• 제목/요약/키워드: Non-surgical treatment

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소아에서 발생한 장중첩증에서 수술적 치료의 필요와 관련된 위험인자 (Risk Factors Associated with the Need for Operative Treatment of Intussusception in Children)

  • 하헌탁;조자윤;박진영
    • Advances in pediatric surgery
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    • 제20권1호
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    • pp.17-22
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    • 2014
  • The aim of this study was to identify the risk factor related to the need for operative treatment and avoid unnecessary non-operative management for intussusception in children. We retrospectively reviewed medical records of patient treated for intussusception at our institution between January 2006 and January 2013. Clinical features such as gender, age, seasonal variation, symptoms and signs, treatment results were analyzed. Univariate and multivariate analyses including a chi-square test for categorical variables and logistic regression analysis were performed. During the study period, 356 patients were treated for intussusception. 328 (92.1%) was treated successfully by the non-operative pneumoreduction, and 28 (7.9%) required operative management. On univariate analysis, risk factors which were related to the need for operative treatment were age, vomiting, bloody stool, lethargy, and symptoms duration. A logistic regression analysis in order to assess for independent predictors of operative treatment was performed. Age (<6 vs ${\geq}12$ months) (OR 4.713, 95% CI 1.198~18.539, p=0.027) and symptoms duration longer than 48 hours (OR 4.534, 95% CI 1.846~11.137, p=0.001) were significantly associated with a requirement for operative treatment. We conclude that younger age and a longer duration of symptoms (${\geq}48$ hours) are the independent risk factor related to the need for operative treatment for intussusception. Early surgical intervention or transfer to a hospital with pediatric surgical capabilities should be considered for patients with these findings.

Surgical Treatment for Non-Small Cell Lung Cancer in Patients on Hemodialysis due to Chronic Kidney Disease: Clinical Outcome and Intermediate-Term Results

  • Park, Byung Jo;Shin, Sumin;Kim, Hong Kwan;Choi, Yong Soo;Kim, Jhingook;Shim, Young Mog
    • Journal of Chest Surgery
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    • 제48권3호
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    • pp.193-198
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    • 2015
  • Background: Patients on dialysis undergoing surgery belong to a high-risk group. Only a few studies have evaluated the outcome of major thoracic surgical procedures in dialysis patients. We evaluated the outcomes of pulmonary resection for non-small cell lung cancer (NSCLC) in patients on hemodialysis (HD). Methods: Between 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses. Results: The median duration of HD before surgery was 55.0 months. Five patients underwent lobectomy and two patients underwent wedge resection. Postoperative morbidity occurred in three patients, including pulmonary edema combined with pneumonia, cerebral infarction, and delirium. There were no instances of in-hospital mortality, although one patient died of intracranial bleeding 15 days after discharge. During follow-up, three patients (one patient with pathologic stage IIB NSCLC and two patients with pathologic stage IIIA NSCLC) experienced recurrence and died as a result of the progression of the cancer, while the remaining three patients (with pathologic stage I NSCLC) are alive with no evidence of disease. Conclusion: Surgery for NSCLC in HD patients can be performed with acceptable perioperative morbidity. Good medium-term survival in patients with pathologic stage I NSCLC can also be expected. Pulmonary resection seems to be the proper treatment option for dialysis patients with stage I NSCLC.

Splint 및 비외과적 치주치료를 통하여 치주질환에 이환된 치아의 안정화 증례 보고 (Stability of periodontally compromised teeth after splint and non-surgical therapy: two cases followed-up for 1 to 3 years)

  • 김연태;박예솔;김도형;정성념;이재홍
    • 구강회복응용과학지
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    • 제34권4호
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    • pp.338-344
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    • 2018
  • 본 증례는 치주적으로 이환된 하악 전치부를 치은연상 치석제거술과 치근활택술을 포함한 비외과적 치주치료, 교합 조정 및 치아 간 치아고정술을 통해 회복한 경우이다 임상적, 방사선학적 평가를 술 후 1 - 3년간 시행하였다. 두 증례 모두 임상적 계측치에서 향상된 결과를 보였고 방사선학적 평가에서 현저한 치조골 및 치조백선의 재생이 관찰되었다. 이번 증례는 발치가 고려되는 심도의 치주질환에 이환된 치아에서 비외과적 치주치료와 치아고정술을 통해 치아를 보존할 수 있는 가능성을 보여준 사례로 보고하는 바이다.

Clinical and microbiological effects of the supplementary use of an erythritol powder air-polishing device in non-surgical periodontal therapy: a randomized clinical trial

  • Park, Eon-Jeong;Kwon, Eun-Young;Kim, Hyun-Joo;Lee, Ju-Youn;Choi, Jeomil;Joo, Ji-Young
    • Journal of Periodontal and Implant Science
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    • 제48권5호
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    • pp.295-304
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    • 2018
  • Purpose: This study was undertaken to evaluate the clinical and microbiological effects of an erythritol powder air-polishing device (EPAP) as a supplement to scaling and root planing (SRP) therapy in patients with moderate chronic periodontitis. Methods: Clinical and microbiological evaluations were performed at 21 sites treated with SRP (control) and 21 sites treated with SRP+EPAP (test). All examinations were performed before treatment, 1 month after treatment, and 3 months after treatment. Results: There were no significant clinical differences between the test group and the control group. Microbiological analysis revealed that the relative expression level of Porphyromonas gingivalis was significantly lower in the test group than in the control group at 1 month after treatment. Clinical and microbiological results showed improvements at 1 month compared to baseline; in contrast, the results at 3 months after treatment were worse than those at 1 month after treatment. Conclusions: In this study, both SRP and SRP+EPAP were clinically and microbiologically effective as non-surgical periodontal treatments. In particular, the SRP+EPAP group showed an antimicrobial effect on P. gingivalis, a keystone bacterium associated with the onset of chronic periodontitis, in a short-term period. Periodic periodontal therapy, at intervals of at least every 3 months, is important for sustaining the microbiological effects of this treatment.

Treatment efficacy of gingival recession defects associated with non-carious cervical lesions: a systematic review

  • Oliveira, Livia Maria Lopes de;Souza, Camila Agra;Cunha, Sinara;Siqueira, Rafael;Vajgel, Bruna de Carvalho Farias;Cimoes, Renata
    • Journal of Periodontal and Implant Science
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    • 제52권2호
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    • pp.91-115
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    • 2022
  • Purpose: This systematic review aimed to compare the efficacy, defined in terms of the mean percentage of root coverage (mRC), of surgical treatment approaches combined with adhesive restorations of non-carious cervical lesions (NCCLs) to that of root coverage alone in patients with a single gingival recession (GR) and NCCL. Methods: A literature search was conducted to identify longitudinal studies reporting the mRC following treatment for the correction of GR defects associated with NCCLs using a combination of surgical and restorative techniques in systemically and periodontally healthy patients. Results: The search resulted in the retrieval of 12,409 records. Seven publications met the inclusion criteria for the qualitative synthesis of data. The mRCs ranged from 69% to 97%. In the medium term, the gingival margin position was more stable when a connective tissue graft (CTG) was used, independently of whether restoration of teeth with NCCLs was performed. Conclusions: The strength of the evidence was limited by methodological heterogeneity in terms of study design as well as the unit and period of analysis, which precluded a metaanalysis. Although no definitive conclusion could be drawn due to the lack of sufficient evidence to estimate the effectiveness of the interventions, CTG-based procedures contributed to gingival margin stability regardless of the performance of restoration to treat NCCLs.

Periodontal granulation tissue preservation in surgical periodontal disease treatment: a pilot prospective cohort study

  • Rodriguez, Jose A. Moreno;Ruiz, Antonio J. Ortiz
    • Journal of Periodontal and Implant Science
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    • 제52권4호
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    • pp.298-311
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    • 2022
  • Purpose: The aim of this study was to evaluate the clinical outcomes of periodontal granulation tissue preservation (PGTP) in access flap periodontal surgery. Methods: Twenty patients (stage III-IV periodontitis) with 42 deep periodontal pockets that did not resolve after non-surgical treatment were consecutively recruited. Access flap periodontal surgery was modified using PGTP. The clinical periodontal parameters were evaluated at 9 months. The differences in the amount of granulation tissue width (GTw) preserved were evaluated and the influence of smoking was analyzed. Results: GTw >1 mm was observed in 97.6% of interproximal defects, and the granulation tissue extended above the bone peak in 71.4% of defects. At 9 months, probing pocket depth reduction (4.33±1.43 mm) and clinical attachment gain (CAG; 4.10±1.75 mm) were statistically significant (P<0.001). The residual probing depth was 3.2±0.89 mm. When GTw extended above the interproximal bone peak (i.e., the interproximal supra-alveolar granulation tissue thickness [iSUPRA-GT] was greater than 0 mm), a significant CAG was recorded in the supra-alveolar component (1.67±1.32 mm, P<0.001). Interproximal gingival recession (iGR) was significant (P<0.05) only in smokers, with a reduction in the interdental papillary tissue height of 0.93±0.76 mm. In non-smokers, there was no increase in the iGR when the iSUPRA-GT was >0 mm. The clinical results in smokers were significantly worse. Conclusions: PGTP was used to modify access flap periodontal surgery by preserving affected tissues with the potential for recovery. The results show that preserving periodontal granulation tissue is an effective and conservative procedure in the surgical treatment of periodontal disease.

Fracture Analysis of Wild Birds in South Korea

  • Jang, Hyun-Kyu;Park, Jong-Moon;Ahmed, Sohail;Seok, Seong-Hoon;Kim, Ho-Su;Yeon, Seong-Chan
    • 한국임상수의학회지
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    • 제36권4호
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    • pp.196-199
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    • 2019
  • This study was conducted to evaluate and analyze fractures types, sites and surgical approach of wild birds in Korea. The study was conducted on data collected for fracture lesion sites, species, outcomes, surgical methods, treatments and medical records from wildlife centers in South Korea. All birds were subjected to clinical examination, followed by surgical invasion and post-operative care. Fractures were more common in adult non-raptor species (51.57%) as compared to raptors (48.43%). Of the 254 cases evaluated, maximum cases comprised ulnar fractures (29.70%), followed by radial (21.76%) and humeral fractures (17.35%). Treatment procedures at 340 fracture sites were maximally treated with figure-8 bandage (33.07%), external skeletal fixator-intramedullary pin (ESF+IM tie-in fixation) (20.86%), and other varied procedures. All birds were kept indoors till recovery. Treatment outcomes were dependent on the type of bone fractured and surgical method applied. Based on the surgical treatments and outcomes, birds were kept hospitalized, and released or euthanized. The findings of this study provide information for veterinarians regarding the fractures sites, basic database for the species and outcomes of fracture repair in wild birds.

피질골절단술을 이용한 상악협소증환자의 치험례 (CORTICOTOMY IN PATIENT WITH NARROW PALATAL ARCH)

  • 김은철;이상철;김여갑;류동목;이백수
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제25권4호
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    • pp.371-374
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    • 1999
  • 상악협소증으로 인하여 골격관계의 수평적인 부조화와 부정 교합을 보인 상기환자의 경우 상악확대를 위해 구개확대장치를 이용하여 치료하였으나 원하는 치료결과를 얻을 수 없었다. 방사선 평가상 안면골의 봉합부골화가 이미 끝난 것으로 보여 외과적인 피질골절단술을 시행하였다. 외과적인 피질골절단술은 상악확대시 주위안면골의 저항을 줄이기 위한 목적으로 시행하는데 좋은 결과를 얻을 수 있었다. 술후 2주경과후와 12개월 경과후 교합관계 및 확대된 상악궁의 재발상태를 평가한 결과 술후 상태로 유지되고 있었다. 전반적인 교합상태도 많이 개선되어 있었다. 그러나 피질골절단술은 사전에 악궁의 형태나 길이, 수술방법의 선택, 술후 합병증에 대한 충분한 평가를 하여야 한다. 외과적인 피질골절단술은 치료비와 치료기간을 줄일 수 있고 술후 재귀가능성을 줄일 수 있다. 이에 본과에서 피질골절단술을 이용하여 양호한 결과를 얻었기에 본 학회지에 보고하는 바이다.

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QLF의 원리와 임상적 활용 (QLF Concept and Clinical Implementation)

  • 김백일
    • 대한치과의사협회지
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    • 제49권8호
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    • pp.443-450
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    • 2011
  • The leading paradigm of dentistry had been focused on the rehabilitation treatment that identifies active caries, manages them surgically, and restores their original functions. However, changes in the external environment including the current disease prevalence require dentistry to have a paradigm shift. The new paradigm suggests the detection of caries in their earlier stages over the visual diagnosis of cavities, and the reversal of the incipient caries by non-surgical approach. For this to be achieved, a high-technology detection device recognizing changes in the earlier stages which can not he visually observed is needed. Development of early caries detection device has recently become a major issue in preventive dentistry on account of this need, and QLF(Quantitified Light induced Fluorescence) conspicuously stands out among the newly released devices. In this study, the fundamental concept of QLF(Quantitified Light induced Fluorescence) and the possible clinical applications of the earlier intraoral camera model as well as the recently designed digital camera model will be discussed.

Intraosseous anesthesia using a computer-controlled system during non-surgical periodontal therapy (root planing): Two case reports

  • Han, Keumah;Kim, Jongbin
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권1호
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    • pp.65-69
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    • 2018
  • Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS.