• Title/Summary/Keyword: 최소침습

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EVALUATION OF THE EFFECTIVENESS OF THERAPEUTIC SEALING ACCORDING TO THE LESION DEPTHS OF PROXIMAL EARLY CARIES (인접면 초기 우식 병소의 깊이에 따른 therapeutic sealing의 유효성 평가)

  • Lee, Geum-Lang;Ahn, Myung-Ki;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.394-403
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    • 2009
  • As the minimally invasive approach against white spot like early caries lesions in proximal surfaces of the teeth, therapeutic sealing has been introduced and studied for effective materials and methods to arrest the early caries lesion effectively, which is still going on. This study was performed for the purpose of evaluating its validity for the non-cavitated lesions according to the depth from surface using therapeutic sealing followed by artificial caries induction and evaluation with micro-CT, and we obtained the results as follows. 1. It was revealed that the deeper the caries lesions are, the lower radiation intensity at lesion body areas in pre-treatment specimen. 2. In the sealed groups, there were no differences in radiation intensity between pre- and post-treatment, whereas there were significant decreases in unsealed groups(p<0.05). 3. Even in the specimens with the lesions reaching deeply into DEJ, the effect of sealing was significant(p<0.05). Conclusively, it was thought therapeutic sealing can be an effective tool against the early caries lesions, regardless of their depth into tooth, unless cavitated.

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Recent Perspectives on Oncoplastic Breast Surgery in Korea (우리나라의 종양성형학적 유방암 수술에 대한 최신 동향)

  • Kang, Taewoo
    • Journal of Life Science
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    • v.30 no.6
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    • pp.563-569
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    • 2020
  • Oncoplastic surgery (OPS) combines oncologically safe tumor resection with aesthetically satisfying reconstruction of defects using established plastic surgery techniques. OPS is characterized by initial excision as extensive as is beneficial for oncological safety, and, once sufficient resection is complete, displacement or replacement techniques are selected based on remnant volume. The size of the lesion and the individual patient are important factors when considering the appropriate approach, and when pre-operative imaging, including MRI, is used to determine the technique, the complete removal of cancer cells by permanent pathology is essential. A frozen section is used during the operation to reduce the reoperation rate, but it is difficult to cover the entire margin surface theoretically and even harder in practice. A recent report about adequate margins has empowered OPS in its oncological safety. Considering the patients to whom each modality could be applied, basic breast volume is an important factor, and this is influenced by ethnic differences. In Europe or the US, for example, the average breast size is 36D (600 ㎤) and reduction mammoplasty is predominantly used. However, the average size of patients in our institution is 33A (300 ㎤), and so quite different approaches are selected in most cases. New techniques involving radiofrequency and fluorescence have been proposed as safe and easily accessible ways of reducing complications.

Feasibility Study of Laparoscopic Gastrostomy Tube Placement in Beagle Dogs (비글견에서 복강경을 이용한 위관삽입술의 유용성 평가 연구)

  • Lee, Jae-Woong;Park, Ji Young;Lee, Hae-Beom;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.28-35
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    • 2015
  • Aim of this study is demonstrate the feasibility of Laparoscopic gastrostomy (LG) tube placement in dogs by comparing with percutaneous endoscopic gastrostomy (PEG) tube placement, based on operative time, complications and gastro-peritoneal adhesion evaluation. Eight intact male beagle dogs were used in this study. Tri-Funnel Replacement Gastrostomy tube (Bard Inc., USA) of 20 Fr was used for LG technique and PEG kit (Ponsky "Pull" PEG Kit$^{(R)}$, Bard Inc., USA) with soft silicone retention dome consisting of a 20 Fr gastrostomy tube was used. Feeding via gastrostomy tube was performed in two weeks, maintenance energy requirement (MER) divided into 3 separate feeding. LG and PEG were evaluated at intraoperative, postoperative and postmortem period. Mean operative time for the PEG group was significantly shorter when compared with the LG group (p < 0.05). Successful maintenance of gastrostomy tube was confirmed in all dogs. Gastric and peritoneal wall adhesions were formed successfully in each group. The mean adhesion length (AL) and width (AW) were significantly larger in LG group compared with in PEG group (p < 0.05). The mean adhesion distance (AD) was not significantly different between two groups (p = 0.182). Consequently, LG is an effective minimally invasive, safe and easy to perform technique for providing enteral nutritional support in dogs.

Videothoracoscopic Surgery for Secondary Spontaneous Pneumothorax (비디오 흉강경을 이용한 이차성 자연기흉의 치료)

  • 양현웅;정해동;최종범;최순호
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.692-696
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    • 1998
  • For the management of a secondary spontaneous pneumothorax, videothoracoscopic surgery may offer the potential therapeutic benefits of a minimally invasive approach. We report on a series of 36 patients(33 men and 3 women) with a mean age of 56.3 years(range, 31 to 80 years) who underwent thoracoscopic surgical procedures for the treatment of secondary spontaneous pneumothorax. Twenty-one patients had emphysema and 20 patients had old pulmonary tuberculosis. Nineteen patients presented a persistent severe air leak more than 3 days preoperatively and 15 patients had more than one recurrence. Bullectomy or exclusion of the lesion was performed in 33 patients. Mechanical pleurodesis was performed in the entire patients, talc was sprayed in 22 and vibramycin in 14. Mild pleural adhesion at the upper lobe was shown in 10 patients and severe pleural adhesion in 7 patients. One patient with persistent air leak died of persistent air leak and respiratory failure. The mean postoperative stay was 7.0 days(range, 2 to 17 days). At a mean follow-up of 15.8 months (range, 5 to 45 months), no pneumothorax had recurred. In comparison with the result of the treatment for 112 patients with primary spontaneous pneumothorax, the operating time was not significantly longer and there were no more primary treatment failures, but the duration of postoperative chest drainage and hospital stay was longer. Videothoracoscopic surgery has proved to be an effective treatment for secondary spontaneous pneumothorax in elderly patients who represent high-risk candidates for thoracotomy.

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Arthroscopic Medial Plication using Pull-out Suture for the Treatment of Acute or Recurrent Patellar Dislocation - Technical Note - (급성 또는 재발성 슬개골 탈구의 치료에 있어서 견인 봉합술을 이용한 관절경적 내측 관절막 중첩술 - 수술 술기 -)

  • Ahn, Jin-Hwan;Kim, Jae-Hoon;Ha, Hae-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.214-218
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    • 2006
  • Purpose: We describe a new technique of arthroscopic medial plication using pull-out suture with consideration of anatomical location of medial patellofemoral ligament for the treatment of acute or recurrent patellar dislocation. Operative technique: Under arthroscopic examination, sutures are passed through the medial capsule, at which medial patellofemoral ligament is located, from outside to inside of knee joint. Three guide wires are inserted from anterior surface of the patella to upper half of its medial border. Intraarticular portions of sutures are pulled out toward anterior surface of the patella through bony tunnels. Under appropriate tension, the sutures are tied after performing lateral retinacular release. Conclusion: As suturing medial patellofemoral ligament, this technique can maximize the effect of medial plication and can correct subluxation and tilt of the patella. It seems to be a minimally invasive, easy and effective method for the treatment of acute or recurrent patellar dislocation.

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Prolotherapy in Orthopedic Field (정형외과 영역에서의 증식치료)

  • Shon, Min Soo;Yoo, Jae Chul
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.2
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    • pp.101-110
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    • 2011
  • To describe the background, mechanism, clinical results and complications of prolotheapy based on the literature review. Prolotherapy is a minimally invasive injection-based treatment of chronic musculoskeletal pain, including ligament and joint laxity. The mechanism of this injection-based technique is to initiate a local inflammatory response with resultant tissue healing. The used proliferants are classified by bio-mechanism to act in three different ways as osmotic, irritants, and chemotatics. The most commonly used proliferant is hyperosmolar (10~25%) dextrose to act by osmotic rupture of cells. High resolution ultrasound imaging of musculoskeletal structure provide a more accurate diagnosis. Also ultrasound-guided intervention provides a more high efficacy and low rate of complications. The most common complication is local pain at the injected site, that is self-limited and good responsive to anti-inflammatory agents. Other complications are rare. It is reported that prolotherapy appears safe when performed by an experienced clinician. Prolotherapy has grown in popularity and has received significant recent attention. However there are limited evidence-based data supporting the indication and efficacy of prolotherapy in the treatment of chronic musculoskeletal pain or soft tissue injuries. Future studies are necessary to determine whether prolotherapy can play an independent and definitive role in a treatment for chronic musculoskeletal pain.

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The Open Surgical Treatment for Stiff Elbow (주관절 구축의 관혈적 치료)

  • Lee, Ji-Ho;Ra, In-Hoo;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.293-298
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    • 2010
  • Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

Usefulness of Minimally Invasive Radio-Guided Parathyroidectomy in Patients with Prior Central Neck Exploration (중앙 경부 수술의 과거력이 있는 환자에서의 방사능 유도 최소 침습 부갑상선 절제술의 유용성)

  • Lee, Sung-Hwan;Kim, Bup-Woo;Kim, Kuk-Jin;Lee, Yong-Sang;Jeong, Jong-Ju;Nam, Kee-Hyun;Chung, Woong-Youn;Chang, Hang-Seok;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.2
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    • pp.138-142
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    • 2009
  • Introduction : Although bilateral exploration has been thought to be the standard therapeutic modality for primary hyperparathyroidism(pHPT) due to the admirable cure rate, questions have remained as to whether bilateral neck exploration for all patients with pHPT is needed because 80-85% of patients with pHPT have a single parathyroid adenoma. If the diseased parathyroid can be determined preoperatively, a directed and minimal operation is appropriate using the recent innovations of preoperative diagnosis and operation techniques for parathyroid diseases, the radio-guided parathyroid surgery(RGPS) is one of the standards. In especial, RGPS has been reported beneficial in special circumstances, such as in recurrent disease, ectopic parathyroid, and in mediastinal parathyroid. It can be also useful for the parathyroid disease in previously explored or irradiated neck. Material and Methods : We experienced 2 cases of pHPT successfully treated by RGPS in who previously underwent extensive neck dissection and concomitant external or internal radiotherapy. We adopted and modified the technique described by Dr. James Norman at the University of South Florida-the minimally invasive parathyroidectomy using intraoperative nuclear mapping with 99mTc-sestamibi scanning and radioactivity detection probe. Results : We acquired the successful results for these patients. Conclusion : RGPS is thought to be the alternative technique for the patients with prior central neck exploration and irradiation.

The Operative Treatment using Mini-open Sinus Tarsi Approach for Displaced Intraarticular Calcaneal Fractures (전위성 관절내 종골 골절에서 최소 침습적 족근동 도달법 및 압박나사 내고정술을 이용한 수술적 치료)

  • Kim, Yong-Min;Cho, Byung-Ki;Shon, Hyun-Chul;Park, Ji-Kang;Jeong, Ho-Seung
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.247-256
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    • 2012
  • Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using mini-open sinus tarsi approach for displaced intraarticular calcaneal fractures. Materials and Methods: We studied 18 cases (16 patients) of intraarticular calcaneal fractures who were treated with sinus tarsi approach by same surgeon. The mean age of patients was 44.8 years, and mean follow-up period was 17.2 months. The measurement of B$\ddot{o}$hler angle, Gissane angle, the degree of articular surface depression, and the period to union were performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: B$\ddot{o}$hler angle and Gissane angle had improved significantly from preoperative average $9.8^{\circ}$, $117.6^{\circ}$to average $22.4^{\circ}$, $113.4^{\circ}$ immediate postoperatively, and had maintained to average $21.8^{\circ}$and $114.2^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 5.2 mm to 1.2 mm at the last follow-up. All cases achieved bone union, and the period to union was average 10.5 weeks. AOFAS score was average 86.2 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the CNHF scale. Therefore, 16 cases (88.8%) achieved satisfactory results. Conclusion: The minimally invasive sinus tarsi approach using headless compression screw seems to be an effective surgical method for displaced intraarticular calcaneal fractures, because of the possibility of accurate restoration of articular surface and the low risk of postoperative soft tissue complications.

Full mouth rehabilitation in patient with loss of vertical dimension and deep bite due to worn dentition (전반적인 치아의 마모로 인한 수직고경 감소와 과피개교합을 갖는 환자의 전악 수복 증례)

  • Nam, Ki-Hun;Park, Pil-Kou;Kim, Hee-Kyung;Kang, Jeong-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.65-71
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    • 2016
  • Gradual occlusal attrition is a normal process of aging. However, severe attrition causes pathogenic pulp, occlusal disharmony, functional disorder and esthetic problems. Alteration of vertical dimension should be considered for space regaining for tooth restoration, esthetic improvement or correction of occlusal relationship. Vertical dimension should be determined within the range of minimal invasive process satisfying patient's esthetic requirements and operator's functional goal. And patient's adaptation to newly determined vertical dimension should be assessed simultaneously. Deep overbite is not a simple problem of overbite, instead it is an usually complicated problem with anterior-posterior occlusal relationship. Considering these facts, appropriate restoration of edentulous part as well as improvement of anterior-posterior relationship should be performed to solve this fundamental problems. In this study, a 67 year-old male patient with many worn teeth and loss of posterior teeth was treated with removable partial denture at edentulous mandibular area to increase vertical dimension and fixed prostheses at dentulous maxillary and mandibular area. With these treatments, we attained a satisfactory result in functional and esthetic aspects as a report case.