• Title/Summary/Keyword: surgery-first

Search Result 3,640, Processing Time 0.033 seconds

Clinical considerations for successful results in FOS(Functional Orthognathic Surgery): Surgery first orthodontic treatment later (임상가를 위한 특집 1 - 성공적인 선 수술 교정 치료를 위한 고려사항)

  • Oh, Chang-Ok
    • The Journal of the Korean dental association
    • /
    • v.50 no.2
    • /
    • pp.58-63
    • /
    • 2012
  • The fundamental principles and the role of surgeons and orthodontists to produce successful results in orthodontic treatment combined with orthognathic surgery is not different from those of conventional procedures and FOS: surgery-first-orthodontic-treatment-later approach. The communication and cooperation between surgeon and orthodontist is of crucial importance. In FOS, the pre-surgical orthodontic preparation is not carried out in the patient's mouth, but in the mounted stone model and in addition to the simulation of tooth movement, to get a precise surgical occlusion, the entire steps of treatment should be simulated on the articulator as well. Right after the surgery, due to the instability of the occlusion, appropriate post operational care should be given according to the surgical technique applied to the mandible by use of final surgical wafer about 8 weeks.

Management of Perirectal Laceration without Fecal Diversion: A Case Report

  • Cho, Dae Hyun;Lee, Seung Hwan;Jung, Myung Jae;Lee, Jae Gil
    • Journal of Trauma and Injury
    • /
    • v.30 no.2
    • /
    • pp.55-58
    • /
    • 2017
  • Standard open procedures for resection of the first rib in thoracic outlet syndrome can prove to be quite difficult with extensive incisions. A minimal invasive procedure can also be painstaking, but provides an attractive alternative to the more radical open procedures. We report the details of the technique with direct video footage of the procedure performed in a 41-year-old man with thoracic outlet syndrome done entirely by thoracoscopic methods.

Effect of Treatment with Desmopressin Acetate to Reduce Blood Loss after Cardiac Surgery (개심술후 Desmopressin Acetate 가 출혈에 미치는 영향)

  • Yu, Jae-Hyeon;Lee, Young
    • Journal of Chest Surgery
    • /
    • v.23 no.2
    • /
    • pp.268-274
    • /
    • 1990
  • Bleeding after cardiopulmonary bypass remains a cause for concern, requiring reexploration of the chest in approximately 3 percent of patients who have had operations on the heart. We examined the possibility that this problem might be alleviated by desmopressin acetate [DDAVP], synthetic vasopressin analogue that lacks vasoconstrictor activity. In a prospective, randomized trial, we studied the effect of intraoperative desmopressin acetate in 20 patients [the treated group 10 patients and the control group 10 patients] undergoing various cardiac operations requiring cardiopulmonary bypass. The result showed that the early postoperative [during first 24hrs] and mean postoperative blood loss [first 3 days] of the treated group were significantly reduced than the control group[447\ulcorner199ml in the treated group versus 746\ulcorner199ml in the treated group versus 746\ulcorner295 ml in the control group, p=0.014; mean\ulcornerstandard deviation and 675\ulcorner276 ml in the treated group versus 1006\ulcorner303 ml in control group, p=0.019]. The mean red-cell transfusion in first 3days were reduced in the treated group than the control group [3.3\ulcorner1.7 units vs 4.9\ulcorner1.7units, P=0.051]. There were no untoward side effects of desmopressin acetate. We conclude that the administration of desmopressin acetate can be recommended to reduce blood loss and blood conservation in patients undergoing cardiac operations.

  • PDF

Traumatic Dynamic Hallux Varus (A Case Report) (외상성 역동적 무지 내반증(1예 보고))

  • Yim, Soo-Jae;Lee, Young-Koo;Kim, Jin-Su;Kim, Chan-Ho;Kang, Hee-Kyung
    • Journal of Korean Foot and Ankle Society
    • /
    • v.13 no.2
    • /
    • pp.193-196
    • /
    • 2009
  • The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, $4^{th}$ extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using $4^{th}$ extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.

  • PDF

Surgery-first approach using a three-dimensional virtual setup and surgical simulation for skeletal Class III correction

  • Im, Joon;Kang, Sang Hoon;Lee, Ji Yeon;Kim, Moon Key;Kim, Jung Hoon
    • The korean journal of orthodontics
    • /
    • v.44 no.6
    • /
    • pp.330-341
    • /
    • 2014
  • A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation. The diagnosis and treatment plan were established by a three-dimensional (3D) virtual setup and 3D surgical simulation, and a surgical wafer was produced using the stereolithography technique. No presurgical orthodontic treatment was performed. Using the surgery-first approach, Le Fort I maxillary osteotomy and mandibular bilateral intraoral vertical ramus osteotomy setback were carried out. Treatment was completed with postorthodontic treatment. Thus, symmetrical and balanced facial soft tissue and facial form as well as stabilized and well-balanced occlusion were achieved.

Changes in Lymphocyte Subsets following Open-Heart Surgery ; A Study for Changes in Lymphocyte Subsets (개심술 환자에서의 면역기능의 변화;T lymphocyte subset의 변화에 대한 고찰)

  • 황재준
    • Journal of Chest Surgery
    • /
    • v.25 no.11
    • /
    • pp.1185-1191
    • /
    • 1992
  • Cell mediated immunity is depressed following surgical procedure and the degree of immunosuppression is directly related to the magintude of the procedure, blood transfusion, and length of operation. So we would expect cardiac operations to be highly immunosuppressive, although little is konwn about their immunosuppressive effect. The nearly complete consumption of complement factors and decreased levels of IgM and IgG resulting in an impaired opsonizing capacity. Additionally, peripheral blood mononuclear cell counts including T-and B-lymphocytes and T-cell subsets are reduced. Depression of cell-mediated immunity following open-heart surgery is potentially detrimental because it could increase the susceptability of patients to viral and bacterial infection. We reviewed 20 patients after cardiac operation to search for changes in peripheral blood lymphocyte subsets. Lymphocyte subsets were measured by flow cytometer and the preoperative values of lymphocyte subsets were compared with those from the first, fourth, and seventh days after operation. After cardiac operation, total mumbers of T lymphocyte was severely depressed on the first postoperative day and returned to the preoperative level by the seventh day after operation. CD3, CD4, and CD8 lymphocytes were decreased on the first postoperative day and returned to the preoperative level by the seventh day also. There was four cases of wound infection and these patients had increased CD4 lympocyte and more decreased CD19 lymphocyte compared with the non-infected group. It is concluded from these data that cell-mediated immunity is significantly depressed for at least one week following open-heart surgery and this result was closely related to the postoperative infection.

  • PDF

Rupture of the Anterior Papillary Muscle Caused by Occlusion of the First Diagonal Branch -Report of 1 Case - (제1 대각지 폐쇄에 의한 승모판막 전방 유두근 파열 - 1예 보고-)

  • Kim Young-Du;Moon Seok-Whan;Jo Keon-Hyeon
    • Journal of Chest Surgery
    • /
    • v.39 no.1 s.258
    • /
    • pp.64-67
    • /
    • 2006
  • Anterior papillary muscle rupture caused by occlusion of the first diagonal branch is reported to be very rare. A 66-year-old woman was transferred to our hospital for acute myocardial infarction and cardiogenic shock. Echocardiography and angiography revealed severe mitral regurgitation caused by rupture of the anterior papillary muscle and the complete occlusion of the first diagonal branch. In an emergent setting, she had been successfully treated by mitral valve replacement and coronary artery bypass grafting. She was discharged on postoperative twelfth day without any event.

Clinical Application of MRI in an Animal Bone Graft Model

  • Liu, Xiaochen;Jia, Wenxiao;Jin, Gele;Wang, Hong;Ma, Jingxu;Wang, Yunling;Yang, Yi;Deng, Wei
    • Journal of Magnetics
    • /
    • v.18 no.2
    • /
    • pp.142-149
    • /
    • 2013
  • We aim to monitor vascularization of early bone perfusion following rabbit lumbar intertransverse bone graft fusion surgery using magnetic resonance imaging assessment. Correlation with graft survival status was evaluated by histological method. Experimental animals were randomly divided into three groups and the model was established by operating bilateral lumbar intertransverse bone graft with different types of bone graft substitute material. The lumbar intertransverse area of three groups of rabbits was scanned via MRI. In addition, histological examinations were performed at the $6^{th}$ week after surgery and the quantitative analysis of the osteogenesis in different grafted area was carried out by an image analysis system. The MRI technique can be used for early postoperative evaluation of vascularized bone graft perfusion after transplantation of different bone materials, whereas histological examination allows direct visualization of the osteogenesis process.

Positional changes in the mandibular proximal segment after intraoral vertical ramus osteotomy: Surgery-first approach versus conventional approach

  • Jung, Seoyeon;Choi, Yunjin;Park, Jung-Hyun;Jung, Young-Soo;Baik, Hyoung-Seon
    • The korean journal of orthodontics
    • /
    • v.50 no.5
    • /
    • pp.324-335
    • /
    • 2020
  • Objective: To compare postoperative positional changes in the mandibular proximal segment between the conventional orthognathic surgery (CS) and the surgery-first approach (SF) using intraoral vertical ramus osteotomy (IVRO) in patients with Class III malocclusion. Methods: Thirty-eight patients with skeletal Class III malocclusion who underwent bimaxillary surgery were divided into two groups according to the use of preoperative orthodontic treatment: CS group (n = 18) and SF group (n = 20). Skeletal changes in both groups were measured using computed tomography before (T0), 2 days after (T1), and 1 year after (T2) the surgery. Three-dimensional (3D) angular changes in the mandibular proximal segment, condylar position, and maxillomandibular landmarks were assessed. Results: The mean amounts of mandibular setback and maxillary posterior impaction were similar in both groups. At T2, the posterior portion of the mandible moved upward in both groups. In the SF group, the anterior portion of the mandible moved upward by a mean distance of 0.9 ± 1.0 mm, which was statistically significant (p < 0.001). There were significant between-group differences in occlusal changes (p < 0.001) as well as in overjet and overbite. However, there were no significant between-group differences in proximal segment variables. Conclusions: Despite postoperative occlusal changes, positional changes in the mandibular proximal segment and the position of the condyles were similar between CS and SF, which suggested that SF using IVRO achieved satisfactory postoperative stability. If active physiotherapy is conducted, the proximal segment can be adapted in the physiological position regardless of the occlusal changes.

A CASE REPORT OF SURGICAL CORRECTION OF MANDIBULAR PROGNATHISM WITH MIDFACIAL DEFICIENCY USING LE FORT III OSTEOTOMY (Le Fort III 골절단술을 이용한 중안면성장부전을 동반한 하악전돌증의 치험례)

  • Lee, Baek-Soo;Ryu, Dong-Mok;Lee, Sang-Chull;Kim, Yeo-Gab;Hwang, Hye-Wook;Cho, Se-Jong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.26 no.1
    • /
    • pp.1-4
    • /
    • 2000
  • True midfacial deficiency is defined as a hypoplasia of various components of midface such as maxilla, orbit, zygoma and nasal bone. For treatment of these anomalies Le Fort III osteotomy and its modifications have been used traditionally. Le Fort III osteotomy is the method which advances maxilla with nasal bone and zygomatic bone at a time. At first midfacial osteotomy was introduced by Gillies to treatment of dentofacial deformity in 1950. In 1967 Tessier designed Le Fort III osteotomy according to Le Fort III midfacial fracture line and popularized to treat midfacial deficiency using coronal incision to appoach osteotomy sites. This is a case of patient who had mandibular prognathism with midfacial deficiency with severe discrepancy in maxillomandibular interrelation. First we performed Le Fort III osteomomy for zygomaticomaxillary advancement, and then carried out simultaneous two jaw surgery with Le Fort I osteotomy and BSSRO three months after first surgery.

  • PDF