• Journal of Chest Surgery
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• 제46권3호
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• pp.202-207
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• 2013

Background: The role of totally implantable central venous port (TICVP) system is increasing. Implantation performed by radiologist with ultrasound-guided access of vein and fluoroscope-guided positioning of catheter is widely accepted nowadays. In this article, we summarized our experience of TICVP system by surgeon and present the success and complication rate of this surgical method. Materials and Methods: Between March 2009 and December 2010, 245 ports were implanted in 242 patients by surgeon. These procedures were performed with one small skin incision and subcutaneous puncture of subclavian vein. Patient's profiles, indications of port system, early and delayed complications, and implanted period were evaluated. Results: There were 82 men and 160 women with mean age of 55.74. Port system was implanted on right chest in 203, and left chest in 42 patients. There was no intraoperative complication. Early complications occurred in 11 patients (4.49%) including malposition of catheter tip in 6, malfunction of catheter in 3, and port site infection in 2. Late complication occurred in 12 patients (4.90%). Conclusion: Surgical insertion of TICVP system with percutaneous subclavian venous access is safe procedures with lower complications. Careful insertion of system and skilled management would decrease complication incidence.

• Journal of Chest Surgery
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• 제24권7호
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• pp.693-700
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• 1991

A rare case of the association of distal aortopulmonary septal defect, aortic origin of the right pulmonary artery, intact ventricular septum, patent ductus arteriosus and interrupted aortic isthmus in a 40-day-old infant is reported. The infant was suffered from two operations with an interval of nine days. At the first operation a 10mm polytetrafluoroethylene prosthesis was inserted instead of the interrupted aortic isthmus and ductus was ligated via the left posterolateral thoracotomy. But the patient could not be weaned from the respirator because of large amount of left-to-right shunt. So the total correction was subsequently performed after an interval of nine days. At the second operation, tunneling of the right pulmonary artery to the main pulmonary artery through the aortopulmonary septal defect was performed using the Dacron patch via a longitudinal transaortic approach and a separate autologous pericardial patch was applied to the longitudinally incised margins of the anterior wall of the ascending aorta. The second postoperative course was relatively uneventful except some respiratory distress and nutritional problems. Now he is at 6 months of age and thrives well without any symptom. Because the success of the surgical repair of this complex anomalies depends upon the accurate diagnosis and meticulous design of each step of procedure prior to operation these problems are also discussed.

• Journal of Periodontal and Implant Science
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• 제32권1호
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• pp.69-87
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• 2002

Implant material, implant design, surface quality, status of the bone, surgical technique, and implant loading conditions were regarded as prerequisites for osseointegration which is a prime condition for implant success. The aim of this review paper was to investigate the survival rate of single implants in relation to the prerequisites for osseointegration. Fifty-eight papers reporting survival rates of single implants were selected by use of the 'PubMed' and hand searching. The survival rate of single implants were assessed with reference to factors influencing osseointegration. The results showed that single implants in general showed a high survival rate except a few failures in certain extreme conditions and early stages. Those failures and complications such as screw loosening and esthetic problem were almost solved with the development of implant components and surgical techniques and a better understanding of biology around a single implant. Single-tooth implant-replacement is now considered as a reliable and predictable treatment option for a single missing tooth and its application seems to expand to compromised situations which were previously thought to be impossible for single implant therapy.

• 대한청각학회지
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• 제25권1호
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• pp.49-54
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• 2021

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

• Journal of Audiology & Otology
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• 제25권1호
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• pp.49-54
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• 2021

Type II mucopolysaccharidosis (MPS II) commonly known as Hunter syndrome, is a rare X-linked lysosomal storage disorder caused by iduronate-2-sulfatase deficiency, which in turn causes otorhinolaryngological manifestations, including sensorineural hearing loss (SNHL). Previously, the median survival age of patients with MPS was approximately 13.4 years. However, in the era of enzyme replacement therapy and other multidisciplinary care modalities, the life expectancy has increased. Herein, we report a rare case of an adolescent with MPS II who underwent SNHL treatment with cochlear implantation (CI). Based on unexpected findings of mastoid emissary veins and overgrowth of the vessels around the temporal bone, CI was performed using the transmeatal approach instead of the conventional transmastoid method, to avoid damage to the vessels. The average hearing threshold after CI was 35 dB and no surgical complications were encountered. Adolescent MPS II may present vessel abnormalities, which can reduce the success rate of surgery. In patients with MPS II with SNHL, CI should be performed under careful monitoring of vessel overgrowth. Moreover, with regard to feasibility of CI in adolescent patients with MPS II with SNHL, surgical techniques such as the transmeatal approach should be selected based on adequate assessment of the case.

• Journal of Digestive Cancer Research
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• 제5권1호
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• pp.37-43
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• 2017

Laparoscopic cholecystectomy is of one the most common general surgical operations performed today. Concomitant choledocholithiasis occurs in roughly 10-20% of patients with symptomatic gallstones. Laparoscopic bile duct exploration (LBDE) offers a single-stage minimally-invasive solution to the management of choledocholithiasis. LBDE may be performed either via the transcystic route or via laparoscopic choledochotomy. A number of strategies to improve success are available to the surgeon to help in the problem of complicated choledocholithiasis, these range from simple maneuvers to the use of laser or mechanical lithotriptors. With the advances in laparoscopic surgery, it is also possible to handle complex surgical conditions such as Mirizzi syndrome or recurrent pyogenic cholangitis laparoscopically, even though these have yet to be accepted as standard of care. Following laparoscopic choledochotomy, options for closure include: primary closure, closure over a T-tube, and closure over an endobiliary stent. T-tube placement has been associated with increased operating time and hospital length of stay compared to primary closure, with no significant differences in morbidity. Based on the available literature, LBDE appears comparable to ERCP with regards to procedural efficacy and morbidity. LBDE remains relevant to the general surgeon and is best viewed as being complementary to endoscopic therapy in the management of choledocholithiasis.

• 대한소아치과학회지
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• 제44권4호
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• pp.461-468
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• 2017

교정치료의 목적으로, 또는 보존 불가능한 치아를 발거 후 치근 형성이 완료된 치아의 자가치아이식을 요구하는 경우가 늘어나고 있지만 미완성 치근 형성 치아를 이식하는 경우에 비하여 치근 형성이 완료된 치아를 이식하는 경우 생존률 및 성공률이 낮음이 보고 되고 있다. 이전의 자가치아이식에서는 공여치와 수여부만을 재현하는 모델만이 사용된 반면에 현재는 불필요한 골삭제와 술식 시간을 감소시켜주는 외과적 가이드 템플레이트들을 3D 프린팅 기술을 통하여 제작, 술식에 추가적으로 이용함으로써 이식시 적절한 방향와 깊이로 수여부를 형성할 수 있으며 술식시간도 감소시켜 자가치아이식의 성공률 및 생존률을 향상시킬 수 있다고 할 수 있다. 본 케이스는 치근 형성이 완료된 치아를 선천성 결손 부위에 자가이식한 케이스로 3D 프린팅 기술을 이용하여 공여치와 수여부 모형 모델 및 외과적 가이드 템플레이트들을 제작함으로써 술식의 성공률과 안정성을 높일 수 있었고 이식치의 양호한 치유 결과를 이끌어냈다.

• Journal of Periodontal and Implant Science
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• 제33권3호
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• pp.373-382
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• 2003

The successful use of osseointegrated implants to replace missing teeth has been demonstrated for both the completely and the partially edentulous patients. Many studies have confirmed an excellent long-term prognosis. The successful outcome of any implant procedure is surely dependent on the interrelationship of the various components that includes the following: biocompatibility of the implant material, macroscopic and microscopic nature of the implant surface, the status of the implant bed in both a health(noninfected) and a morphologic(bone quality) context, the surgical technique, the undisturbed healing phase, the subsequent prosthetic design, and long-term loading phase. Periodontally compromised patients have poor status of the implant bed and periodontal pathogen. No longitudinal data are available whether these factors affect the prognosis of implants. In this study, 102 machined $Br{{\aa}}nemark$ implants are inserted to analyze the success rate of 1-4 years and marginal bone loss in 49 chronic periodontitis patients. The following conclusions could be drawn from this study. 1. The cumulative success rate of implants at the 4-year of loading was 95.10%. 2. 5 failed implants have been removed. One implant have been removed due to infection, two implants were removed due to failure of osseointegration. and other two implants were removed due to mechanical failure caused by over-loading. 3. Mean marginal bone loss from the time of loading was 0.94mm at first year, 1.12mm at second year, 1.25mm at third year. These results suggest that implant therapy is good treatment modality in chronic periodontitis patients, and periodontal treatment including oral hygiene program is completed prior to insertion of implants.

• Clinical and Experimental Reproductive Medicine
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• 제23권1호
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• pp.61-66
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• 1996

Vasectomy has become a popular method for male sterilization and this, in tum, has been followed by an increase in the number of patients requiring vasectomy reversal. Recently, many authors have reported a high success rate of vasovasostomy using microsurgical techniques. However, a significant discrepancy exist between the anatomical patency rate and pregnancy rate despite improvements in surgical techniques. Number of 420 patients who underwent vasovasostomy by a modified one layer reanastomosis from January 1986 to December 1994 were reviewed. Of the total, Complete follow up were possible in 115 patients. Of the 115 patients, 74 patients were treated by macroscopic reanastomosis, and microscopic technique were applied in 41 patients. Duration of vasal obstruction, gross apperance of vasal fluid, operative method, presence or absence of sperm and sperm granuloma, and results of postoperative semen analysis were analyzed as factors influencing the pregnancy rate. Success rates for patency and for pregnancy were 81% and, 42% respectively. Rate of pregnancy were increased if there were shorter periods of obstruction(<10years), bilateral observation of watery vasal fluid, presence of sperm bilaterally, bilateral presence of sperm granuloma at the vasectomy site, and normal results on postoperative semenalysis. With these results, we can conclude that all factors mentioned may affect the success rate of pregnancy following vasovasostomy.

• Journal of Veterinary Science
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• 제23권5호
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• pp.65.1-65.10
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• 2022

Background: Persistent uroliths after a cystotomy in dogs are a common cause of surgical failure. Objectives: This study examined the following: the success rate of retrograde urohydropropulsion in male dogs using non-enhanced computed tomography (CT), whether the CT mean beam attenuation values in Hounsfield Units (mHU) measured in vivo could predict the urolithiasis composition and whether the selected reconstruction kernel may influence the measured mHU. Methods: All dogs and cats that presented with lower urinary tract uroliths and had a non-enhanced CT preceding surgery were included. In male dogs, CT was performed after retrograde urohydropropulsion to detect the remaining urethral calculi. The percentage and location of persistent calculi were recorded. The images were reconstructed using three kernels, from smooth to ultrasharp, and the calculi mHU were measured. Results: Sixty-five patients were included in the study. The success rate of retrograde urohydropropulsion in the 45 male dogs was 55.6% and 86.7% at the first and second attempts, respectively. The predominant components of the calculi were cystine (20), struvite (15), calcium oxalate (8), and urate (7). The convolution kernel influenced the mHU values (p < 0.05). The difference in mHU regarding the calculus composition was better assessed using the smoother kernel. A mHU greater than 1,000 HU was predictive of calcium oxalate calculi. Conclusions: Non-enhanced CT is useful for controlling the success of retrograde urohydropropulsion. The mHU could allow a prediction of the calculus composition, particularly for calcium oxalate, which may help determine the therapeutic strategy.