• Title/Summary/Keyword: Mucosal incision

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Osteotomy and iliac bone graft for the treatment of malunion caused by failed mandibular fracture reduction

  • Hwang, Kun;Ma, Sung Hwan
    • Archives of Craniofacial Surgery
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    • v.21 no.6
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    • pp.384-386
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    • 2020
  • This report describes osteotomy and iliac bone graft for malunion caused by failed mandibular fracture reduction. A 27-year-old man was referred 3 months after a motor vehicle accident. At another hospital, two operations had been performed for symphyseal fracture using two resorbable plates. Malocclusion was noted, and panoramic radiography and computed tomography revealed a misaligned dental arch, with a 9.37-mm gap between the central and the lateral incisor of the left mandible. A wafer was made from the patient's dental model, and a maxillary arch bar was applied. Through a lower gingivolabial incision, osteotomy was performed between the malunited symphyseal fracture segments. Both segments were reduced to their original position using the wafer and fixed with titanium miniplates via intermaxillary fixation (IMF). The intersegmental gap was filled with cancellous bone from the iliac crest. The gingival defect was covered with a mucosal transposition flap from the gingivolabial sulcus. IMF and the wafer were maintained for 5 and 9 weeks, respectively. At postoperative week 13, the screws were removed from the mandible and satisfactory occlusion was noted. His mouth opening improved from 2.5 to 3 finger breadths (40 mm). This case demonstrates the need for sufficient IMF when using resorbable plates.

Effects of Green Tea Extract on Intestinal Mucosal Esterification of $^{14}C$-Oleic Acid in Rats (녹차 추출물이 흰쥐 소장세포의 지방 에스테르화 과정에 미치는 영향)

  • Seo, Yun-Jung;Noh, Sang-K.
    • Food Science and Preservation
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    • v.15 no.3
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    • pp.450-455
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    • 2008
  • Previously, we have shown that green tea extract lowers the intestinal absorption of cholesterol, fat, and other fat-soluble compounds. We conducted this study to determine whether green tea extract affects the rate of $^{14}C$-oleic acid esterification into various lipids in the intestinal mucosa of rats. Male Sprague-Dawley ruts were had free access to a nutritionally adequate AIN-93G diet and deionized water. Initially, the rat's mucosal content of total lipids was measured following 1 mL olive oil administration with (green tea group) or without (control group) 100 mg green tea extract powder. At 1 h and 5 h, intestinal segments were extracted for total lipid analysis. Secondly, to measure mucosal esterification rates of lipids, an abdominal incision was made along the midline, and a 10-cm long jejunal segment of the small intestine was ligated in situ. Then, micellar solutions with or without green tea extract were injected into the ligated jejunal segments and incubated for 10 mill. The micellar solution contained $200.0\;{\mu}$ Ci $^{14}C$-oleic acid, $200.1\;{\mu}mol$ unlabelled oleic acid, $66.7\;{\mu}mol$ 2-monooleoylglycerol, $66.7\;{\mu}mol$ palmitoyl-sn-glycero-3-phosphocholine, 2.2 mmol glucose, $50.0\;{\mu}mol$ albumin, and 16.5 mmol Na-taurocholate per L of phosphate buffered saline (pH, 6.3) with or without 8.87 g green tea extract powder. At 10 min, each rat was sacrificed by cervical dislocation under anesthesia and the segment was removed for lipid analysis. Significant differences were observed in mucosal triglyceride content at 1 h and 5 h in ruts given green tea extract. Significant differences in the rate of $^{14}C$-oleic acid esterification into triglycerides and phospholipids fractions were observed between control and green tea groups. However, There were no significant differences in other lipid fractions. These results indicate that the lowered esterification rates of $^{14}C$-oleic acid into triglycerides and phospholipids fractions is attributable to presence of green tea extract. This may be associated with an inhibitory effect of green tea catechin on the mucosal processes of lipids, leading to the inhibition of intestinal absorption of lipids.

Influence of cingulate cortical ablation and vagotomy upon gastric ulceration in rats (흰쥐의 위궤양 발생에 미치는 대상회전 제거 및 미주신경 절단의 영향)

  • Park, Hyoung-Jin;Kang, Sook-Hee;Jo, Yang-Hyeok;Kim, Chul
    • The Korean Journal of Physiology
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    • v.11 no.1
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    • pp.45-50
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    • 1977
  • This study was undertaken to investigate the effect of cingulate cortical ablation upon gastric ulceration, and the pathway through which cingulate cortex exerts the effect. 56 female rats were divided equally into cingulate (cingulate cortical ablation), cingulate-vagal (cingulate cortical ablation and vagotomy), normal control and vagal (vagotomy) groups. Cingulate cortex was ablated through a slit-shaped opening (1 mm in width, 13 mm in length) which was made symmetrically on both sides of, and parallel to, the sagittal suture by removing a bone flap from parietal and frontal bones on each side. Vagus nerves on both sides were transected around the distal end of the esophagus. In the normal control animals, surgical intervention ended with scalp incision. All rats were kept without restraint or food deprivation for 3 weeks after surgery. The stomach of each rat was inflated with 7 ml of physiological saline and then removed under deep anesthesia. The mucosal surface was examined under dissecting microscope for the location, shape and number of ulcers, and then enlarged photograph $(4{\times})$was taken. The incidence of ulcer in each group was counted and the number of ulceration as well as the total area of glandular mucosa were measured on the photograph. Results obtained were as follows: 1. The mean number of ulcer per stomach and the total area of ulcer exprssed as permillage of the total area of glandular mucosa were significantly higher in the cingulate group than the cingulate-vagal, the normal control and the vagal groups. There was no difference among the latter three groups. 2. The incidence of ulcer in the cingulate group was significantly higher than that in the .normal control group and was also higher, though not significantly, than those in the cingulate-vagal and the vagal groups. There was no difference among the normal control, the cingulate-vagal and the vagal groups. It is inferred from the above results that the cingulate cortex exerts an inhibitory influence upon gastric ulceration and that this influence is mediated by controlling the vagal activity.

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Antibiotic use in nasal bone fracture: a single-center retrospective study

  • Jung, Ji Hyuk;Jeon, Yeo Reum;Song, Joon Ho;Chung, Seum
    • Archives of Craniofacial Surgery
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    • v.22 no.6
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    • pp.319-323
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    • 2021
  • Background: Prophylactic antibiotics are used to prevent surgical wound infection; however, proper indications must be followed with careful consideration of the risks and benefits, especially in clean or clean-contaminated wounds. Nasal bone fractures are the most common type of facial bone fracture. The most common method for treating nasal bone fracture is closed reduction, which is performed inside the nasal cavity without an incision. The purpose of this study was to determine the need for antibiotic use in the closed reduction of nasal bone fractures. Methods: A retrospective study was conducted using data from the National Insurance Service Ilsan Hospital of the Republic of Korea between 2016 and 2018. The records of patients who underwent closed reduction of nasal bone fracture were reviewed and classified according to sex, age, comorbidities, perioperative antibiotic usage, postoperative complications, nasal packing, anesthesia type, surgeon's specialty, and operation time. Results: Among the 373 patients studied, the antibiotic prescription rate was 67.3%. Just 0.8% of patients were prescribed preoperative antibiotics only, 44.0% were prescribed postoperative antibiotics only, and 22.5% were prescribed both preoperative and postoperative antibiotics. There were no cases that satisfied the definition of "surgical site infection." Furthermore, 2.1% of infection-related complications (e.g., mucosal swelling, synechia, and anosmia) occurred only in the antibiotic usage group. The use of nasal packing, anesthesia type, and surgeon's specialty did not show any difference in infection-related complication rates. Conclusion: According to the study findings, the routine use of perioperative antibiotics is not recommended in uncomplicated nasal bone fracture surgery.

Significance of rescue hybrid endoscopic submucosal dissection in difficult colorectal cases

  • Hayato Yamaguchi;Masakatsu Fukuzawa;Takashi Kawai;Takahiro Muramatsu;Taisuke Matsumoto;Kumiko Uchida;Yohei Koyama;Akir Madarame;Takashi Morise;Shin Kono;Sakik Naito;Naoyoshi Nagata;Mitsushige Sugimoto;Takao Itoi
    • Clinical Endoscopy
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    • v.56 no.6
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    • pp.778-789
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    • 2023
  • Background/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is performed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing perforation. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of rescue hybrid ESD (RH-ESD). Methods: We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group (SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes. Results: Resection time was significantly shorter in the following order: RH-ESD (149 [90-197] minutes) >C-ESD (90 [60-140] minutes) >SH-ESD (52 [29-80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dissection rate was significantly lower in the piecemeal resection group (25% [20%-30%]) than in the en bloc resection group (40% [20%-60%]). Conclusions: RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoiding surgery.

Maxillary reconstruction using tunneling flap technique with 3D custom-made titanium mesh plate and particulate cancellous bone and marrow graft: a case report

  • Takano, Masayuki;Sugahara, Keisuke;Koyachi, Masahide;Odaka, Kento;Matsunaga, Satoru;Homma, Shinya;Abe, Shinichi;Katakura, Akira;Shibahara, Takahiko
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.43.1-43.5
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    • 2019
  • Background: Reconstructive surgery is often required for tumors of the oral and maxillofacial region, irrespective of whether they are benign or malignant, the area involved, and the tumor size. Recently, three-dimensional (3D) models are increasingly used in reconstructive surgery. However, these models have rarely been adapted for the fabrication of custom-made reconstruction materials. In this report, we present a case of maxillary reconstruction using a laboratory-engineered, custom-made mesh plate from a 3D model. Case presentation: The patient was a 56-year-old female, who had undergone maxillary resection in 2011 for intraoral squamous cell carcinoma that presented as a swelling of the anterior maxillary gingiva. Five years later, there was no recurrence of the malignant tumor and a maxillary reconstruction was planned. Computed tomography (CT) revealed a large bony defect in the dental-alveolar area of the anterior maxilla. Using the CT data, a 3D model of the maxilla was prepared, and the site of reconstruction determined. A custom-made mesh plate was fabricated using the 3D model (Okada Medical Supply, Tokyo, Japan). We performed the reconstruction using the custom-made titanium mesh plate and the particulate cancellous bone and marrow graft from her iliac bone. We employed the tunneling flap technique without alveolar crest incision, to prevent surgical wound dehiscence, mesh exposure, and alveolar bone loss. Ten months later, three dental implants were inserted in the graft. Before the final crown setting, we performed a gingivoplasty with palate mucosal graft. The patient has expressed total satisfaction with both the functional and esthetic outcomes of the procedure. Conclusion: We have successfully performed a maxillary and dental reconstruction using a custom-made, pre-bent titanium mesh plate.

MARSUPIALIZATION OF RANULA (조대술을 시행한 하마종의 치료)

  • Na, Hye-Jin;Lee, Jae-Ho;Kim, Seong-Oh;Song, Je-Seon;Kim, Seung-Hye;Choi, Hyung-Jun;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.1
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    • pp.88-94
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    • 2011
  • Ranula is a mucosal cyst that occurs in the mouth floor. This is a pseudo cyst caused by mucous retention within the tissue due to the rupture of catheter in the salivary gland. Ranula occurs mainly in a unilateral form and is characterized by painless bluish transparent swelling, with a increasing mass size. If the size is large, it can cause discomfort during swallowing, pronounciation, and mastication, but external swelling and infection is rare. Treatments include observation for spontaneous resolution, simple incision and drainage, marsupialization and excision. Marsupialization done by removing parts of the cyst wall and connecting it to the oral mucosa. It is a conservative procedure and recommended for children. It has advantages such as maintaining outline of oral tissue and less risk of damaging anatomic structure. Recurrence is common, mostly occurring within 4 months after surgery. This case is about a eight-year-old girl with ranula on the right mouth floor. This patient was treated with marsupialization that is one of treatment for ranula, and recurrence was not observed.

Case Reports of Bone Grafting in Unilateral Alveolar-palatal Cleft Patients (편측성 치조. 구개 파열 환자에서 골 이식술의 치험레)

  • Bae, Yun-Ho;Park, Jae-Hyun;Lee, Myeong-Jin;Lee, Chang-Gon;Chin, Byung-Rho;Lee, Hee-Kyeung
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.198-205
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    • 1991
  • We obtained successful functional and esthetic results by grafting of iliac marrow-cancellous bone in 2 cases of alveolar-palatal cleft patients. Bone graft of alveolar-palatal clefts provide bony support to adjacent teeth of cleft area, prevented from relapse of orthodontic arch expansion, closure of oroantral fistula and improvement of speech problem. 1. In one case, extraction of upper right central incisor that was little bone support, alignment of rotated teeth and expansion of collapsed arch segment were done with pre-ortodontic treatment. The other case, Bone grafting was done after removal of prosthesis with no preorthodontic treatment. 2. After mucoperiosteal incision in cleft area. The mucosal flap of labial area, palate and nose were separation and the raised nasal mucosa was sutured for closure of oroantral fistula. Then, the iliac marrow-cancellous bones were grafted to cleft site. 3. After 6 months of operation, we had seen the new bone deposition to cleft site in dental radiography and prosthetic treatments of missing teeth were done.

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