• Archives of Plastic Surgery
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• 제36권2호
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• pp.221-224
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• 2009

Purpose: The treatment of children mandibular condyle fracture that is severely displaced is controversial. The conservative treatment of it may lead to complications - mandibular deficiency, asymmetry, malocclusion and temporomandibular joint dysfunction. Moreover, open reduction carries risks for growth retardation, facial nerve injury, scarring and joint stiffness. The aim of this article is to present an alternative technique of the treatment by using a threaded Kirschner wire and external rubber traction. Materials: From November 2005 to May 2008, three patients underwent the management by using a threaded Kirschner wire and external rubber traction. A threaded Kirschner wire was inserted in the condylar segment by using a C-arm. We applied the external rubber traction, and we reducted the segment progressively until complete reduction. The mandibular - maxillary fixations were removed after 3 weeks, and patients went into training for mouth opening. Results: The technique didn't result in complications - joint dysfunction, facial nerve injury, sore, infection and nonunion during follow - up period. Radiologic follow - up examinations revealed correct reduction in all patients. In all cases, we found restoration of preinjury occlusion and temporomandibular joint function. Conclusions: Closed reduction of children mandibular condyle fracture by using a threaded Kirschner wire and external rubber traction did achieve anatomic reduction and restore mandibular height. This alternative technique is simple, effective, inexpensive, easy to apply and minimally invasive.

• 구강회복응용과학지
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• 제17권2호
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• pp.107-112
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• 2001

The prosthodontic treatment of severely resorbed edentulous patients has been one of the frustrating areas due to extensive loss of tissues. The integrated neuromuscular balance among tongue, lip, and cheek is compromised. The retention, stability, and support are the three major factors to influence the clinical outcome. Fish described a denture as having three surface, with each surface playing an independent and important role in the over all fit, stability, and comfort of the denture. He recommended that the polished surface should be a series of inclines so that pressure from muscular activity will retain dentures. Within the denture space there is an area that has been termed the neutral zone. The neutral zone is that area in the mouth where, during function, the forces of the tongue pressing outward are neutralized by the forces of the cheeks and lips pressing inward. According to Jacobson and Krol, neuromuscular control interacts to provide retention and the relationship of polished surface of denture base to the surrounding muscular structure of orofacial capsule facilitates the stability and retention. This neutral zone concept has been demonstrated with various modification by a number of authors. The theory used to develop the denture base contours is based on the belief that the muscle should functionally mold not only the border but the entire polished surface. Lott and Walsh reported the clinical success on complete mandibular dentures with application of neutral zone concept. A number of studies demonstrated that denture stability and retention are more dependent on correct position of the teeth and correct contour of external surfaces of the denture in a severely resorbed alveolar ridge. This article presents a prosthodontic approach to treatment of a edentulous patient using neutral zone technique to improve the retention and stability of the prosthesis.

• Tuberculosis and Respiratory Diseases
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• 제62권1호
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• pp.62-66
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• 2007

A bronchial artery aneurysm is a rare condition, which needs optimal treatment due to the possibility of a life-threatening hemorrhage by rupture. The surgical removal of the aneurysm is the standard treatment. However, there are a few reports of coil embolization with a transcatheter. A 69 year-old man was referred for a further evaluation of a mass in the right hilum on chest radiography. He denied any respiratory symptoms. A chest CT scan showed a $3{\times}3{\times}4.5cm$ sized vascular mass with strong contrast enhancement on the right hilar area that originated from the bronchial artery. On the angiogram, the bronchial artery originated from the descending thoracic aorta at the T8 level. A bronchial artery aneurysm was catheterized selectively. and embolized successfully with a coil. After coil embolization, the selective bronchial arteriography confirmed complete occlusion. We report this case of bronchial aneurysm that was treated successfully with coil embolization.

• 구강회복응용과학지
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• 제31권3호
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• pp.242-252
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• 2015

무치악 환자에서는 치아가 상실되면서 주위 치조골의 개조와 흡수가 일어나고, 이에 따라 총의치의 유지력 감소, 저작 효율의 저하와 통증으로 인해 의치 사용에 어려움을 겪게 된다. 이를 개선하기 위해 하악에 2 - 4개의 임플란트를 식립하고 어태치먼트에서 유지 또는 지지를 얻는 피개의치가 바람직한 치료 방법으로 고려되고 있다. 본 증례들은 하악 완전 무치악 환자들을 악간 관계, 골흡수 정도, 안모지지 등을 평가하여 하악에 2개의 임플란트 식립을 고려하고, 다양한 종류의 어태치먼트를 이용한 임플란트 피개의치 수복을 계획하여 치료하였다. 주기적인 경과 관찰 결과 심미적, 기능적으로 만족할만한 결과를 얻었기에 이를 보고하는 바이다.

• 구강회복응용과학지
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• 제16권3호
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• pp.211-220
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• 2000

The use of autopolymerizing-cured resin and light-cured resin for direct relining of complete and partial dentures has been popular. This investigation compared the adhesion of autopolymerizing-cured reline resin(Tokuso Rebase, Mild Rebaron) or light-cured reline resin(Mild Rebaron LC, Lighton-U) to metal base or resin base. Cylindrical samples were made from metal($Biosil^{(R)}$) or heat-cured resin(QC-20) and were prepared to produce a flat bonding surface. Cylindrical metal samples were roughened by scratch or by scratch and sandblast and were treated with primer(MR Bond) after scratch and sandblast. And then, liners were prossesed to the cylindrical metal or resin samples according to the manufacturer's recommendations so as to bond metal base or resin base. The specimens were tested in pure tension by using an Instron Univesal testing machine for the four direct reline resins. The results were as follows ; 1. In comparison with tensile bond strength of material relined on resin base or metal base, the case of resin base produced significantly higher tensile bond strength than the case of metal base. 2. Metal surface pretreatment or primer improved the tensile bond strength between the reline resin and the metal($Biosil^{(R)}$) base. 3. The tensile bond strength of Mild Rebaron LC relined on resin base or metal base were similar to those of the other reline resins.

• 구강회복응용과학지
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• 제16권2호
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• pp.161-170
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• 2000

The use of autopolymerizing-cured resin and light-cured resin for direct relining of complete and partial dentures has been popular. This investigation compared the adhesion of autopolymerizing-cured reline resin(Tokuso Rebase, Mild Rebaron) or light-cured reline resin(Mild Rebaron LC, Lighton-U) to metal base or resin base. Cylindrical samples were made from metal($Biosil^{(R)}$) or heat-cured resin(QC-20) and were prepared to produce a flat bonding surface. Cylindrical metal samples were roughened by scratch or by scratch and sandblast and were treated with primer(MR Bond) after scratch and sandblast. And then, liners were prossesed to the cylindrical metal or resin samples according to the manufacturer's recomendations so as to bond metal base or resin base. The specimens were tested in pure tension by using an Instron Univasal testing machine for the four direct reline resins. The results were as follows ; 1. In comparison with tensile bond strength of material relined on resin base or metal base, the case of resin base produced significantly higher tensile bond strengths than the case of metal base. 2. Metal surface pretreatment or primer improved the tensile bond strength between the reline resin and the metal($Biosil^{(R)}$) base. 3. The tensile bond strengths of Mild Rebaron LC relined on resin base or metal base were similar to those of the other reline resins.

• Journal of Chest Surgery
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• 제35권6호
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• pp.483-486
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• 2002

71세 남자 환자로 좌측 총장골 동맥의 완전 폐쇄를 동반한 복부 대동맥류로 수술하였다. 술 전, 좌측 대퇴 및 장골 정맥에 동반된 만성 심부정맥 혈전증은 진단하지 못 하였다. 동맥류 절제술 및 우측은 외측 장골동맥에, 좌측은 대퇴동맥에 문합한 Y-graft 치환술과 대퇴동맥간 우회술을 시행하였으나, 술 후 반복적인 부종과 통증이 발생하였고 점차 악화되어 결국 광범위한 정맥 혈전증으로 사망하였다. 본례는 만성 심부정맥 혈전증을 동반한 폐쇄성 대동맥 장골 동맥 질환에 있어 수술적 치료 및 합병증에 관한 보고이다.

• Journal of Korean Neurosurgical Society
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• 제53권6호
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• pp.349-355
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• 2013

Objective : Recently, microscope-integrated near infrared indocyanine green videoangiography (ICG-VA) has been widely used in cerebrovascular surgery because it provides real-time high resolution images. In our study, we evaluate the efficacy of intraoperative ICG-VA during cerebrovascular surgery. Methods : Between August 2011 and April 2012, 188 patients with cerebrovascular disease were surgically treated in our institution. We used ICG-VA in that operations with half of recommended dose (0.2 to 0.3 mg/kg). Postoperative digital subtraction angiography and computed tomography angiography was used to confirm anatomical results. Results : Intraoperative ICG-VA demonstrated fully occluded aneurysm sack, no neck remnant, and without vessel compromise in 119 cases (93.7%) of 127 aneurysms. Eight clipping (6.3%) of 127 operations were identified as an incomplete aneurysm occlusion or compromising vessel after ICG-VA. In 41 (97.6%) of 42 patients after carotid endarterectomy, the results were the same as that of postoperative angiography with good patency. One case (5.9%) of 17 bypass surgeries was identified as a nonfunctioning anastomosis after ICG-VA, which could be revised successfully. In the two patients of arteriovenous malformation, ICG-VA was useful for find the superficial nature of the feeding arteries and draining veins. Conclusion : ICG-VA is simple and provides real-time information of the patency of vessels including very small perforators within the field of the microscope and has a lower rate of adverse reactions. However, ICG-VA is not a perfect method, and so a combination of monitoring tools assures the quality of cerebrovascular surgery.

• 대한치과보철학회지
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• 제57권4호
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• pp.364-373
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• 2019

2급 악간관계를 갖는 환자는 1급 악간관계인 환자와는 달리 불안정한 교합을 가질 수 있으며, 무치악인 경우 총의치를 사용할 때 불안정한 교합을 보이면서 의치의 움직임이 커질 가능성이 있다. 이런 환자에 있어 임플란트 피개의치를 사용함으로써 의치의 안정을 향상시킬 수 있다. 임플란트 피개의 치에서 attachment 종류는 크게 bar type과 solitary type으로 나눌 수 있는데 각각 적응증이 있어 상황에 따라 적용을 달리 하여야 한다. 본 증례는 2급 악간관계를 가진 하악 무치악 환자에서 임플란트 피개의치를 계획함에 있어 디지털 기술을 이용함으로써 더 적합한 attachment를 선택하고 임플란트의 위치 및 깊이를 미리 계획하여 계획한 위치에 식립하였다. 상악은 국소의치로 수복하였고 하악은 임플란트 피개의치로 수복하여 만족할만한 결과를 얻었기에 이를 보고하고자 한다.

• 구강회복응용과학지
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• 제34권4호
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• pp.331-337
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• 2018

상악골 결손을 갖고 있는 무치악 환자를 폐쇄장치로 수복할 때 임상가들은 많은 어려움을 겪게 된다. 결손부를 통한 공기의 누출, 안정성과 지지의 부족, 감소된 의치 피개 면적은 의치의 흡착과 변연 폐쇄를 어렵게 한다. 본 증례는 편평상피암에 이환된 우측 상악동 부위에 상악골 절제술을 받은 무치악 환자로 술전 치과 검진, 수술용 폐쇄장치, 이행 폐쇄장치, 그리고 최종 폐쇄장치에 이르는 단계적 치료 과정을 통해 보철적 재건을 완료하였다. 본 증례의 환자는 전상악골 및 양측 상악 결절이 온전하며 한정된 크기의 결손부를 가져 적절한 유지와 지지를 갖는 폐쇄장치를 제작할 수 있었으며 심미 및 기능면에서 양호한 예후를 보였기에 이를 보고하는 바이다.