• Title/Summary/Keyword: 최소 침습적

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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.

Retrospective Evaluation of Implant Retained Overdentures Using Two Implants and Locator Attachments in the Edentulous Mandibles (Locator attachment를 이용한 하악 임플란트 유지 피개의치의 후향적 평가)

  • Lee, Ju-Hyoung;Sohn, Dong-Seok;Lee, Cheong-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.2
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    • pp.153-162
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    • 2013
  • This study compared the marginal bone loss around dental implants that were placed in the canine areas of the mandibles and finded the survival rate of the implants, marginal bone loss around implants and prosthetic complications in 20 patients treated with overdentures retained with Locator attachments. Implants placed in this study showed a 95% survival rate and the average marginal bone loss was 1.21 mm($SD{\pm}0.60mm$) in 94.3 weeks of functional loading. Implant-retained overdentures had various prosthetic complications such as male change, metal cap loosening, Locator attachment loosening, denture teeth change, relining and denture fracture. Implant-retained overdentures using two implants and Locator attachments in the edentulous mandibles is considered as a stable way for long terms because of minimal invasive operation, simple prosthetic process and easy repair.

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.

Design and Implementation of A Medical Image Guided System for Vertebroplasty (척추성형술을 위한 의료 영상 시스템의 설계 및 개발)

  • Tack, Gye-Rae;Lee, Sang-Bum;Lee, Sung-Jae
    • The KIPS Transactions:PartB
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    • v.10B no.5
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    • pp.503-508
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    • 2003
  • Since surgical treatment of the spine should overcome neurological compromises, the operative procedures need to be carefully planned and carried out with high degree of precision. Percutaneous vertebroplasty is a surgical procedure that was introduced for the treatment of compression fracture of the vertebrae. This procedure includes puncturing vertebrae and filling with polymethylmethacrylate (PMMA). Recent studies have shown that the procedure could provide structural reinforcement for the osteoporotic vertebrae while being minimally invasive and safe with immediate relief of pain. However, failures of treatment due to excessive PMMA volume injection have been reported as one of complications in vertebroplasty. It is believed that the control of PMMA volume is one of the most critical factors that can reduce the incidence of complications. Therefore, clinical success of vertebroplasty can be dependent on the volume of PMMA injection for a given patient. In this study, the optimal volume of PMMA injection for vertebroplasty was predicted based on the image analysis of a given patient.

Tumor Seeding after Percutaneous Transthoracic Needle Biopsy of Metastatic Pulmonary Ameloblastoma (경피적 흉부 생검 이후에 발생한 전이성 폐 법랑모세포종의 종양 파종)

  • Hye Mi Park;Yun Hyeon Kim;Hyo Soon Lim;So Yeon Ki;Hyo-jae Lee;Jong Eun Lee;Won Gi Jeong
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.1000-1004
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    • 2021
  • Percutaneous transthoracic needle biopsy (PTNB) is a minimally-invasive procedure that is an indispensable tool for evaluating pulmonary lesions. Though extremely rare, tumor seeding of the pleura and chest wall can occur as a complication. Given that the breast is located anterior to the thorax, needle tracking through the breast is inevitable when PTNB is performed using the anterior approach. We describe tumor seeding of metastatic pulmonary ameloblastoma in the pectoralis muscle layer of the breast along the needle track of PTNB in a 51-year-old female presenting with a palpable lump in the right breast.

Systematic Approach to The Extraction of Effective Region for Tongue Diagnosis (설진 유효 영역 추출의 시스템적 접근 방법)

  • Kim, Keun-Ho;Do, Jun-Hyeong;Ryu, Hyun-Hee;Kim, Jong-Yeol
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.45 no.6
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    • pp.123-131
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    • 2008
  • In Oriental medicine, the status of a tongue is the important indicator to diagnose the condition of one's health like the physiological and the clinicopathological changes of internal organs in a body. A tongue diagnosis is not only convenient but also non-invasive, and therefore widely used in Oriental medicine. However, the tongue diagnosis is affected by examination circumstances like a light source, patient's posture, and doctor's condition a lot. To develop an automatic tongue diagnosis system for an objective and standardized diagnosis, segmenting a tongue region from a facial image captured and classifying tongue coating are inevitable but difficult since the colors of a tongue, lips, and skin in a mouth are similar. The proposed method includes preprocessing, over-segmenting, detecting the edge with a local minimum over a shading area from the structure of a tongue, correcting local minima or detecting the edge with the greatest color difference, selecting one edge to correspond to a tongue shape, and smoothing edges, where preprocessing consists of down-sampling to reduce computation time, histogram equalization, and edge enhancement, which produces the region of a segmented tongue. Finally, the systematic procedure separated only a tongue region from a face image with a tongue, which was obtained from a digital tongue diagnosis system. Oriental medical doctors' evaluation for the results illustrated that the segmented region excluding a non-tongue region provides important information for the accurate diagnosis. The proposed method can be used for an objective and standardized diagnosis and for an u-Healthcare system.

All-inside Arthroscopic Capsular Imbrication and Lateral Release in Patellofemoral Instability (Operative technique) (슬개대퇴관절 불안정성에서의 관절경적 All-inside 관절막 중첩술 및 외측 지대 유리술 (수술 술기))

  • Kim, Jae-Hwa;Cho, Duck-Yun;Yoon, Hyung-Ku;Kim, Jung-Ryul
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.118-122
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    • 2006
  • Purpose: We introduce a technique of all inside arthroscopic capsular imbrication and lateral release used to treat patellofemoral instability. Methods: With the arthroscope in the anteromedial portal for best viewing, the arthroscopic scissor is placed through superolateral portal for proximal to distal release. The release performed 5mm to 1cm from the edge of the patella. After completion of the procedure, with the arthroscope in anterolateral portal, we inserted 5mm cannula in superolateral portal and made working portal from superomedial portal. Medial reefing was performed with all inside technique by using curved needle of the spectrum suturing system and No. 1 monofilament PDS suture is passed through the superomedial portal percutaneously and retrieved through a superolateral portal. Conclusion: Several methods for arthroscopic patella realignment have been proposed, but they have consisted primarily of arthroscopically assisted techniques using a medial incision. We believe that our procedure is preferable to arthroscopically assisted methods commonly used, in that an incision is avoided and the vastus medialis obliqqus is not violated. Our technique is minimally invasive and is easy to control the tightness of the medial patellofemoral ligament (MPFL) under direct vision.

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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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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.

Endovascular Treatment for Vascular Injuries of the Extremities (사지 혈관 손상의 인터벤션 치료)

  • Tae Won Choi;Yohan Kwon;Jinoo Kim;Je Hwan Won
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.846-854
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    • 2023
  • Vascular injuries of the extremities are associated with a high mortality rate. Conventionally, open surgery is the treatment of choice for peripheral vascular injuries. However, rapid development of devices and techniques in recent years has significantly increased the utilization and clinical application of endovascular treatment. Endovascular options for peripheral vascular injuries include stent-graft placement and embolization. The surgical approach is difficult in cases of axillo-subclavian or iliac artery injuries, and stent-graft placement is a widely accepted alternative to open surgery. Embolization can be considered for arterial injuries associated with active bleeding, pseudoaneurysms, and arteriovenous fistula and in patients in whom embolization can be safely performed without a risk of ischemic complications in the extremities. Endovascular treatment is a minimally invasive procedure and is useful as a simultaneous diagnostic and therapeutic approach, which serve as advantages of this technique that is widely utilized for vascular injuries of the extremities.