Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.47
no.5
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pp.365-372
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2021
Objectives: Mandibular fractures vary significantly with respect to epidemiological and demographic parameters among populations. To date, no study has evaluated these aspects of mandibular fractures in Nuh, Mewat, Haryana, India. To retrospectively analyze the incidence, age and sex distributions, etiology, anatomic distribution, occlusal status, treatment modality provided, and their correlation in patients who suffered isolated mandibular fractures. Materials and Methods: The records of maxillofacial injury patients who reported to the Department of Dentistry, SHKM Government Medical College from January 2013 to December 2019, were retrieved from our database, and necessary information was collected. The data collected were analyzed statistically using IBM SPSS ver. 21. Results: Totals of 146 patients and 211 fractures were analyzed. There were 127 males and 19 females with an age range of 3-70 years (mean age, 26 years). Road traffic accident (RTA) was the most common cause of fracture (64.4%), followed by fall (19.9%), assault (15.1%), and sports injury (0.7%). Of all patients, 42.5% had bilateral fractures, 31.5% had left side fracture, 21.2% had right side fracture, 3.4% sustained midline symphyseal fracture, and 1.4% had symphyseal fracture along one side of the mandible. Site distribution was as follows: parasymphysis (34.6%), angle (23.7%), condyle (20.4%), body (12.8%), symphysis (4.3%), ramus 2.4%, and dentoalveolar 1.9%. The most common facture combination was angle with parasymphysis (17.8%). Occlusion was disrupted in 69.2% patients. Closed reduction was the predominant treatment modality. Conclusion: The data obtained from retrospective analyses of maxillofacial trauma increase the understanding of variables and their outcomes among populations. The results of the present study are comparable to those of the literature in some aspects and different in others.
Min Choon Tan;Yong Hao Yeo;Jia Wei Tham;Jian Liang Tan;Hee Kong Fong;Bryan E-Xin Tan;Kwan S Lee;Justin Z Lee
International Journal of Heart Failure
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v.6
no.2
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pp.76-81
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2024
Background and Objectives: Real-world clinical data, outside of clinical trials and expert centers, on adverse events related to the use of SyncCardia total artificial heart (TAH) remain limited. We aim to analyze adverse events related to the use of SynCardia TAH reported to the Food and Drug Administration (FDA)'s Manufacturers and User Defined Experience (MAUDE) database. Methods: We reviewed the FDA's MAUDE database for any adverse events involving the use of SynCardia TAH from 1/01/2012 to 9/30/2020. All the events were independently reviewed by three physicians. Results: A total of 1,512 adverse events were identified in 453 "injury and death" reports in the MAUDE database. The most common adverse events reported were infection (20.2%) and device malfunction (20.1%). These were followed by bleeding events (16.5%), respiratory failure (10.1%), cerebrovascular accident (CVA)/other neurological dysfunction (8.7%), renal dysfunction (7.5%), hepatic dysfunction (2.2%), thromboembolic events (1.8%), pericardial effusion (1.8%), and hemolysis (1%). Death was reported in 49.4% of all the reported cases (n=224/453). The most common cause of death was multiorgan failure (n=73, 32.6%), followed by CVA/other non-specific neurological dysfunction (n=44, 19.7%), sepsis (n=24, 10.7%), withdrawal of support (n=20, 8.9%), device malfunction (n=11, 4.9%), bleeding (n=7, 3.1%), respiratory failure (n=7, 3.1%), gastrointestinal disorder (n=6, 2.7%), and cardiomyopathy (n=3, 1.3%). Conclusions: Infection was the most common adverse event following the implantation of TAH. Most of the deaths reported were due to multiorgan failure. Early recognition and management of any possible adverse events after the TAH implantation are essential to improve the procedural outcome and patient survival.
Decreased equilibrium in standing and walking is a common problem associated with hemiparesis secondary to cerebral vascular accident. In patients with hemiplegia, postural sway is increased and often displaced laterally over the non-affected leg, reflecting asymmetry in lower extremity weight bearing during standing balance. Human balance is a complex motor control task, requiring integration of sensory information, neural processing, and biomechanical factors. Limits of stability (LOS) is a one of the biomechanical factors. The purposes of this study were to establish the influence of asymmetrical weight-bearing on the LOS of independent ambulatory hemiparetic patients. The subjects of this study were 29 hemiparetic patients (18 males, 11 females) being treated as admitted or out patients at Young-Nam University Hospital and Taegu Catholic University Hospital, all of whom agreed to participate in the study. Participants were asked to lean and displace their center of gravity (COG) as far as possible in directions to the sides and front of the body. The LOS and weight-bearing ratio were measured with a Balance Performance Monitor (BPM) Dataprint Software Version 5.3. In order to assure the statistical significance of the results, the independent t-test and a Pearson's correlation were applied at the .05 and .01 level of significance. The results of this study were as follows: 1) There were statistically significant differences in anteroposterior LOS according to the cause of brain demage (p<.01). 2) There were statistically significant differences in mediolateral LOS according to the hemiparetic side (p<.05). 3) There were statistically significant differences in anteroposterior and mediolateral LOS according to the brain operation (p<.01). 4) The mediolateral LOS significantly correlated with weight-bearing ratio (p<.01).
The neck of the talus is its most vulnerable and fragile segment, because of narrow diameter, devoid of hyaline padding and honeycombed internally by vascular channels etc. Talar neck fractures comprise 50% of all major to the talus. The majority occurs as a result of high-energy injuries, such as motor vehicle accidents or fall from a height. Anatomically, talar surface is covered mainly with articular cartilage and blood supply to the talus is very poor. So, complications, such as non-union, avascular necrosis and post traumatic arthritis, are frequent. The authors reviewed fourteen cases of talar neck fractures treated in our clinics from Jan. 1992 to Mar. 1997, and average follow-up period was over 15 months. The results obtained were as follows; 1. Patients' average age was 31.2 years. 2. The most common cause was traffic accident(9/14, 64%), and hyperdorsiflexion injury of the ankle was common mechanism of the fractures. 3. According to the modified Hawkins classification, type I was four cases, type II was nine cases, type III was one case and type IV was no case. 4. Hawkins sign of subcortical radiolucency was found in 64% (9/14) of the fractures. 5. Avascular necrosis was occurred in 21% (3/14) of the fractures(in two cases of type II fractures, and in one of type III). 6. According to the Hawkins criteria, four cases in type I, five in type II were an excellent result. Two cases, one in type II and one in type III were good result, and two in type II were fair. One in type II was poor result.
The author investigated the 162 patients with the condylar fractres of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Hospital of Chosun Dental School from January 1985 to September 1992 clinically, including fracture incidennce, age and sex of the patients, causes of injures, associated injures, treatments and complications and obtained the following results. 1. Of the 449 patients with mandibular fractures, 162patients suffered condylar fractures(36.1%). 2. Of the 162 patients, males with condylar fractures were 128 patients, by a ratio of 3.8 : 1. 3. The most frequently affected age group was the third decade(32.7%). 4. Falls were ranked as the predominant cause(50.6%), followed by traffic accident(27.8%) and violence (16.0%). 5. The incidence of single condylar fractures was 28% and symphysis fractures were the most commomest of the concomittant injuries(60%). 6. The subcondylar fractures occurred most frequently(41.6%) and anteromedial displacement of the condylar fragments occurred most frequently(45.4%) 7. Of the all condylar fracture patients, children under 15 of age comprized 31 patients(19.1%) and condylar head fractures occurred most frequently at those children. 8. Of the managetments in condylar fractures, open reduction was 52.5% and remainder were closed reduction(47.5%). 9. Complications ensured such as TMJ ankylosis, limitation of mouth opening and mandibular movements, TMJ dysfunction, and anterior open bite.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.25
no.2
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pp.471-482
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1995
Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age. They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group(83%). 2. Fallen down(54%) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to paipation09 cases). Mouth opening limitation07 cases), swelling(7 cases), malocclusion(3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients(44%). Condyle fractures with symphysis fracture(9 patients, 39%), condyle fractures with ascending ramus fracture(2 patients, 9%), condyle fracture with mandibular body fracture(1 patient, 4%), and condyle fractures with mandibular angle fracture(1 patient, 4%) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, dispiacement(17 cases, 66%) was most common. Dislocation(5 cases, 19%) and deviation (4 cases, 15%) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual condylar shape in 23 cases and with prominently different shape in 3 cases.
Background : It is well-known that esophageal perforation (EP) is difficult in diagnosis and has high mortality rate despite proper management. There are disputes in regarding the reatment in cases of delayed diagnosis although in the early diagnosed cases, operation is recommended without arguments. Methods: From April, 2001 to December, 2004, nine patients who were diagnosed as EP in our hospital were analyzed retrospectively about the causes, the interval between the cause and the treatment, and operation methods. Results: There were 8 male and one female with men age of 49.3 years (range: 25-67 years). The causes of EP included perforations following operations of corvical spine in three cases, spontaneous perforation(Boehaave syndrome) in two cases, foreign bodies in two cases, operation of esophageal diverticulum in one case and blunt trauma bytraffic accident in one case. Mean interval between the first treatments and the causes was 11.6 days (range: 2-30 days). The sites of perforation were upper third of esophagus in three cases, middle third in three cases and lower third in three cases. All except two cervical cases presented as mediastinitis or empyema at the time of diagnosis. Primary repair and irrigation had been performed in 7 cases but five cases out of them required more than two procedures. Conclusions : More than one procedure wasrequired in the treatment of EP because of contaminations and infections which had been spread at the time of initial manifestatios, howeverprimary closure and massive irrigation is the best method in order to preserve esophagus unless the remaining esophagus is extensively damaged.
Objectives : This study was designed to evaluate various tools including C-spine X-ray for estimating cervical curvature and identify the effect of wooden pillow on patients diagnosed with straightening of cervical curvature. Methods : This study was carried out on 51 subjects who were encountered traffic accident suffering cervical pain and diagnosed with straightening of cervical curvature by X-ray. 51 subjects were divided into wooden pillow(experimental) group and conservative therapy(control) group. Visual analogue scale, neck disability index and lateral pictures were used and compared after treatment. C-spine AP., Lat. X-ray were used on admission day to calculate cervical curvature and scoliosis by various ways. Results : 4 different measurements of cervical curvature didn't show common results. Both wooden pillow(experimental) group and conservative therapy(control) group showed significant improvement in the visual analogue scale(VAS) and neck disability index(NDI) after hospital treatment. Comparison between center line pictured by lateral view and C-spine Lat. pictured by X-ray showed significant difference in cervical curvature. Lateral deviation of cervical vertebra showed lengthened distance between mastoid process and spinous process of C7. Conclusion : As a result of this research, I found out that various tools for calculating cervical lordosis could derive different results and C-spine AP., Lat X-ray could cause artificial cervical lordosis. According to visual analogue scale(VAS) and neck disability index(NDI) wooden pillow was not effective to reduce pain & disability caused by straightening of cervical curvature. Futhermore, correction effect of straightening of cervical curvature and scoliosis by wooden pillow was weak.
For the purpose of disclosing estimated annual incidence rate and causative factors of traumatic spinal cord injury and obtaining basic data for the establishment of effective measures to prevent this injury, the medical record of 204 cases of Seoul residents with spinal cord injury which admitted in 46 general hospitals and National rehabilitation center located in Seoul, including Sam Yook Rehabilitation Center and Jung Ang Hospital in Kyungi do and occurred in 1995 were analyzed. The results were as follows: 1) The estimated annual incidence rate of traumatic spinal cord injury in 1995 of Seoul residents was 20.5 per million population. This incidence rate was the highest in the 40th years (34.1), followed by in the 50th years (26.5) and in the 20th years (25.6) in descending order. 2) The incidence rate ratio between male and female was 3.5:1. 3) The leading cause of injury was the highest in traffic accidents (42.2%), followed by falls from elevation (29.4%) and falls on the same level (9.8%). 4) Traffic accident mainly occured from 20th years to 40th years and falls from elevation in 50th years. 5) The level of spinal cord injury was the highest in cervical cord (63.2%), followed by the thoracic cord (21.1%) and lumbosacral cord (15.7%). Traffic accidents mainly caused in cervical cord injury whereas thoracic cord injury and lumbosacral cord injury were caused from falls from elevation. Above theconsiderations in mind, it suggested that in order to prevent traumatic spinal cord injuries, safety education of falls from elevation should be focused on the 20th years and 50th years male, moreover safety education of traffic accidents will be needed in the 30th years and 40th years male.
Background: Blunt traumatic cardiac rupture is rare. However, such cardiac ruptures carry a high mortality rate. This study reviews our experience treating blunt traumatic cardiac rupture. Methods: This retrospective study included 21 patients who experienced blunt traumatic cardiac rupture from 1999 to 2015. Every patient underwent surgery. Several variables were compared between survivors and fatalities. Results: Sixteen of the 21 patients survived, and 5 (24%) died. No instances of intraoperative mortality occurred. The most common cause of injury was a traffic accident (81%). The right atrium was the most common location of injury (43%). Ten of the 21 patients were suspected to have cardiac tamponade. Significant differences were found in preoperative creatine kinase-myocardial band (CK-MB) levels (p=0.042) and platelet counts (p=0.004) between the survivors and fatalities. The patients who died had higher preoperative Glasgow Coma Scale scores (p=0.007), worse Trauma and Injury Severity Scores (p=0.007), and higher Injury Severity Scores (p=0.004) than those who survived. Conclusion: We found that elevated CK-MB levels, a low platelet count, and multi-organ traumatic injury were prognostic factors predicting poor outcomes of blunt cardiac rupture. If a patient with blunt traumatic cardiac rupture has these factors, clinicians should be especially attentive and respond promptly in order to save the patient's life.
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