• Title/Summary/Keyword: Repeated surgery

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Clinical Comparison of Immediately Loaded and Delayed Loaded OSSTEM GS III Implant in Partially Edentulous Patients (자연치 부분 결손 환자에서 테이퍼 형태의 국산 임플란트(OSSTEM GS III)의 즉시하중 성공률에 대한 지연하중군과의 비교 임상연구)

  • Kwon, Min-Jung;Kim, Young-Kyun;Yeo, In-Sung;Yi, Yang-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.267-275
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    • 2011
  • This prospective study was designed to compare clinical outcomes of immediately loaded implant with delayed loaded implant in partially posterior edentulous patients. For test group, 42 GS III (Osstem, Korea) implants in 17 patients were loaded within 48 hours after the placement. Control group was 27 implants in 15 patients loaded at $2.6{\pm}1.7months$ from the placement surgery. Before loading, primary stability was evaluated by ISQ value. Clinical symptoms, mobility, soft tissue state was evaluated at baseline, 3 months, 6 months and 12 months of loading. Marginal bone level change was also measured with periapical radiographs. Mann-Whitney test (${\alpha}$=0.05) and repeated measured ANOVA (${\alpha}$=0.05) was used for marginal bone level change between two groups. At the baseline, mean ISQ value of test group and control group was $80.3{\pm}7.1$ and $69{\pm}17$ respectively. Test group showed 95.23% of success rate and 100% of control group was successful. At 3 and 6months of loading, significantly more bone resorption was observed in test group than in control group (p<0.05). However, there was no significant difference in the bone level change at 12months of loading between two groups (p>0.05). Marginal bone level change showed no significant difference with gender and location (p>0.05). Within the limitation of this study, when primary stability was obtained, immediate loading of GS III implant at posterior region could be predictable treatment option.

The Effect of Repetitive Insertion and Pullout of Spinal Screws on Pullout Resistance : A Biomechanical Study (척추 수술에 사용되는 나사못의 반복 삽입과 인출이 인장항력에 미치는 영향 : 생체 역학적 연구)

  • Bak, Koang Hum;Ferrara, Lisa;Kim, Kwang Jin;Kim, Jae Min;Kim, Choong Hyun;Benzel, Edward C.
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.131-136
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    • 2001
  • Object : The clinical uses of screws are increasing with broader applications in spinal disorders. When screws are inserted repeatedly to achieve optimal position, tips of screw pitch may become damaged during insertion even though there are significant differences in the moduli of elasticity between bone and titanium. The effect of repeated screw insertion on pullout resistance was investigated. Methods : Three different titanium screws(cortical lateral mass screw, cancellous lateral mass screw and cervical vertebral body screw) were inserted into the synthetic cancellous material and then extracted axially at a rate of 2.4mm/min using Instron(Model TT-D, Canton, MA). Each set of screws was inserted and pulled out three times. There were six screws in each group. The insertional torque was measured with a torque wrench during insertion. Pullout strength was recorded with a digital oscilloscope. Results : The mean pullout force measurements for the cortical lateral mass screws($185.66N{\pm}42.60$, $167.10N{\pm}27.01$ and $162.52 N{\pm}23.83$ for first, second and third pullout respectively : p=0.03) and the cervical vertebral body screws($386.0N{\pm}24.1$, $360.2N{\pm}17.5$ and $330.9N{\pm}16.7$ : p=0.0024) showed consecutive decrease in pullout resistance after each pullout, whereas the cancellous lateral mass screws did not($194.00N{\pm}36.47$, $219.24N{\pm}26.58$ and 199.49N(36.63 : p=0.24). The SEM after insertion and pullout three times showed a blunting in the tip of the screw pitch and a smearing of the screw surface. Conclusions : Repetitive screw insertion and pullout resulted in the decrease of pullout resistance in certain screws possibly caused by blunting the screw tip. This means screw tips suffer deformations during either repeated insertion or pullout. Thus, the screws that have been inserted should not be used for the final construct.

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Nitroglycerin-Challenged Tc-99m MIBI Quantitative Gated SPECT to Predict Functional Recovery After Coronary Artery Bypass Surgery (니트로글리세린 투여 Tc-99m-MIBI 정량 게이트 심근SPECT를 이용한 관상동맥우회로술 후 심근 기능 회복 예측)

  • Lee, Dong-Soo;Kim, Yu-Kyeong;Cheon, Gi-Jeong;Paeng, Jin-Chul;Lee, Myoung-Mook;Kim, Ki-Bong;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.5
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    • pp.278-287
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    • 2003
  • Purpose: The performance of nitroglycerin-challenged Tc-99m-MIBI quantitative gated SPECT for the detection of viable myocardium was compared with rest/24-hour redistribution Tl-201 SPECT Materials and Methods: In 22 patients with coronary artery disease, rest Tl-20l/ dipyridamole stress Tc-99m-MIBI gated/24-hour redistribution Tl-201 SPECT were peformed, and gated SPECT was repeated on-site after sublingual administration of nitroglycerin (0.6 mg). Follow-up gated SPECT was done 3 months after coronary artery bypass graft surgery. For 20 segments per patient, perfusion at rest and 24-hour redistribution, and wall motion and thickening at baseline and nitroglycerin-challenged state were quantified. Quantitative viability markers were evaluated and compared;(1) rest thallium uptake, (2) thallium uptake on 24-hour redistribution SPECT, (3) systolic wall thickening at baseline, and (4) systolic wall thickening with nitroglycerin-challenge. Results: Among 100 revascularized dysfunctional segments, wall motion improved in 66 segments (66%) on follow-up gated myocardial SPECT after bypass surgery. On receiver operating characteristic (ROC) curve analysis, the sensitivity and specificity of rest and 24-hour delayed redistribution Tl-201 SPECT were 79%, 44% and 82%, 44%, respectively, at the optimal cutoff value of 50% of Tl-201 uptake. The sensitivity and specificity of systolic wall thickening at baseline and nitroglycerin-challenge were 49%, 50% and 64%, 65% at the optimal cutoff value of 15% of systolic wall thickening. Area under the ROC curve of nitroglycerin-challenged systolic wall thickening was significantly larger than that of baseline systolic wall thickening (p=0.004). Conclusion: Nitroglycerin-challenged quantitative gated Tc-99m-MIBI SPECT was a useful method for predicting functional recovery of dysfunctional myocardium.

The Effect of Nitric Oxide, Isosorbide Dinitrate and Sodium Nitroprusside on Ischemic Myocardium of Rat (Nitric oxide, Isosorbide dinitrate 및 Sodium nitroprusside가 쥐의 허혈성 심근에 미치는 영향)

  • Jeong, Jong-Hwa;Kim, Su-Hyeon;Kim, Song-Myeong
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1055-1065
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    • 1996
  • This experiment was undertaken to assess the effect of nitric oxide, isosorbide dinitrate, and sodium nitroprusside, which are known to increase coronary flow by vasodilation and to improve the cardiac function of an ischemic heart The experiment was carried out to investigate the effect of nitric oxide on the coronary artery of an ischemic rat myocardium using isolated constant pressure Langendorfr system. The experimental parameters were lactate and CK-MB for the frozen myocardium and coronary flow. the quantity of coyonary flow, left ventricular developed pressure (LVDP), and dp/dt. The experimental groups were decided as control group (Group I), nitric oxide group (Group II), Iso orbide dinitrate group (Group III) and sodium nitroprusside group (Group IV). Statistical analysis was performed using repeated measured analysis of variance and 2tudent t-test The results were as follows: 1 . The lactic acid contents of group II and IV were less than other groups for the frozen myocardium at preischemic state (p< 0.0025), whereas the determined coronary flows were higher. 2. In the ratio of produced lactic acid between the preischemia and reperfusion for the coronary flow, group II and IV exhibitrod less value than others (p< 0.005). 3. Group II and III were less than others in the coronary flow for the quantity of CK-MB, but or the frozen myocardium, group II and IV were less. 4. Group II and IV showed higher coronary flow compared to others throughout entire experimental period (p< 0.005). 5. Group II was highest at the preischemic state for the left ventricular developed pressure. 6. The +maximal dp/dt of group II was highest compared to others. 7. Group I exhibi ed the highest recovery rate of coronary flow between prelschemla and reperfusion. 8. The(-dp/dt)1(+dp/dt) ratio was 116%, 100%, 100%, and 55% for the 4 groups, respectively And the recovery rate of total dp/dt was 34%, 67%, 51%, and 76% for the four groups, respectively.

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THREE DIMENSIONAL ANALYSIS OF MAXILLOFACIAL STRUCTURE BY FRONTAL AND LATERAL CEPHALOGRAM (두부 방사선 규격사진을 이용한 악안면 구조의 3차원적 분석법)

  • Kwon, Kui-Young;Lee, Sang-Han;Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.174-188
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    • 1999
  • The purpose of this study is to evaluate the precision and accuracy of a three dimensional cephalogram constructed by using the frontal and lateral cephalogram of twelve human dry skulls. After achieving the three dimensional image reconstruction program, we tried to apply this program to two dentofacial deformity patients. 1. Conventional nasion relator in cephalostat was used to reproduce the same head position for the same dry skull. The mean difference of the three dimensional cephalogram for the same dry skull was $0.34{\pm}0.33mm$. Closeness of repeated measures to each skull reveals the precision of this method for the three dimensional cephalogram. 2. Concerning the accuracy, the mean difference between the three dimensional reconstruction data and actual lineal measurements was $1.47{\pm}1.45mm$ and the mean magnification ratio was $100.24{\pm}4.68%$. This Diffrerence is attributed mainly to the ill defined cephalometric landmarks, not to the positional change of the dry skull. 3. Cephalometric measurement of lateral and frontal radiographs had no consecutive magnification ratio because of the different focus-object distance. The mean difference between the frontal and lateral cephalogram to the actual lineal measurements was $4.72{\pm}2.01mm$ and $-5.22{\pm}3.36mm$. Vertical measurements were slightly more accurate than horizontal measurements. 4. Applying to the actual patient analysis, it is recommendable to use this program for analyzing the asymmetry or spatial change after operation. The orthodontic bracket would be a favorable cephalometric landmark for constructing the three dimensional images.

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Results of Preoperative Chemoradiotherapy in Low Rectal Cancer (하부 직장암의 수술 전 화학방사선요법 결과)

  • Yun Hyong-Geun
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.21-29
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    • 2006
  • Purpose: This study explored the anal sphincter-saving rate and down-staging rate after preoperative chemoradiotherapy for treating lower rectal cancer. We also explored the prognosis of the patients who refused surgery after preoperative chemoradiotherapy. Materials and Methods: Thirty seven patients with histologically proven lower rectal cancer who underwent preoperative chemoradiotherapy were retrospectively analyzed. In each case, the tumor location was 0 to 5 em from the anal verge, and curative resection of the cancer with performing a sphincter-saving procedure was not feasible before chemoradiotherapy. In each case, the staging examinations, including biopsy, were done before starting radiotherapy and this was repeated at 1 month after radiation therapy. Results: After chemoradiotherapy, among the 37 included patients, 56.8% and 32.4% were downstaged to the T stage and N stage, respectively, when comparing the postradiotherapy stage with pre-radiotherapy stage. Twenty five patients underwent complete resection of cancer at 6 weeks after radiotherapy: eleven, eight and six patients underwent abdominoperineal resection, low anterior resection and local excision, respectively. The sphincter-saving rate among the 24 completely resected cases was 54.2%. Twelve patients refused surgery after radiotherapy. Among 6 patients who refused surgery with biopsy-proven complete remission after chemoradiotherapy, 5 patients were alive without disease at a median follow up period of 31 months, and only 1 patient had local failure. Conclusion: For lower rectal cancer, a high sphincter-saving rate was accomplished with preoperative chemoradiotherapy. The prognosis of the patients who refused surgery with biopsy proven complete remission after chemoradiotherapy was good and these patients need to be kept under close surveillance.

Lung Preservation Study for Above 20 Hours of LPDG Solution in Canine Lung Allotransplactation (폐이식 실험견에서 LPDG용액을 이용한 20시간 이상 폐보존효과 관찰)

  • Park, Chang-Gwon;Gwon, Geon-Yeong;Yu, Yeong-Seon
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.949-960
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    • 1997
  • Background. Limited ischemic tolerance of the lung has remained one of the factors that limits the expansion of pulmonary transplantation as a treatment for end-stage pulmonary disease. Numerous studies on safe long term preservation for lung transplantation has been performed for the purpose of developing ideal preservation solution with extracellular type or intracellular type solutions. In this. study, we examined the efficacy of L DG solution in lung preservation longer than 20 hours by comparison with modified Euro-Collins solution. Iwethods. Thirty-(our adult mongrel dogs were divided into two groups. Donor lungs were flushed with LPDG solution(n=9) or modified Euro-Collins(MEC) solution(n=8) and stored for 24 hours at 1$0^{\circ}C$. All donor lungs were perfused through the pulmonary arteries with solutions containing prostaglandin El and verapamil. Left canine lung allotransplantations wereperformed. Assessment(hemodynamic indices and arterial blood gas analysis) of left implanted lung was made by occluding the right pulmonary artery for ten minutes using pulmonary artery Cuff. Assessment was repeated at the interval of 30 minutes, one hour, and two hours later after reperfusion and then chest X-ray, computed tomogram and lung perfusion scan were obtained. In survival dogs follow-up studies were done with assessment with chest X-ray, computed tomogram of the chest and lung perfusion scan on 7th day postoperatively. After preservation above 20 hours, pathological examinations for ultrastructural findings on right lung were performed in each group. Results. With respect to arterial oxygen tension, LPDG group was superior to MEC but there was no statistical significance for 2 hours after reperfusion. Mean pulmonary artery pressure was less increased(p < 0.05) and cardiac output higher(p <0.05) than MEC group until 2 hours after reperfusion. After 2 hours of reperfusion, both groups showed transplanted lung function deteriorated gradually. Perfusion scan of the transplanted lung in LPDG group showed better perfusion rate in immediate post-reperfusion, 3 days and 7 days later respectively but there was no statistical significance and corelation with PaO2 and computed tomoRravhic views. In scanning electron microscopy of pulmonary artery after preservation, LPDG group relatively shows less irregular protrusion of the inner surface of endothelial cell of poulmonary artery than MEC group. Conclusions, e concluded that LPDG solution can offer safe lung preservation above 20 hours with adequate immunosuppressive therapy and prevention of the infection.

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Anchor Hole Augmentation with Bone Cement in Arthroscopic Rotator Cuff Repair (관절경적 회전근 개 봉합술에서 골 시멘트를 이용한 봉합 나사 구멍 보강술)

  • Lee, Ho-Min;Tae, Suk-Kee;Park, Jeong-Min
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.237-243
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    • 2010
  • Purpose: In arthroscopic rotator cuff repair, the crucial step is secure fixation of Anchor to bone. However, osteoporosis of the tuberosity is frequently encountered in old patients, and can cause insecure fixation of anchors. The Aim of our study was to introduce a technique for anchor hole augmentation with bone cement when fixation failure of an anchor occurs, and to investigate the outcome. Materials and methods: Among 223 rotator cuff repairs performed between 2005 and 2009, anchor hole augmentation with polymethylmethacrylate was performed in 15 cases (all females; mean age of 65 years: range 49~77). Bone cement was injected into the anchor hole in a thick fluid state and the procedure was repeated to make a pot-like cement mantle. The anchor was inserted into the cement mantle while the cement hardened. The outcome was investigated, on average, at 16 months (6~32). Results: Radiographs showed cystic changes of the tuberosity. On follow-up radiographs and MRI, a change in the cement mantle was not noted. The final average UCLA score was 31 (28~35); 6 had excellent, 8 good and 1 fair results (p=0.008). Age-sex matched Constants score was 90 (74~98) (p=0.008). Conclusion: Anchor hole augmentation with bone cement is useful when fixation failure of an anchor is encountered due to bone atrophy. Anchor hole augmentation with bone cement does not negatively influence the outcome.

Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries: Clinical Outcomes of Transcatheter Systemic Artery Embolization (흉벽 및 흉곽 내 장기 손상으로 인한 외상성 혈흉: 전신 동맥 색전술의 임상 결과)

  • Chang Mu Lee;Chang Ho Jeon;Rang Lee;Hoon Kwon;Chang Won Kim;Jin Hyeok Kim;Jae Hun Kim;Hohyun Kim;Seon Hee Kim;Chan Kyu Lee;Chan Yong Park;Miju Bae
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.923-935
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    • 2021
  • Purpose We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. Materials and Methods Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. Results Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. Conclusion TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency surgery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

Nonvital Pulp Therapy of Elongation of Roots of Mandibular Cheek Teeth in Pet Rabbits (애완토끼에서 과잉성장된 하악치아의치신경치료 연구)

  • Park, Cheon-Sik;Cha, Se-Yeoun;Kang, Min;Kim, Jury;Jeong, Soon-Wuk;Jang, Hyung-Kwan
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.474-482
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    • 2012
  • Elongation of cheek teeth roots in pet rabbits is very common, and is associated with malocclusion followed by reduced appetite, salivation, periapical abscess, and epiphora. Conservative methods including medication, drainage, irrigation, tooth trimming, intraoral and extraoral extraction, surgical treatment of periapical abscessation, and diet control have been adapted as the only treatments to resolve elongation of teeth roots. However, remaining challenges include the long-term period of cure and recurrence. This study was performed to investigate the possibility of nonvital pulp therapy on elongation of the mandibular cheek teeth roots in pet rabbits. Thirty-one pet rabbits with dental problems due to root elongation were submitted. Ten pet rabbits among them were treated by nonvital pulp therapy procedures (group A), while the others were treated by conservative methods (group B). Appetite improved within 1-5 days after nonvital pulp therapy and the treatment was discontinued 1 month postoperatively in group A. Abscess occurred in another site not treated with nonvital pulp therapy in only two rabbits. Growth of the mandibular cheek teeth treated with nonvital pulp therapy stopped, resulting in malocclusion, intraoral inflammation from the enamel spur, and abscess of the teeth roots. In the group B rabbits treated with conservative therapy, partial drainage, long term medication, recurrent oral trimming and control of repeated oral inflammation occurred. Consequently, buccotomy or tooth extraction was performed in group B. Owners were satisfied with nonvital pulp therapy preventing dental root abscess and repeated troubles including inflammation and malocclusion and reduction of the treatment period. These results suggest that nonvital pulp therapy can be performed on pet rabbits with elongation of mandibular cheek teeth roots.