• Title/Summary/Keyword: 레이저 수술

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Clinical Effect Of Low Level Laser Therapy In The Treatment Of Dentin Hypersensitivity Following Periodontal Surgery (치주수술 후 상아질 지각과민증에 대한 저수준 레이저 처치의 임상적 효과)

  • Kim, Nam-Yun;Lim, Sung-Bin;Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.26 no.1
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    • pp.230-243
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    • 1996
  • Root surface exposure due to gingival recession after periodontal surgery, dentin exposure after root planing elicit pain response when exposed to mechanical, heat, chemical or osmotic stimulation. Especially, patients treated with periodontal surgery, show high frequency and there have been reports showing the 1 out of 7 patients have dentin hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentin hypersensitivity. but, none could provide absolute clinical efficacy. In this study, 45 teeth from 30 patients, who had had periodontal surgery and showed dentin hypersensitivity after surgery were chosen for the experimental group and they were illuminated with laser, 15teeth were chosen for the control group and they were not exposed to laser. After this dentin hypersensitivity was elicited by tactile, compressed air, cold water and then, the degree was evaluated using NRS(Numerical Rating Scale). And during LLLT(Low Level Laser Therapy) semiconductor laser using Gallium - Arsenide as a diode was illuminated for 180 seconds at a frequency of 7(500Hz). This therapy was done 10 times, and each time the changes in dentin hypersensitivity was evaluated using NRS. The results were as follows : 1. After treat with LLLT on dentin hypersensitivity due to periodontal surgery, 22.2% showed total loss of dentin hypersensitivity, 60.0% showed loss of tactile dentin hypersensitivity, 48.8% showed loss of compressed air dentin hypersensitivity, 22.2% showed loss of cold water dentin hypersensitivity. 2. As a result of clinical evaluation of dentin hypersensitivity using NRS, there was significant increase in improvement of dentin hypersensitivity in the experimental group compare to the control group(P<0.05). And there was almost no natural loss of dentin hypersensitivity in the control group. 3. In comparison of the stages of evaluation, there was significant difference in between experimental and control group. after the second visit(P<0.05), and the difference increased with each visit.

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Phonosurgery after Laser Cordectomy (레이저 성문절제술 후의 음성수술)

  • So, Yoon-Kyung;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.11-15
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    • 2008
  • Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

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A Case of Plexiform Neurofibroma Arising from Laryngeal Surface of Epiglottis (후두개 후두면에 발생한 망상형 신경섬유종 1예)

  • Kim, So Yeon;Kim, Tae Hwan;Lee, Sang Hyuk;Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.2
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    • pp.137-140
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    • 2015
  • Neurofibroma is characterized as a benign, slow growing neoplasm, originating from Schwann cells or fibroblast in peripheral nerve sheaths. It may appear as a solitary tumor or have multiple localizations in von Recklinghausen disease. They are commonly found in the gastrointestinal tract and laryngeal neurofibromas are extremely rare, accounting for only 0.03 to 0.1% of benign tumors of the larynx. The aryepiglottic fold and arytenoid are the common site of occurrence for laryngeal neurofibroma, because the branch of the superior laryngeal nerve is involved. We present a case of solitary plexiform neurofibroma arising from the laryngeal surface of epiglottis in a 55-year old female who found the lesion incidentally. We removed the tumor completely by transoral laser surgery and no recurrence was found after 7 months. The case of solitary neurofibroma arising from laryngeal surface of epiglottis has not been reported in Korea. We report this case regarding the diagnosis and treatment with review of literatures.

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A Mechanical Model of Excimer Laser Surgery (엑시머 레이저 수술의 역학적 모델)

  • Shin, Jung-Woog;Kim, Jong-Hyun
    • Proceedings of the KOSOMBE Conference
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    • v.1993 no.05
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    • pp.57-60
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    • 1993
  • A finite element-based computer simulation of excimer laser susery was conducted to study some factors on the surgery. In particular, the radius of curvature at the apex of the cornea was examined under various surgical conditions. Corneal tissue was assumed to be a nearly incompressible, linear elastic, homogeneous, isotropic material under very small deformation. The geometry of the human cornea was taken from the experimental data[1]. The simulation utilized ANSYS(Swanson Analysis System Inc.Rev.4.4A). In this study, the major factors which affect the outcomes of the excimer laser surgery were investigated. First, two patterns of surgery with various surgery thickness(40-70micrometers) were examind. The pattern#1 describes the meridian from the apex to the edge of the surgery area to be straight. And the corresponding meridian of the pattern 2 can be expressed as a quardratic function. The results show that the pattern #2 is more realistic and effective. Then, the effects of other factors were investigated based on the pattern #2. Other factors are:various diameters of the surgical area (3-8 milimeters), Young's modules(3.5-4.5MPa), and depth of surgery at the apex(40-70micrometers). Compared with the computer simulation of the radial keratotomy surgery[2], the excimer laser surgery was proven to be more effective in treating myopia patients. In conculusion, the results of the simulation are qualitative agreement with clinical experience[3] indicating the potential of the finite element model of the surgery as a guideline to the surgeon before actual surgery.

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A COMPARATIVE STUDY OF WOUND HEALING AFTER SKIN INCISION WITH SCALPEL, $CO_2$, AND Nd:YAG LASER IN RATS (수술칼, $CO_2$ 및 Nd:YAG 레이저에 의한 절개 창상의 치유에 관한 비교 연구)

  • Choi, Jae-Sun;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.1
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    • pp.33-42
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    • 2000
  • The purpose of this study was to compare the wound healing process after skin incision using scalpel, $CO_2$ laser and pulsed Nd:YAG laser in rats. After skin on the back was incised 3 cm long, rats were sacrificed at 1, 3, 7, 14, 21 and 28 days. Macroscopic, histologic and immunohistochemical examinations using the collagen type IV and the CD34 antibodies which are necessary to the forming process of new capillary were performed. Results obtained were as follows ; Macroscopically the initial wound healing of the laser group was about $1{\sim}2$ weeks slower than that of the scalpel group. There weren't however any remarkable differences in all groups in 4 weeks after incision. By histologic finding, acute inflammatory cells were more prominent during the initial wound healing in the scalpel group than in the other groups. Epithelialization started in the order of scalpel, $CO_2$ and Nd:YAG laser group after skin incision. By the Masson's trichrome stain, collagen synthesis in the Nd:YAG laser group was more slowly initiated than in the other groups. But it was completed at the $3{\sim}4$ weeks in all groups. Immunohistochemically, collagen type IV and CD34 expression were markedly increased at 2 weeks in the scalpel and $CO_2$ laser group. Meanwhile, in the Nd:YAG laser group, these reactions were observed later tan the other groups. Collagen type IV and CD34 expression were decreased in all groups after 4 weeks. These results suggest that $CO_2$ and Nd:YAG laser showed similar healing process compared with scalpel and a potential substitute for scalpel in skin incision.

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Histological Changes of the Wound in the Tongue Mucosa of White Rats by Pulsed Nd:YAG Laser - A Comparative Experiment with the Scalpel Incision (Pulsed Nd:YAG 레이저로 유발된 백서 설점막 창상의 조직학적 변화-수술칼에 의해 형성된 창상과의 비교 실험)

  • 박준상;박미희;박봉수
    • Journal of Oral Medicine and Pain
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    • v.22 no.1
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    • pp.125-135
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    • 1997
  • The Author examined the clinical and histological changes on the dorsal tongue mucosa of the adult rats after lasing by pulsed Nd:YAG laser and incising with scalpel. The dorsal tongue was lased through 320$\mu\textrm{m}$optic fiber moving 2.5mm/second to make linear incision 5mm. The five conditions of lasing were three application with 1.0W, 1.75W, 3.0W and 3.0W under saline cooling, and single application with 3.0W at 20Hz. With scalpel, linear incisions through the surface epithelium were performed to 5mm in length. After observing the clinical changes of the incised wounds, the animals were sacrified and the tissues were excised to make the tissue specimens. The stained microscopic tissue slide were observed histologically under the microscope. The following results were obtained : 1. While incision with scalpel causes severe bleeding, lasing does not cause bleeding. 2. In three applications with 1.75W and 20Hz, tissue ablation was limited to areas contacted with optic fiber. 3. In three applications with 3.0W and 20Hz, deep incised wound, extensive destruction of the adjacent epithelium and charring were observed. 4. In three applications with 3.0W and 20Hz under saline cooling, tissue ablation was limite to the superficial mucosa and charring was not observed. 5. In single application with 3.0W and 20Hz, the shape of the incised wound was similar to that of the scalpel incision.

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TEMPERATURE CHANGES OF IMPLANT SURFACE IN SECOND STAGE SURGERY WITH DETAL LASER : IN VITRO STUDY (레이저를 이용한 임프란트 이차수술시 온도변화에 관한 실험적 연구)

  • Ahn, Hyun-Jeong;Kim, Hyoun-Chull;Choi, Byeong-Gap;Song, Eon-Hee;Kim, Rae-Gyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.2
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    • pp.256-268
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    • 1999
  • Submerged implants require secondary surgical uncovering of implants after healing period of 3-6 months. In surgical methods, there are surgical scalpel, tissue punch, electro-surgical, and laser-used uncovering, and so forth The objectives of this study are investigation and assessment of 1) thermal change in clinical application for uncovering of HA-coated implant and pure titanium implant irradiated by pulsed Nd-YAG, $CO_2$, and Er-YAG laser. 2) surface change of cover screws aaer irradiation using laser energy. The temperature of apex & side wall of implants were recorded at 10sec, 20sec, 30sec after 30sec irradiation to implant healing screw; 1) pulsed Nd-YAG laser; 2W, 20pps, contact mode 2) $CO_2$ laser; water-infused & non-water infused state, 2.5-3.5W, contibuous mode, noncontact mode 3) $CO_2$ laser ; non-water infused state, 3W, superpulse, noncontact. mode 4) Er-YAG laser; (1) non-water infused state, 10pps, 60mj, contact mode (2) water-infused state, 10pps, 60mj, 80mj, 101mj, contact mode. According to the results of this study, pulsed Nd-YAG laser is not indicated because of increased thermal change and pitting of metal surface of implant cover screw. By contrast, $CO_2$ laser & Er-YAG laser are presumed to indicate because of narrow range of thermal change & near abscence of thermal damage of metal surface. Dental laser is thought to be much helpful to surgical procedure when it is used as optimal power and time condition considering characteristics and indications of each laser. Further research is needed to verify that these techniques are safe and beneficial to implant success.

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Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion (전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡)

  • Lee, Sang Haak;Choi, Young Mee;Park, Ye Ree;Kang, Ji Ho;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.295-298
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    • 2005
  • We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

SIALOLITHIASIS ON THE MOUTH FLOOR IN A CHILD (소아의 구강저에 발생한 타석증)

  • Lee, Hyo-Seol;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Song, Je-Seon;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.114-118
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    • 2009
  • Sialolithiasis is the formation of calcific concretions within the ductal system of major or minor salivary glands. The submandibular gland is most involved because of its high viscosity of the saliva and the long, curved duct. It may occur at any age but, it is most common in middle-aged adults and rare in childhood. Clinical symptoms in sialolithiasis are variable but, swelling is the most common, followed by the pain. Clinical examination and radiographic examination(panoramic and mandibular occlusal radiographs, sialography, intraoral-, extraoral- ultrasound, CT scan, MRI and sialoendoscopy) can help to confirm a diagnosis and localize a stone. The treatment is surgical intervention, either removal of the sialolith or sialoadenectomy. However, non-invasive techniques including shock-wave lithotripsy, $CO_2$ laser and endoscopic treatment used in selected cases. A 5-Year-old girl referred from private practice for evaluation of a yellowish mass on the floor of the mouth. She complained that it had became three times bigger than four months ago when it was found for the first time and she had some pain on submandibular gland area occasionally. On physical examination, a firm and yellowish mass could be seen at the orifice of the submandibular duct. Diagnosis is the submandibular sialolithiasis in the anterior Wharton`s duct. Under local anesthesia, stone was removed.

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Experimental Investigation on Behavior of Single Horizontal Buoyant Jet (단일수평부력제트의 거동에 관한 실험적 연구)

  • Seo, Il-Won;Kim, Ho-Jung;Kwon, Seok-Jae
    • Proceedings of the Korea Water Resources Association Conference
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    • 2005.05b
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    • pp.1011-1015
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    • 2005
  • 본 실험에서는 부력 조건이 달라질 때 단공방류구에서 정체수역으로 수평방류되는 부력제트의 거동을 규명하였다. LIF (Laser Induced Fluorescence) 시스템을 이용하여 수행하였는데, LIF 시스템은 고해상도의 이미지를 취득할 수 있어 데이터의 정확도가 높으며, 동시에 한 평면상의 농도장을 일시에 측정할 수 있는 장점이 있는 기술이다. LIF 시스템은 크게 세부분으로 구성되어 있는데 방출시스템, 포착시스템, 처리시스템이 그것이다. 실험 조건을 고려해서 온수를 이용하여 주변수와의 밀도차를 재현하였으며, LIF 시스템의 추적입자로 형광염료 Rhodamine B를 사용하였다. 또한, 실험 데이터 취득과정에서 필요한 검정과정을 수행하였는데, LIF 시스템에서 검정과정은 레이저 입사광의 강도가 불균등한 분포를 가지는 점과 주변수의 매질에 의한 근의 감쇠가 발생하는 문제를 해결하기 위한 것이다. LIF 시스템은 부력제트의 농도장을 매우 정밀하게 측정할 수 있는데, 방류밀도 Froude 수가 변함에 따라 측정된 순간이미지를 통해 제트의 진화과정을 상세하고 가시적으로 확인할 수 있었다. 검정과정을 거친 농도 종단면에서 중심선의 연장선이 LIF 시스템에 의해 측정된 순간이미지의 중심선 궤적과 거의 일치하는 것도 알 수 있었다. 또한 LIF 시스템을 통해서 취득된 단일수평부력제트의 궤적과 중심선 희석률을 기존의 상용모형인 VISJET과 CORMIX1에 의해 예측된 결과와 비교$\cdot$분석한 결과, 제트 중심선 궤적의 경우, LIF 시스템을 이용한 측정값은 대체로 VISJET 모형의 결과와 일치하는 것으로 밝혀졌다. 중심선 희석률의 경우, LIF 측정값은 대체로 CORMIX1 모형, Cederwall(1968)의 경험식과 일치하는 경향을 보였다.0\%$일 때가 밸브를 $60\%$$80\%$ 개폐시켰을 때보다 $0.3kg/cm^2,\;0.29kg/cm^2$ 낮게 나타나 밸브를 전체 개방 했을 때 관로내의 수압이 상수설계기준에 적합한 수압을 유지함을 알 수 있다. 상수관로 설계 기준에서는 관로내 수압을 $1.5\~4.0kg/cm^2$으로 나타내고 있는데 $6kg/cm^2$보다 과수압을 나타내는 경우가 $100\%$로 밸브를 개방하였을 때보다 $60\%,\;80\%$ 개방하였을 때가 더 빈번히 발생하고 있으므로 대상지역의 밸브 개폐는 $100\%$ 개방하는 것이 선계기준에 적합한 것으로 나타났다. 밸브 개폐에 따른 수압 변화를 모의한 결과 밸브 개폐도를 적절히 유지하여 필요수량의 확보 및 누수방지대책에 활용할 수 있을 것으로 판단된다.8R(mm)(r^2=0.84)$로 지수적으로 증가하는 경향을 나타내었다. 유거수량은 토성별로 양토를 1.0으로 기준할 때 사양토가 0.86으로 가장 작았고, 식양토 1.09, 식토 1.15로 평가되어 침투수에 비해 토성별 차이가 크게 나타났다. 이는 토성이 세립질일 수록 유거수의 저항이 작기 때문으로 생각된다. 경사에 따라서는 경사도가 증가할수록 증가하였으며 $10\% 경사일 때를 기준으로 $Ro(mm)=Ro_{10}{\times}0.797{\times}e^{-0.021s(\%)}$로 나타났다.천성 승모판 폐쇄 부전등을 초래하는 심각한 선천성 심질환이다. 그러나 진단 즉시 직접 좌관상동맥-대동맥 이식술로 수술적 교정을 해줌으로써 좋은 성적을 기대할 수 있음을 보여주었다.특히

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