• Journal of Korean Neurosurgical Society
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• 제53권6호
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• pp.360-363
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• 2013

We recently experienced self-detachment of the Solitaire stent during mechanical thrombectomy of acute ischemic stroke. Then, we tried to remove the detached stent and to recanalize the occlusion, but failed with endovascular means. The following diffusion weighted image MRI revealed no significant increase in infarction size, therefore, we performed surgical removal of the stent to rescue the patient and to elucidate the reason why the self-detachment occurred. Based upon the operative findings, the stent grabbed the main thrombi but inadvertently detached at a severely tortuous, acutely angled, and circumferentially calcified segment of the internal carotid artery. Postoperative angiography demonstrated complete recanalization of the internal carotid artery. The patient's neurological deficits gradually improved, and the modified Rankin scale score was 2 at three months after surgery. In the retrospective case review, bone window images of the baseline computed tomography (CT) scan corresponded to the operative findings. According to this finding, we hypothesized that bone window images of a baseline CT scan can play a role in terms of anticipating difficult stent retrieval before the procedure.

• Vascular Specialist International
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• 제34권4호
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• pp.117-120
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• 2018

The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.

• Journal of Dental Rehabilitation and Applied Science
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• 제32권2호
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• pp.109-116
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• 2016

Purpose: The aim of this study was to evaluate correlations between denture satisfaction and various factors related to patients' and wearing dentures. Materials and Methods: Total 43 edentulous patients were recalled and they were wearing complete dentures fabricated more than one year ago. For patients' subjective assessment, the questionnaire based on the various literatures was developed and applied to patients for data acquisition. In addition, correlations were evaluated between subjective assessment and denture satisfaction score. For statistical analysis, Spearman correlation coefficient, multiple regression analysis, Mann-whitney U test and Kruskal-Wallis test were used to found out what the most considerable factors to denture satisfaction score (P < 0.05). Results: Denture satisfaction score of maxilla was higher than mandible (P < 0.05). In functional aspects, maxillary denture were received a favorable evaluation. Especially fit and pain causing were highly correlated to satisfaction. Gender, age, using period, visiting times after manufacturing denture were unrelated to satisfaction. But previous experience was related to denture satisfaction. Conclusion: Denture satisfaction was determined by a combination of various factors related to patients.

• Journal of Dental Rehabilitation and Applied Science
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• 제32권4호
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• pp.301-306
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• 2016

It is very hard for edentulous patients to satisfy retention and stability with their complete denture. Especially, for patients with systemic diseases such as Parkinson's disease causing involuntary and limited movements, fabricating complete dentures may be challenging to both dentists and patients due to functional limitations. To overcome this problem, overdentures can be used through conserving retained roots. In this case, a 45-year-old male patient had to extract numerous teeth due to dental caries, and at the time of visit he was taking drugs for diabetes and Parkinson's disease for a period of long time. A complete denture was applied to maxilla, and for mandible, an overdenture on two preserved retained roots was applied where its retention and stability were obtained by magnetic attachments. This case reports that overdenture with retained roots improved overall functional limitations.

• Journal of Dental Rehabilitation and Applied Science
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• 제34권4호
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• pp.262-269
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• 2018

Purpose: The purpose of this study was to evaluate the deformation of the complete denture artificial teeth arrangement after festooning over time. Materials and Methods: 10 wax dentures of equal teeth arrangement and equal gingival contour were used in this study. Festooning of the wax dentures were conducted and 3D model scans were conducted every 10 minutes for 120 minutes. Interdental transverse distances were measured with the scanned images. Statistical analyses were performed with SPSS Ver. 22. 0. Results: Interdental transverse distance between teeth varied from 0.0999 mm to 0.1787 mm. Mean rate of deformation showed statistically significant change between the 40 - 50 minute interval and 50 - 60 minute interval and between the 50 - 60 minute interval and 60 - 70 minute interval. No statistically significant change of the mean rate of deformation was observed later on. Conclusion: Monitoring of the interdental transverse distance for 120 minute after festooning have shown the deformation and displacment of the artificial teeth arrangement. From after the 60 - 70 minute interval after festooning, the mean deformation showed no statistically significant change of the mean rate of deformation was observed. Within the limitations of this in vitro study results suggest that the final occlusal adjustment in wax denture before complete denture curing should be proceeded at least 60 minutes later after festooning.

• Journal of Dental Rehabilitation and Applied Science
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• 제38권1호
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• pp.34-41
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• 2022

Recently, digital technology and computer-aided design/computer-aided manufacturing (CAD/CAM) environment have changed the clinician treatment method in the fabrication of dentures. The denture manufacturing method with CAD/CAM technology simplifies the treatment and laboratory process to reduce the occurrence of errors and provides clinical efficiency and convenience. In this case, complete dentures were fabricated using stereolithography (SLA)-based 3D printing in patient with mandibular deviation. Recording base were produced in a digital model obtained with an intraoral scanner, and after recording a jaw relation in the occlusal rim, a definitive impression was obtained with polyvinyl siloxane impression material. In addition, facial scan data with occlusal rim was obtained so that it can be used as a reference in determination of the occlusal plane and in arrangement of artificial teeth during laboratory work. Artificial teeth were arranged through a CAD program, and a gingival festooning was performed. The definitive dentures were printed by SLA-based 3D printer using a Food and Drug Administration (FDA)-approved liquid photocurable resin. The denture showed adequate retention, support and stability, and results were satisfied functionally and aesthetically.

• Clinical and Experimental Pediatrics
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• 제48권2호
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• pp.158-164
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• 2005

Purpose : We reviewed the therapeutic results of various Duct-Occlud coils(pfm AG, $K{\ddot{o}}ln$, Germany) to evaluate the efficacy of the most-recently modified Duct-Occlud coil(Nit-Occlud) in the transcatheter closure of patent ductus arteriosus(PDA), including large defects more than 4 mm in diameter. Methods : Two hundred and five patients who underwent percutaneous PDA occlusion using Duct-Occlud devices from March 1996 to December 2003 were enrolled and four types of Duct-Occlud [Standard(S), Reinforced(R), Reinforced reverse cone(RR) and Nit-Occlud(N)] were used in this study. The patients were followed up by echocardiogram and physical examination before discharge, one month, six months and 12 months after the procedure. Results : The rate of residual shunt according to the type of Duct-Occlud were as follows : S-54%, R-72%, RR-50%, N-14%(P<0.05 compared with other devices) at one month, S-25%, R-44%, RR-37%, N-0%(P<0.05 compared with other devices) at six months, S-8%, R-8%, RR-4%, N-0%(P<0.05 compared with S and R) at 12 months and later. Nit-Occlud coil showed the complete occlusion of PDA after six months of follow-up, even in 12 patients with relatively large PDA(>4 mm). Conclusion : The transcatheter closure of PDA using Duct-Occlud was an effective treatment and our study revealed that a Nit-Occlud coil which showed higher rate of occlusion even in PDA with large diameters over than 4 mm, was a more effective modality compared to previous devices.

• Journal of dental hygiene science
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• 제16권2호
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• pp.176-182
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• 2016

The purpose of this study was to evaluate the in-vitro efficacy of the active ingredients of dentifrice following treatment time. The whitening effect was evaluated by a change in lightness value relative to the contact time of hydrogen peroxide, by using artificially stained hydroxyapatite discs. The anti-calculus effect was assessed based on the amount of calcium eluted from the human dental calculus by sodium pyrophosphate. Remineralization was evaluated by the Vickers hardness test following the application of sodium fluoride to bovine enamel. In order to view dentinal tubules occlusion, the formation of insoluble calcium salts by bovine dentin specimens was observed using scanning electron microscopy. Change in lightness value (${\Delta}L$) was $5.50{\pm}1.51$ after 1 min of treatment, $5.73{\pm}0.43$ after 3 min, $8.64{\pm}0.24$ after 10 min, $18.93{\pm}0.76$ after 30 min, and $27.35{\pm}0.54$ after 60 min. The amount of calcium eluted from the human dental calculus was $4.23{\pm}0.14ppm$ after 1 min of treatment, $4.51{\pm}0.04ppm$ after 3 min, $12.12{\pm}0.16ppm$ after 10 min, $17.85{\pm}0.81ppm$ after 30 min, and $25.15{\pm}0.32ppm$ after 60 min. The Vickers hardness change value (${\Delta}VHN$) was $1.96{\pm}1.44$ after 1 min, $1.52{\pm}1.06$ after 3 min, $9.06{\pm}0.15$ after 10 min, $10.83{\pm}5.13$ after 30 min, and $12.55{\pm}2.09$ after 60 min. Partial dentinal tubules occlusion was observed at 10 min and complete occlusion was evident at 60 min. In summary, the use of patch type dentifrices for 10, 30, or 60 min were 1.57 to 8.26 times more effective than using the paste type dentifrices for 1 to 3 min. Based on these findings, it is reasonable to expect that the use of patch type dentifrices for 10 min would lead to remineralization, anti-calculus and dentinal tubules occlusion effects, and that use for 30 min would result in a whitening effect.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.184-191
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• 2015

Objective : Anterior communicating artery (AcomA) aneurysms represent the most common intracranial aneurysms and challenging to treat due to complex vascularity. The purpose of this study was to report our experience of endovascular treatment of AcomA aneurysms. Methods : Between January 2003 and December 2013, we retrospectively reviewed the medical records of 134 AcomA aneurysm patients available more than 6 months conventional angiographic and clinical follow-up results. We focused on aneurismal or AcomA vascular characters, angiographic and clinical follow-up results, and retreatment. Results : The rate of ruptured cases was 75.4%, and the small (<10 mm) aneurysms were 96.3%. Based on the subtypes defined by dominance of A1, 79 patients (59%) had contralateral A1 hypoplasia or agenesis. The immediate post-procedural angiography confirmed complete occlusion in 75.4%, partial occlusion in 24.6%. Procedure related complications were observed in 25 (18.6%) patients. Most of the adverse events were asymptomatic. Follow-up conventional angiography at ${\geq}6$ months was performed in all patients (mean 16.3 months) and major recanalization was noted in 6.7% and regrowth in one case. The aneurysm size (p=0.016), and initial treatment results (p=0.00) were statistically significant risk factors related to aneurysm recurrence. An overall improvement in mRS was observed during the clinical follow-up period and no rebleeding episode occurred. Conclusion : This study demonstrated that endovascular treatment is an effective treatment modality for AcomA aneurysms with low morbidity. Patients should take long term clinical and angiographic follow-up in order to assess the recurrence and warrant retreatment, especially ruptured, large, and initially incomplete occluded aneurysms.

• Journal of Korean Neurosurgical Society
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• 제61권4호
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• pp.450-457
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• 2018

Objective : Very large (20-25 mm) and giant (${\geq}25mm$) intracranial aneurysms have an extremely poor natural course, and treatment of these aneurysms remains a challenge for endovascular and surgical strategies. This study was undertaken to describe our experiences of endosaccular treatment of very large and giant intracranial aneurysms with parent artery preservation. Methods : From January 2005 to October 2016, twenty-four very large or giant aneurysms in 24 patients were treated by endosaccular coil embolization with parent artery preservation. Nine (37.5%) aneurysms were ruptured and 15 were unruptured, and of these 15, 11 were symptomatic cases and 4 were incidentally discovered. The cohort comprised 17 women and 7 men of mean age 58.5 years (range, 26-82). Mean aneurysm size was 26.0 mm (range, 20-39) and 13 of the 24 aneurysms were giant. Results : Immediate angiographic results were complete occlusion in nine (37.5%) cases, remnant neck in six (25.0%), and remnant sac in nine (37.5%). Overall procedural related morbidity and mortality rates were 12.5% and 4.2%, respectively. Angiographic follow-up was available in 16 patients (66.7%). Mean and median follow-up periods were 27.2 (range, 2-77) and 10.5 months, respectively. In 12 cases (12/16, 75%) stable occlusion was achieved, four cases (4/16, 25%) had recanalized, and two of these were retreated with additional coiling. At clinical follow-up of the nine ruptured cases, three patients (33.3%) achieved a good clinical outcome (Glasgow outcome scale [GOS] score of 4 or 5), two (22.2%) a poor outcome (GOS score of 2 or 3), and four patients (44.4%) expired (GOS 1). On the other hand, of the 15 unruptured cases, 13 patients (86.7%) achieved a good clinical outcome (GOS 4 or 5), one patient a poor outcome (GOS score of 2 or 3), and one patient expired (GOS 1). Conclusion : The present study shows endosaccular treatment of very large or giant intracranial aneurysms with parent artery preservation is both feasible and effective with acceptable morbidity and mortality.