• Title/Summary/Keyword: Efficiency of Surgery

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A MULTICENTER RETROSPECTIVE STUDY OF OUTPATIENT INTRAVENOUS SEDATION FOR DENTAL TREATMENTS (치과 치료를 위한 외래 정주진정 법에 대한 다기관 후향적 임상연구)

  • Jung, Se-Hwa;Baik, Sang-Hyun;Roh, Hyun-Ki;Kang, Na-Ra;Im, Jae-Jung;Lee, Byung-Ha;Jeon, Jae-Yoon;Hwang, Kyung-Gyun;Shim, Kwang-Sup;Park, Chang-Joo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.394-400
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    • 2009
  • Purpose : On outpatient facilities, our sedation protocol focuses on the intermittent bolus injections of midazolam intravenously, according to patient's and operator's needs during the dental treatment. This multicenter retrospective study was aimed to prove the efficiency and safety of our sedation protocol. Patients and Methods : In three centers using the same outpatient sedation protocol for dental treatment (Division of Oral and Maxillofacial Surgery/Department of Dentistry in Hanyang University Medical Center, S-plant Dental Hospital. and Grand Oral and Maxillofacial Surgery), total 937 patients had various dental treatments under intravenous conscious sedations with independent patient monitoring from March 2006 to March 2009. By reviewing charts, we analyzed the results of sedation and dental treatment, retrospectively. Results : Our sedation protocol had no severe postoperative complications requiring admission. while showing good compatibility with almost all dental treatments, with acceptable satisfaction of both patients and operators. Conclusion : We assure that our sedation protocol can be used efficiently and safely on routine outpatient basis. We also hope that this study will provide the concrete concepts to common dental practitioners, who desire to perform sedation for dental treatment.

Outcome of Suture Suspension Arthroplasty for Thumb Carpometacarpal Joint Arthritis (무지 수근중수 관절염에 대한 현수 봉합 관절성형술의 결과)

  • Kim, Sehun;Gong, Hyun Sik;Lee, Se Yeon;Lee, Minho;Kim, Jihyeung;Baek, Goo Hyun
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.223-229
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    • 2018
  • Purpose: A number of procedures were introduced to stabilize the 1st metacarpal bone after resection of the trapezium in the thumb carpometacarpal joint (CMCJ) arthroplasty. However, some surgical procedures may inevitably damage normal structures, such as harvesting tendons or drilling of a bone for tendon passage. Suture suspension arthroplasty is relatively less invasive and easier to perform than the previously described surgical methods. The purpose of this study was to report the therapeutic efficiency of the suture suspension arthroplasty. Methods: We retrospectively reviewed 12 patients who underwent suture suspension arthroplasty for the treatment of thumb CMCJ arthritis. Pain visual analogue scale (VAS), satisfaction about surgical outcomes, and the disabilities of the arm, shoulder and hand (DASH) scores were measured to evaluate the functional outcomes and the Trapezial Space Ratios were measured. Satisfaction was measured in the range of "very dissatisfied" (0) to "very satisfied" (10). Results: The mean follow-up period was 23 months. Pain VAS score improved significantly from 7.0 to 2.9 (p<0.05). And mean satisfaction scale was 6.9. However, there was no significant difference in DASH scores between before and after surgery (p=0.06). The mean trapezial space ratio was calculated to be 0.45 before surgery, 0.33 immediately after surgery, 0.23 at the last follow-up. Conclusion: Suture suspension arthroplasty is a satisfactory surgical procedure. And compared with other procedures, there is no significant difference in the reduction of the trapezial space. It may be useful in advanced thumb CMCJ arthritis.

COMPARATIVE STUDY ON MUSCLE ACTIVITIES OF PRE- AND POST-ORTHOGNATHIG SURGERY IN SKELETAL CLASS III MALOCCLUSION PATIENTS AND NORMAL GROUP (성인에서 골격형 제 III급 부정교합자의 악교정 수술 전, 후와 정상교합자의 근활성도에 대한 비교연구)

  • Jung, Kyung-Jin;Sohn, Byung-Wha
    • The korean journal of orthodontics
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    • v.25 no.3 s.50
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    • pp.355-373
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    • 1995
  • Craniofacial region is a musculodentoskeletal system that consists of many anatomical structures ; cranioskeletal structures, dental arches, and formation and functions of masticatory muscles have close correlations. Growth and development of craniofacial region are influenced by not only hereditory factors, but also environmental factors such as craniofacial muscles and surrounding tissues. On the contrary, however, study on changes in functions or adaptations of craniofacial muscles following changes of craniofacial skeletal structures has been somewhat insufficient. The author's purpose was to observe correlations between masticatory muscular functions and change patterns according to cranial skeletal structures and occlusion patterns, for this, comparative study of muscle activity changes of preand post- orthognathic surgery states in skeletal Cl III malocclusion patients was peformed. The selected sample groups were 15 normal male patients, 15 skeletal Cl III pre-orthognatic surgery patients and 15 skeletal Cl III post-orthognatic surgery patients. For each sample groups, cephalometric x-ray taking, masticatory efficiency test and measurements of muscle activities in anterior temporal muscle, masseter and upper lip in rest, clenching, chewing and swallowing were carried out. The following results were obtained : 1. In resting state of mandible, pre-surgery malocclusion group showed higher m. activities in ant. temporalis, masseter and upper lip than post-surgery group. Post-surg. malocc. group showed significantly high m. activity only in upper lip compared to the normal group. 2. In clenching state, post-surg. malocc. group showed higher m. activities in ut. temporalis, masseter and upper lip than pre-surg. malocc. group. 3. In chewing state, post-surg. malocc. group showed higher m. activities in ant. temporalis and masseter than pre-surg. malocc. group, on the other hand, decreased upper lip activity was noticed. 4. In swallowing state, post-surg. malocc. group showed lower upper lip activity than pre-surg. malocc. group but higher than that of the normal group. No significant difference in m. activities of ant, temporalis and masseter was noticed among the three groups. 5. Masticatory efficiency was lower in pre-surg. malocc. group than normal group, masticatory efficiency showed an increase in post-surg. malocc. group compared to the pre-surg. malocc. group. However, both groups showed significant differences compared to the normal group.

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XPC 939A>C and 499C>T Polymorphisms and Skin Cancer Risk: a Meta-analysis

  • Ji, Geng;Lin, Yuan;Cao, Song-Yu;Li, Luo-Zhu;Chen, Xin-Long;Sun, Bu-Mei;Chen, Chuan-Jun;Ma, Hong-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.4983-4988
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    • 2012
  • The xeroderma pigmentosum complementation group C gene (XPC) has been identified as important for repairing UV-related DNA damage. Some subtle changes in this gene may impair repair efficiency and influence susceptibility to human cancers, including skin cancer. Two polymorphisms in XPC, 939A>C (rs2228001) and 499C>T (rs2228000), are considered to have possible associations with the risk of skin cancer, but the reported results have been inconsistent. Here we performed a meta-analysis of the available evidence regarding the relationship between these two polymorphisms and the risk of skin cancer. All relevant studies were searched using PubMed, Embase and Web of Science before February 2012. A total of 8 case-control studies were included in this analysis, and no convincing associations between the two polymorphisms and risk of skin cancer were observed in any of the genetic models. Stratified analyses by skin cancer type also did not detect significant associations in any subgroup. This meta-analysis suggested that the XPC 939A>C and 499C>T polymorphisms may have little involvement in susceptibility to skin cancer.

Efficiency of MVP ECG Risk Score for Prediction of Long-Term Atrial Fibrillation in Patients With ICD for Heart Failure With Reduced Ejection Fraction

  • Levent Pay;Ahmet Cagdas Yumurtas;Ozan Tezen;Tugba Cetin;Semih Eren;Goksel Cinier;Mert Ilker Hayiroglu;Ahmet Ilker Tekkesin
    • Korean Circulation Journal
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    • v.53 no.9
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    • pp.621-631
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    • 2023
  • Background and Objectives: The morphology-voltage-P-wave duration (MVP) electrocardiography (ECG) risk score is a newly defined scoring system that has recently been used for atrial fibrillation (AF) prediction. The aim of this study was to evaluate the ability of the MVP ECG risk score to predict AF in patients with an implantable cardioverter defibrillator (ICD) and heart failure with reduced ejection fraction in long-term follow-up. Methods: The study used a single-center, and retrospective design. The study included 328 patients who underwent ICD implantation in our hospital between January 2010 and April 2021, diagnosed with heart failure. The patients were divided into low, intermediate and high-risk categories according to the MVP ECG risk scores. The long-term development of atrial fibrillation was compared among these 3 groups. Results: The low-risk group included 191 patients, the intermediate-risk group 114 patients, and the high-risk group 23 patients. The long-term AF development rate was 12.0% in the low-risk group, 21.9% in the intermediate risk group, and 78.3% in the high-risk group. Patients in the high-risk group were found to have 5.2 times higher rates of long-term AF occurrence compared to low-risk group. Conclusions: The MVP ECG risk score, which is an inexpensive, simple and easily accessible tool, was found to be a significant predictor of the development of AF in the long-term follow-up of patients with an ICD with heart failure with reduced ejection fraction. This risk score may be used to identify patients who require close follow-up for development and management of AF.

Immediate restorations in a fully edentulous patient utilizing digital system: A case report (완전 무치악 환자에서 디지털 시스템을 이용한 임플란트 즉시 보철수복 증례)

  • Fang, Jeong-Whan;Jeong, Seung-Mi;Kang, Se-Ha;Hwang, Chan-Hyeon;Kim, Dae-Hwan;Choi, Byung-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.2
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    • pp.157-166
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    • 2015
  • This article describes how to use CBCT and an intraoral scanner in a fully edentulous case that enables the clinician to place implants with flapless guided surgery and to engage prefabricated, customized implant abutments at the time of implant surgery, with only 1 clinical consultation before implant surgery. The patient's existing denture is used to simulate the teeth, the soft tissue and the vertical dimension of occlusion, and jaw relationship in the fully edentulous jaw. It provides clinicians with a fast workflow and improves clinical efficiency.

A Systematic Review of Evidence for Education and Training Interventions in Microsurgery

  • Ghanem, Ali M.;Hachach-Haram, Nadine;Leung, Clement Chi Ming;Myers, Simon Richard
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.312-319
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    • 2013
  • Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

Freeze-dried bovine amniotic membrane as a cell delivery scaffold in a porcine model of radiation-induced chronic wounds

  • Oh, Daemyung;Son, Daegu;Kim, Jinhee;Kwon, Sun-Young
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.448-456
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    • 2021
  • Background Locoregional stem cell delivery is very important for increasing the efficiency of cell therapy. Amnisite BA (Amnisite) is a freeze-dried amniotic membrane harvested from bovine placenta. The objective of this study was to investigate the retention of cells of the stromal vascular fraction (SVF) on Amnisite and to determine the effects of cell-loaded Amnisite in a porcine radiation-induced chronic wound model. Methods Initially, experiments were conducted to find the most suitable hydration and incubation conditions for the attachment of SVF cells extracted from pig fat to Amnisite. Before seeding, SVFs were labeled with PKH67. The SVF cell-loaded Amnisite (group S), Amnisite only (group A), and polyurethane foam (group C) were applied to treat radiation-induced chronic wounds in a porcine model. Biopsy was performed at 10, 14, and 21 days post-operation for histological analysis. Results Retaining the SVF on Amnisite required 30 minutes for hydration and 1 hour for incubation. A PKH67 fluorescence study showed that Amnisite successfully delivered the SVF to the wounds. In histological analysis, group S showed increased re-epithelialization and revascularization with decreased inflammation at 10 days post-operation. Conclusions SVFs had acceptable adherence on hydrated Amnisite, with successful cell delivery to a radiation-induced chronic wound model.

Injection Therapy for Calcific Tendinitis of Shoulder Under the Sonographic Guidance (초음파하 극상근 석회화 건염 주사 요법)

  • Nam, Ki Young;Moon, Young Lae;Yang, Kyung Ho
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.1
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    • pp.10-13
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    • 2008
  • Purpose: To evaluate the efficiency of needling and injection technique without steroid for symptomatic calcific tendinitis of the shoulder. Material and Methods: We chose 12 symptomatic calcific tendinitis patients, whose ages ranged from 35 to 64. Procedure ware dry needling and injection of prolotherapic agent near the lesion. Results: All the case revealed prominent improvement without limitation of shoulder function, especially in active painful stage. Conclusion: Sonographic injection technique for calcific tendinitis would be one of the good modality not only for symptomatic relieve but also good functional recovery.

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A Fully Digital Auricular Splint Workflow for Post-Keloid Excision

  • Rahmat Maria;Yee Onn Kok;Khim Hean Teoh
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.563-567
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    • 2023
  • Ear keloids are challenging lesions to treat due to high recurrence rates postexcision. Conservative compression techniques as adjunct treatment have been reported to be effective. An innovative technique of using computer-aided design/computed-aided manufacturing to print a customized auricular splint improves efficiency and comfort level for patients compared with conventional methods. The ear is scanned using an intraoral scanning 2 weeks postsurgery. A two-piece auricular splint is designed on the digital model, incorporating perforated projections for three nylon screws for retention of the splint. The splint is printed with clear acrylic material, postprocessed, and finished. The patient is taught to assemble the components of the splint and instructed to wear for at least 8 hours daily. The surgery site reviewed for any ulceration, pain, or recurrence of keloid for 6 months. During the 6-month review, the excision scar remained flat and pink. The patient also reports unrestricted daily activities. The digital workflow increases comfort for the patient and reduces the number of hours required to produce a customized auricular splint compared with conventional methods. A fully digital workflow for a printed auricular splint should be considered for adjunctive treatment to excision of ear keloids.