• Title/Summary/Keyword: Indication of surgical treatment

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Reparability and Surgical Indications of Rotator Cuff Tears (회전근 개 파열의 봉합 가능성 및 수술 적응증)

  • Ko, Sang-Hun;Park, Han-Chang;Lee, Seon-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.92-97
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    • 2012
  • Purpose: The reparability of rotator cuff tears is very important to establish the indication of the surgical treatment of rotator cuff tears. We reviewed the factors that effect to reparability of rotator cuff tears, and considered about the surgical indication of rotator cuff tears. Materials and Methods: The reparability was considered by the surgical reparability and the postoperative healing potentials of rotator cuff. The natural history of rotator cuff tear gives us the information to make decision about the surgical treatment or the conservative treatment. Results: There are 3 general categories of factors that help predict the healing potential of a rotator cuff tear. These include surgical technique, biology, and environmental issues. Surgeon can control the surgical technique by himself. The control of biology comes from careful operative indications by age, acute trauma history, chronicity, and tear size. And the control of environmental factor can give better outcomes by cessation of smoking and nonsteroidal anti-inflammatory drug (NSAID). Conclusion: A better understanding of the natural history and the reparability of rotator cuff tear will help us to estabilish the indication of surgical treatement of rotoator cuff tears, and lead to satisfactory clinical outcomes.

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Decannulation Difficult (기관 캐뉼 발거 곤란증)

  • 봉정표;임구일;유기원;이준규;박성원;홍기수
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.165-170
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    • 1998
  • Background and Objectives : Decannulation failure may result from factors such as inadequate ability 0 clear secretion, mucosal induration, granulation tissue, restenosis, tracheal wall depression and vocal cord palsy. We were to evaluate the effectiveness of surgical treatment on the basis of site and type of stenosis. Materials and Method : A series of 44 cases of decannulation difficulty between 1993 and 1997 were reviewed. The following data were collected on each of these patients : primary disease, indication for tracheostomy, site of stenosis, endoscopic findings of stenosis, surgical techniques used for treatment. Results : Primary diseases were 30 head trauma, 4 neck injury, 10 other diseases. Indication for tracheostomy were 37 prolonged intubation, 4 emergency tracheostomy, 3 laryngeal trauma. Endoscopic findings of stenosis were 24 granulation tissue, 16 laryngotracheal collapse, 4 combined with granulation tissue and collapse. Site of stenosis were 3 glottic, 9 subglottic, 24 stomal, 1 substomal, 7 mixed. 22 of 24 cases were decannulation using endoscopic treatment. Conclusion : The most common cause of failed decannulation was sternal granulation tissue. The most effective treatment of granulation tissue was endoscopic technique.

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Autogenous Transplantation of Impacted teeth : Indication and Case Report (매복치 자가이식술의 적응증과 치험례)

  • Yu, Hyung-Seog;Kim, Tae-Gyun
    • The Journal of the Korean dental association
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    • v.38 no.1 s.368
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    • pp.22-29
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    • 2000
  • The purpose of this paper is to discuss the indication. treatment procedure. prognosos and complication of autogenous transplantation in treating impacted teeth of orthodontic patient. Autogenous transplantation is indicated, in cases of rejecting orthodontic treatment due to the visible orthodontic appliance, the relatively long treatment time, unfavorable tooth position for orthodontic repositioning, unrestorable advanced detal caries. advanced periodontitis and ankylosed tooth. Most process related to the decision of the prognosis is dependent on the careful surgical technique. In comparison to other orthodontic and surgical procedure, the application of the autotransplantation is limited, although its success rate is markedly increased today. Therefore we must we must pay attention to the treatment planning and cooperation with other specialties is needed.

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Recent Treatment Options for the Clavicle Fracture (쇄골 골절 치료의 최근 경향)

  • Oh, Joo-Han;Choi, Hye-Yeun
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.43-51
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    • 2012
  • Purpose: We sought to determine the appropriate management modality for clavicle fracture through the review of current literature. Materials and Method: This article provides an overview of the knowledge regarding clavicular fracture in adults, including epidemiology, classification, surgical indication, current technique, and results. We also addressed recent debates: the range of the surgical indication for mid-clavicular fracture and the introduction of anatomically precontoured plate as a new treatment modality. Result and Conclusion: Nonsurgical treatment has been regarded as the first choice in the management of clavicle fractures. Quite recently, mounting evidence has shown that adverse outcomes, after a nonsurgical treatment, such as nonunion and malunion, were more prevalent than previously assumed. Accordingly, the indications for surgical fixation appear to be broadening. However, given that the ideal treatment option remains to be determined, the appropriate treatment of clavicle fractures should be tailored based on careful assessment of individual patient's data and preference.

Endoscopic Resection for Early Gastric Cancer beyond Absolute Indication with Emphasis on Controversial Issues

  • Min, Yang Won;Lee, Jun Haeng
    • Journal of Gastric Cancer
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    • v.14 no.1
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    • pp.7-14
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    • 2014
  • Endoscopic resection is the established treatment for early gastric cancer in selected patients with negligible risk of lymph node metastasis ('absolute indication'). Based on clinical observations and large pathological databases, expanding indications for endoscopic resection beyond absolute indication has been tried in Japan and Korea. However, controversies exist regarding the safety of treating early gastric cancer beyond absolute indication in terms of pathological evaluation of the resected specimen, definition of expanded indication, discrepancy between pre-endoscopic resection and post-endoscopic resection diagnoses of gastric neoplasm, and the best strategy for cases with non-curative resection. In this brief review, current evidence and clinical experience regarding issues of endoscopic resection beyond absolute indication will be summarized.

Surgery First Approach in Orthognathic Surgery : Indication and limitation (임상가를 위한 특집 4 - 턱교정수술에서 선수술접근 :적응증과 한계)

  • Hwang, Dae-Seok
    • The Journal of the Korean dental association
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    • v.50 no.11
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    • pp.682-688
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    • 2012
  • Surgery first approach in orthognathic surgery is to proceed the orthognathic surgery without preoperative orthodontic treatment. This approach has many advantages, which include a shorter total treatment period, a high level of patient satisfaction due to immediate post-surgical facial improvement, easy postoperative orthodontic treatment due to early normalization of skeletal muscle, and the rapid tooth movement reflecting the regional accelerated phenomenon. However instability due to transient occlusal interference after surgery make worse of long-term skeletal stability. Especially increasing of vertical occlusion caused by interference of interbicupid and molar happen postsurgical skeletal change. Until now, there is no common consensus about treatment protocol of surgery first approach in orthognathic surgery. The purpose of this paper is to introduce our treatment protocol of the surgery first approach and to evaluate indication and limitation with case analysis.

SIMULTANEOUS SURGICAL REPOSITIONING OF THE MAXILLA, MANDIBLE, AND CHIN (상악골, 하악골 및 이부의 외과적 동시 이동술)

  • Lee, Jae-Hwy;Lee, Ho-Jun;Hwang, Byung-Nam;Lee, Jeong-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.2
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    • pp.184-199
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    • 1996
  • The challenges to achieve three dimensional facial proportionality and occusal stability in many patients with complex dentofacial deformity have been met by the development and use of the maxilla, mandible, and chin surgery techniques in combination with efficient orthodontic treatment. There is a clinical, biological, and biomechanical foundation for simultaneous surgical repositioning of the maxilla, mandible, and chin in a significant proportion of adult and adolescent patients. A combination of the surgical and orthodontic approach may provide increased treatment efficiencies and optimal esthetic results. Art and science to determine the treatment objectives, specifically, the desired soft tissue changes are firstly established by using the clinician's "esthetic sense" of the facial beauty and proportion aided to a few cephalometric guidelines. In this sense, the dependence on the clinician's "esthetic eye" by Dr. Bell is more important in analyzing the facial proportion than the satisfaction of rigid cephalometric norms. The purpose of this article was to elucidate the indication for simultaneous surgical repositioning of the maxilla, mandible, and chin, and to describe the clinical cephalometric analysis for orthognathic surgery. Representative 6 case reports were presented and discussed to illustrate the esthetic, orthodontic, and surgical treatment objectives with long-term follow-up.

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Clinical Study of Pulmonary Resection for Tuberculosis[IV] (폐결핵에대한 외과적 치험[제 4보])

  • Lee, S.;Ahn, W.S.;Hur, Y.;Kim, B.Y.;Lee, J.H.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.79-85
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    • 1992
  • We have analyzed 1559 operated cases during the 32 year period, from October, 1958 to December, 1990. Annual incidence of the surgical treatment decreased from 101[1960] to 25[1990]. The ratio between male and female was 2.1: 1 and the age of peak incidence was in the 3rd and 4th decades. Recently, patients below the age of 20 years were decreased, but above 50 years were much increased. The patients were consisted of far-advanced case in 71.8% and moderately-advanced case in 22.0% in 1990, as compared with 44% and 54% correspondingly in 1960. Preoperative sputum positivity decreased from 91%[1958~1963] to 38%[1982~1990]. Preoperative antituberculous chemotherapy for more than 3 years increased from 16% [1958~1963] to 56.5% [1982~1990]. From the view of surgical indication, totally destroyed lung and destroyed lobe or segment has been main indication. Recently empyema with parenchymal lesion was increased, and so more extensive surgical resection such as pleuropneumonectomy was performed more frequently. The trends in the mode of surgical treatment revealed that thoracoplasty has virtually disappeared and operations required for residuals of pleural disease have increased. Postoperative mortality increased from 1.6-2.0% to 3.6% recently as well as morbidity. On the basis of our study, far-advanced and drug-resistant patients increased in number recently, whose pulmonary function was poor. So postoperative mortality and morbidity was increased despite improved anesthetic and surgical techniques. Proper surgical intervention should be considered before the appearance of resistance for all chemotherapeutic drugs.

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Traumatic Tricuspid Regurgitation Cause by Chordal Rupture: A Case Report (건삭 파열에 의한 외상성 삼천판 역류: 증례보고)

  • Keum, Min Ae;No, Hyo Keun;Sun, Byung Joo;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.67-70
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    • 2015
  • Traumatic tricuspid regurgitation is a rare complication of blunt chest trauma caused by chordal rupture, anterior papillary muscle rupture and anterior leaflet tear. Since clinical symptoms are vague, early diagnosis is difficult and some patient exhibit symptoms of right heart failure. Right heart failure has been the traditional indication for surgical treatment, such as tricuspid valve replacement. Recently, early detection using transthoracic echocardiography and surgical treatment, like valve repair, prior to overt right heart failure have been shown to better prognosis. We report a case of traumatic tricuspid regurgitation with chordal rupture in patient due to traffic accident.

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Surgical treatment of maxillary transverse deficiency (임상가를 위한 특집 3 - 상악골 횡적 부조화의 외과적치료)

  • Kwon, Yong-Dae;Lee, Hyun-Woo
    • The Journal of the Korean dental association
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    • v.51 no.6
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    • pp.322-329
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    • 2013
  • Among the occlusal discrepancies, maxillary transverse deficiency is quite common in several reasons. The reasons are comprised of maxillary hypoplasia, thumb sucking habits, non-syndromic palatal synostosis and syndromal patients including cleft patients. Orthodontic treatment is used routinely to correct a deficiency in young patients while it has limitations for a skeletally mature patient. Surgical treatments help provide effective maxillary expansion to correct a deficiency in adults. Surgical methods can be categorized to segmental Le Fort I osteotomy and surgically assisted rapid maxillary expansion(SARME). Both methods seem successful but each method would have its own indication. We give a review on transverse maxillary deficiency and two surgical methods.