• Title/Summary/Keyword: surgical intervention

Search Result 905, Processing Time 0.029 seconds

Maxillary sinus septum;panoramic radiographic and dental computed tomographic analyses in the planning of implant surgery (상악동 중격;임플란트 수술 계획시 파노라마와 치과용 전산화 단충촬영 분석)

  • So, Hyun-Ja;Jeong, Dong-Keun;Kwon, Jin-Hee;Ryu, So-Hyun;Kim, Hyung-Seop
    • Journal of Periodontal and Implant Science
    • /
    • v.36 no.1
    • /
    • pp.147-154
    • /
    • 2006
  • Surgical intervention in the posterior maxillary region requires detailed knowledge of maxillary sinus anatomy and the possible anatomical variations. This study evaluated the incidence, location of maxillary sinus septa by using radiographic (panoramic radiography and computed tomography) findings and comparison of panoramic radography with CT in antral anatomical variation. This study was based on data from 70 sinuses in partial dentate maxilla. The sample consisted of 61 patients(25 women and 36 men, with ages ranging between 19 and 77 years and a mean age of $49.4{\pm}11.3$ years) who were being treatment-planned to receive implant-supported restorations. First, the panoramic images were examined for the presence of antral septa by radiologist and examiner who don't know about CT findings. And incidence of antral septa was evaluated using an axial plane of CT image. The incidence of septa was compared between panoramic radiography and CT. The accuracy of the incidence was compared between radiologists and dentists. A total of 20 septa were found in 70 sinuses on CT image and the prevalence of one or more septa per sinus was found to be 28.6%. The assumed incidence of septa on panoramic radiography was $27.6%{\pm}2.2%$ in radiologist and $31.9%{\pm}5.8%$ in dentists. Erroneous diagnosis rate was 11.42% in radiologist and 15.96% in dentists. 40% of antral septa were located in the anterior(premolar) region, 30% of septa were located in the middle(first molar) and posterior(second molar) region separately. Prior to implant placement, it seems appropriate to consider panoramic radiography as a standard radiographic examination and periapical radiographs may be used to complete the findings in regions not sharply depicted in the panoramic radiograph. And cross-sectional imaging should be used in sites with severe bone loss and close proximity of the maxillary sinus.

A Case of Coronary-Pulmonary Artery Fistula (관상동맥-폐동맥 누공 1예)

  • Lee, Kyung Hae;Wang, Joon Kwang;Shin, Sung Joon;Kim, Mi Ok;Kim, Tae Hyung;Son, Jang Won;Yun, Ho Ju;Shin, Dong Ho;Park, Sung Soo;Kim, Kyung Soo
    • Tuberculosis and Respiratory Diseases
    • /
    • v.56 no.4
    • /
    • pp.420-425
    • /
    • 2004
  • Fistula between coronary artery and pulmonary artery is a type of coronary artery anomalies. It can cause atypical chest pain and fatigue, angina pectoris, endocarditis, finally myocardial steal can result in heart failure and myocardial infarction. But only 0.1-0.2% of coronary angiographic studies reveal the communications between coronary artery and other spaces. (heart chamber, pulmonary artery etc.) It is frequently congenital, but acquired types are increasing because chest and heart manipulations such as opertion of tetralogy of Fallot, endomyocardial biopsy, radiation therapy, or penetrating blunt trauma are increasing. There are reports about repair of fistula using thrombogenic tips, coil embolization and surgical intervention. We report a connection between coronary artery and pulmonary artery in 79 years old female. She was 30 pack-years smoker and suffered from dyspnea several years with chronic obstructive pulmonary disease. She presented with atypical chest pain and palpitation after admission. Electrocardiography showed ST-T wave abnormality. Emergency coronary angiography and chest CT scan revealed coronary-pulmonary artery fistula. Transcatheter embolization was performed and she was relieved from discomforts.

Clinical Study of Jaw Cysts (악골낭종에 대한 임상적 연구)

  • Moon, Cheol;Lee, Dong-Keun;Min, Seung-Ki;Oh, Sung-Hwan;Kim, Tae-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.22 no.3
    • /
    • pp.301-309
    • /
    • 2000
  • This clinical study was made of 214 cases of the jaw cysts which were diagnosed histopathologically in the Department of Oral and Maxillofacial Surgery, Wonkwang University Dental Hospital from Jan. 1, 1991 to Dec. 31, 1998. Medical records, radiographs, histopathological reports of 214 cases with jaw cysts were retrospectively reviewed. The results were as follows : 1. Among the total patient of 214 cases, male were 143 cases, and female are 71 cases, male predominated by the ratio of 2.04. 2. The periapical cysts and the dentigerous cyst are the most common cyst, irrespective of 116 cases(54.2%) and 58 cases(27.1%). 3. The periapical cyst has no gender prediction, male were 70 cases and female were 54 cases, the mean ages were 39.3 years(SD=18.4). The most common involving teeth were maxillary anterior teeth(59.7%). 4. The dentigerous cyst predominantly occurred in third decade (18 cases : 31%), and the mean ages were 31.9 years(SD=14.8). Dentigerous cysts predominantly occurred in male by the ratio of 7.29 (male : 51 cases, female : 7 cases). Maxillary anterior teeth(43.1%) and mandibular molars(32.8%) were most frequently involved. 5. The odontogenic keratocyst predominantly occurred in second and third decade and mean ages were 23.5 years(SD=17.2). The mandibular molars(60%) were most frequently involved. 6. All nasopalatine cyst occurred after fourth decade, mean ages were 49.5years(SD=10.4). In the gender incidence of nasopalatine cyst, 1 case occurred in female and 10 cases occurred in male. 7. In the surgical intervention of jaw cyst, cyst enucleation and marsupialization performed in 156 cases. Cyst enucleation with bone graft performed in 58 cases and iliac autogenous bone grafts most frequently performed in 29cases. 8. The diameter range of cyst enucleation with bone graft were from 15mm to 120mm with a cyst diameter of 33.3mm. (SD=15.2) The diameter range of cyst enucleation and marsupialization were from 7mm to 82mm with a cyst diameter of 20.4mm.(SD=9.0) The diameter of cyst enucleation with bone graft were significantly greater than diameter of cyst enucleation. (p<0.05) 9. Post-operative complications occurred in 9 cases(15.5%) in which cyst enucleation with bone grafts performed and occurred in 31 cases(19.9%) in which cyst enucleation.

  • PDF

The Effect of Aroma Inhalation on the Preoperative Pain and Anxiety of the Elderly Preparing to Undergo Spine Surgery (척추 수술 전 노인환자에게 적용한 아로마 향흡입요법이 통증 및 불안에 미치는 효과)

  • Park, Sohwi;Kim, Bokyoung;Park, Kyungsook
    • Journal of Digital Convergence
    • /
    • v.17 no.12
    • /
    • pp.523-533
    • /
    • 2019
  • This study's purpose is to determine the effects of aroma inhalation on preoperative pain and anxiety of the elderly preparing to undergo a spine surgery. A Quasi-experimental design, with non-equivalent control group non-synchronized design was used in this study. Blended essential oils with frankincense, marjoram and mandarin were inhaled twice in the experimental group (n=30). The control group (n=30) was treated with the standard preoperative care. Pain, state anxiety, and vital sign were measured twice (before and after). The results of this study showed that pain (t=-1.223, p=.226), systolic blood pressure (t=-0.211, p=.833), diastolic blood pressure (t=0.638, p=.526), and respiration rate (t=0.734, p=.466) were not statistically significant in the experimental and the control group. There were significant differences in state anxiety (t=-3.202, p=.002) and pulse rate (t=-0.213, p=.037) in the experimental group compared to the control group. According to the results, aroma inhalation is an effective nursing intervention for relieving anxiety in surgical patients.

Assessment of the quality of life in maxillectomy patients: A longitudinal study

  • Kumar, Pradeep;Alvi, Habib Ahmad;Rao, Jitendra;Singh, Balendra Pratap;Jurel, Sunit Kumar;Kumar, Lakshya;Aggarwal, Himanshi
    • The Journal of Advanced Prosthodontics
    • /
    • v.5 no.1
    • /
    • pp.29-35
    • /
    • 2013
  • PURPOSE. To longitudinally assess the quality of life in maxillectomy patients rehabilitated with obturator prosthesis. MATERIALS AND METHODS. Thirty-six subjects were enrolled in the span of 16 months, out of which six were dropouts. Subjects (age group 20-60 years) with maxillary defects, irrespective of the cause, planned for definite obturator prosthesis, were recruited. The Hindi version of European Organization for Research and Treatment of Cancer, Head and Neck version 1 of Quality of Life Questionnaire was used before surgical intervention and one month after definitive obturator. Questionnaire includes 35 questions related to the patient's physical health, well being, psychological status, social relation and environmental conditions. The data were processed with statistical package for social science (SPSS). Probability level of P<.05 was considered statistically significant. RESULTS. The quality of life after rehabilitation with obturator prosthesis was 81.48% (${\pm}13.64$) on average. On item-level, maximum mean scores were obtained for items problem with teeth ($1.87{\pm}0.94$), pain in mouth ($1.80{\pm}0.92$), trouble in eating ($1.70{\pm}0.88$), trouble in talking to other people ($1.60{\pm}1.22$), problems in swallowing solid food ($1.57{\pm}1.22$) and bothering appearance ($1.53{\pm}1.04$); while minimum scores were obtained for the items coughing ($1.17{\pm}0.38$), hoarseness of voice ($1.17{\pm}0.53$), painful throat ($1.13{\pm}0.43$), trouble in having social contacts with friends ($1.10{\pm}0.40$) and trouble having physical contacts with family or friends ($1.10{\pm}0.31$). CONCLUSION. Obturator prosthesis is a highly positive and non-invasive approach to improve the quality of life of patients with maxillectomy defects.

Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review (수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰)

  • Lee, Jeong-Woo;Lee, Keun Hyeong;Lee, Ju-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.20 no.10
    • /
    • pp.303-308
    • /
    • 2019
  • Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

Ultrasound-Guided Injections in the Lumbar and Sacral Spine (요추 및 천추부에 대한 초음파 유도하 중재 시술)

  • Ko, Kwang Pyo;Song, Jae Hwang;Kim, Whoan Jeang;Kim, Sang Bum;Min, Young Ki
    • Journal of Korean Society of Spine Surgery
    • /
    • v.25 no.4
    • /
    • pp.185-195
    • /
    • 2018
  • Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

Percutaneous Vertebroplasty versus Conservative Treatment Using a Transdermal Fentanyl Patch for Osteoporotic Vertebral Compression Fractures

  • Oh, Younggyu;Lee, Byungjou;Lee, Subum;Kim, Junghwan;Park, Jinhoon
    • Journal of Korean Neurosurgical Society
    • /
    • v.62 no.5
    • /
    • pp.594-602
    • /
    • 2019
  • Objective : Although surgical intervention, such as percutaneous vertebroplasty (PVP), is the standard treatment for osteoporotic vertebral compression fractures (OVCFs), its effectiveness and safety are unclear. Therefore, this study compared the safety and efficacy of conservative treatment with that of PVP for acute OVCFs. Methods : Patients with single-level OVCFs who were treated conservatively with a transdermal fentanyl patch (TFP) or with PVP between March 2013 and December 2017 and followed-up for more than 1 year were retrospectively evaluated. Patients with pathologic fractures, fractures of more than two columns, or a history of PVP were excluded. Clinical outcomes (visual analog scale [VAS] scores) and radiographic factors were evaluated, including changes in the compression rate of the corresponding vertebral body at onset and after 12 months, sagittal Cobb angle at onset and after 6 and 12 months, and the incidence of adjacent compression fractures. Results : Of the 131 patients evaluated, 75 were treated conservatively using TFPs and 56 underwent PVP. We divided the patients into TFP and PVP groups. Their baseline characteristics (including sex, level of fracture, and bone mineral density T-scores) were similar, but the TFP group was significantly younger. The overall VAS score for pain showed a greater decrease during the first month (1 week after PVP) in the PVP group but remained similar in the two groups thereafter. The compression rate after 12 months increased in the TFP group but decreased in the PVP group. Five patients in the PVP group, but none in the TFP group, experienced adjacent compression fractures within 12 months. Conclusion : We compared clinical and radiological outcomes between the TFP and PVP groups. The immediate pain reduction effect was superior in the PVP group, but the final clinical outcome was similar. Although the PVP group had a better-preserved compression rate than the TFP group for 1 year, the development of adjacent fractures was significantly higher. Although TFPs seemed to be beneficial in reducing the failure rate of conservative treatment, the possibility of side effects (22.6%, 17 out of 75 patients, in this study) should be carefully monitored.

Effects of pain, sleep and self-care behavior in patients underwent robotic minimally invasive cardiac surgeries (로봇을 이용한 심장수술이 환자의 통증, 수면 및 자가간호수행에 미치는 영향)

  • Park, Soohyun;Jang, Insil
    • Journal of Digital Convergence
    • /
    • v.17 no.7
    • /
    • pp.265-274
    • /
    • 2019
  • The purpose of this study was to know the difference in pain, sleep, self-care behavior in patients performed by sternotomy and robotic minimally invasive cardiac surgeries. The participants were 64 patients with sternotomy and 64 patients with minimal thoracotomy in heart valve surgeries at a tertiary hospital in Seoul. Data were analyzed using descriptive statistics, ${\chi}^2$ test, paired t-test. with SPSS/WIN(22.0). The participants with minimally invasive thoracotomy felt severe pain than the patients with thoracotomy at post operation day 2 & 5. The severe pain site were the surgical site in both groups. The participants with sternotomy had better sleep than minimally invasive thoracotomy patients. Self-care behavior was higher in the minimally invasive thoracotomy group. Therefore, despite the many advantages of robotic surgery such as rapid recovery and shortening of length of stay in hospital, accurate pain assessment and application of differentiated protocols are needed for the management of pain in the patients with robotic minimally invasive cardiac surgeries. In addition, a structured education program intervention is needed to improve comfort by considering gender, age, and method of operation.

Toxic Megacolon as a Complication of Infectious Colitis Caused by Salmonella enteritidis Group D in a Previously Healthy Child (건강한 소아에서 살모넬라 장염의 합병증으로 발생한 독성거대결장)

  • Jeon, Sung Bae;So, Cheol Hwan;Jo, Young Min;Yu, Seung Taek
    • Pediatric Infection and Vaccine
    • /
    • v.28 no.2
    • /
    • pp.110-117
    • /
    • 2021
  • Toxic megacolon is a fatal complication of inflammatory or infectious bowel disease. Prognosis depends on the severity of the disease. In cases of poor prognosis, clinical outcomes range from intestinal resection to death, so early diagnosis and appropriate treatment are very important. However, the prevalence of toxic megacolon in children is very low, and in those without underlying diseases such as inflammatory bowel disease, early diagnosis may be delayed. A previously healthy 12-year-old boy presented to our hospital with lower abdomen pain, fever, and hematochezia. Despite antibiotic therapy, the symptoms worsened. On the third day, abdominal computed tomography revealed severe dilatation of the transverse colon, which indicated toxic megacolon. Stool culture was positive for Salmonella enteritidis group D, and rectal endoscopy showed no signs of inflammatory bowel disease. Ceftriaxone and intravenous methylprednisolone were administered, and the patient's condition improved without any complications. We report a case of toxic megacolon as a complication of infectious colitis caused by S. enteritidis group D, which was diagnosed using early imaging and successfully treated without surgical intervention.