• Title/Summary/Keyword: screw removal

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A Case of Lumbar Metastasis of Choriocarcinoma Masquerading as an Extraosseous Extension of Vertebral Hemangioma

  • Lee, Ji-Hoon;Park, Chan-Woo;Chung, Dong-Hae;Kim, Woo-Kyung
    • Journal of Korean Neurosurgical Society
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    • v.47 no.2
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    • pp.143-147
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    • 2010
  • We report here on an uncommon case of metastatic choriocarcinoma to the lung, brain and lumbar spine. A 33-year-old woman was admitted to the pulmonary department with headache, dyspnea and hemoptysis. There was a history of cesarean section due to intrauterine fetal death at 37-weeks gestation and this occurred 2 weeks before admission to the pulmonary department. The radiological studies revealed a nodular lung mass with hypervascularity in the left upper lobe and also a brain parenchymal lesion in the parietal lobe with marginal bleeding and surrounding edema. She underwent embolization for the lung lesion, which was suspected to be an arteriovenous malformation according to the pulmonary arteriogram. Approximately 10 days after discharge from the pulmonary department, she was readmitted due to back pain and progressive paraparesis. The neuroradiological studies revealed a hypervascular tumor occupying the entire L3 vertebral body and pedicle, and the tumor extended to the epidural area. She underwent embolization of the hypervascular lesion of the lumbar spine, and after which injection of polymethylmethacrylate in the L3 vertebral body, total laminectomy of L3, subtotal removal of the epidural mass and screw fixation of L2 and L4 were performed. The result of biopsy was a choriocarcinoma.

TWO PART MINI-IMPLANT AS AN EFFICIENT TOOL FOR INTERMAXILLARY FIXATION (분리형 미니 임플란트를 이용한 효과적인 악간고정법의 소개)

  • Lee, Won;Kim, In-Soo;Seo, Woon-Kyung;Heo, Hyun-A;Kim, Seong-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.5
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    • pp.477-482
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    • 2006
  • The new type of orthodontic mini-implant named C-implant can be an effective alternative to conventional one-component mini-implant in the intermaxillary fixation (IMF) cases because of its particular design. The small size, two-part design, efficiency, and low cost of the C-implant make it applicable to various types of IMF cases easily such as fracture reduction and orthognathic surgery. The two part design resists highly to the fracture or deformation during implantation and removal. The long span head allows the patient to easily attach intermaxillary elastics, so that the patient can apply intermaxillary elastics for traction easily. Through this article, we tried to show the possibility of this appliance as a good adjunct for the IMF screw.

New Fixation Method Using Two Crossing Screws and Locking Plate for Cubitus Varus Deformity in Young Adult Elbow: Case Report

  • Kim, Byoung Jin;Seol, Jong Hwan;Kim, Myung Sun
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.43-47
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    • 2016
  • Many types of osteotomy have been proposed for the treatment of cubitus varus deformity of the elbow, and various methods for fixation of the osteotomy site have also been described. However, no method has been perfect. We treated two cases of cubitus varus elbow deformity with step-cut osteotomy using a new fixation method with two crossing screws and an anatomically designed locking plate. Active assisted elbow range of motion (ROM) exercise was permitted at postoperative 3 days, after removal of the drainage. Preoperative and postoperative humerus-elbow-wrist angles and ranges of motion of the two patients were compared. At 3 months followup, each patient had recovered the preoperative elbow ROM, and achieved the complete bony union of the osteotomy site and proper correction of the cubitus varus deformity. In addition, the appropriate remodeling of the lateral bony protrusion was observed. Therefore, we introduce a new fixation method for achievement of stable fixation allowing immediate postoperative elbow motion after corrective osteotomy for cubitus varus deformity in young adults.

Fractures of implant fixtures: a retrospective clinical study

  • Yu, Han-Chang;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.13.1-13.6
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    • 2020
  • Background: The aim of this study was to evaluate the factors that may affect implant fixture fractures. Methods: Patients who experienced implant fixture removal at Seoul National University Bundang Hospital from 2007 to 2015 due to implant fixture fracture were included. Implant/crown ratio, time of implant fracture, clinical symptoms before implant fracture, treatment of fractured implants, and the success and survival rate of the replaced implants were evaluated retrospectively. Results: Thirteen implants were fractured in 12 patients. Patient mean age at the time of fracture was 59.3 years. Of the 13 implants, 7 implants were placed at our hospital, and 6 were placed at a local clinic. The mean crown/implant ratio was 0.83:1. The clinical symptoms before fracture were screw loosening in five implants, marginal bone loss in five implants, and the presence of peri-implant diseases in five implants. All the fractured implants were removed, and 12 out of the 13 sites were re-implanted. Parafunctions were observed in two patients: one with bruxism and one with attrition due to a strong chewing habit. Conclusions: Several clinical symptoms before the fracture of an implant can predict implant fixture failure. Therefore, if these clinical symptoms are observed, appropriate treatments can be taken before more serious complications result.

A CLINICAL STUDY OF BIODEGRADABLE PLATES AND SCREWS IN ORAL AND MAXILLOFACIAL SURGERY (구강 악안면 영역의 생체 흡수성 고정판 사용에 관한 임상 연구)

  • Kim, Il-Kyu;Park, Seung-Hoon;Jang, Keum-Soo;Yang, Jung-Eun;Jang, Jae-Won;Sasikala, Balaraman
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.451-458
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    • 2009
  • Metallic bone plates and screws have been commonly used in oral and maxillofacial surgery for internal fixation. However, there are several disadvantages such as atrophy of cortical bone inherent to excessive rigid fixation systems, growth disturbance in growing individual, allergy reaction, interference with radiographic imaging, palpability, thermal sensitibity and the need for subsequent removal. To overcome these disadvantages and avoid additional surgery of removal of plates and screws, there have been many studies of biodegradable plates and screws. But, It also has complication such as foreign body reactions. We have undertaken a clinical and retrospective study on 140 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from February 2006 to March 2009. The purpose of this study is to report the clinical cases and review of the literatures with biodegradable plates and screws. And we concluded following results. 1. 6 cases(3.4%) of the 177 operation sites(140 patients) experienced complications. 1 case(0.6%) was a failure of initial fixation, 1 case(0.6%) was a postoperative infection, 4 cases(2.3%) were inflammations or foreign body reaction. 2. Postoperative infections, inflammations and foreign body reactions were completely recovered with incision and drainage, supporative care with antibiotic coverage and removal of biodegradable plates. 3. Biodegradable plates and screws provide acceptable rigidity and stability clinically. But, long-term observation is required for the tissue reactions around the biodegradable plates and screws because of long resorption periods of the biodegradable materials.

Effects of electrical stimulation on healing of endo-osseous titanium implants in circumferential defect (전기자극이 성견 골결손부에 매식된 임플란트 주위조직의 치유에 미치는 영향)

  • Shim, Jae-Chang;Kim, Young-Jun;Chung, Hyun-Ju;Kim, Ok-Su
    • Journal of Periodontal and Implant Science
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    • v.34 no.1
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    • pp.177-193
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    • 2004
  • Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggested that electrical currents promote osseointegration around dental implants. The purpose of this study was to determine the effect of direct microcurrent to endosseous titanium implants placed in bone defects. The right and left 2nd, 3rd and 4th mandibular premolars in ten mongrel dogs (15Kg of weight) were extracted. One monthe later, Ti-machined screw type implants(3.8 mm diameter x 8.5 mm length, $AVANA^{(R)}$, Ostem) were placed in surgically created circumferential defect area(width 5mm, depth 4mm). The implants were divided into three groups according to the treatment modalities: Control group- implants without electrical stimulation; Experimental group I- implants with allogenic demineralized freeze dried bone grafting; and Experimental group II-implants allogenic demineralized freeze dried bone grafting and electric stimulation. The animals were sacrificed in the 4th and 8th week after implant placement and un-decalcified specimens were prepared for histological and histometrical evaluation of bone-implant contact ratio (BIC) and bone formation area ratio (BFA) in defect area. Some specimens at 8 weeks after implantation were used for removal torque testing. Histologically, there was connective tissue infiltration in the coronal part of defect area in control and the experimental group I, whereas direct bone contact was found in the experimental group II without connective tissue invasion. Average BIC ratios at 4 weeks of healing were 60.1% in the experimental group II, 47.4% in the experimental group I and 42.7% in the control. Average BIC ratios at 8 weeks after implantation were 67.6% in the experimental group II, 55.9% in the experimental group I and 54.6% in the control. The average BFA ratio was 84.0% in the experimental group II, 71.8% in the experimental group I and 58.8% in the control at 4 weeks, and the BFA ratios were 89.6% in the experimental group II, 81.4% in the experimental group I and 70.5% in the control at 8 weeks after implantation. The experimental group II showed also significantly greater BIC and BFA ratios compared to the control and the experimental group I (p<0.05). The removal torque values at 8 weeks after implantation were 56 Ncm in the experimental group II, 49 Ncm in the experimental group I and 43 Ncm in the control. There was a statistically significant difference among 3 groups (p<0.05). These results suggest that electrical stimulation improve and accelerate bone healing around endosseous titanium implants in bone defect.

Development of an Underwater Rope-cutter Device and Controller for Removal of Propeller and Shaft Foreign Material for Small Vessel (소형선박용 프로펠러 및 샤프트 이물질 제거를 위한 수중절단기 기구 설계 및 제어기 개발)

  • Lee, Hunseok;Oh, Jin-Seok;Choi, Sun-Hong
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.25 no.7
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    • pp.927-935
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    • 2019
  • Screw-failure accidents in small ships frequently occur in coastal waters. In particular, vessels' propulsion systems are frequently coiled due to objects such as fish-nets and ropes that float on the sea. The failure of the ship's propulsion system can cause primary accidents such as ship operation delays and drifting due to loss of power; furthermore, the possibility of secondary accidents such as those involving operators in the underwater removal of rope stuck in a propeller. Ships that do not have the proper tools to solve these problems must be either lifted onto land to be repaired or divers must dive directly under the ship to solve the problem. Accordingly, some small vessels have been equipped with rope-cutter devices on the propeller shaft to prevent ship propeller system accidents in recent years; however, they are not being applied efficiently due to the cost and time of installation. To solve these problems, this study develops an underwater rope-cutter device and controller for the removal of propeller and shaft foreign material in small vessels. This device has simple structures that use the principle of a saw. Meteor gears and crank pins were used for the straight-line rotation of saw blades of the underwater rope-cutters to allow for long strokes. Furthermore, the underwater rope-cutting machines can be operated by being connected to the ship battery. The user, a non-professional, can ensure convenience and stability by applying reverse current prevention and a speed control circuit so that it can be used more conveniently and safely.

Development of an Solid Separation System for Pig Slurry (돈 슬러리용 고형물 분리시스템 개발)

  • 김민균;김태일;최동윤;백광수;박진기;양창범;탁태영
    • Journal of Animal Environmental Science
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    • v.8 no.1
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    • pp.9-16
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    • 2002
  • This study was conducted to develope the new solid separating system which can be efficiently and economically removed the solid parts in high pollutants concentration of pig slurry. The pollutants concentration, BOD$_{5}$ , COD and SS of the slurry used in this study was 15,990($\pm$2,389)mg/l, 20,004($\pm$5,512)mg/l and 26,486($\pm$5,935)mg/l, respectively. After removal of solid part in slurry, the pollutants concentration, BOD$_{5}$, COD and SS was change into 5,617($\pm$690)mg/l, 5,553($\pm$633)mg/land 1,456($\pm$341)mg/l, respectively in the Fixed biological membrane tank. The reduction of the pollutants concentration of suspend liquid through membrane will be allowed to greatly improve the water purification by an Activated sludge method. This separating system consisted of a temporary storage, a circulating tank and a Fixed Biological membrane tank. A temporary storage which has a draining system of screw type and an aeration device played a tremendous role in draining the solid by filled an aeration of 0.3 l/min. A Fixed Biological membrane tank of which a styrofoam filled in a 2/3 volume as a Biological media was fixed by a stainless steel net (pore size : 0.5mm) to separate the liquid layer of influx in them. The separating system efficiency factors were the speed of screw motor, cycle number of slurries in a circulating tank and moisture contents of solid effluent through the screw path. Although the pollutants concentration was very variable in temporary storage, the final concentration of $BOD_5$ and SS, except COD of the suspended liquid in a Fixed biological membrane were not different regardless of cycle number of a circulating tank. Moisture contents of effluent from temporary storage was 73% under the speed 1 ppm of screw motor and 62% under the 1/4rpm of it.

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CLINICAL STUDY ON SURGICAL MANAGEMENT OF MANDIBULAR CONDYLAR FRACTURES (하악 과두 골절의 외과적 처치에 관한 임상적 연구)

  • Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.167-180
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    • 1997
  • 79 surgically managed mandibular condylar fracture patients included the 25 patients treated with Dr, Nam's method were analysed the postoperative resluts in Oral and Maxillofcial Surgery, School of Dentistry, Wonkwang University since 1993 to 1995. Mean patient's age is 32.5 years (range, 8 to 65 years), and follow-up periods were a minimum of 3 months to 28 months. 19% condylar fractures were associated with mostly symphysis portion. According to the patient's age, severity of condylar fractures, clinical signs and symptoms, radiographic findings, treatmenet plans had been performed. Rigid fixation have performed greatly, and then fragment removal of fractured mesial pole of proximal segment of the condylar and little cases of reshaping and eminoplasty and lag screw have been applied. Two cases of the both condylar resorption and deviated condyle posteriorly in Dr. Nam's method. None of infection or necrosis signs of treated condyle surgically. In my opinion, whenever possible, displaced condylar fracture can be managed surgically with rigid fixation, but not Dr. Nam's method. Usually if perform the surgical management of condylar fractures you should maintain maxillomandibular fixation for 2 weeks, or more and has to follow-up functional mandibular exercise should be kept continuously.

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External Fixation of Retaining Ligament in Correction of Facial Disfigurement in Type-1 Neurofibromatosis Patients (유지 인대의 외부 고정을 통한 제1형 신경섬유종증 환자의 안면부 변형 교정)

  • Myung, Yu-Jin;Lee, Yoon-Ho
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.257-262
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    • 2011
  • Purpose: In neurofibromatosis patients, complete surgical excision of the mass is almost impossible and surgical treatment usually consists of multiple serial excisions that only result in a debulking effect. Remnant tumor mass has a gravitational effect on facial soft tissues that leads to sagging of skin and soft tissue, and eventually, facial disfigurement and asymmetry. The purpose of our surgical method is to perform soft tissue lifting with longer lasting effect with less surgical risk of damaging facial nerve and vessels. With external fixation using K-wire or surgical screw, the procedure only called for a short incision length and had additional adhesive properties that enabled anchoring of soft tissue in a lifted position for a longer postoperative period. Methods: A total of 5 neurofibromatosis patients (NF-1) visited our clinic for mass reduction and face lifting. The age of patients ranged from 13 to 42 (mean 28.8 years), and most patients had a long history of multiple excisions in the past. Face lifting was performed in 2 different areas, the periorbital area in 3 patients, and the midface in 2 patients. The materials used in fixation of retaining ligament were K-wire (n=3) and titanium screw (n=2). Results: Follow up period was from 5 month to 3 years and 1 month (mean=2 years and 1 month). All patients conveyed satisfaction with the results and no major complications were reported. The lifting effect lasted for as long as 3 years, and there were no complaints of relapse of soft tissue depression or sagging within the operated area. 1 patient (M/13) needed secondary k-wire insertion and additional mass excision in 1 year and 10 months postoperatively due to tumor growth. In two patients with K-wire fixation, mild dimpling and tenderness were observed in the follow up period, but in about 2 months postoperatively, dimpling was relieved and there was no need for removal of fixating material. Conclusion: Surgical lifting in neurofibromatosis patients can be challenging, for mass excision cannot be done completely and gravitational effect by residual mass can be persistent. External fixation of the retaining ligament in patients with neurofibromatosis can give satisfactory results-for incision length is relatively shorter, and the lifting effect can last longer compared to other various face lifting techniques.