Objectives: To evaluate the mechanical properties and metallurgical characteristics of the M3 Rotary and M3 Pro Gold files (United Dental). Materials and Methods: One hundred and sixty new M3 Rotary and M3 Pro Gold files (sizes 20/0.04 and 25/0.04) were used. Torque and angle of rotation at failure (n = 20) were measured according to ISO 3630-1. Cyclic fatigue resistance was tested by measuring the number of cycles to failure in an artificial stainless steel canal ($60^{\circ}$ angle of curvature and a 5-mm radius). The metallurgical characteristics were investigated by differential scanning calorimetry. Data were analyzed using analysis of variance and the Student-Newman-Keuls test. Results: Comparing the same size of the 2 different instruments, cyclic fatigue resistance was significantly higher in the M3 Pro Gold files than in the M3 Rotary files (p < 0.001). No significant difference was observed between the files in the maximum torque load, while a significantly higher angular rotation to fracture was observed for M3 Pro Gold (p < 0.05). In the DSC analysis, the M3 Pro Gold files showed one prominent peak on the heating curve and 2 prominent peaks on the cooling curve. In contrast, the M3 Rotary files showed 1 small peak on the heating curve and 1 small peak on the cooling curve. Conclusions: The M3 Pro Gold files showed greater flexibility and angular rotation than the M3 Rotary files, without decrement of their torque resistance. The superior flexibility of M3 Pro Gold files can be attributed to their martensite phase.
Objective : Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL. Patients underwent minimally invasive anterior decompression without fusion. This method created a space on the ventral side of the OPLL without violating global thoracic spinal stability. Via this space, the OPLL and anterior lateral side of the dural sac can be seen and manipulated directly. Then, total removal of the OPLL was accomplished. No orthosis was needed. In this article, we share our key technique and concepts for treatment of huge thoracic OPLL. Methods : Case 1. 51-year-old female was referred to our hospital with right lower limb radiating pain and paresis. Thoracic OPLL at T6-7 had been identified at our hospital, and conservative treatment had been tried without success. Case 2. This 54-year-old female with a 6-month history of progressive gait disturbance and bilateral lower extremity radiating pain (right>left) was admitted to our institute. She also had hypoesthesia in both lower legs. Her symptoms had been gradually progressing. Computed tomography scans showed massive OPLL at the T9-10 level. Magnetic resonance imaging of the thoracolumbar spine demonstrated ventral bony masses with severe anterior compression of the spinal cord at the same level. Results : We used this surgical method in 2 patients with a huge beaked-type OPLL in the thoracic level. Complete removal of the OPLL via anterior decompression without instrumented fusion was accomplished. The 1st case had no intraoperative or postoperative complications, and the 2nd case had 1 intraoperative complication (dural tear) and no postoperative complications. There were no residual symptoms of the lower extremities. Conclusion : This surgical technique allows the surgeon to safely and effectively perform minimally invasive anterior decompression without instrumented fusion via a transthoracic approach for thoracic OPLL. It can be applied at the mid and lower level of the thoracic spine and could become a standard procedure for treatment of huge beak-type thoracic OPLL.
Kalyanaraman, Meena;McQueen, Derrick;Sykes, Joseph;Phatak, Tej;Malik, Farhaan;Raghava, Preethi S.
Clinical and Experimental Pediatrics
/
v.58
no.4
/
pp.154-157
/
2015
Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.26
no.6
/
pp.684-687
/
2000
Mongolia is a huge, landlocked, middle-Asian country bordering Russia in the north, and China in the south. Mongolia was under socialism from 1921 to 1990, and its political system has started moving toward capitalistic democratism in 1990. The history of the Mongolian Oral & Maxillofacial Surgery can be divided into four periods; the incipient period($1956{\sim}1971$), the period of early development($1971{\sim}1981$), the period of active development($1981{\sim}1991$), and the period of reformation($1991{\sim}$). Mongolian Oral & Maxillofacial Surgery had been developed by the cooperation of Soviet Union and Eastern European countries before the 1990s, but the role of Korea, Japan, and western countries has been increasing from the 1990s. In Mongolia Oral & Maxillofacial Surgery is well recognized to the people and is considered as one of the specialized medical field. There are specialized departments of Oral & Maxillofacial Surgery in State Central Hospital, Child & Maternal Research and Clinical Center, and Oncology Center in Ulaanbaatar. Now, the basic knowledge and surgical technique of the Mongolian Oral & Maxillofacial Surgeons are satisfactory. But because of the difficult social and economic situation, there is a shortage of surgical instruments and materials, and acquirement of new knowledge is not easy. In 1998 the Mongolian Association of Oral & Maxillofacial Surgeons was established and its members want to have international relationship to keep up with the new medical information. Mongolia and Korea have ethnic, linguistic and cultural similarity, so the interchange and cooperation between Mongolian and Korean Oral & Maxillofacial Surgeons are recommended to make a beautiful one-world.
Maluf, Gustavo;Caldas, Rogerio Jardim;Fregnani, Eduardo Rodrigues;da Silva Santos, Paulo Sergio
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.46
no.2
/
pp.150-154
/
2020
We present a case of osteoradionecrosis treated with leukocyte- and platelet-rich fibrin (LPRF) and surgery and followed up with clinical and tomographic investigations. A 65-year-old woman presented with pain in the posterior region of the right palate. Her medical history included cardiovascular disease and squamous cell carcinoma in the anterior region of the floor of the mouth that had been treated with intensity-modulated radiation therapy. Measurements of isodose curves showed a full dosage of 6,462.6 cGy in the anterior mandibular region, whereas that in the posterior region on the right side of the maxilla reached 5,708.1 cGy. Osteotomy was performed using rotary instruments, and debridement and placement of two LPRF membranes were also carried out. New gum tissue with no bone exposure was noted 14 days postoperatively. Tissue repair was complete, and the patient had no further complaints. During a 39-month follow-up period, the oral mucosa remained intact, and the patient was rehabilitated with a new upper denture. Since there is no consensus regarding the best protocol to treat osteoradionecrosis, LPRF might be an interesting adjuvant to a surgical approach. The use of LPRF is simple and reduces operational costs, time of handling, probability of technical failure, and associated morbidities for patients with osteoradionecrosis.
Objective : Though the operating microscope (OM) has been the standard optical system in neurosurgery, a new technology called three-dimensional (3D) exoscope has emerged as an alternative. Herein, two types of 3D exoscopes for brain tumor surgery are presented. In addition, the advantages and limitations compared with the OM are discussed. Methods : In the present study, 3D exoscope VOMS-100 or VITOM 3D was used in 11 patients with brain tumor who underwent surgical resection; the Kinevo 900 OM was used only in emergency. After completion of all surgeries, the participants were surveyed with a questionnaire regarding video image quality on the display monitor, handling of equipment, ergonomics, educational usefulness, 3D glasses, and expectation as a substitute for the OM. Results : Among 11 patients, nine patients underwent neurosurgical resection with only 3D exoscope; however, two patients required additional aid with the OM due to difficulty in hemostasis. Regarding video image quality, VITOM 3D was mostly equivalent to the OM, but VOMS-100 was not. However, both 3D exoscopes showed advantages in accessibility of instruments in the surgical field and occupied less space in the operating theater. Differences in ergonomics and educational usefulness between the exoscopes were not reported. Respondents did not experience discomfort in wearing 3D glasses and thought the exoscopes could be currently, and in the future, used as a substitute for the OM. Conclusion : Although many neurosurgeons are not familiar with 3D exoscopes, they have advantages compared with the OM and similar image quality. Exoscopes could be a substitute for OM in the future if some limitations are overcome.
Purpose: This study examined differences in nursing care activity, work performance outcomes, and job satisfaction associated with upgrading nurse staffing of a nurse-to-patients ratio. Methods: Descriptive design was used in this study. In total, 148 medical and surgical nurses were recruited from one university hospital. Three instruments were used for data collection: Scale of Nursing Care Activity, Nurses' Work Performance Outcome Measurement Scale and Nurses' Job Satisfaction Scale. Data were analyzed by using descriptive statistics, t-test, ANOVA, and paired t-test. Results: There were significant differences in nursing care activity (t=-5.06, p<.001), in work performance outcomes (t=-5.46, p<.001) and in job satisfaction (t=4.61, p<.001) when the grading for the nursing staff was changed from three to two indicating increasing number of nurses. Conclusion: The findings from this study showed that there were more nursing care activities, better work performance outcomes, and higher job satisfaction when numbers of nurses were increased. The changes in the scale to evaluate nursing staff influence nursing activities, work performance and job satisfaction.
During a full-thickness skin graft procedure, the thickness of the harvested donor skin is adjusted based on the location of the recipient site and the judgment of the surgeon. Conventionally, the thickness of the harvested skin is roughly adjusted using surgical instruments such as scalpels and scissors. However, this method is not only time-consuming, but also requires effort to obtain both the desired thickness of the harvested skin and a smooth surface of that skin. Moreover, there is a possibility of skin perforation. Hence, the authors devised a method of adjusting harvested skin thickness using the Versajet Hydrosurgery System. The Versajet device is a handheld hydrosurgical tool that delivers a high-speed jet stream of saline solution, which enables the precise debridement of tissue. This method makes it easier and faster for the surgeon to obtain the desired thickness of harvested skin. In addition, by obtaining a smooth surface and an even thickness of harvested donor skin, this technique may lead to improved graft viability.
Journal of Korean Academy of Fundamentals of Nursing
/
v.12
no.2
/
pp.215-222
/
2005
Purpose: To identify the incidence of cutaneous injury in clinical nurses. Method: From Feb.1 to 28, 2005, 276 clinical nurses were surveyed by questionnaire. Results: 1. Of the nurses, 53.6% had at least one incidence of cutaneous injury, and the mean number of injuries was 1.34. A higher incidence rate for cutaneous injury was found in nurses who were under the age of 25, unmarried and who had less than 3 years career experience. 2. The major causes of injury were syringe needles at 65.0%, and medical instrument were next followed by sharp objects or blades. The injuries occurred when the nurses were rearranging equipment after care (25.2%), taking blood samples (22.8%), separating syringes and needles (17.1%), during surgical operations (14.2%), and distribution of medications, treatments and recapping of needles (5.7% each). The hands were the most common body parts injured, and the most prevalent pathogens contaminating the instruments causing the injury were HBV syphilis, HCV and HIV in that order. 3. Of the injured nurses, 77.9% did not report the accident and 25.8% did not receive any treatment because there were no pathogens, it was a bother or there was difficulty reporting the incident. Conclusion: To reduce cutaneous injuries, intensive training and supervision may be needed for those of nurses under the age of 25, unmarried and with less than 3 years career experience.
Purpose: The purpose of this study was to analyze nursing records for pain management in intensive care unit (ICU) patients. Methods: Nursing process for pain management were analyzed retrospectively by 180 ICU patients' nursing records. Instruments consisted of 3 questionnaires (pain assessment, intervention, and evaluation). Results: For assessment, there was different pain intensity between cancer patients (7.95) and non-cancer patients (7.20). Also pain intensity was lower in PCA group (5.08) than in PCA with PRN group (8.27). Common pain site was surgical areas, along with 17 kinds of words expressed for pain, and mean of pain intensity was 7.47 by numeric rating scales (NRS). For intervention, the patients received pharmacologic interventions (99.4%) such as narcotic analgesics (38.3%) intermittently (70.5%) without side effects (94.4%). For evaluation, mean of pain intensity was decreased to 3.14, but a few patients (12.8%) experienced pain over 5 points despite the intervention. Nurses evaluated the degree of pain relief after the intervention in 87.2% of patients. Conclusion: Nurses do assess patients' pain by using objective tool, intervene, and evaluate for effective pain management. Nurses should make an individual approach and record all nursing activities for pain management.
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