• Title/Summary/Keyword: Repeated surgery

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Immunogenicity of botulinum toxin

  • Wee, Syeo Young;Park, Eun Soo
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.12-18
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    • 2022
  • Botulinum toxin treatment is the most common non-surgical cosmetic treatment. Although there are many available treatments using botulinum toxin, their effects are temporary and repeated injections are required. These frequent injections can trigger an immunological response. In addition, botulinum toxin acts as an antigen in the body; thus, its effect disappears progressively due to this immunological reaction, which may cause treatment failure. Active botulinum toxin consists of a core neurotoxin and complexing proteins, the exact effects of which remain unclear. However, the complexing proteins are closely related to the immune response and the formation of neutralizing antibodies. Since neutralizing antibodies can lead to treatment failure, their formation should be prevented. Furthermore, various methods of detecting neutralizing antibodies have been used to predict treatment failure.

Successful removal of remnant cystic duct stump stone using single-operator cholangioscopy-guided electrohydraulic lithotripsy: two case reports

  • Sung Hyeok Ryou;Hong Ja Kim
    • Clinical Endoscopy
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    • v.56 no.3
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    • pp.375-380
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    • 2023
  • Cholecystectomy is the best method for treating gallstone diseases. However, 10%-30% of patients who undergo a cholecystectomy continue to complain of upper abdominal pain, dyspepsia, or jaundice-this is referred to as postcholecystectomy syndrome. Cystic duct stump stones are a troublesome cause of postcholecystectomy syndrome. Conventionally, surgery is mainly performed to remove cystic duct stump stones. However, repeated surgery can cause complications, such as postoperative bleeding, biliary injury, and wound infection. As an alternative method of surgery, endoscopic retrograde cholangiopancreatography is sometimes used to remove cystic duct stump stones, although the success rate is not high due to technical difficulties. Recently, peroral cholangioscopy, which can directly observe the bile duct, has been suggested as an alternative method. We report two cases in which a cystic duct stump stone was successfully removed via a single-operator cholangioscopy, after failure with an endoscopic retrograde cholangiopancreatography.

Effect of repeated use of an implant handpiece on an output torque: An in-vitro study

  • Son, KeunBaDa;Son, Young-Tak;Kim, Ji-Young;Lee, Jae-Mok;Yu, Won-Jae;Kim, Jin-Wook;Lee, Kyu-Bok
    • The Journal of Advanced Prosthodontics
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    • v.13 no.3
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    • pp.136-143
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    • 2021
  • Purpose. This study aimed to evaluate the effect of repeated use of an implant handpiece under an implant placement torque (35 Ncm) and overloading torque condition (50 Ncm) on an output torque. Materials and Methods. Two types of implant handpiece systems (Surgicpro/X-DSG20L [NSK, Kanuma, Japan] and SIP20/CRB46LN [SAESHIN, Daegu, South Korea]) were used. The output torque was measured using a digital torque gauge. The height and angle (x, y, and z axes) of the digital torque gauge and implant handpiece were adjusted through a jig for passive connection. The experiment was conducted under the setting torque value of 35 Ncm (implant placement torque) and 50 Ncm (overloading torque condition) and 30 times per set; a total of 5 sets were performed (N = 150). For statistical analysis, the difference between the groups was analyzed using the Mann-Whitney U test and the Friedman test was used to confirm the change in output torque (α=.05). Results. NSK and SAESHIN implant handpieces showed significant differences in output torque results at the setting torques of 35 Ncm and 50 Ncm (P<.001). The type of implant handpiece and repeated use influenced the output torque (P<.001). Conclusion. There may be a difference between the setting torque and actual output torque due to repeated use, and the implant handpiece should be managed and repaired during long-term use. In addition, for successful implant results in dental clinics, the output torque of the implant handpiece system should be checked before implant placement.

The Surgical Treatment for Aorto-cutaneous Fistula after Open Heart Surgery - A case report- (개심술 후 발생한 대동맥-피부 누공의 치험 1예 -1예 보고 -)

  • Kim, Mi-Jung;Kim, Byung-Yul;Shin, Yong-Chul;Kim, Woo-Shik;Jeong, Seong-Cheol;Song, Chang-Min
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.516-519
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    • 2008
  • Aorto-cutaneous fistula is a rare complication after performing open heart surgery, but if this develops, it is a fatal condition. So, prompt diagnosis and aggressive surgical treatment is needed. We report here on a patient who had two mechanical double valves placed during heart surgery and she was treated for repeated sternal wound infections for about 5 years. She visited the ER due to abrupt bleeding at the sternal wound. She was diagnosed as having an aorto-cutaneous fistula by performing an aortogram and we then performed cardio-pulmonary bypass surgery. The patient is currently doing well and is under follow up 24 months after the repair.

Anatomic Study of the Vessels of the Digital Nerves in the Fingers (손가락 신경의 혈관 구조에 대한 해부학적 연구)

  • Lee, Joo Chul;Choi, Hwan Jun;Kim, Jun Hyuk;Lee, Young Man;Nam, Doo Hyun
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.149-152
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    • 2012
  • Purpose: The vessels of peripheral nerves have been extensively studied since Breidenbach used vascularizd nerve grafts. Tayor and Pinel studied the course and distribution of the vessels of peripheral nerves. However, the vessels of digital nerves are still not well known. The objective of this study was to prove vessels of digital nerves and to investigate the pathway of that. Materials and Methods: 36 patients and 2 fresh human cadavers were studied under the microscope and histologic sections under the light microscope.. Results: We found that digital nerves had own arterioles and venules as well as peripheral nerves. This small vessels of digital nerves paralleled the digital nerves or run in a spiral. Digital nerves were abundantly vascularized throught their length by a succession of vessels and by their repeated divisions and anastomoses. Conclusion: The clinical implications of this results can be discussed in relation to the dissection of nerves, the possibility of vasculized nerve grafts.

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CEPHALOMETRIC ANALYSIS OF SNORING AND OBSTRUCTIVE SLEEP APNEA SYNDROME PATIENTS (코골기 환자의 두부규격 방사선학적 분석)

  • Kim, Tae-Kyu;Yang, Dong-Kyu;Chung, In-Kyo;Kim, Jong-Ryoul;Roh, Hwan-Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.3
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    • pp.463-469
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    • 1996
  • Sonoring is caused by the repeated obstructions of versatile upper air way structure during sleep and is known as a kind of disease entity varing from simple snoring to obstructive sleep apnea syndrome(OSAS) which can cause serious cardiopulmonary complications due to its hypoxic pathophysiology. It has been reported that over 30% of middle-aged person have the problems of snoring and its accompanied symptomes and signs. Cephalometric measurements, frequently used to measure sella-nasion-subspinale(SNA) and sella-nasion-supramentale(SNB) angles, can provide the informations about the posterior airway space(PAS), the mandibular plane(MP) and the position of hyoid bone. These informations are useful in determining the therapeutic modalities of the snoring and OSAS patients. However, with conventional routine upright position, it does not represent the actual images of obstructive mechanism during sleep but only show the images of awaken normal upper airway anatomy. Therefore we have taken dual images of a routine upright lateral and a supine cephalometric view to compare both.

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The Effect of Listening to Music on Anxiety, Sedation, and Vital Signs of Patients Undergoing Spinal Anesthesia (수술 중 음악청취가 척수마취 환자의 불안, 진정 및 활력징후에 미치는 효과)

  • Moon, Yang-Hee;Kang, In-Soon;Hwang, Sun-Kyung
    • Journal of Korean Biological Nursing Science
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    • v.11 no.2
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    • pp.105-113
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    • 2009
  • Purpose: The aim of this study was to examine the effect of listening to music on the level of anxiety, sedation, and vital signs of patients undergoing surgery with spinal anesthesia. Methods: A convenience sample of 70 adult patients, ASA physical status I-II, scheduled for elective urologic or orthopedic surgery with spinal anesthesia, was included in this study. They were assigned to either an experimental group (n=35), listening to music during surgery, or a control group (n=35), not listening to music. Their anxiety was measured with the Spielberg's Trait and State Anxiety Inventory (STAI-KYZ). Sedation level was monitored with the Bispectral Index, and the vital signs at beginning, 10, 20, 30, and 45 min after operation. Results: The music group reported significantly lower state anxiety level during surgery as compared with the control group (t=3.91, p<.001). Repeated measures of ANOVA indicated a significant by group interaction on BIS index scores of sedation (F=4.23, p=.006). Among the vital signs, only heart rate was a significant by group interaction (F=5.529, p=.004). Conclusion: These findings indicate that listening to music during surgery with spinal anesthesia is a useful and effective nursing intervention to reduce anxiety and to maintain proper sedation.

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Calcaneal Insufficiency Avulsion Fracture in a Well-Controlled Type 2 Diabetic Patient: A Case Report

  • Kim, Seong-Tae;Moon, Myung-Sang;Kwon, Ki-Tae;Park, Bong-Keun;Ha, Chang Won;Ahn, Jungtae
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.2
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    • pp.73-76
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    • 2015
  • The calcaneal insufficiency avulsion fracture usually occurs in an area of fused apophysis in adults without significant history of trauma or overuse activities. It is an uncommon injury which has been described in patients with complicated diabetes, Charcot neuroarthropathy, amyloidosis with neuropathy, severe osteoporosis, and other conditions. Discussion of the issue of fracture location is still not sufficient. We report on a case of a 50-year-old male who experienced a non-traumatic diabetic calcaneal insufficiency fracture. Intraoperatively, a biopsy specimen was obtained from the exposed fracture site for histological study. We assume that the calcaneal fused apophyseal line is the weak point of failure due to various incomplete mixtures of trabecular bone, woven bone, and cartilaginous tissues, and may fail when repeated tensile stress is imposed.

The Effect of Pre-warming for Patients under Abdominal Surgery on Body Temperature, Anxiety, Pain, and Thermal Comfort (Forced-air Warming System을 이용한 수술 전 가온이 복부 수술 환자의 체온, 불안, 통증 및 온도 편안감에 미치는 효과)

  • Park, Ok-Bun;Choi, Hee-Jung
    • Journal of Korean Academy of Nursing
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    • v.40 no.3
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    • pp.317-325
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    • 2010
  • Purpose: The purpose of this study was to examine the effect of pre-warming on body temperature, anxiety, pain, and thermal comfort. Methods: Forty patients who were scheduled for abdominal surgery were recruited as study participants and were assigned to the experimental or control group. For the experimental group, a forced air warmer was applied for 45-90 min (M=68.25, SD=15.50) before surgery. Body temperature and anxiety were measured before and after the experiment, but pain and thermal comfort were assessed only after the surgery. Hypotheses were tested using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature than the control group from right before induction to two hours after surgery. Post-operative anxiety and pain in the experimental group were less than those of the control group. In addition, the score of thermal comfort was significantly higher in the experiment group. Conclusion: Pre-warming is effective in maintaining body temperature, lowering sensitivity to pain and anxiety, and promoting thermal comfort. Therefore, pre-warming can be recommended as a preoperative nursing intervention.

Internal Mammary Artery Perforator Flap for Immediate Volume Replacement Following Wide Local Excision of Breast Cancer

  • van Huizum, Martine A.;Hage, J. Joris;Oldenburg, Hester A.;Hoornweg, Marije J.
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.502-508
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    • 2017
  • Background Breast-conserving therapy is defined as a breast-conserving wide local excision (WLE) of a mammary tumour combined with postoperative radiotherapy. Immediate restoration of the mammary shape by use of breast reduction techniques (volume displacement) or tissue replacement techniques (volume replacement) is gaining popularity to prevent breast malformation. Methods To date, using the internal mammary artery perforator (IMAP) flap has been suggested for immediate volume replacement after WLE, but has never been evaluated in a published study. Results We applied this flap in 12 women (mean age, 56.1 years) after WLE (mean specimen weight, 46.5 g) of the medial aspect of the breast. Over a median follow-up of 35.3 months (standard deviation, 1.2 months), 4 women needed repeated surgery for dog-ear correction of the donor site. Conclusions In our experience, the use of an IMAP flap was a reliable technique with good cosmetic outcomes after oncoplastic reconstruction. In this series, donor site revision often proved necessary initially, but we showed that this may easily be prevented.