• Title/Summary/Keyword: prosthetic treatment

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Surgical Treatment for Multivalvular Heart Disease (중복 심장판막 질환의 외과적 치료)

  • Kim, Jin; Jo, Jung-Ku;Kim, Kong-Soo
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.875-882
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    • 1996
  • Multlvalvular heart surgery was performed In 78 cases, in the Department of Thoracic & Cardiovascu far Surgery of Chonbuk national University Hospital from november 1983 to March 1994. There Where 31 men and 47 women. whose ranged from 14 to 63 years. The causes of the valvular lesions were 57 rheumatic origin, 18 degenerative, 1 previous endocarditls, 1 prosthetic valve mal-function. There were 25 double valve replacement with or wit out tricuspid valve repair, i M VR and aortic valve repair, 18 MVR and tricuspid valve repair, 1 MVR and aortic and tricuspid valve repair, 10 AVR and mi- tral valve repair, 1 AVR and tricuspid valve repair, 8 mitral aortic valve repair, 13 mitral and tricuspid valve repair. They were improved mean New York Heart Association functional cldss, from 2.72% 121 Early deaths were 5 cases(6.4%). The cause of death wet'e low cArdiac output syndrome. veritricular tachycardia, massive bleeding and cerebral thromboembolism. All the survivors belonged to New York Heart Association functional class I or ll at discharge. The patients who had had valve replacement operation were medicated with warfarin to maintain the level of 30∼ 50% of normal prothrombin time. During follow-up(93.6%, mean 49.9 months), 2 late deaths were developed. One was due to intracranial hemorrhage and the other congestive heart failure. The pre-operative New York Heart Association Functional class IV was statistically sig ificant operat- ive risk factors(p< 0.05).

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Analysis of Relationship Between Dental Health Condition and Eating Habit (치아건강상태와 식습관과의 상관관계 분석)

  • kim, Jeong-Sook;Lee, Jong-Do;Jung, Hyo-Kyung
    • Journal of Technologic Dentistry
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    • v.29 no.1
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    • pp.103-119
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    • 2007
  • The survey on dental health condition and eating habit of local residents in Daegu and Kyungbuk had been conducted. Through the analysis of influence of dental health condition on eating habit I could get the following result. The number of subjects of survey is 630. The period of survey is from June 2006 to September 2006. 1. General quality of subjects is that forty-four point four percent of subjects are male and fiftyfive pointsix percent are female. The age of thirty point one percent of subjects is between 20 and 29. Fifty-six point two percent of subjects are married. Fifty-one point four percent of subjects have above bachelor degree. Monthly income of forty-four point eight percent of subjects is less than one million won. Twenty-four point four percent of subjects are students. Fifty-five point seven percent of subjects are living in big cities. 2. Forty-seven point seven percent of male and fifty-one point eight percent of female answered their subjective dental health condition is bad. Marital status, age and academic background have relationship with answer. Forty-three point nine percent of married subjects and forty-one point five percent of divorced or bereaved subjects said they have bad dental health condition. The older he is or the lower academic background he has subjects think they have bad dental health condition. Forty-seven point four percent of non-educated subjects answered their dental health condition is bad. Forty-six percent of self-employed subjects and subjects who live in the country have tendency to think their dental health condition is bad. 3. About eating habit knowledge, male's knowledge of 2.03$\pm$0.20 is lower than female's of 2.08$\pm$0.21. This shows there is statistically significant difference(p<0.01). 4. There is significant relationship between subjective dental health condition and health condition of subjective. This means subject who has better health condition has also better dental health condition(37.5%). About subjective dental health condition, subject who eats restoratives has worse dental health condition. This shows there is a relationship between dental health condition and eating restoratives(p=0.004) and subject who works out steadily has better dental condition. 5. About relation between dental health condition and eating habit, subject who eats vegetables has worse dental health condition by fifty point seven percent. As cross tabulation result, p-value is 0.002. In level of significance of 0.05, there is statistically significant difference in eating habit. 6. It seems that eating habit has an effect on marital status, age, academic background, income and also on dental prosthetic treatment situation. Many subjects think their dental health condition is bad. About eating habit, subjects who eat meat have better dental health condition. Subjects who drink green tea and fruit juice has better dental health condition than who drink coffee and Balanced diet is good for dental health condition. As eating habit is important for developing dental health, government should make a proper program. Dental health education program especially for elderly, low-eduacted, residents in the country and poor people should be developed. Government, dental health organization, dental health specialist, associated research institution and people work in the press should be concerned and devote to improve quality of life. Primary prevention education will help for dental health.

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Effect of the Number and Location of Implants on the Stress Distribution in Three-unit Fixed Partial Denture: A Three-Dimensional Finite Element Analysis (임플란트 고정성 보철물에서 수와 식립위치 변화에 따른 골과 임플란트에서의 응력분포에 관한 3차원 유한요소법적 연구)

  • Lee, Woo-Hyun;Lim, Jong-Hwa;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.221-239
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    • 2010
  • Bone loss may occur depending on the loading conditions. careful treatment planning and prosthetic procedures are very important factors for the proper distribution of stress. Evaluate the stress distributions according to numbers and location of implants in three-unit fixed partial dentures. A mandible missing the right second premolar, first molar and second molar was modeled. Using the CT data. we modeled a mandible with a width of 15mm, a height of 20mm and a length of 30mm, 2mm-thickness cortical bone covering cancellous bone mallow. An internal type implant and A solid type abutment was used. A model with 3 implants placed in a straight line, offset 1.5 mm buccally, offset 1.5 mm lingually and another model with 3 implants offset in the opposite way were prepared. And models with 2 implants were both end support models, a mesial cantilever model and a distal cantilever model. Three types of loading was applied; a case where 155 N was applied solely on the second premolar, a case where 206 N was applied solely on the second molar and a case where 155 N was applied on the first premolar and 206 N was applied on the first and second molar. For all the cases, inclined loads of 30 degrees were applied on the buccal cusps and vertical loads were applied on the central fossas of the teeth. Finite element analysis was carried out for each case to find out the stress distribution on bones and implants. This study has shown that prostheses with more implants caused lower stress on bones and implants, no matter what kind of load was applied. Furthermore, it was found out that inclined loads applied on implants had worse effects than vertical loads. Therefore, it is believed that these results should be considered when placing implants in the future.

Composite Graft Aortic Root Replacement with Coronary Button Reimplantation: The Early and Mid-Term Results (Composite graft를 이용한 대동맥근부 치환술: Button 술식의 중단기 결과)

  • 나찬영;백만종;김웅한;오삼세;김수철
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.356-364
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    • 2002
  • Background: This study was undertaken to investigate the outcome of composite graft aortic root replacement using coronary button reimplantation technique for the treatment of aneurysms of the ascending aorta involving the aortic root. Material and Method: Between April 1995 and September 2001, 54 patients having aortic root replacement with a composite valve graft using direct coronary button reimplantation were reviewed retrospectively. Left ventricular dysfunction was present in 14 patients(25.9%), aortic regurgitation in 48(89%), and Marfan's syndrome in 17(31.5%). The indications for operation were annuloaortic ectasia in 29 patients(53.7%), aortic dissection in 11(20.4%), aneurysms of the ascending aorta involving aortic root in 12(22.2%), and aortitis in 2(3.7%). Six patients(11.1%) had previous cardiac or ascending aortic operations. Concomitant procedures were arch replacement in 21 patients(38.9%), coronary artery bypass graft in 7(13%), mitral valve repair or replacement in 4(7.4%), and others in 6. The mean time of circulatory arrest, total bypass, and aortic crossclamp were 18 $\pm$ 9 minutes, 177 $\pm$ 42 minutes, and 127 $\pm$ 31 minutes, respectively. Result: There was 1 early death(1.9%). Mean follow-up was 24.6$\pm$ 19.5 months. There were two late deaths(3.8%) including one death due to the traumatic cerebral hemorrhage. The Kaplan-Meier survival rate was 98.0 $\pm$ 2.0% and 93.1 $\pm$ 5.1% at 1 and 6 years, respectively. Two patients required reoperation owing to a false aneurysm at the root anastomosis site and a malfunction of prosthetic aortic valve(3.8%). Staged operation for dissection of the remaining thoracoabdominal aorta was performed in 1 patient. The freedom rate from reoperation was 97.8 $\pm$ 2.0% and 65.3 $\pm$ 26.7% at 1 and 6 years, respectively.

Purification and Characterization of the Red Carotenoprotein from the Muscle of Blue Mussel, Mytilus edulis (진주담치 근육중의 적색 Carotenoprotein의 정제 및 특성)

  • YANG Huyn-Pil;LEE An-Jong;KIM Yong-Tae;KIM Se-Kwon
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.27 no.5
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    • pp.482-494
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    • 1994
  • Most of carotenoprotein complexes have been extracted by using buffered solutions. However, in this study carotenoprotein from the muscle of Blue mussel(Mytilus edulis) was extracted by a detergent such as Triton X-100. It was purified and characterized by $20\%$ (w/v) $(NH_4)_2SO_4$, DEAE-cellulose ion exchange and Sephacryl S-300 gel filtration. The carotenoprotein(${\lambda}_{max}=462nm$) had an approximate M. W. of 372KDa(gel filtration). SDS-PAGE analysis of the carotenoprotein indicated the presence of four polypeptides of 60KDa($23.70\%$), 46.9KDa($9.14\%$), 26KDa($49.14\%$) and 13KDa($18.02\%$). Carotenoprotein denaturated by treatment with SDS to a final concentration of $0.2\%$ (w/v) caused a hypsochromic shift of ${\lambda}_{max}$ from 462nm to 456nm. The carotenoprotein contained lipids as structure units. The amino acid composition of the carotenoprotein contained large essential amino acid amounts of $62.8\%$, and the content of threonine($35.9\%$) was higher than other amino acids, but histidine, methionine and proline were not present. In the carotenoprotein, the major fatty acids were $C_{16:4},\;C_{16:0},\;C_{20:5}\;and\;C_{22:6}$. The percentages of polyunsaturated fatty acids($62.4\%$) were higher compared to other fatty acids(saturated fatty acids $19.6\%$, monounsaturated fatty acids $18.0\%$). Carotenoid was extracted from the carotenoprotein by acetone and it was separated into five different components by preparative TLC(benzene:petroleum ether:acetone=69:17:14). The major components of carotenoid were mytiloxanthin($74.79\%$) and 3,4,3'- trihydroxy-7',8'-didehydro-${\beta}$-carotene($18.26\%$), and they were at least presented as prosthetic groups of carotenoprotein.

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The Morphologic Changes by Immunosuppression after Heterotopic Transplantation of the Murine Cryopreserved Trachea: An Animal Model for Obliterative Bronchiolitis (이소 이식된 쥐 기관의 면역억제 및 초냉동 보관에 의한 형태학적 변화: 폐색성 모세기관지염의 연구를 위한 동물 실험 모델)

  • 이창하;성숙환;오미혜
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.215-223
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    • 1999
  • Background: The replacement of the narrowed long-segment trachea with various prosthetic materials or tissue grafts remains a difficult and unsolved surgical problem. Homologous cryopreserved tracheal transplantation has been considered to treat the irreversibly-damaged organs, such as in the lung or heart transplantation and also to overcome the limited supply of donor organs. We examined the morphological changes and the immunosuppressive effects of the cryopreserved trachea after the heterotopic transplantation in the rats. Material and Method: Sixty tracheal segments harvested from 30 donor Wistar rats were heterotopically implanted into the peritoneal cavity of 20 recipient Wistar rats and 40 Sprague Dawley rats. The 60 recipient rats were divided into 6 groups(10 rats/ group). In groups I, II, and III, 30 tracheal segments were implanted immediately after the harvesting and in groups IV, V, and VI, the segments were implanted 28 days after the cryopreservation. Groups I and IV were Wistar syngeneic controls. Groups II and V were Sprague Dawley recipients receiving no immunosuppression and Groups III and VI, were Sprague Dawley recipients receiving immunosuppressive agents. At 28 days all rats were sacrificed and the tracheal segments were evaluated grossly and histologically. Result: Immunosuppression of the tracheal segments had a significant influence on the changes of the tracheal lumen and tracheal epithelial cells, irrespective of the cryopreservation of the trachea(p<0.001). In groups III and VI receiving immunosuppressive agents, the tracheal lumen was patent and the normal epithelial cells were observed, however in the other groups not receiving the immunosuppressive agents, there were almost luminal obliteration by the proliferation of the fibrous tissues and a loss of the epithelial cells, the findings were similar to those in the case of obliterative bronchiolitis after a lung and a heart-lung transplantation. Conclusion: With the appropriate immunosuppressive agents, the lumen and the respiratory epithelium of the transplanted tracheal segment were well preserved, even after the cryopreservation of the tracheal segment, which shows the possibility of the long-term preservation and homologous transplantation of the trachea. But fibroproliferative obliteration of the tracheal lumen and the loss of the normal respiratory epithelial cells, characteristic findings of obliterative bronchiolitis, were observed in the groups without the immunosuppression. This experiment using the rat trachea may be useful in studying the pathogenesis, treatment, and prevention of obliterative bronchiolitis after a lung and a heart-lung transplantation.

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Full mouth rehabilitation for a patient with vertical dimension loss using digital diagnostic analysis: A clinical report (수직고경이 감소된 환자의 디지털 진단 분석을 이용한 완전 구강 회복 증례)

  • Choi, Yeawon;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Kim, Hyeong-Seob;Kwon, Kung-Rock;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.487-496
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    • 2021
  • Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient's occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient's condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient's condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

Periprosthetic Fracture around Tumor Prosthesis, Comparison of Results with or without Cortical Strut Onlay Allograft (종양인공관절 주위 골절의 피질골 지주 중첩 동종골 이식술 유무에 따른 결과 비교)

  • Kim, Yongsung;Cho, Wan Hyeong;Song, Won Seok;Lee, Kyupyung;Jeon, Dae-Geun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.42-50
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    • 2021
  • Purpose: Periprosthetic fractures of a tumor prosthesis are rare but have difficulties in achieving sound fixation because of the poor bone quality, which increases the risk of loosening or re-fracture, even after bone union. A cortical strut onlay allograft was adopted for peri-prosthetic fractures after hip arthroplasty into the periprosthetic fracture of a tumor prosthesis, assuming that it would assist in firm fixation, shorten the time to union, and increase the bone stock, thereby, lower the chance of loosening and re-fracture. Materials and Methods: This study reviewed 27 patients (30 cases) of periprosthetic fracture of tumor prosthesis. Sixteen cases (allograft group) had augmentation with an onlay allograft, while 14 cases (conventional group) had internal fixation or conservative treatment. The following were assessed; mode of periprosthetic fracture, difference in the time to union between a strut cortical onlay allograft and without it, and survival of prosthesis, complication, and functional outcome between the two groups. Results: According to the unified classification system (UCS), 21 cases were type B (70.0%; B1, 14; B2, 1; B3, 6) and 9 cases were type C. The five-, 10-year survival of the 30 reconstructions by Kaplan-Meier plot was 84.5%±4.18% and 42.2%±7.83%, respectively. The average time to bone union of the entire cohort was 5.1 months (range, 2.0-11.2 months). The allograft group (3.5 months) showed a shorter period for union than the conventional group (7.2 months) (p<0.0001). All four cases of major complications occurred in the conventional group. Two cases with loosening and anterior angulation were treated with a change of prosthesis, and another with infection underwent amputation. The remaining case with loosening had conservative management. At the final follow-up, the average Musculosketal Tumor Society score of the allograft group (26.1) was better than that of the conventional group (20.9). Conclusion: Bone union in periprosthetic fractures of a tumor prosthesis can be achieved, but the minimization of complications is important. An onlay allograft facilitates firm fixation and increases the bone stock with a shortened time to union. This simple method can minimize the risk of loosening, joint contracture, and re-fracture.

Surgical Treatment for Isolated Aortic Endocarditis: a Comparison with Isolated Mitral Endocarditis (대동맥 판막만을 침범한 감염성 심내막염의 수술적 치료: 승모판막만을 침범한 경우와 비교 연구)

  • Hong, Seong-Beom;Park, Jeong-Min;Lee, Kyo-Seon;Ryu, Sang-Woo;Yun, Ju-Sik;CheKar, Jay-Key;Yun, Chi-Hyeong;Kim, Sang-Hyung;Ahn, Byoung-Hee
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.600-606
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    • 2007
  • Background: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. Material and Method: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male female=18 : 7, mean age $43.2{\pm}18.6$ years) and 23 patients with isolated mitral endocarditis (Group II, male female=10 : 13, mean age $43.2{\pm}17.1$ years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patients developed mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II, The pre-operative left ventricular ejection fraction for each group was $60.8{\pm}8.7%$ and $62.1{\pm}8.1%$ (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was $37.2{\pm}23.5$ (range $9{\sim}123$) months. Result: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and foo%, 84.9%, and 84.9% for Group II patients, respectively. Conclusion: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.

A Study on the Stress Distribution of Tooth/Implant Connected with Konus Telescope Denture Using 3-Dimensional Finite Element Method (이중관으로 연결된 자연치와 임플랜트의 악골 내응력분포에 관한 3차원 유한요소분석)

  • Lee, Su-Ok;Choi, Dae-Gyun;Kwon, Kung-Rock;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.4
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    • pp.381-395
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    • 2008
  • Purpoose: For decades dental implants have been used widely in the field of prosthetic dentistry. However there is confusion when establishing treatment plans in cases where some teeth are remained but an insufficient number of implants can be used due to limited anatomical status and ecomomical problems. Many clinicians have tried to connect natural teeth and implants, and it still has controversy. But, there have been few studies on mechanical analysis of connecting natural teeth and implants with konus telescopic removable partial dentures. The purpose of this study was to analyze the stress distribution of prosthesis, abutment and alveolar bone when teeth and implants were connected with the konus telescopic denture, by means of 3-dimensional finite element analysis. Material and methods: The assumption of this study was that there were 2 mandibular canine (11 mm in length, 4 mm in diameter) and 2 implants(10 mm in length, 4 mm in diameter) which are located in the second premolar region. The mandible, teeth, implants, abutments, and connectors are modeled, and analyzed with the commercial software, ANSYS Version 8.1(Swanson, Inc., USA). The control group used implants instead of natural teeth. 21038 elements, 23544 nodes were used in experimental group and 107595 elements, 21963 nodes were used in control group, Stress distribution was evaluated under 150 N vertical load on 3 experimental conditions - between teeth and implants (Load case 1), posterior to implants (Load case 2), between natural teeth (Load case 3). Results: 1. In all load cases, higher von mises stress value was observed in the experimental group. 2. Maximum von miss stress observed in all load cases and all locations were as follows ; a. 929.44 Mpa in the experimental group, 640.044 Mpa in the control group in outer crown and connector - The experimental group showed 1.45 times high value compared with the control group. b. 145,051 Mpa in the experimental group, 142.338 Mpa in the control group in abutment - The experimental group showed 1.02times high value compared with the control group. c. 32.489 Mpa in the experimental group, 25.765 Mpa in the control group in alveolar bone - The experimental group showed 1.26times higher value compared with the control group. 3. All maximum von mises stress was observed in load case 2, and maxim von mises stress in alveolar bone was 32.489 Mpa at which implant failure cannot occur. 4. If maximum von mises stress is compared between two groups, the value of the experimental group is 1.02 times higher than the control group in abutment, 1.26 times higher than the control group in alveolar bone. Conclusion: If natural teeth and implants are connected with the konus telescopic denture, maximum stress will be similar in abutment, 1.26 times higher in alveolar bone than the control group. With this result, there may be possible to make to avoid konus telescopic dentures where natural teeth and implants exist together.