• Title/Summary/Keyword: Non-surgical treatment

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Clinical Experience of Abdominal Aortic Aneurysm (복부 대동맥류 수술의 임상적 고찰)

  • Kwak, Young-Tae;Lim, Sang-Hyun;Lee, Sak;Yoo, Kyung-Jong;Chang, Byung-Chul;Kang, Meyun-Shick;Hong, Yoo-Sun
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.261-266
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    • 2003
  • Background: Surgery of abdominal aortic aneurysm revealed high operative mortality. We reviewed our 11-years' experiences of abdominal aortic aneurysm operation and wish to obtain information on the treatment. Material and Method: From Jan. 1990 to Dec. 2000, 48 patients were operated due to abdominal aortic aneurysm in Yonsei Cardiovascular Center Mean age was $62.8{\pm}12.7$ and there were 40 males and 8 females. Among 48 patients, nine patients had ruptured abdominal aortic aneurysm, and mean aneurysm diameter of non-ruptured cases was $8.8{\pm}2.4$cm. Result: There were 6 early deaths, and early mortality was 12.5%. Among 9 patients of preoperative aneurysm rupture, three patients died (33.3%), and among 39 patients of non-ruptured cases, 3 patients died (7.7%). Among preoperative variables, age (p<0.05), preoperative BUN level (p<0.05), and DM (p<0.05) were risk factors of early mortality. Among discharged 42 patients, 40 patients were followed up (f/u rate=95.2%) and mean follow up was $3.6{\pm}0.2$ years. During follow up periods, five patients died (late mortality=11.9%), and Kaplan-Meier survival analysis revealed $81.7{\pm}7.6$% survival rate at five and ten year. Linealized incidence of graft related event was 3.53% per patient-year. Conclusion: Surgical mortality of ruptured abdominal aortic aneurysm was higher than non-ruptured cases; therefore, early resection of the aneurysm can decrease the surgical mortality.

The Bone regenerative effects of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague dawley rats (백서 두개골 결손부에서 항생제를 함유한 키토산 차단막의 골재생 유도 효과)

  • Chae, Gyung-Joon;Kim, Tae-Gyun;Jung, Ui-Won;Lee, Soo-Bok;Jung, Yong-Sik;Lee, Yong-Keun;Kim, Chang-Sung;Chae, Jung-Kiu;Cho, Kyoo-Sung;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.35 no.4
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    • pp.1019-1037
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    • 2005
  • The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease as well as the reduction of signs and symptoms of progressive periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. There have been increasing interest on the chitosan made by chtin. Chitosan is a derivative of chitin made by deacetylation of side chains. Chitosan has been widely studied as bone substitution and membrane material in periodontology. Many experiments using chitosan in various animal models have proven its beneficial effects. Tetracycline has been considered for use in the treatment of chronic periodontal disease and gingivitis. The aim of this study is to evlauate the osteogenesis of tetracycline blended chitosan membranes on the calvarial critical size defect in Sprague Dawley rats. An 8mm surgical defect was produced with a trephine bur in the area of the midsagittal suture. The rats were divided into five groups: Untreated control group versus four experimental group. Four types of membranes were made and comparative study was been done. Two types of non-woven membranes were made by immersing non-woven chitosan into either the tetracycline solution or chitosan-tetracycline solution. Other two types of sponge membranes were fabricated by immersing chitosan sponge into the tetracycline solution, and subsequent freeze-drying. The animals were sacrificed at 2 and 8 weeks after surgical procedure. The specimens were examined by histologic analyses. The results are as follows: 1. Clinically the use of tetracycline blended chitosan membrane showed great healing capacity. 2. The new bone formations of all the experimental group, non-woven and sponge type membranes were greater than those of control group. But, there was no significant difference between the experimental groups. 3. Resorption of chitosan membranes were not shown in any groups at 2 weeks and 8 weeks. These results suggest that the use of tetracycline blended chitosan membrane on the calvarial defects in rats has significant effect on the regeneration of bone tissue in itself. And it implicate that tetracycline blended chitosan membrane might be useful for guided tissue regeneration.

Clinical Significance of MRI Findings During Medical Treatment for Tuberculous Spondylitis (척추염 환자의 약물치료기간 중 추적 검사한 MRI소견 변화의 임상적 중요성)

  • Kim, Dae-Jung;Chung, Tae-Sub;Suh, Sang-Hyun;Kim, Keun-Su;Cho, Yong-Eun;Yoon, Young-Sul;Kim, Sam-Soo
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.146-151
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    • 2009
  • Purpose : To evaluate magnetic resonance (MR) imaging features of non-surgically treated tuberculous spondylitis and to evaluate the relationships between these features and clinical outcomes. Materials and Methods : Data from ten patients (male:female=6:4, mean age=45 years) with clinically proven tuberculous spondylitis who were treated nonsurgically over three months were analyzed retrospectively from 2000 to 2007. MRI was performed at least three times for each patient, at baseline, every three or six months, and at the end of treatment. All images were analyzed by two radiologists. Results : The mean follow-up period for the MR examination was 10.1 months (range, 4-17 months). Six patients had clinically complete resolution of tuberculous spondylitis with medication treatment only. Four patients were treated with surgical management alongside medication. All ten patients were divided into two groups by clinical outcome; six patients with complete treatment and four patients with incomplete treatment. In the complete treatment group, follow-up MR findings showed a loss of subligamentous spread of abscesses, decreased size of abscesses, no interval changes in vertebral body heights, and fatty changes in spinal lesions. MR findings in the incomplete treatment group showed bone marrow edema extension to adjacent vertebra, extension of the abscesses, and decreased height of the vertebral bodies. Conclusion : During the nonsurgical management of tuberculous spondylitis, MR imaging may play a role in predicting patient response to antituberculous drug treatment.

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Analysis of Neonatal Gastrointestinal Diseases in a Neonatal Intensive Care Unit for 3 Years Neonatal GI Diseases in a NICU for 3 Years (3년간 단일기관 신생아실의 위장관 질환의 분석)

  • Kwon, Kyoung-Ah;Bae, Mi-Hae;Park, Kyung-Hee;Byun, Shin-Yun;Cho, Yong-Hoon;Kim, Hae-Young;Sung, Si-Chan
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.337-344
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    • 2011
  • Purpose: To report our experience of gastrointestinal operations performed in neonates including low birth weight infants and to evaluate their clinical characteristics. Methods: We retrospectively reviewed the medical records of patients who underwent neonatal gastrointestinal surgery or had necrotizing enterocolitis (NEC) or inguinal hernia from January 2008 to December 2010 at Pusan National University School of Medicine. Results: The main disease was anorectal malformation and male patients were dominant. Twenty four patients (19.2%) had one or more associated anomalies including hydronephrosis and congenital heart disease. Eighteen patients (43.9%) of anorectal malformation had other anomalies. Seventy six percent of NEC cases were very low birth weight infants. Concerning mean days of full enteral feeding after operation, NEC patients needed 30.8 days, which was the longest period. Overall mortality of operation (except NEC and inguinal hernia operation) was 1.6%. The mortality of NEC with surgical treatment was 18.8%. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC patients. Conclusion: The morbidity and mortality after neonatal gastrointestinal surgery were excellent. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC.

Production of In-Vivo Embryos by Superovulation and Result of Transfer with Fresh or Frozen Embryos for Hanwoo and Holstein Cattle (한우 및 젖소에서 과배란 처리를 이용한 체내수정란 생산과 신선 및 동결 수정란 이식 결과)

  • Kim Y. J.;Song J. W.;Seo S. H.;Jeong K. N.;Kim Y. S.;Lee H. R.;Shin D. S.;Jo S. W.;Kim S. H.
    • Journal of Embryo Transfer
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    • v.19 no.3
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    • pp.209-218
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    • 2004
  • To investigate the feasibility of embryo transfer technology to promote productivity of cattle, 36 cows(18 Holstein, 18 Hanwoo) were superovulated. Fresh embryos were transferred to 25 recipients(14 Holstein, 11 Hanwoo), whereas frozen embryos were transferred to 17 recipients(10 Holstein, 7 Hanwoo). Two embryos were transferred at a time to 13 recipients(9 Holstein, 4 Hanwoo) to produce twin calves. 1. 75.0% of donor cattle were reacted to hormonal treatment far superovulation. 2. The rate of embryo recovery by non-surgical method for Holstein and Hanwoo was 90.4 and 95.8% in comparison with numbers of corpus luteum. 3. Of all the ova collected non-surgically, the rate of viable blastocyst was 66.4% and the rate of transferrable blastocysts was 48.6%. 4. The rate of embryo collection by one-catheter method was 75.0%. 5. The rate of pregnancy/delivery following embryo transfer with fresh embryos was 60.0%. 6. The rate of pregnancy/delivery following embryo transfer with frozen embryos was 35.3%. 7. In embryo transfer to produce twin calves, the rate of pregnancy/delivery was 28.6% with fresh embryos and 16.7% with frozen embryos.

A STUDY OF CLINICAL RESULTS ON STERI-OSS ENDOSSEOUS IMPLANTS (Steri-Oss 임플랜트의 임상 결과에 관한 연구)

  • Min, Young-Kyu;Kweon, Hyeog-Sin;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.2
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    • pp.258-272
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    • 1998
  • This investigation evaluated patients who received Steri-Oss implants from the Dental Hospital of Chosun University during the period from March 1989 to August 1997. 346 fixtures of 127 patients were included in this study. The results were as follows ; 1.The follow-up period was defined as the period between the surgical placement of the implants and the last follow-up examination. The mean follow-up period was $2.17{\pm}1.21$ years. 2.The period between fixture installation and second surgery was $0.71{\pm}0.44$ years in the maxilla and $0.46{\pm}0.21$ years in the mandible. 3.The number of fixtures which were installed in the upper jaw(112) was less than that in the lower jaw(234) and in the posterior region(260) was more than in the anterior region(86). 4.The length of fixture which was most frequently used was 12 mm and least was 8mm. Screw implants were installed more than cylindrical implants. 3.8mm implant was the most common implans, followed by 4.5mm and 3.25mm. 5.The number of augmentation cases was more than that of non-augmentation cases and the rate of augmentation cases in the maxilla was more than that in the mandible. 6.Implant restorations for partial edentulos patients(94cases) were more than single- tooth implant restorations(33cases) or implant restorations for complete edentulos patients(10cases). 7.Free-standing prostheses for partially edentulous patients were more commom than any other type of connection between implants and natural teeth. 8.Plaque Index($0.95{\pm}0.74$) and Gingival Index($0.31{\pm}0.52$) were very similar around the natural teeth and reflected an acceptable level of plaque and gingivitis control. Mean value for keratinized mucosa index($1.93{\pm}1.20$) remained fairly constant around level 2(1-2 mm keratinized epithelium). 9.Patients were generally satisfied with implant in terms of comfort, function, speech and esthetics. 10.There was not a statistically significant differences in overall survial rate between implants placed in the maxilla (91.5%) and those placed in the mandible (93.8%). Fourteen implants lost before the prosthetic rehabilitation and eleven implants lost following variable periods in function after the prosthetic phase of the treatment. 11.Cause of implant failures was exfoliation or removal of fixture due to non-osseointegration before the prosthetic rehabilitation or due to fracture of fixture, masticatory pain after the prosthetic rehabilitation. 12.The survival rate of Steri-Oss implants using the Kaplan-Meier statistical analysis was 93.8% at 2 year and 86.6% at 5 year, In all cases, implant losses occured predominantly in the healing period. There was a steep decline in the rate of implant loss after the first year. 13.The survival rate of Steri-Oss implants in the anterior region was 94.8% at 2 year and 94.8% at 5 year and that in the posterior region was 92.8% at 2 year and 75.9% at 5 year. In conclusion, this study revealed a number of parameters and guidelines for achieving an optimal success rate in osseointegration.

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Accuracy of artificial intelligence-assisted landmark identification in serial lateral cephalograms of Class III patients who underwent orthodontic treatment and two-jaw orthognathic surgery

  • Hong, Mihee;Kim, Inhwan;Cho, Jin-Hyoung;Kang, Kyung-Hwa;Kim, Minji;Kim, Su-Jung;Kim, Yoon-Ji;Sung, Sang-Jin;Kim, Young Ho;Lim, Sung-Hoon;Kim, Namkug;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.52 no.4
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    • pp.287-297
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    • 2022
  • Objective: To investigate the pattern of accuracy change in artificial intelligence-assisted landmark identification (LI) using a convolutional neural network (CNN) algorithm in serial lateral cephalograms (Lat-cephs) of Class III (C-III) patients who underwent two-jaw orthognathic surgery. Methods: A total of 3,188 Lat-cephs of C-III patients were allocated into the training and validation sets (3,004 Lat-cephs of 751 patients) and test set (184 Lat-cephs of 46 patients; subdivided into the genioplasty and non-genioplasty groups, n = 23 per group) for LI. Each C-III patient in the test set had four Lat-cephs: initial (T0), pre-surgery (T1, presence of orthodontic brackets [OBs]), post-surgery (T2, presence of OBs and surgical plates and screws [S-PS]), and debonding (T3, presence of S-PS and fixed retainers [FR]). After mean errors of 20 landmarks between human gold standard and the CNN model were calculated, statistical analysis was performed. Results: The total mean error was 1.17 mm without significant difference among the four time-points (T0, 1.20 mm; T1, 1.14 mm; T2, 1.18 mm; T3, 1.15 mm). In comparison of two time-points ([T0, T1] vs. [T2, T3]), ANS, A point, and B point showed an increase in error (p < 0.01, 0.05, 0.01, respectively), while Mx6D and Md6D showeda decrease in error (all p < 0.01). No difference in errors existed at B point, Pogonion, Menton, Md1C, and Md1R between the genioplasty and non-genioplasty groups. Conclusions: The CNN model can be used for LI in serial Lat-cephs despite the presence of OB, S-PS, FR, genioplasty, and bone remodeling.

SIALOLITHIASIS ON THE MOUTH FLOOR IN A CHILD (소아의 구강저에 발생한 타석증)

  • Lee, Hyo-Seol;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Song, Je-Seon;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.114-118
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    • 2009
  • Sialolithiasis is the formation of calcific concretions within the ductal system of major or minor salivary glands. The submandibular gland is most involved because of its high viscosity of the saliva and the long, curved duct. It may occur at any age but, it is most common in middle-aged adults and rare in childhood. Clinical symptoms in sialolithiasis are variable but, swelling is the most common, followed by the pain. Clinical examination and radiographic examination(panoramic and mandibular occlusal radiographs, sialography, intraoral-, extraoral- ultrasound, CT scan, MRI and sialoendoscopy) can help to confirm a diagnosis and localize a stone. The treatment is surgical intervention, either removal of the sialolith or sialoadenectomy. However, non-invasive techniques including shock-wave lithotripsy, $CO_2$ laser and endoscopic treatment used in selected cases. A 5-Year-old girl referred from private practice for evaluation of a yellowish mass on the floor of the mouth. She complained that it had became three times bigger than four months ago when it was found for the first time and she had some pain on submandibular gland area occasionally. On physical examination, a firm and yellowish mass could be seen at the orifice of the submandibular duct. Diagnosis is the submandibular sialolithiasis in the anterior Wharton`s duct. Under local anesthesia, stone was removed.

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An Analysis of the Prognostic Factors of Malignant Melanoma (악성 흑색종의 예후 인자에 대한 분석)

  • Lee, Hyung-Seok;Park, Jong-Hyuk;Ham, Dong-Hun;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.122-129
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    • 2009
  • Purpose: To evaluate treatment outcomes of malignant melanoma and to analyze the factors that contributes to outcomes. Materials and Methods: We reviewed the 51 cases of malignant melanoma from March, 1997 to March, 2004 and were followed up more than 5 years. Average age was 49.4. We compared 5-year survival rate for each age, gender, site of occurrence, depth of tumor, metastasis of regional lymph node and immuno-chemo therapy. Results: 5-year survival rate was 88.5% for the age group below 65, 88.0% for the age group 65 and above, 62.5% for male and 100% for female. 5-year survival rate for the site of occurrence showed 100% in upper extremities, and 80.0% in lower extremities and 100% in other sites. 5-year survival rate was 100% for the stage below Clark stage III and 79.3% for the stage above IV. In surgical resection, 5-year survival rate was 66.7% for lymph node metastasis group and 94.9% for non-lymph node metastasis group. Conclusion: The prognostic factors of malignant melanoma were gender, tumor site, depth of tumor (Clark's stage) and metastasis of regional lymph node. But, there was no relation between the age and the survival rate in our study.

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Multiple Primary Malignant Tumors in Patients with Gastric Cancer (위암 환자에서의 다발성 원발성 악성종양)

  • Ryu Dong Do;Um Jun Won;Son Gil Soo;Cho Min young;Song Tae Jin;Kim Chong Suk;Mok Young Jae;Kim Seung Joo
    • Journal of Gastric Cancer
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    • v.3 no.3
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    • pp.139-144
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    • 2003
  • Purpose: Because of an improving gastric cancer detection program and treatment methods, we can expect improved survival of patients with gastric cancer. Given the longer survival times, the chance of an occurrence of multiple primary malignant tumors other than stomach is increased in the same patients. The purpose of this study is to analyze the clinical characteristrics and the survival of patients with gastric cancer and other malignancies. Materials and Methods: A retrospective study of 3669 patients with gastric cancer observed at our department between January 1994 to December 2002 was conducted. Associated tumors were diagnosed using the Warren and Gates criteria, and included tumors that were not considered to be a metastasis, invasion, or recurrence of the gastric cancer. Results: Of all 3669 patients, $2.07\%$ (n=76) had primary tumors other than gastric cancer, $63\%$ of which were synchronous (n=48) and $37\%$ metachronous (n=28). The mean age of the study group was 64.9 (65.5 in males, 61.8 in females), and the male-to-female ratio was 4.8 : 1. The most common cancer associated with gastric cancer was a hepatocellular carcinoma ($23.7\%$), followed by colorectal cancer ($17.1\%$), esophageal cancer ($10.5\%$), breast cancer ($6.6\%$). Of the 45 patients who had undergone a resection, 14 were in stage I, 12 in stage II, 13 in stage III, and 6 in stage IV. No statistically significant differences were found between the synchronous and the metachronous groups with regard to age, sex ratio, differentiation, and stage. The 5-year survival rates of the metachronous and the resected patients were significantly higher than those of the synchronous and the non resected patients, respectively. Conclusion: Due to increasing length of the follow-up period for patients with gastric cancer, another malignancy may develop in other organs. Therefore, physicians should pay attention to detect other cancers early in these patients, and a surgical resection is recommended as the treatment of choice in the management of multiple primary cancer associated with gastric cancer.

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