• Title/Summary/Keyword: Surgery first approach

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Surgical Treatment of Annuloaortic Ectasia (Report of One Case) (Annuloaortic Ectasia 의 수술치험 (1례 보고))

  • Jo, Gwang-Hyeon;Park, Cheol-Ho;Ryu, Ji-Yun
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.340-346
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    • 1988
  • The surgical treatment of annuloaortic ectasia falls into two basic categories, depending on the management of the coronary artery ostia and the sinus of Valsalva. The conventional method, first suggested by Groves, Wheat and their associates, employs a supracoronary graft for the treatment of aneurysm and conventional valve replacement. A more radical approach, that of Bentall and DeBono, uses a valve conduit from the aortic annulus to the distal extent of the aneurysm. This latter technique requires reimplantation of the coronary artery ostia for reestablishment of coronary artery blood flow. Recently we experienced a case of annuloaortic ectasia to which we applied the Bentall operation with the good postoperative result, and now we report this with literature review.

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Protocol for management of odontogenic keratocysts considering recurrence according to treatment methods

  • Titinchi, Fadi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.5
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    • pp.358-360
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    • 2020
  • The management of odontogenic keratocysts (OKC) remains a hotly debated topic in oral and maxillofacial surgery. Despite numerous studies and systematic reviews on treatment options, there is a lack of consensus and no accepted protocol on the management of OKC. Hence, the aim of this study was to briefly summarize all large systematic reviews in the literature on the management of OKC and formulate an evidence-based management protocol. Data from five large systematic reviews were combined to calculate the mean recurrence rate for each technique. Decompression followed by enucleation along with adjuvant methods such as application of Carnoy's solution and peripheral ostectomy can result in very low recurrence and is an acceptable first line treatment. The surgical approach should be determined by lesion size, patient age, proximity to vital structures, accessibility, soft tissue/cortical perforation, and if the lesion is recurrent.

Ridge Augmentation Using Vascularized Interpositional Periosteal- Connective Tissue (VIP-CT) in Conjunction with Anterior Implant Placement in Maxilla : Report of Three Cases (상악 전치부의 임플란트 식립과 관련하여 혈관개재골막결합조직판막술을 이용한 치조제증대술: 3가지 증례보고)

  • Kim, Yun-Sang
    • Journal of Periodontal and Implant Science
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    • v.38 no.2
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    • pp.207-214
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    • 2008
  • Purpose: The aim of augmentation of the alveolar ridge is to restore absorbed alveolar ridges for future implant site or esthetic prosthodontic restoration. The present clinical report describes the anterior maxillary augmentation cases using a soft tissue rotated palatal flap, and considers various problems of before and after surgery. Method: First & second patients were treated by vascularized interpositional periosteal-connective tissue(VIP-CT) flap for horizontal soft tissue augmentation. Especially second patient was progressed with bone grafting at the same time. Third patient was treated by the same flap with bone graft and implant placement in single tooth missing premaxillary area. Result: The obtained horizontal augmentation width measured $0.5{\sim}2.7\;mm$. Conclusion: This technique constitutes a viable approach for augmentation the anterior sector of alveolar ridge with the placement of dental implants. But it needs correct diagnosis preparation and careful surgery skill.

Polydeoxyribonucleotide, as a Novel Approach for the Management of Medication-Related Osteonecrosis of the Jaw: A Preliminary Observational Study

  • Jung, Junho;Lim, Hae Soo;Lee, Deok-Won
    • Journal of Korean Dental Science
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    • v.11 no.2
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    • pp.57-61
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    • 2018
  • Purpose: Polydeoxyribonucleotide (PDRN), consisting of a mixture of deoxyribonucleotide polymers, has been suggested to have anti-inflammatory effects and enhance angiogenesis as an adenosine $A_{2A}$ receptor agonist. The aim of this study was to report the effectiveness of PDRN as an adjuvant therapy after surgical debridement in MRONJ (medication-related osteonecrosis of the jaw) patients. Materials and Methods: Five patients (1 male, 4 females, age 65~79 years) who were diagnosed with MRONJ stage 2 or 3 underwent surgical debridement and PDRN mucosal injection. After surgical debridement, patients were subject to daily injection with 1 ml of PDRN around the surgical wound for 14 days. Result: The patients' symptoms gradually disappeared. The surgical wound uneventfully healed, and no recurrence was observed during the follow-up period. Conclusion: Although further studies are required, the present study first describes the possibility of PDRN as a useful option for MRONJ treatment.

Experimental Evaluation of Algin-coated Vascular Grafts in Dogs (잡견에서의 알진 코팅 인조혈관 삽입실험)

  • 김원곤
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.557-564
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    • 1995
  • Microvel knitted double velour vascular grafts coated with biodegradable algin were evaluated in the canine experimental model as a new biologically coated Dacron graft. Three series of implantations were conducted involving the insertion of 6 mm diameter grafts in the abdominal aortae of mongrel dogs. The first series used the regular Microvel vascular grafts coated with algin,whereas the second and third series used Hemashield [collagen-coated grafts and the regular Microvel grafts with preclotting,respectively as control groups. Each series involved the implantation of one prosthesis for each of 2 preselected periods,namely 3 months and 6 months. In addition,algin-impregnated grafts were implanted for 4 hours,72 hours,2 weeks,and 4 weeks. All grafts were patent when the animals were sacrificed at intervals ranging from 4 hours to 6 months. Histological examinations revealed no obvious or significant differences in the healing characteristics of the algin-coated grafts and the control grafts after 3 months and 6 months of implantation. Endothelial cell-like cells were present on the midsegments of all grafts explanted from animals sacrificed after 3 months and 6 months,except a suspicious finding in the 3 month-implantation animal of a preclotted graft. With special stains,the algin became invisible between the polyester filaments during the first 3 months of implantation. This study has demonstrated that the use of a biodegradable algin coating is a feasible approach as biological sealants for textile arterial prostheses.

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Approach for the Treatment on Hallux Valgus (무지 외반증의 치료에 대한 고찰)

  • Lee, Sung-Hyun;Lee, Yeong-Chang
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.143-148
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    • 2019
  • Although many patients who undergo bunion repair do well and have satisfactory results, a critical evaluation of these results shows the potential for improvement. Metatarsal deformity of the hallux valgus is a 3-dimensional deformity, including rotation in the coronal plane. Theoretically, it is important to understand the 3-dimensional displacement of the first metatarsal for correcting the deformities of valgus rotation in the frontal plane. Yet the current methods of metatarsal osteotomy principally attempt to correct the deformity in the transverse plane. The modified technique for the Lapidus procedure can be used in a variety of hallux valgus conditions and severities, and the early results suggest that a powerful correction can be maintained. In addition, efforts have been made to correct the 3-dimensional deformity by performing metatarsal shaft osteotomy. In the case of degenerative arthritis, first metatarsophalangeal joint arthrodesis is a good option to correct the 3-dimensional deformation. Correction of the 3-dimensional deformity, including a rotational deformity in the frontal plane of the metatarsals, should be considered when selecting surgical treatment and is essential for achieving a good prognosis for patients with hallux valgus. This article reviews the classification and treatment of hallux valgus for correction of the 3-dimensional deformity.

An application of datamining approach to CQI using the discharge summary (퇴원요약 데이터베이스를 이용한 데이터마이닝 기법의 CQI 활동에의 황용 방안)

  • 선미옥;채영문;이해종;이선희;강성홍;호승희
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2000.11a
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    • pp.289-299
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    • 2000
  • This study provides an application of datamining approach to CQI(Continuous Quality Improvement) using the discharge summary. First, we found a process variation in hospital infection rate by SPC (Statistical Process Control) technique. Second, importance of factors influencing hospital infection was inferred through the decision tree analysis which is a classification method in data-mining approach. The most important factor was surgery followed by comorbidity and length of operation. Comorbidity was further divided into age and principal diagnosis and the length of operation was further divided into age and chief complaint. 24 rules of hospital infection were generated by the decision tree analysis. Of these, 9 rules with predictive prover greater than 50% were suggested as guidelines for hospital infection control. The optimum range of target group in hospital infection control were Identified through the information gain summary. Association rule, which is another kind of datamining method, was performed to analyze the relationship between principal diagnosis and comorbidity. The confidence score, which measures the decree of association, between urinary tract infection and causal bacillus was the highest, followed by the score between postoperative wound disruption find postoperative wound infection. This study demonstrated how datamining approach could be used to provide information to support prospective surveillance of hospital infection. The datamining technique can also be applied to various areas fur CQI using other hospital databases.

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Delayed Reduction of Facial Bone Fractures (정복 시기가 지난 안면골 골절의 수술적 교정)

  • Lee, Kyu-Seop;Park, Jae Beom;Song, Seung Han;Oh, Sang Ha;Kang, Nak Heon
    • Archives of Craniofacial Surgery
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    • v.14 no.2
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    • pp.119-123
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    • 2013
  • Except for special situations, it is generally agreed that best results in the treatment of facial fractures is expected if reduction is done within the first 2 or 3 weeks after injury. We reduced facial bone fractures at 4 to 7 weeks after trauma. A 44-year-old female patient underwent open reduction for her right zygomaticomaxillary complex fracture at 7 weeks after injury. A 59-year-old female patient underwent surgery for the right mandible body and left parasymphysis fractures at 4 weeks after injury. Using traditional approaches, granulation tissue and callus were removed from the fracture sites, and malunited fracture lines were separated by a small osteotome. We reduced the displaced fractured zygoma and mandible to their normal anatomical positions and fixed them using titanium plates. No complications such as asymmetry, malunion, malocclusion, or trismus were seen. Unfavorable asymmetric facial contours were corrected, and we obtained good occlusion with favorable bony alignment. The functional and aesthetic outcomes were satisfactory. Through removal the callus and limited osteotomy, a successful approach to the previously fractured line was possible, and an exact correction with symmetry was obtained. This method can be a good option for obtaining good mobility and clinical results in treating delayed facial bone fractures.

Robot-Assisted Transoral Odontoidectomy : Experiment in New Minimally Invasive Technology, a Cadaveric Study

  • Yang, Moon-Sul;Yoon, Tae-Ho;Yoon, Do-Heum;Kim, Keung-Nyun;Pennant, William;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.248-251
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    • 2011
  • Objective : In the field of spinal surgery, a few laboratory results or clinical cases about robotic spinal surgery have been reported. In vivo trials and development of related surgical instruments for spinal surgery are required before its clinical application. We investigated the use of the da $Vinci^{(R)}$ Surgical System in spinal surgery at the craniovertebral junction in a human cadaver to demonstrate the efficacy and pitfalls of robotic surgery. Methods : Dissection of pharyngeal wall to the exposure of C1 and odontoid process was performed with full robotic procedure. Although assistance of another surgeon was necessary for drilling and removal of odontoid process due to the lack of appropriate end-effectors, successful robotic procedures for dural sutures and exposing spinal cord proved its safety and dexterity. Results : Robot-assisted odontoidectomy was successfully performed in a human cadaver using the da $Vinci^{(R)}$ Surgical System with few robotic arm collisions and minimal soft tissue damages. Da $Vinci^{(R)}$ Surgical System manifested more dexterous movement than human hands in the deep and narrow oral cavity. Furthermore, sutures with robotic procedure in the oral cavity demonstrated the advantage over conventional procedure. Conclusion : Presenting cadaveric study proved the probability of robot-assisted transoral approach. However, the development of robotic instruments specific to spinal surgery must first precede its clinical application.

Epithelial-myoepithelial carcinoma on the superficial lobe of the parotid gland: a case report (이하선 천엽에 발생한 상피-근상피암종의 치험례)

  • Jin, Sun-Mi;Ryu, Hyun-Ho;Ryu, Seok-Hwan;Shin, Dong-Yoon;Hwang, Hie-Sung;Kim, Chul-Hoon;Kim, Bok-Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.6
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    • pp.505-509
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    • 2011
  • Epithelial-myoepithelial carcinoma (EMC) is a low-grade malignant salivary gland neoplasm that was first described in 1972. EMC occurs in the older age group, there is a female predilection and mainly involves the parotid gland. Most authors recommend superficial parotidectomy as a treatment for low-grade malignant tumor in the superficial lobe of parotid gland. The treatment of epithelial-myoepithelial tumors typically includes surgical excision aimed at achieving a R0 resection. This paper reports a case of EMC of the parotid gland treated only by a conservational surgical excision. The lesion was exposed by the retromandibular approach and detached. After the parotid gland envelop was exposed, the mass was observed and was easy to remove due to capsulation. The preoperative diagnosis was a pleomorphic adenoma on the left parotid gland. The tumor was removed surgically with a conservative extracapsular dissection. The postoperative diagnosis was EMC, so superficial parotidectomy or radiation therapy was considered. Nevertheless, the patient was observed and no additional treatment was attempted because the patient was old and a successfully excision of the tumor had been achieved.