• Journal of Periodontal and Implant Science
• /
• 제52권6호
• /
• pp.466-478
• /
• 2022

Purpose: Coronally advanced split-or full-thickness (CAST or CAFT) flaps in combination with subepithelial connective tissue grafts (SCTGs) are commonly used in root-coverage procedures despite postoperative pain and bleeding from the graft donor site. Therefore, the modified vestibular incision subperiosteal tunnel access procedure (VISTAX) uses a novel collagen matrix (VCMX) instead of autogenous tissue to address the limitations associated with autogenous tissue grafting. This retrospective study compared the clinical outcomes of VISTAX to the results obtained after using a CAST or CAFT flap in combination with SCTG for root coverage. Methods: Patients with single or multiple adjacent recession I/II defects were included, with 10 subjects each in the VISTAX, CAFT, and CAST groups. Defect coverage, keratinized tissue width, esthetic scores, and patients' perceived pain and dentinal hypersensitivity (visual analogue scale [VAS]) were assessed at baseline, 3 months, and 6 months. Results: All surgical techniques significantly reduced gingival recession (P<0.0001). Defect coverage, esthetic appearance, and the reduction in dentinal hypersensitivity were comparable. However, the VAS scores for pain were significantly lower in the VISTAX group than in the CAFT and CAST groups, which had similar scores (P<0.05). Furthermore, the clinical results of VISTAX and CAFT/CAST generally remained stable at 6 months. Conclusions: The clinical outcomes of VISTAX, CAFT, and CAST were comparable. However, patients perceived significantly less pain after VISTAX, indicating a potentially higher patient acceptance of the procedure. A prospective trial with a longer follow-up period and a larger sample size should therefore evaluate VISTAX further.

• Journal of Korean Dental Science
• /
• 제16권2호
• /
• pp.218-226
• /
• 2023

Treatment of multiple gingival recession defects is usually more challenging than that of single gingival recession. Various techniques for the treatment of multiple gingival recession have been established. Recently, vestibular incision subperiosteal tunnel access (VISTA) technique has been considered to exhibit high predictive ability. Connective tissue graft (CTG) has also been considered a gold standard technique owing to its high predictability of root coverage. However, this technique requires a suitable donor site and has clinical disadvantages, such as additional pain. Thus, in this case presentation, platelet-rich fibrin (PRF) was used as an alternative material for CTG along with VISTA. We herein report cases of two patients with Miller's class I and III multiple gingival recession defects, respectively. These patients underwent VISTA along with the use of a PRF membrane. They were followed up for 12 months postoperatively, and their clinical parameters, including probing depth, depth of gingival recession, clinical attachment level, and width of attached gingiva at baseline and at 2, 6, and 12 months postoperatively, were assessed. The patient with class 1 recession defects exhibited a significant amount of root coverage, which remained stable during the follow-up period. Whereas the patient with class 3 recession defects had lesser amount of coverage compared to class 1 patient. The partial coverage observed may be attributed to not only anatomical factors but also the technique-sensitive nature of the procedure. Considering these results, the use of VISTA along with PRF is a viable option for treating gingival recession, as it does not cause discomfort to patients. However, various factors need to be considered during the surgical procedure.

• 한국임상수의학회지
• /
• 제28권5호
• /
• pp.497-505
• /
• 2011

자연개구부를 통한 내시경적 수술 (NOTES)은 최근 많은 잠재적인 장점들로 인해 새롭게 주목받고 있는 수술방법이다. 하지만 국내에서 대부분 사용되어지고 있는 내시경은 기구가 삽입되는 포트가 한 개인 것이 대부분으로 순수 NOTES를 시행하기에는 다소 어려움이 있을 수 있다. 이에 본 실험에서는 복강경과 순수 NOTES의 중간 단계 인 하이브리드 NOTES를 통해 담낭절제술을 실시하였다. 이 방법은 한 개의 복강경 포트를 삽입함으로써 이를 통해 복강경용 겸자를 사용하여 담낭의 견인 역할을 할 수 있다는 장점을 지닌다. 내시경은 경위장관, 경결장 및 경질을 통 해 외부 피부 절개 없이 복강 내로 삽입되어 수술이 진행되었으며 복강 내압은 $CO_2$를 이용하여 4 mmHg로 유지하였다. 위 세 경로를 통한 접근으로 담낭절제술은 모두 성공적으로 이루어졌으며 모든 실험견들은 실험기간동안 임상적인 유의성 없이 좋은 회복을 나타내었다. 본 연구를 통해 개에서 최소 침습적 수술로 담낭절제술을 실시할 수 있는 방법을 확립하고 시술 시에 발생할 수 있는 부작용 등을 확인함으로써 소동물 수의 임상영역에서 최소 침습적 수술이 보급될 수 있는 기초가 되며, 복강경과 내시경의 임상 활용도를 높일 수 있을 것으로 생각된다. 하지만 경결장의 경우 내시경 접근 시 복강 내에서 소수의 세균 감염이 확인되었으며 경결장 접근의 경우 접근 방법에 대한 다른 연구가 필요할 것으로 생각된다.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2008년도 제16차 학술대회
• /
• pp.179-179
• /
• 2008

For a partial tear of the subscapularis tendon, the presenting technique requires only the anterior portal for preparing the footprint and suture management, as well as the subclavian portal for placing the suture anchor and suture hook without inserting a cannula. It provides both a good angle for anchor placement and sufficient space for managing the upper portion of a subscapularis tendon tear. A spinal needle was inserted through the subclavian portal in order to identify the appropriate angle for placing the suture anchor. A 3-mm incision was made for the subclavian portal and a biosuture anchor was placed on the footprint portion of the subscapularis tendon. In order to avoid crowding, each limb of both strands of the biosuture anchor were passed through the tendon- posteromedial side first, and anterolateral side second, using a switching technique with suture hook embedded with no.1 PDS. A suture tie was applied in a reverse sequence (the lateral strand first and the medial strand second) through the anterior cannula using a sliding technique.

• 대한두개안면성형외과학회지
• /
• 제21권5호
• /
• pp.305-308
• /
• 2020

Madelung's disease (MD) otherwise known as Launois-Bensaude syndrome, multiple symmetrical lipomatosis, or benign symmetric lipomatosis, is a rare disease characterized by abnormal diffuse lipomatosis in proximal upper limbs and neck. Here, we report a rare case of MD. A 66-year-old man presented with massive growth of soft tissues in the cervico-occipital region of more than 2 years duration. Physical examination showed diffuse enlargement of the anterior neck (Madelung's collar) and three huge humps at the posterior neck. Under a diagnosis of MD, lipectomy via a single anterior transverse incision and liposuction were performed. This rare case report may be helpful for assessing patients with abnormal diffuse lipomatosis in the neck and proximal upper limbs.

• Journal of Chest Surgery
• /
• 제27권3호
• /
• pp.238-240
• /
• 1994

We performed post-operative hemodynamic evaluation and lung perfusion scan after left lung transplantation in dog. The heart & lungs were extracted from donor dog while the both lungs were flushed with 4oC Euro-Collin`s solution after heparinization & infusion of prostaglandin E1.In the recipient dog, anastomosis of the left atrial cuff was performed by continuous 4-0 Prolene everted suture, and bronchial anastomosis by telescope method with 4-0 Prolene continuous suture. The end-to-end anastomosis of left main pulmonary arteries was performed with continuous 6-0 Prolene suture. After closure of left thoracotomy incision, the lung perfusion scan was performed post operative 2 days for evaluation of the function of the transplanted lung which showed good perfusion. The dog was sacrificed in the post-operative 5 days for autopsy.

• Journal of Chest Surgery
• /
• 제27권6호
• /
• pp.502-505
• /
• 1994

Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen,hence the descriptive term dumbbell.Recently we had an occasion to remove a dumbbell neurilemmoma in a 62 years old woman using an approach designed to allow wide posterolateral thoracotomy and concomitant laminectomy for a single stage removal of the entire tumor. The mass in the posterior mediastinum was discovered on routine chest roentgenography. CT scan demonstrated a dumbbell shaped soft tissue mass density compressing spinal canal but preserving spinal cord. There were no neurologic signs. A standard posterolateral thoracotomy incision was made to remove tumor mass and then T5 unilateral laminectomy has done by Neurosurgeon. 7 x 7 cm sized extrapleural neurilemmoma was round, cystic, soft mass which covered parietal pleural with invaded regional vertebrae. There was no postoperative neurological complication.

• Journal of Life Science
• /
• 제10권2호
• /
• pp.50-54
• /
• 2000

The RAD4 gene of Saccharomyces cerevisiae is essential for the incision step of UV-induced excision repair. A yeast RAD4 gene has been previously isolated by functional complementation. In order to identify the RAD4 homologous gene from fungus Coprinus cinereus, we have constructed cosmid libraries from electrophoretically separated chromosomes of the C. cinereus. The 13 C. cinereus chromosomes were resolved by pulse-field gel electrophoresis, hybridized with S. cerevisiae RAD4 DNA, and then isolated homologous C. cinereus chromosome. Here, we report the cloning and characterization of fungus C. cinereus homolog of yeast RAD4 gene. Southern blot analysis confirmed that C. cinereus contains the sequence homologous DNA to RAD4 gene and this gene exists as a single copy in C. cinereus genome. When total RNA isolated from C. cinereus cells was hybridized with the 3.4 kb BglII DNA fragment of the S. cerevisiae RAD4 gene, a 2.5 kb of transcript was detected. The isolated gene encodes a protein of 810 amino acids.

• The Korean Journal of Pain
• /
• 제32권1호
• /
• pp.30-38
• /
• 2019

Background: The adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group. Methods: Patients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured. Results: Postoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were $0.14{\pm}0.37$, $4.57{\pm}2.37$, $6.00{\pm}1.63$, and $4.28{\pm}1.49$, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB. Conclusions: In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.

• 한국임상수의학회지
• /
• 제24권3호
• /
• pp.315-319
• /
• 2007

1년령, 암컷, 15 kg의 잡종견에서 위내시경을 이용한 경위장관 담낭절제술을 최소한의 복강경 도움아래에서 성공적으로 수행하였다. 내시경용 바늘 절개도를 이용하여 배쪽 유문부에서 위절개를 실시하였다. 위절개부를 통하여 내시경을 복강내로 진입한 다음 뒤쪽으로 돌려서 담낭쪽 시야를 확보하였다. 술야의 확보를 위해 복강경용 겸자를 이용하여 담낭의 바닥부위를 부드럽게 들어올렸다. 담낭관과 동맥을 내시경용 endoclip을 이용하여 3중 결찰하였다. 담낭관과 동맥을 절단한 후 내시경용 소작겸자와 바늘 절개도를 이용하여 담낭을 간으로부터 분리하였다. 분리된 담낭은 내시경을 이용해 입을 통하여 제거하고, 위절개부위는 내시경용 endoclip을 이용하여 봉합하였다. 술후 3일째 방사선검사 및 혈청화학검사를 통해 위봉합부위의 천공이 없음과 담즙의 누출이 없음을 확인하였다. 술후 16일째 위내시경과 복강경 검사를 실시하였다. 위내시경검사 결과 봉합부위가 완전히 유합 되었음을 확인하였고 복강경 검사를 통해 담낭절제부위와 위절개부의 장막에 대망막이 유착되어있음을 확인하였다. 본 연구는 개에서 자연개구부 내시경수술(NOTES)을 이용한 담낭절제술의 최초 보고로써 새로운 방법에 의한 담낭절제술에 대한 가능성을 제시한다.