Purpose: In cases when implant supported overdenture is made by using standard size implant, additional procedure such as bone surgery and bone grafting can be required. And it gives burden to doctor and patient in terms of cost. Therefore, it is necessary to find the implant therapy for the edentulous patients in making denture with accordable cost and simple procedure. Materials and methods: Edentulous patients with upper and lower dentures participated in this study. Before the operation, survey about patient's satisfaction to the existing dentures was carried out. Surgical procedures included four small diameter implants installation anterior area and immediate loading. One and three month after the procedure, the same survey about patient's satisfaction was carried out, and radiography was taken. Results: We are doing research to the nine patients. Survival rate is 97.2 percent. The comparison of patient's satisfaction before and after surgery is performed based on oral health impact profile 49. We analyze mainly with masticatory discomfort, retention, aesthetics, social problem, psychological discomfort problems. As a result, satisfaction level is increased at all factors. Retention is the most increased satisfactory factor followed by mastication difficulty, pronunciation, psychological discomfort, social discomfort, aesthetics in order. Marginal bone loss is 0.21 mm at 12 weeks after implant placement. Conclusion: This research reveals that the denture supported by mini dental implant increases patient's satisfaction. This study will be continued with more patients for a long time and we are scheduled for taking additional radiography to check whether peri-implant bone resorption occurs or not.
Sung, Il Soon;Song, Mi Ra;Kim, Hee Sun;Kim, Eun Sook;Jung, Mi A;Lee, Su Mi;Sung, Young Hee;Ha, Kook Hee;Kim, Seong Hwa;Lee, Hye Ran;An, Kyoung Jin;Shim, Mi Ok;Kim, Nag Hee;Sung, Young Hee
Quality Improvement in Health Care
/
v.14
no.1
/
pp.49-54
/
2008
Background : This study was to reduce incidence of falls by analyzing actual problem and drawing out improvement plan applicable to the clinical practice through operation of the staff nurses-centered fall peer review group. Method : The fall peer review group was composed of 8 nurses having patient nursing experience for over 5 years, and each of fall cases was reviewed and the root cause was analyzed. As a result, it was found that the patients and their families did not fully understandthe content of the education, and the staff nurses did not completely inspect the risk factors of falls and perform immediate intervention when patient's condition changed. Based on the above-mentioned results, improvement activity was conducted for the purposes of consolidating patients education method and supplementing computerized system to support nurses' decision making as well as devices and facilities. Result : As a result of conducting improvement activity in the aspects of education for patients, support of nurse's decision-making, and devices and facilities through operation of the staff nurses-centered fall peer review group, falls decreased by 9.5% compared to before improvement activity. Conclusion : It is concluded that operation of the clinical nurses-centered fall peer review group played a role of promoter to draw out practical and applicable improvement plan to the clinical practice and apply directions of the field-centered, and increased nurses' interest in falls and ultimately, reduced incidence of falls. Therefore the Center will continue to operate the staff nurses-centered peer review group, and recommends participation of nurses who actually take the charge of nursing patients in further analysis of patients' safety accidents.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.10
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pp.63-68
/
2017
Although automated metro subway systems have the advantage of operating a train without a train driver, it is difficult to detect an immediate fault condition and take countermeasures when an unusual situation occurs. Therefore, it is important to construct a maintenance information system (MIS) that detects the vehicle failure/status information in real time and maintains it efficiently in the depot of the railway's vehicles. This paper proposes a conceptual design method that realizes the interface between the train control system (TCS), the operation control center train control monitoring system (OCC-TCMS) console, and the MIS using wireless communication network in real-time. To transmit a large amount of information on 800,000 occurrences per day during operation, data was collected in a 56 byte data table using a data processing algorithm. This state information was classified into 4 hexadecimal codes and transmitted to the MIS by mapping the status and the fault information on the vehicle during the main line operation. Furthermore, the transmission and reception data were examined in real time between the TCS and MIS, and the implementation of the failure information screen was then displayed.
Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.
Background: Obtaining precise hemodynamic and morphological information in the early postoperative period after surgical correction of congenital heart disease is important in determining the need for future medical or surgical intervention. We investigated the residual shunting after surgical repair of simple ventricular septal defect in order to know the incidence of residual shunting in the postoperative period and the natural history of small residual shunts located in the peripatch area. Material and Method: Forty three consecutive patients under one year of age who underwent patch repair of a simple ventricular septal defect were evaluated for incidence of residual shunts by echocardiography. Result: Eleven patients had echocardiographic residual shunt in the peripatch area at immediate postoperative period, however, there were no patients who needed reoperation due to deteriorated hemodynamic effect of residual shunt. The incidence of residual shunts was not significantly different with type of ventricular septal defect and material used for closure. During follow up period, two patients were lost and remaining nine patients no longer showed evidence of residual shunt. The mean time of last evidence of shunt was $4.2{\pm}3.6$ months after operation. Conclusion: Residual peripatch shunt flow was frequently noted in the immediate postoperative period following surgical repair of ventricular septal defect, however, most of them were disappeared within six months.
The Journal of the Korean bone and joint tumor society
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v.2
no.1
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pp.18-26
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1996
We investigated the effect of deep-freezed, boiled and autoclaved autogenous long bone graft on the incorporation of the radial diaphyseal reconstruction in 30 rabbits by radiogram and histology for 8 weeks. Immediate histologic changes of 1cm of resected long bone treated by deep freezing, boiling and autoclaving in each 2 rabbits were also observed as control. Resected, boiled ($95^{\circ}C$ for 5 min.) and reimplanted bone was compared with resected, autoclaved ($131^{\circ}C$ for 5 min.) and reimplanted bone, and resected, deep freezed with liquid nitrogen for 5 minutes and thawing in saline and reimplanted bone in the reconstruction of bilateral radial defects in each of 8, and in total 24 adult rabbits. The results were as follows : 1. Immediate histologic changes showed that intracortical osteocytes in lacunae were partially necrotized and the cortex were faintly stained with they Masson trichrome stain in both boiled and deep freezed groups, while they completely necrotized and their cortex stained more weakly with Masson trichrome stain in autoclaved group which means less amount of collagen and protein in cortex of long bone. 2. Radiographies at 8 weeks showed complete union with more marked incorporation and external callus formation in all boiled and freezed groups, whereas there was delayed union in four of sixteen (25%) in autoclaved group. Histologically, at 8 weeks after boiled and freezed, more intense incorporation with new bone formation and neovascularization were observed, whereas transverse clefts consisted with delayed union in 4 cases of autoclaved group (25%) were observed at osteotomy site. Through these studies, the boilod and deeply freezed bones acted as an osteoinductive material as well as osteoconductive, but the autoclaved bone only as osteoconductive. Though boilod and deeply freezed bone showed higher osteogenic potentials than autoclaved bone, the necrotizing effect on cortical and boiled bone was inferior to that of autoclaved. Thus the deeply freezed bone can be used for the treatment of aggressive benign or less malignant bone tumor not involving cortical bone, but the autoclaved bone supplemented with bone graft for the treatment of malignant bone tumor involving cortex of long bone.
Since January 1977 to the end of September 1982, total 60 Ionescu-Shiley pericardial xenograft heart valves were implanted for valve replacement in 50 patients at the Han Yang University Hospital. The operative procedures were as follow: Mitral valve replacement [MVR] in 25 patients, Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 7 patients, Aortic valve replacement [AVR] in 8 patients, Aortic valve replacement [AVR] and Mitral valve replacement [MVR] in 8 patients. Aortic valve replacement [AVR] and Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 2 patients. To evaluate the immediate hemodynamic changes after valve replacements, the pressures of each cardiac chamber and ulmonary artery were checked before and after valve replacement on the operation table. Right ventricle [RV] pressure was decreased from 52.09\ulcorner6.71 to 45.57\ulcorner5.03 mmHg, Pulmonary artery [PA] pressure was decreased from 45.97\ulcorner2.69 to 41.00\ulcorner3.99 mmHg, and Left atrium [LA] pressure was decreased from 30.33\ulcorner13.02 to 22.76\ulcorner.97 mmHg before and after valve replacement. In MVR group, RV pressure was decreased from 49.17\ulcorner7.89 to 43.14\ulcorner4.14 mmHg, PA pressure was decreased from 44.67\ulcorner3.18 to 38.67\ulcorner2.85 mmHg, and LA pressure was decreased from 31.46\ulcorner13.47 to 21.91\ulcorner.17 mmHg. In AVR group, RV pressure was decreased from 53.0\ulcorner7.44 to 44.71 \ulcorner3.24 mmHg, PA pressure was decreased from 34.83\ulcorner0.73 to 31.86\ulcorner.36 mmHg, and LA pressure was not changed. In double valve replacement [MVR and AVR] group, RV pressure was decreased from 57.50\ulcorner3.82 to 42.50\ulcorner.80 mmHg, PA pressure was decreased from 51.17\ulcorner1.42 to 43.33\ulcorner4.53mmHig, and LA pressure was decreased from 34.33\ulcorner2.09 to 25.50\ulcorner0.21 mmHg. But in the group where MVR and TV annuloplasty were performed, preoperative RV and PA pressure were markedly increased and no pressure decrease in RV and PA noticed after valve replacement. This study shows good immediate postoperative hemodynamic results after valve replacement using Ionescu-Shiley xenograft valve except in the cases of MVR and TV annuloplasty and advanced disease with pulmonary hypertension.
The ameloblastoma is the most common form of the odontogenic tumors exhibiting minimal inductive change in connective tissue, it comprising 1% of all tumor and cysts of the jaws. It is a true neoplasm, generally considered to be a benign but persistent or, locally malignant lesion. The tumor occurs most commonly in persons between the age of 20 and 50 years. 80% and 90% of all lesions are in the mandible. The presenting clinical signs and symptoms of the ameloblastoma very from patient to patient, but most common symptom was swelling, followed by pain, draining sinuses, and superficial ulcerations. It is slow-growing lesion, and the radiographic features of the ameloblastoma depend large one the nature and the local bone reaction to the particular tumor. Recurrence rate is about 33%, but this is probably due to incommplete initial removal of lesion. We had operated a patient ; 29-year-old female immediate reconstruction combined with autocompression plate and iliac bone graft and screw fixation after hemimandibulaectomy with recurred ameloblastoma involving from premolar to ascending ramus at right side mandible. We obtained favorable results of good function, short intermaxillary fixation periods and easy operation precedure than the other reconstruction methods.
Park, Seong-Cheol;Yoon, Sang-Hoon;Hong, Yong-Pyo;Kim, Ki-Jeong;Chung, Sang-Ki;Kim, Hyun-Jib
Journal of Korean Neurosurgical Society
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v.46
no.4
/
pp.292-299
/
2009
Objective : Clinical and radiological results of posterior dynamic stabilization using interspinous U (ISU, $Coflex^{TM}$, Paradigm Spine $Inc.^{(R)}$, NY, USA) were analyzed in comparison with posterior lumbar interbody fusion (PLIF) in degenerative lumbar spinal stenosis (LSS). Methods : A retrospective study was conducted for a consecutive series of 61 patients with degenerative LSS between May 2003 and December 2005. We included only the patients completed minimum 24 months follow up evaluation. Among them, 30 patients were treated with implantation of ISU after decompressive laminectomy (Group ISU) and 31 patients were treated with wide decompressive laminectomy and posterior lumbar interbody fusion (PLIF; Group PLIF). We evaluated visual analogue scale (VAS) and Oswestry Disability Index (ODI) for clinical outcomes (VAS, ODI), disc height ratio disc height (DH), disc height/vertebral body length ${\times}100$), static vertebral slip (VS) and depth of maximal radiolucent gap between ISU and spinous process) in preoperative, immediate postoperative and last follow up. Results : The mean age of group ISU ($66.2{\pm}6.7$ years) was 6.2 years older than the mean age of group PLIF ($60.4{\pm}8.1$ years; p=0.003). In both groups, clinical measures improved significantly than preoperative values (p<0.001). Operation time and blood loss was significantly shorter and lower in group ISU than group PLIF (p<0.001). In group ISU, the DH increased transiently in immediate postoperative period ($15.7{\pm}4.5%{\rightarrow}18.6{\pm}5.9%$), however decreased significantly in last follow up ($13.8{\pm}6.6%$, p=0.027). Vertebral slip (VS) of spondylolisthesis in group ISU increased during postoperative follow-up ($2.3{\pm}3.3{\rightarrow}8.7{\pm}6.2$, p=0.040). Meanwhile, the postoperatively improved DH and VS was maintained in group PLIF in last follow up. Conclusion : According to our result, implantation of ISU after decompressive laminectomy in degenerative LSS is less invasive and provides similar clinical outcome in comparison with the instrumented fusion. However, the device has only transient effect on the postoperative restoration of disc height and reduction of slip in spondylolisthesis. Therefore, in the biomechanical standpoint, it is hard to expect that use of Interspinous U in decompressive laminectomy for degenerative LSS had long term beneficial effect.
Kim, Jong Duk;Chee, Hyun Keun;Shin, Je Kyoun;Kim, Jun Seok;Lee, Song Am;Kim, Yo Han;Lee, Woo Surng;Kim, Hye Young
Journal of Chest Surgery
/
v.47
no.3
/
pp.240-248
/
2014
Background: Open heart surgery using cardiopulmonary bypass (CPB) is considered one of the most frequent surgical procedures in which acute kidney injury (AKI) is a frequent and serious complication. The aim of the present study was to evaluate the efficiency of neutrophil gelatinase-associated lipocalin (NGAL) as an early AKI biomarker after CPB in cardiac surgery (CS). Methods: Thirty-seven adult patients undergoing CS with CPB were included in this retrospective study. They had normal preoperative renal function, as assessed by the creatinine (Cr) level, NGAL level, and estimated glomerular filtration rate. Serial evaluation of serum NGAL and Cr levels was performed before, immediately after, and 24 hours after the operation. Patients were divided into two groups: those who showed normal immediate postoperative serum NGAL levels (group A, n=30) and those who showed elevated immediate postoperative serum NGAL levels (group B, n=7). Statistical analysis was performed using Statistical Package for the Social Sciences version 18. Results: Of the 37 patients, 6 (6/37, 16.2%) were diagnosed with AKI. One patient belonged to group A (1/30, 3.3%), and 5 patients belonged to group B (5/7, 71.4%). Two patients in group B (2/7, 28.5%) required further renal replacement therapy. Death occurred in only 1 patient (1/37, 2.7%), who belonged to group B. Conclusion: The results of this study suggest that postoperative plasma NGAL levels can be used as an early biomarker for the detection of AKI following CS using CPB. Further studies with a larger sample size are needed to confirm our results.
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