PURPOSE: On July 27, 2011, landslides occurred on Woomyun Mountain, resulting in development of mass casualties. Seoul St. Mary's Hospital was the primary recipient of patients. This experience prompted the drafting of a formal disaster plan. Therefore, we outline the Emergency Management External Disaster Plan of Seoul St. Mary's Hospital and discuss the time course of presentation and medical characteristics of the patients. METHODS: We conducted a retrospective review of medical records of patients who visited Seoul St. Mary's Hospital from Woo-myun Mountain landslides. In addition, we reviewed the time course of hospital disaster response. RESULTS: A total of 33 patients participated in this study. Mean age was 40.2 (+/-21.8) years; eight patients died at the time of admission and cardiopulmonary resuscitation was performed in one patient. Mean Injury Severity Score (ISS) was 9.19 and four patients were ISS above 15. Six patients were admitted to our hospital and two patients underwent an emergency operation. Overall, the emergency disaster management was appropriate due to the formal disaster plan and experiences in conduct of disaster drills. However, there were also several problems. The major problems of our disaster response were as follows: delayed activation of external disaster, difficulties in securing a treatment section, and absence of a decontamination facility. CONCLUSION: We observed several problems from our experience with Woo-myun Mountain landslides. Reassessment of the disaster plan and additional planning for other possibilities are needed.
Cardiopulmonary Resuscitation ; Decontamination ; Disaster Planning ; Disasters ; Emergencies ; Humans ; Injury Severity Score ; Landslides ; Mandrillus ; Mass Casualty Incidents ; Medical Records ; Retrospective Studies

PURPOSE: Field triage, medical care, and transportation are important and life-saving medical tasks performed at the site of a mass-casualty incident (MCI). We experienced a mass-casualty incident when an express bus fell off the Incheon bridge and conducted an evaluation of problems. We are willing to provide information for equipping an local disaster planning. METHODS: We surveyed the local emergency medical system response time, transportation time, and patients' clinical data using paramedics' records and medical records. We evaluated the adequacy of the order of priority of transportation by field triage used using the simple triage and rapid treatment (START) method. We evaluated field medical care, as well preponderance of transportation. RESULTS: Twenty four people who were on the bus were evacuated, and 2 persons were dead on the scene. Two persons died within one week. There was a transport delay for patients who would benefit significantly from medical intervention because dead persons were transported early. Neither advanced airway nor fluid resuscitation was provided. Sixteen patients (66.7%) were transported to one hospital. CONCLUSION: When we reviewed this mass-casualty incident, there was no appropriate medical control, such as triage, field medical care, and transportation. In construction of the emergency medical service system for preparation for MCI or disasters, we suggest integration and unification of 119 rescue services and emergency medical information centers for effective medical control. Disaster drills should be performed according to guidelines for local emergency medical services.
Disasters ; Emergencies ; Emergency Medical Services ; Humans ; Information Centers ; Mandrillus ; Medical Records ; Reaction Time ; Resuscitation ; Transportation ; Triage

A 49-year-old man was referred to our department with profuse serous fluid discharge from a Penrose drain after undergoing internal fixation with metal screws for multiple pelvic bone fractures. A definite ureteral penetration was identified that was orientated from the lateral to the medial aspect of the right distal ureter. The patient was surgically treated with excision of the 2-cm injured ureteral segment, end-to-end ureteroureterostomy, and double J ureteral stent placement. To our knowledge, a penetrating ureteral injury caused by bone drilling has not been reported previously in the published literature. This case shows that surgeons who do pelvic surgery, including orthopedic surgeons, should be familiar with the anatomical relationship of the ureter and its potential injuries.
Humans ; Mandrillus ; Orthopedics ; Pelvic Bones ; Stents ; Ureter

PURPOSE: The aim of this study was to evaluate the heat generation in bone in vitro during the guided flapless drilling procedure and the effect of drilling methods on the heat generation. MATERIALS AND METHODS: A model that has missing the first and second mandibular molars bilaterally was used. In group A, classical flap implant surgery was performed. In group B, flapless implant surgery using surgical guide was performed. In group C, flapless implant surgery using surgical guide without up-and-down pumping motion was performed. Temperature was measured with k-type thermocouple and a real-time digital thermometer. The thermocouples were placed at 0.5 mm away from the osteotomy area at the depths of 3 mm and 6 mm. The measured values were evaluated with independent t-test. RESULTS: The mean temperature generated was 27.2degrees C (SD +/- 2.1degrees C) and 27.5degrees C (SD +/- 2.3degrees C) for groups A and B, respectively. These differences were not statistically significant. In group C, the mean temperature was 37.0degrees C (SD +/- 3.4degrees C). There were statistically significant differences between groups B and C with respect to the mean temperature. CONCLUSION: These findings suggest that guided flapless drilling with up-and-down pumping motion may not significantly increase the bone temperature.
Dental Implants ; Hot Temperature ; Mandrillus ; Molar ; Osteotomy ; Thermometers

BACKGROUND: Ultrasound-aided fixation is a recently developed alternative method of treatment of zygomatico-maxillary (ZM) fracture, and it can resolve the problems of excessive torsion force and subsequent fractures of screws. We conducted this study to evaluate the clinical usefulness of ultrasound-aided fixation as compared with the conventional fixation method using a drill and an expander in patients with ZM fracture. METHODS: We conducted a retrospective study in 35 patients with ZM fracture who had been treated at our hospital during a period ranging from March of 2008 to December of 2010. We divided them into two groups: an ultrasound-aided fixation group, comprising 13 patients who underwent ultrasound-aided fixation (SonicWeld Rx, KLS Martin), and a conventional group, comprising 22 patients who underwent conventional fixation (Biosorb FX, Linvatec Biomaterials Ltd.). We compared such variables as sex, direction, age at operation, follow-up period, operation duration, number of fixed holes, and time to discharge between the two groups. RESULTS: The ultrasound-aided fixation reduced the operation duration by about 30 minutes as compared with that of conventional fixation. There was no significant difference in follow-up period, number of fixed holes, or time to discharge between the two groups. Furthermore, there were no complications in either group. CONCLUSIONS: The ultrasound-aided fixation of fractured ZM bone using an absorbable implant system is safe and effective in promptly reducing the bone fracture and providing satisfactory cosmetic outcomes over time.
Absorbable Implants ; Biocompatible Materials ; Bone Plates ; Cosmetics ; Facial Bones ; Follow-Up Studies ; Fractures, Bone ; Humans ; Mandrillus ; Retrospective Studies ; Ultrasonics

OBJECTIVES: Mastoid obliteration is used to obliterate the mastoid cavity following a mastoidectomy or to prevent the formation of a retraction pocket. This study evaluated the effectiveness of beta-tricalcium phosphate and polyphosphate (beta-TPP) for mastoid obliteration in middle ear surgeries in prospective human and animal studies. METHODS: Twenty patients with chronic otitis media underwent mastoid obliteration using beta-TPP after a intact canal wall mastoidectomy or simple mastoidectomy. The clinical data were prospectively evaluated including: the diagnosis, temporal bone computed tomography (TBCT), otoscopic findings, pure tone audiogram, and complications. In the animal experiment, beta-TPP was applied into the right bulla in five rats, and the opposite bulla was used as the control in the non-obliterated state. The skulls of five other rats were drilled out and the holes were obliterated with beta-TPP. TBCT were obtained at 3, 6, and 9 months after the obliteration and histologic analysis was done at 3 and 9 months after surgery. RESULTS: In the human study, fourteen TBCTs were obtained at 12 months after the surgery. All demonstrated no bone resorption in the obliterated mastoids. Among the 15 cases displaying retracted tympanic membranes preoperatively, 11 showed no retraction, 2 showed retraction postoperatively, 1 was lost to follow-up and 1 was a case of postoperative wound infection. Among 20 cases, one case developed a postoperative infection that necessitated a second operation. Sixteen underwent ossiculoplasty; hearing improvements were obtained in 15 cases and 1 case showed decreased hearing. In the animal study, new bone formation without significant bone resorption in the radiologic and histologic findings were noted in both the skull and bulla groups. CONCLUSION: Although beta-TPP is a foreign material having the possibility of infection, mastoid obliteration with it can be a treatment option in middle ear surgeries to prevent retraction pockets or the recurrence of diseases.
Animal Experimentation ; Animals ; Blister ; Bone Resorption ; Calcium Phosphates ; Cholesteatoma ; Ear, Middle ; Hearing ; Humans ; Lost to Follow-Up ; Mandrillus ; Mastoid ; Osteogenesis ; Otitis Media ; Prospective Studies ; Rats ; Recurrence ; Skull ; Surgical Wound Infection ; Temporal Bone ; Tympanic Membrane

PURPOSE: Implant stability at the time of surgery is crucial for the long-term success of dental implants. Primary stability is considered of paramount importance to achieve osseointegration. The purpose of the present study was to investigate the correlation between the insertion torque and primary stability of dental implants using artificial bone blocks with different bone densities and compositions to mimic different circumstances that are encountered in routine daily clinical settings. METHODS: In order to validate the objectives, various sized holes were made in bone blocks with different bone densities (#10, #20, #30, #40, and #50) using a surgical drill and insertion torque together with implant stability quotient (ISQ) values that were measured using the Osstell Mentor. The experimental groups under evaluation were subdivided into 5 subgroups according to the circumstances. RESULTS: In group 1, the mean insertion torque and ISQ values increased as the density of the bone blocks increased. For group 2, the mean insertion torque values decreased as the final drill size expanded, but this was not the case for the ISQ values. The mean insertion torque values in group 3 increased with the thickness of the cortical bone, and the same was true for the ISQ values. For group 4, the mean insertion torque values increased as the cancellous bone density increased, but the correlation with the ISQ values was weak. Finally, in group 5, the mean insertion torque decreased as the final drill size increased, but the correlation with the ISQ value was weak. CONCLUSIONS: Within the limitations of the study, it was concluded that primary stability does not simply depend on the insertion torque, but also on the bone quality.
Bone Density ; Dental Implants ; Humans ; Mandrillus ; Mentors ; Osseointegration ; Torque

PURPOSE: The purpose of this study was to evaluate the osseointegration of calcium phosphate (CaP)-coated implants by ion beam assisted deposition with a lack of primary stability. METHODS: A total of 20 CaP-coated implants were bilaterally placed in the mandible of five dogs. In the rotational implant group, the implants were inserted in oversized drilled sockets without mechanical engagement, while the conventional surgical protocol was followed in the control group. Each group was allowed to heal for 4 and 8 weeks. The bone-to-implant contact (BIC, %) was measured by a histometric analysis. RESULTS: All of the implants were well-maintained and healing was uneventful. In the histologic observation, all of the implants tested were successfully osseointegrated with a high level of BIC at both observation intervals. There was no significant difference in BIC among any of the groups. CONCLUSIONS: Within the limitation of this study, successful osseointegration of CaP-coated implants could be achieved in unfavorable conditions without primary stability.
Animals ; Calcium ; Calcium Phosphates ; Coated Materials, Biocompatible ; Dental Implants ; Dogs ; Mandible ; Mandrillus ; Osseointegration

Accessory navicular is a congenital anomaly of the tuberosity of the navicular from a secondary ossification center. The accessory navicular is occasionally the source of pain and local tenderness over the medial side of midfoot. If conservative treatment fails for the painful accessory navicular, surgical treatment is required. There are several surgical option for accessory navicular, which vary from simple excision, percutaneous drilling, modified Kidner procedure and osteosynthesis of the accessory ossicle to the navicular body. In addition, symptomatic flatfoot deformity should be addressed concomitantly.
Congenital Abnormalities ; Flatfoot ; Mandrillus

PURPOSE: An individual surgical stent fabricated from computed tomography (CT) data, called a CT-guided stent, would be useful for accurate installation of implants. The purpose of the present study was to introduce a newly developed CT-guided stent with a simple design and evaluate the accuracy of the stent placement. MATERIALS AND METHODS: A resin template was fabricated from a hog mandible and a specially designed plastic plate, with 4 metal balls inserted in it for radiographic recognition, was attached to the occlusal surface of the template. With the surgical stent applied, CT images were taken, and virtual implants were placed using software. The spatial positions of the virtually positioned implants were acquired and implant guiding holes were drilled into the surgical stent using a specially designed 5-axis drilling machine. The surgical stent was placed on the mandible and CT images were taken again. The discrepancy between the central axis of the drilled holes on the second CT images and the virtually installed implants on the first CT images was evaluated. RESULTS: The deviation of the entry point and angulation of the central axis in the reference plane were 0.47+/-0.27 mm, 0.57+/-0.23 mm, and 0.64+/-0.16degrees, 0.57+/-0.15degrees, respectively. However, for the two different angulations in each group, the 20degrees angulation showed a greater error in the deviation of the entry point than did the 10degrees angulation. CONCLUSION: The CT-guided template proposed in this study was highly accurate. It could replace existing implant guide systems to reduce costs and effort.
Axis, Cervical Vertebra ; Dental Implants ; Diagnosis, Computer-Assisted ; Mandible ; Mandrillus ; Plastics ; Stents ; Tomography, X-Ray Computed