 대하여 소개하고자 한다.

외과적 근관치료의 핵심 - 치근단 미세누출 폐쇄술 (Essential of Endodontic microsurgery with the use of a Surgical Operating Microscope)

  • 김선일
    • 대한치과의사협회지
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    • 제55권8호
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    • pp.556-564
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    • 2017
  • Endodontic surgery is a procedure to treat apical periodontitis or abscess in cases that did not heal after nonsurgical treatment or retreatment. This might include situations with persistent intracanal infection after root canal treatment. Other reasons might be found in extraradicular infection, such as bacterial biofilm on the apical root surface or bacteria within the lesion. For many years, the treatment standard was the traditional approach with surgical burs and amalgam for root-end filling. Endodontic microsurgery is the most recent step in the evolution of endodontic surgery, applying not only ultrasonic tip and biocompatible filling materials but also incorporating high-power magnification and illumination. Although many studies have been published that advocate the use of modern technique, the traditional techniques are still widely used in the surgery community. The purpose of this study was to demonstrate the endodontic microsurgery procedure including the root-end preparation and filling with the use of a surgical operating microscope.

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The hybrid perventricular closure of apical muscular ventricular septal defect with Amplatzer duct occluder

  • Kim, Soo Jin;Huh, June;Song, Jin Young;Yang, Ji-Hyuk;Jun, Tae-Gook;Kang, I-Seok
    • Clinical and Experimental Pediatrics
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    • 제56권4호
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    • pp.176-181
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    • 2013
  • Purpose: Apical muscular ventricular septal defects (MVSDs), especially in small infants, can be difficult to manage using surgical and percutaneous closure. An intraoperative perventricular procedure is a good option for closing apical MVSDs in small children with or without associated cardiac anomalies. We evaluated the results of hybrid perventricular closure of apical MVSDs performed using an Amplatzer duct occluder (ADO). Methods: We retrospectively reviewed the medical records of 5 patients who underwent hybrid perventricular closure of MVSDs with ADOs, from March 2006 to May 2011. The median patient age at the time of the procedure was 12 months (range, 25 days to 25 months), and the median body weight was 9.1 kg (range, 4.3 to 15 kg). Two patients had multiple ventricular septal defects (VSDs; additional perimembranous VSD in 1 patient and multiple MVSDs in the other) and 3 patients had associated cardiac anomalies; complete transposition of the great arteries in 1 patient and an atrial septal defect in 2 patients. All the procedures were performed on beating hearts, exception in 1 case. The ADO selected for the aortic side was at least 1 to 2 mm larger than the largest VSD in the left ventricle side. Results: The procedure was successful in all patients and each device was well positioned. During the median follow-up of 2.4 years, a small residual VSD was noted in 2 patients who had multiple VSDs and no leakage was seen in the other 3 patients. Conclusion: Perventricular closure of MVSD with an ADO is a good option for patients with apical MVSD. However, careful manipulation is important, especially in the case of small infants.

Cemento-osseous dysplasia: clinical presentation and symptoms

  • Nam, Inhye;Ryu, Jihye;Shin, Sang-Hun;Kim, Yong-Deok;Lee, Jae-Yeol
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권2호
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    • pp.79-84
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    • 2022
  • Objectives: The purpose of this study was to evaluate risk factors and symptoms in cemento-osseous dysplasia (COD) patients. Materials and Methods: In this study, 62 patients who were diagnosed histologically with COD were investigated from 2010 to 2020 at the author's institution. We compared clinical and radiological characteristics of symptomatic and asymptomatic patients. The factors were sex, age, lesion size, site, radiologic stage of lesion, apical involvement, sign of infection, and history of tooth extraction. Statistical analysis was performed using Fisher's exact test and the chi-square test. Results: COD was more prevalent in female patients. With the exception of three cases, all were focal COD. The majority of patients presented with symptoms when the lesion was smaller than 1.5 cm in size. Symptoms were observed when the apex of the tooth was included in the lesion or there was a local infection around the lesion. The history of tooth extraction and previous endodontic treatment were evaluated, and history was not a significant predictor for the onset of symptoms. Conclusion: In this study, risk factors associated with symptomatic patients were size of lesion, apical involvement, and local infection.

Usefulness of Simple Rod Rotation to Correct Curve of Adolescent Idiopathic Scoliosis

  • Kim, Ji Yong;Song, Kyungchul;Kim, Kyung Hyun;Rim, Dae Cheol;Yoon, Seung Hwan
    • Journal of Korean Neurosurgical Society
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    • 제58권6호
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    • pp.534-538
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    • 2015
  • Objective : To correct apical vertebral rotation for adolescent idiopathic scoliosis (AIS), direct vertebral derotation (DVD) or simple rod rotation (SRR) might be considered. The aim of the present study is to introduce the surgical experiences of AIS by a Korean neurosurgeon and to evaluate the effectiveness of SRR for apical vertebral rotation. Methods : A total of 9 patients (1 male and 8 females) underwent scoliosis surgery by a neurosurgeon of our hospital. The Lenke classifications of the patients were 1 of 1B, 2 of 1C, 1 of 2A, 1 of 2C, 3 of 5C and 1 of 6C. Surgery was done by manner of simple rod rotation on the concave side and in situ coronal bending. Coronal Cobb's angles, vertebral rotation angles and SRS-22 were measured on a plain standing X-ray and CT before and after surgery. Results : The mean follow up period was 25.7 months (range : 5-52). The mean number of screw positioning level was nine (6-12). The mean age was 16.4 years (range : 13-25) at surgery. The mean Risser grade was $3.7{\pm}0.9$. The apical vertebral rotation measured from the CT scans was $25.8{\pm}8.5^{\circ}$ vs. $9.3{\pm}6.7^{\circ}$ (p<0.001) and the Coronal Cobb's angle was $53.7{\pm}10.4^{\circ}$ vs. $15.4{\pm}6.5^{\circ}$ (p<0.001) preoperatively and postoperative, respectively. The SRS-22 improved from 71.9 preoperatively to 90.3 postoperatively. There were no complications related with the operations. Conclusion : SRR with pedicle screw instrumentation could be corrected successfully by axial rotation without complications. SRR might serve as a good option to correct AIS deformed curves of AIS.

배농관(排膿管) 삽입(揷入)에 의(依)한 치근단병소(齒根端病巢) 처치(處置)의 임상적(臨床的) 연구(硏究) (CLINICAL STUDY ON THE INTUBATION TO PERIAPICAL LESIOON)

  • 민병덕
    • Restorative Dentistry and Endodontics
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    • 제1권1호
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    • pp.18-25
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    • 1975
  • The author has experienced 8 cases of periapical lesion which were very closed to adjacent root tip. To avoid damage on neighboring nerve and blood supply polyvinyl tube was inserted through buccal window leaving a little pathological changes in involved area. The results are as follows: 1. The purpose to maintain adjacent tooth vitality was achieved by means of intubation in the lesion. 2. Swelling and pain after operation was rather lesser than routine apical surgery, because of drainage. 3. The total treatment period seems longer than that of routine apical amputation.

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Location of Ruptured Bullae in Secondary Spontaneous Pneumothorax

  • Choi, Jinseok;Ahn, Hyo Yeong;Kim, Yeong Dae;I, Hoseok;Cho, Jeong Su;Lee, Jonggeun
    • Journal of Chest Surgery
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    • 제50권6호
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    • pp.424-429
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    • 2017
  • Background: The surgical treatment of secondary spontaneous pneumothorax (SSP) can be complicated by fragile lung parenchyma. The preoperative prediction of air leakage could help prevent intraoperative lung injury during manipulation of the lung. Common sites of bulla development and ruptured bullae were investigated based on computed tomography (CT) and intraoperative findings. Methods: The study enrolled 208 patients with SSP who underwent air leak control through video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the sites of bulla development on preoperative CT and the rupture sites during VATS. Results: Of the 135 cases of right-sided SSP, the most common rupture site was the apical segment (31.9%), followed by the azygoesophageal recess (27.4%). Of the 75 cases on the left side, the most common rupture site was the apical segment (24.0%), followed by the anterior basal segment (17.3%). Conclusion: The azygoesophageal recess and parenchyma along the cardiac border were common sites of bulla development and rupture. Studies of respiratory lung motion to measure the pleural pressure at the lung surface could help to determine the relationship between cardiogenic and diaphragmatic movement and bulla formation or rupture.

The epithelial ingrowth in specimen from the apical surgery and the clinical conditions

  • Park, Chin-Su;Kim, Jin;Lee, Seung-Jong
    • 대한치과보존학회:학술대회논문집
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    • 대한치과보존학회 2003년도 제120회 추계학술대회 제 5차 한ㆍ일 치과보존학회 공동학술대회
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    • pp.620-620
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    • 2003
  • The purpose of this study was to see the occurrence of the epithelial ingrowth in the periapical lesion and its relevance with the clinical symptoms. The subjects of this study included 129 specimens which were obtained from the apical surgery during the year of 2001-2002. The patterns of epithelial ingrowth were classified as either as either lining or networking. The clinical records were reviewed and the relevance between the clinical symptoms and the pattern of the epithelial ingrowth were evaluated under the light microscope.(중략)

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The Effect of Thoracoscopic Pleurodesis in Primary Spontaneous Pneumothorax: Apical Parietal Pleurectomy versus Pleural Abrasion

  • Huh, Up;Kim, Yeong-Dae;Cho, Jeong Su;I, Hoseok;Lee, Jon Geun;Lee, Jun Ho
    • Journal of Chest Surgery
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    • 제45권5호
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    • pp.316-319
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    • 2012
  • Background: The standard operative treatment of primary spontaneous pneumothorax (PSP) is thoracoscopic wedge resection, but necessity of pleurodesis still remains controversial. Nevertheless, pleural procedure after wedge resection such as pleurodesis has been performed in some patients who need an extremely low recurrence rate. Materials and Methods: From January 2000 to July 2010, 207 patients who had undergone thoracoscopic wedge resection and pleurodesis were enrolled in this study. All patients were divided into two groups according to the methods of pleurodesis; apical parietal pleurectomy (group A) and pleural abrasion (group B). The recurrence after surgery had been checked by reviewing medical record through follow-up in ambulatory care clinic or calling to the patients, directly until January 2011. Results: Of the 207 patients, the recurrence rate of group A and B was 9.1% and 12.8%, respectively and there was a significant difference (p=0.01, Cox's proportional hazard model). There was no significant difference in age, gender, smoking status, and body mass index between two groups. Conclusion: This study suggests that the risk of recurrence after surgery in PSP is significantly low in patients who underwent thoracoscopic wedge resection with parietal pleurectomy than pleural abrasion.