• Title/Summary/Keyword: Efficiency of Surgery

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An experimental study on the myocardial protection effect of the methylprednisolone mixed GIK solution (Methylprednisolone을 첨가한 GIK용액의 심근보호효과에 관한 실험적 연구)

  • 유시원
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.574-586
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    • 1984
  • Although corticosteroid have been shown to stabilize lysosomal membranes and prevent release of hydrolytic enzymes, the mechanism of membrane stabilization remains obscure. This study described functional assessment of efficiency of methylprednisolone in GIK solution by using a isolated Rat Heart Model. Isolated rat heart were subjected to a 2-minute period of coronary infusion with a cold GIK or methylprednisolone mixed cold GIK solution immediately before and also at the midpoint of a 60-minute period of hypothermic [$10{\pm}1^{\circ}C$] ischemic arrest. The result of this were as follow: 1.Spontaneous heart beat after ischemic arrest occurred 11 second later after Langendorffs reperfusion in the methylprednisolone mixed GIK group and 14 second later in the control group. 2.The percentage of recoveries of heart rate at 30 minute after postischemic working heart perfusion was 88.6\ulcorner.6% in the methylprednisolone mixed GIK group. This percentage of recovery was not significantly greater than the control group. 3.The percentage of heart function at 30 minute after postischemic working heart perfusion were; peak aortic pressure $90.8{\pm}4.5%$ coronary flow $87.5{\pm}1.45$ and aortic flow $74.9{\pm}11.8%$ in the methylprednisolone mixed GIK group. This percentage of recovery was significantly greater than the control group. [p<0.05]

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Postoperative Phonetic Evaluation of Two Cases of Verrucous Carcinoma of the Larynx after Partial Laryngectomy with False Vocal Cord Advancement Flap (후두 우상암에서 후두 부분적출술 및 가성대 전진피판에 의한 성대 재건술 전후의 음성변화 : 2례)

  • 정성민;장주애;김윤정
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.9 no.1
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    • pp.86-90
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    • 1998
  • Verrucous carcinoma is a variant of highly differentiated squamous cell carcinoma and has a predilection for the oral cavity and larynx. It is known to be of good prognosis due to its low regional and distant metastatic potential. Peak incidence is at ages 40-69 while predominantly occuring in males and its association with tobacco smoking has been implicated. The verrucous carcinoma have accordingly been treated by radiotherapy or surgical procedures but there has been considerable controversy regarding the effect of radiotherapy due to the possibility of anaplastic transformation Laser surgery and partial resection are among the commonly used surgical procedures but laser surgery has not yet shown results in improving phonetic abilities. Authors experienced two cases of verrucous carcinoma of the larynx treated by partial laryngectomy and false vocal cord advancement flap who showed no recurrence of disease under stroboscopic examination after two year follow up and when compared to preoperative aerodynamic studies, the expiratory air pressure was decreased and mean air flow rate increased which improved glottal efficiency markedly.

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Virtual reality training simulator for tooth preparation techniques

  • Jung, HeeSuk;Kim, HyoJoon;Moon, SeongYong
    • Oral Biology Research
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    • v.42 no.4
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    • pp.235-240
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    • 2018
  • Standard oral and maxillofacial three-dimensional model was developed with patients' medical data while virtual reality (VR) simulator was developed in conjunction with head mount display (HMD) and Haptic device. The objective of this study was to evaluate the preclinical use of a VR training simulator in tooth preparation practice. Eighty-nine dental students were trained how to operate the simulator. The participants were then given sufficient time on the simulator to practice dental preparation. The students experience and opinion was then taken in through filling of questionnaires. On average content received 1.8 points, anatomy had 2.5 points, 2.6 points for the applicability, and 2.0 for the usability. As for the detailed items scores, queries about the possible development of the simulator and the interest of the learning process through the simulator were the highest at 3.1 and 3.0 points, respectively. Question about the benefit of the HMD and the haptic device during the practice had 1.5 and 1.6 points, respectively. The average total score was 2.2 points. VR tooth preparation simulator in the field of clinical dental education has powerful potential in regard to realistic models, environments, vision, posture, and economical efficiency.

Isolated Working Canine Heart Perfusion Apparatus for Evaluation of Myocardial Protection Methods (심장기능 평가를 위한 견 적출심장 관류장치의 설계)

  • 이종국
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.246-253
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    • 1988
  • An in vitro model providing with a recirculating perfusion apparatus using an isolated canine heart and its autogenous blood, which was prepared for study of myocardial protection method. This apparatus was easily used by quick connect system and maintained well heart function for about 2 hours. The Langendorff perfusion was initiated for a 10 minute period by introducing perfusate at 37` into the aorta from aortic reservoir located 100 cm above the heart. The isolated perfused working canine heart model was a left heart preparation in which oxygenated perfusion medium [at 37K] entered the cannulated left atrium at a constant flow rate [900ml/ min] under 20 mmHg overflow system and was spontaneously ejected[no electrical pacing] via an cannula against a hydrostatic pressure of 80 cm H2O. During this working period, various indices of cardiac function were measured. The cardiac functions were stable for over 2 hours with perfusion of Krebs-Henseleit solution and autologous blood[1:1] mixture in volume and maintained heart rate ]]3-122/bpm peak systolic pressure 109-113 mmHg, cardiac output 900 ml / min and left atrial mean pressure 8-9 mmHg. In this model, the efficiency of myocardia] protection could be easily measured by means of functional, enzymatic, biochemical and ultrastructural assessment. And also, we believe this model to be a useful assessment screening model of recovery state after long duration of myocardial preservation of donor heart without difficult transplantation procedures.

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Development of Dual-Arm Anticancer Drug Compounding Robot and Preparation System with Adaptability and High-Speed

  • Nam, Giyoon;Kim, Young Joo;Kim, Yun Jung;Kim, Yeoun Jae;Seo, Jung Ae;Kim, Kyunghwan;Kim, Kwang Gi
    • Journal of International Society for Simulation Surgery
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    • v.3 no.2
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    • pp.64-68
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    • 2016
  • Aim Robots are able to increase safety for pharmacy staff as separating from toxicity of anti-cancer drugs. For patient safety, it would provide right dose of the drugs. Additionally, it can reduce price of the drugs. Therefore, in this study, a novel compounding anticancer drugs robot system (Dupalro) was developed. Methods We used the robot system, Motoman dual-arm robot from YASKAWA, Japan and medications which are adapted for the robot were constructed. In order to develop a process of compounding anticancer drugs, information about five medications that are required to make anticancer drugs in hospitals was used. Results System for the five types of medications was constructed, and relating procedures for anticancer drugs compounding robot were developed. Conclusion Dupalro successfully was able to not only provide incremental safety and efficiency for both patients and pharmacy staff, but also decrease price of anticancer drugs.

Appropriateness of Bed Utilization in One University Hospital (병상 이용의 적절성에 영향을 미치는 요인에 관한 연구 -한 대학병원 자료를 중심으로-)

  • 이상일;김용익;신영수
    • Health Policy and Management
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    • v.3 no.1
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    • pp.1-24
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    • 1993
  • This study is designed to find clues to make a plan for efficient hospital bed utilization. Author has tried to estimate the level of appropriateness and to find out factors affecting intra-hospital variation of inappropriate bed utilization using modified Appropriateness Evaluation Protocol of which criteria are based on service intensity and patients' conditions. Systematic random sampling was done from the population of inpatients during one month in on university hospital. Data were collected by concurrent and retrospective medical record review and analysed by multiple logistic regression. In medical services, 83.5% of admission reveals appropriate and the level of inappropriate admission shows significant differences by patients' residence, type of department admitted to, admission 개\ulcorner, and length of stay. In surgical services, 97.3% and 34.7% are appropriate in location and timing of surgery respectively. Inappropriate timing of surgery differs significantly depending on patients' age, type of department admitted to, admission route, and length of stay. Sixty two percent of hospital days shows appropriate and the level of inappropriateness show marked differences by patients'age, type of services, admission routes, part of the month, part of the stay, and length of stay. Inappropriate hospital days are due to inappropriate level of care, premature admission, improper scheduling of diagnostic or therapeutic procedures, and problems in scheduling surgery in sequence. In conclusion, substantially high proportion of inappropriate hospital bed utilization was confirmed. To reduce it, it is necessary to develop alternative services with which can replace inpatient services, and to introduce utilization management system which may include internal peer review.

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Restoration of Blink Function in the Paralyzed Rabbit Using Electroactive Polymer (안면신경마비 동물모델에서 전기활성고분자를 이용한 눈 깜박임 기능의 회복)

  • Kwon, Seong-Keun;Sung, Myung-Whun;Kim, Kwang-Hyun;Kim, Hee-Chan
    • Korean Journal of Bronchoesophagology
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    • v.12 no.2
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    • pp.19-25
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    • 2006
  • There have been numerous modalities to recover blink function of orbicularis oculi muscle in patients with facial paralysis. However, there is still no optimal method for reanimation of eyelid. In this study, we tried to recover blink function of paralyzed rabbit's eyelid with the ion polymer metal composite (IPMC) which is one of the electroactive polymers that is spotlighted as artificial muscle. We manufactured IPMC by plating the platinum over perfluorosulphonic acid polymer ($Nafion^{(R)}$). IPMC was coated by Norland optical adhesive for the purpose of insulation and keeping it from dry. IPMC modifications by roughening the surface of Nafion, repetitive plating (maximum 4 times) with platinum, and lengthening the width of IPMC were done. The facial paralysis was induced in the rabbit by sectioning of facial nerve at the main trunk. After minimum period of 4 weeks, IPMC was inserted in the paralyzed rabbit's eyelid. By modification, the force generated by IPMC was enhanced. Restoration of blink function in paralyzed rabbit was achieved on electrical stimulation of the IPMC by 5 voltage direct current. IPMC can be promising option for facial reanimation, but further studies are needed to enhance the efficiency of IPMC.

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Effect of Gleevec on Head and Neck Squamous Cell Carcinoma (두경부편평세포암종에서 Gleevec의 효과)

  • Chu Hyung-Ro;Weisman Robert A.
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.158-164
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    • 2005
  • Purpose: The serine/threonine kinase Akt was described to inhibit apoptosis in cancer. This study was to examine the effect of Gleevec on head and neck squamous cell carcinoma(HNSCC) through the mechanism of Akt. Experimental Design: Gleevec was introduced into the HNSCC cell lines UMSCC10B, HN12 and HN30 in a range of concentrations. Cell viability was assessed by clonogenic survival analysis. Targets of Gleevec(PDGFR, c-Kit, and c-Abl) were evaluated by Western blot. HNSCC tissue samples were stained for PDGFR, c-Kit and phosphorylated Akt. Akt phosphorylation following Gleevec treatment was assessed using Western blot. Akt siRNA was used to as the positive control. Results: Colony forming efficiency decreased with an increase in concentration of Gleevec. Expressions of PDGFR, c-Kit, and c-Abl were observed in HNSCC cells. Immunohistochemistry confirmed high expression of PDGFR, c-Kit, and p-Akt in human HNSCC tissues. Akt kinase activity was significantly inhibited with increasing concentration of Gleevec in HNSCC cells, and near complete dephosphorylation of Akt was observed at $6{\mu}M$ of Gleevec in the UMSCC10B and HN30 cell lines. Conclusions: Gleevec at clinically comparable concentrations caused a dose dependant decrease in HNSCC survival. The decreased cell survival was related to the inhibition of Akt kinase activity and dephosphorylation of Akt. Akt signaling pathway may be a relevant target for Gleevec in treating HNSCC.

Possibility of Undifferentiated Human Thigh Adipose Stem Cells Differentiating into Functional Hepatocytes

  • Lee, Jong Hoon;Lee, Kuk Han;Kim, Min Ho;Kim, Jun Pyo;Lee, Seung Jae;Yoon, Jinah
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.593-599
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    • 2012
  • Background This study aimed to investigate the possibility of isolating mesenchymal stem cells (MSCs) from human thigh adipose tissue and the ability of human thigh adipose stem cells (HTASCs) to differentiate into hepatocytes. Methods The adipose-derived stem cells (ADSCs) were isolated from thigh adipose tissue. Growth factors, cytokines, and hormones were added to the collagen coated dishes to induce the undifferentiated HTASCs to differentiate into hepatocyte-like cells. To confirm the experimental results, the expression of hepatocyte-specific markers on undifferentiated and differentiated HTASCs was analyzed using reverse transcription polymerase chain reaction and immunocytochemical staining. Differentiation efficiency was evaluated using functional tests such as periodic acid schiff (PAS) staining and detection of the albumin secretion level using enzyme-linked immunosorbent assay (ELISA). Results The majority of the undifferentiated HTASCs were changed into a more polygonal shape showing tight interactions between the cells. The differentiated HTASCs up-regulated mRNA of hepatocyte markers. Immunocytochemical analysis showed that they were intensely stained with anti-albumin antibody compared with undifferentiated HTASCs. PAS staining showed that HTASCs submitted to the hepatocyte differentiation protocol were able to more specifically store glycogen than undifferentiated HTASCs, displaying a purple color in the cytoplasm of the differentiated HTASCs. ELISA analyses showed that differentiated HTASCs could secrete albumin, which is one of the hepatocyte markers. Conclusions MSCs were islolated from human thigh adipose tissue differentiate to heapatocytes. The source of ADSCs is not only abundant abdominal adipose tissue, but also thigh adipose tissue for cell therapy in liver regeneration and tissue regeneration.

Application of the New Surgical Technique for Orthotopic Heart Transplantation in Dogs (잡견에 있어서 새로운 심장수술기법의 적용)

  • 원태희;한재진;김기봉;노준량
    • Journal of Chest Surgery
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    • v.33 no.3
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    • pp.207-211
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    • 2000
  • Backgroud: Conventional cardiac transplantation with each atrial anastomosis designed by Shumway and associates has been used widely in cardiac transplantation because of its simplicity and efficiency. There have been many reports about the postoperative atrioventricular value regurgitation resulting from the alteration in atrial geometry after cardiac transplantation by Shumway's technique. New surgical technique of direct anastomosis of superior vena cava, inferior vena cava, right pulmonary vein and left pulmonary vein was introduced to overcome the those problems. We performed this study to test the feasibility of this new surgical technique prior to application to clinical practice. Material and Method: Conventional cardiac transplantation was performed on 12 mongrel dogs(Group I) and cardiac transplantation with new surgical mthod of direct anastomosis of SVC, IVC, left and right pulmonary veins was performed on 11 mongrel dogs(Group II). After weaning from cardiopulmonary bypass, we compared the postoperative rhythm, hemodynamic data, and echocardiographic findings between two groups. Result : The cardiopulmonary bypass time and graft ischemic time were 119.0$\pm$4.4 minutes, 162.0$\pm$4.5 minutes respectively in group I, and 140.0$\pm$7.1 minutes, 180.5$\pm$5.4 minutes respectively in group II. The cardiopulmonary time and graft ischemic time in group II were longer than those of group I (p<0.05). There were 3 cases of failure to weaning from cardipulmonary bypass onein group I and two in group II, and this difference was not significant statistically. Sinus rhythm was regained postoperatively in 58% (group I) and 82%(group II), without statistical significant between 2 groups. Postoperative echolcardiography showed 2 cases of tricuspid value regurgitation and 1 case of mitral regurgitation in group I, and no regurgitation of atrioventricular value in group II. Conclusion: Although these was no statistically significant difference between 2 groups, there was tendency of less arrhythmia and less atrioventricular valvular regurgitation in group II. We suggested that the new surgical technique could be a useful strategy in heart transplantation, especially in the case of size mismatching between donor and recipient.

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