• 제목/요약/키워드: Efficiency of Surgery

검색결과 240건 처리시간 0.026초

경비강 식도경의 임상적 활용 (Trends in Utilization of Transnasal Esophagoscopy)

  • 박일석
    • 대한후두음성언어의학회지
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    • 제29권2호
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    • pp.67-69
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    • 2018
  • The development of office-based, unsedated transnasal esophagoscopy (TNE) has proven to be a major technological advance and with time and experience the application of this technology is becoming more widespread. TNE has allowed otolaryngologists to perform a variety of diagnostic and therapeutic procedures in the office setting. Studies consistently demonstrate that the image quality and diagnostic capability of TNE is equivalent to conventional esophagoscopy. The modern TNE endoscopes offer high quality optics, air-insufflation, and irrigation capability through a 2-mm working channel, and the ability to perform biopsies and select procedures. In general, the role of TNE in the head and neck patient is three-fold : to screen for synchronous and metachronous esophageal squamous cell carcinoma (ESCC) ; to differentiate post-treatment changes/symptoms from malignancy ; and to perform certain office-based procedures. TNE offers many specific advantages to the head and neck patient that are not afforded by conventional esophagoscopy. Because of surgical and postirradiation changes, many HNSCC patients have trismus or neck stiffness preventing completion of conventional transoral esophagoscopy. Perhaps most importantly, TNE provides enhanced patient safety, increased tolerability, better practice efficiency, and cost savings. For these reasons, TNE has become a particularly useful tool in the otolaryngologist's armamentarium.

식도발성 남성 발화의 말 속도 (Speech Rates of Male Esophageal Speech)

  • 박원경;심희정;고도흥
    • 말소리와 음성과학
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    • 제4권3호
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    • pp.143-149
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    • 2012
  • The purpose of this study is to investigate the speech rate of an esophageal speech group that is capable of vocalization after surgery. The subjects in this experiment were 10 male esophageal speakers and 10 male laryngeal speakers. Each group read a reading passage that was recorded by a DAT recorder (Rolando, EDIROL R-09). These records were analyzed by using CSL (Computerized Speech Lab, model 4150). The results were as follows: (1) the overall speech rate of esophageal speech was 2.50 SPS (syllable per second) while the overall speech rate of laryngeal speech was 4.23 SPS. (2) The articulatory rate of esophageal speech was 3.14 SPS (syllable per second) while the articulatory rate of laryngeal speech was 4.75 SPS. Speech rates as well as articulatory rates of esophageal speech were significantly lower than laryngeal speech. These differences between the two groups may be due to reduced efficiency of airflows across the pharyngeal-esophageal segment for esophageal speakers when compared to airflow through the glottis for laryngeal speakers. These results would provide a guideline in speech rates for esophageal speakers in clinical settings.

A clinico-radiographic and histomorphometric analysis of alveolar ridge preservation using calcium phosphosilicate, PRF, and collagen plug

  • Tarun Kumar, AB;Chaitra, N.T.;Gayatri Divya, PS;Triveni, M.G.;Mehta, Dhoom Singh
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.32.1-32.7
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    • 2019
  • Background: Tooth extraction commonly leads to loss of residual alveolar ridge, thus compromising the room available for the implant placement. To combat the post-extraction alveolar loss, alveolar ridge preservation is practiced, with the advent of the biomaterial available. The purpose of this study was to assess the efficiency of calcium phosphosilicate biomaterial in alveolar ridge preservation. Twenty patients indicated for extraction were selected followed by socket grafting using calcium phosphosilicate. Implant placement was done 6 months postoperatively during which a core was harvested from the preserved sockets. Clinico-radiographic measurements of hard and soft tissues were taken at baseline and 6 months post-grafting. Results: There were no significant changes in the radiographic and soft tissue parameters while significant changes in hard tissue parameters with 1.9 mm (p = 0.013) gain in mid-buccal aspect and 1.1 mm (p = 0.019) loss in horizontal bone width were observed. The histomorphometric evaluation depicted the vital bone volume of 54.5 ± 16.76%, non-mineralized tissue 43.50 ± 15.80%, and residual material 2.00 ± 3.37%. Conclusion: The implants placed in these preserved ridges presented 100% success rate with acceptable stability after a 1-year follow-up, concluding calcium phosphosilicate is a predictable biomaterial in alveolar ridge preservation.

척추측만증 조기검진의 필요성 (The review on the need for early screening of scoliosis)

  • 공상은;오민석
    • 혜화의학회지
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    • 제20권1호
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    • pp.137-142
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    • 2011
  • Objective : The purpose of this study was to review on the need for early screening of scoliosis. Methods : We have researched and analyzed theories and literatures of scoliosis screening program. Result : The following results were obtained in this study. 1. Scoliosis screening should be carried out to improve middle and high school students's health and learning abilities. 2. The methods are the forward bending test, Moire test and X-Ray. 3. After the examination held by differentiating the degree of scoliosis, surgery or brace treatment for students should be carried out. 4. After the examination, appropriate acupuncture, exercise therapy and orthodontic treatment for students should be carried out. 5. Spinal health courses for young people should be held regularly to equip and encourage a healthy body and healthy mind and contribute to improve the learning efficiency. Conclusion : Scoliosis screening and early detection should be done in the Daejeon city middle school or high school students, and appropriate treatment should be performed as soon as possible.

영상장치 기반 정밀치료용 레이저 수술기의 성능 평가 방법 개발 (Study of Efficiency Test Evaluations Method for Imaging Device Based Laser Equipment)

  • 김대창;이승봉;정재훈;김성민
    • 대한의용생체공학회:의공학회지
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    • 제40권6호
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    • pp.230-234
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    • 2019
  • Medical laser equipment using optical energy is used to surgery and treat diseases by destroying and removing tissue. Domestic laser equipment has been used steadily in the skin and cosmetics sectors and has been changed to radiate high-power energy in a wide range to shorten patient treatment time. However, side effects such as burns and damage of normal tissues occurred. To solve this problem, techniques for detecting lesions using an imaging device and selectively radiating the laser have been developed. In this study, we proposed an evaluation method to evaluate the safety and performance of target detection accuracy, laser irradiation accuracy and motion protection device technology derived from product analysis and investigation. Finally, the validity of the evaluation method was evaluated by evaluating the imaging device based laser equipment as the proposed evaluation method.

A Preoperative Marking Template for Deep Inferior Epigastric Artery Perforator Flap Perforators in Breast Reconstruction

  • Miranda, Benjamin H.;Pywell, Matthew;Floyd, David
    • Archives of Plastic Surgery
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    • 제41권2호
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    • pp.171-173
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    • 2014
  • Preoperative perforator marking for deep inferior epigastric artery perforator flaps is vital to the success of the procedure in breast reconstruction. Advances in imaging have facilitated accurate identification and preselection of potentially useful perforators. However, the reported imaging accuracy may be lost when preoperatively marking the patient, due to 'mapping errors', as this relies on the use of 2 reported vectors from a landmark such as the umbilicus. Observation errors have been encountered where inaccurate perforator vector measurements have been reported in relation to the umbilicus. Transcription errors have been noted where confusing and wordy reports have been typed or where incorrect units have been given (millimetres vs. centimetres). Interpretation errors have also occurred when using the report for preoperative marking. Furthermore, the marking process may be unnecessarily time-consuming. We describe a bespoke template, created using an individual computed tomography angiography image, that increases the efficiency and accuracy of preoperative marking. The template is created to scale, is individually tailored to the patient, and is particularly useful in cases where multiple potential suitable perforators exist.

Patient-specific implants in reverse shoulder arthroplasty

  • Emil R Haikal;Mohamad Y. Fares;Joseph A. Abboud
    • Clinics in Shoulder and Elbow
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    • 제27권1호
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    • pp.108-116
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    • 2024
  • Reverse total shoulder arthroplasty (RTSA) is widely popular among shoulder surgeons and patients, and its prevalence has increased dramatically in recent years. With this increased use, the indicated pathologies associated with RTSA are more likely to be encountered, and challenging patient presentations are more likely to be seen. One prominent challenging presentation is RTSA patients with severe glenoid bone loss. Several techniques with varying degrees of invasiveness, including excessive reaming, alternate centerline, bone grafting, and patient-specific implants (PSIs), have been developed to treat patients with this presentation. PSI treatment uses a three-dimensional reconstruction of a computed tomography scan to design a prosthetic implant or component customized to the patient's glenoid morphology, allowing compensation for any significant bone loss. The novelty of this technology implies a paucity of available literature, and although many studies show that PSIs have good potential for solving challenging shoulder problems, some studies have reported questionable and equivocal outcomes. Additional research is needed to explore the indications, outcomes, techniques, and cost-efficiency of this technology to help establish its role in current treatment guidelines and strategies.

Enhancement of Adenoviral Transduction and Immunogenecity of Transgenes by Soluble Coxsackie and Adenovirus Receptor-TAT Fusion Protein on Dendritic Cells

  • Kim, Hye-Sung;Park, Mi-Young;Park, Jung-Sun;Kim, Chang-Hyun;Kim, Sung-Guh;Oh, Seong-Taek;Kim, Tai-Gyu
    • IMMUNE NETWORK
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    • 제6권4호
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    • pp.192-198
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    • 2006
  • Background: Investigating strategy to enhance efficiency of gene transfer via adenovirus is critical to sustain gene expression in targeted cells or tissues to regulate immune responses. However, the use of adenovirus as a gene delivery method has been limited by the native tropism of the virus. In this study, the critical parameter is to improve the efficient binding of viral particles to the plasma membrane prior to cellular uptake. Methods: Human immunodeficiency virus (HIV-1) trans-acting activator of transcription (TAT), a protein transduction domain, was fused to the ectodomain of the coxsackie-adenovirus receptor (CAR). The CAR-TAT protein was produced from a Drosophila Schneider 2 cells (S2) transfected with CAR-TAT genes. The function of CARTAT was analyzed the efficiency of adenoviral gene transfer by flow cytometry, and then immunizing AdVGFP with CAR-TAT was transduced on dendritic cells (DCs). Results: S2 transfectants secreting CAR-TAT fusion protein has been stable over a period of 6 months and its expression was verified by western blot. Addition of CAR-TAT induced higher transduction efficiency for AdVGFP at every MOI tested. When mice were vaccinated with DC of which adenoviral transduction was mediated by CAR-TAT, the number of IFN-${\gamma}$ secreting T-cells was increased as compared with those DCs transduced without CAR-TAT. Conclusion: Our data provide evidence that CAR-TAT fusion protein enhances adenoviral transduction and immunogenecity of transgenes on DCs and may influence on the development of adenoviral-mediated anti-tumor immunotherapy.

수지 조갑하 사구종의 진단 및 치료에서 자기 공명 영상의 임상적 의미 (Clinical Significance of MR Imaging for the Diagnosis and Treatment of Subungual Glomus Tumor in the Fingers)

  • 김병석;김우식;한경진;조재현;이기범;하헌교;강신영
    • 대한골관절종양학회지
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    • 제7권1호
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    • pp.28-35
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    • 2001
  • 목적 : 임상적으로 수지 사구종으로 의심되는 환자의 수술전 자기 공명 영상을 시행하여, 자기 공명 영상을 이용한 진단의 유용성과 변연 절제술 후의 임상적 결과를 알아보고자 하였다. 연구대상 및 방법 : 수지 사구종을 의심하는 10례를 대상으로 수술전 문진, 이학적 검사, 단순 방사선 검사, 자기 공명 영상(9례)을 시행하였다. 수술적 치료는 변연 절제술을 시행하였으며, 수술후 병리 소견, 수술후 합병증 등을 비교 분석하였다. 결과 : 사구종으로 확진된 10례 중 호소하는 증세는 동통 10례, 압통 9례, 냉온에 대한 민감도 3례, 부종 1례였다. 자기 공명 영상 소견상 T1 강조 영상에서 저신호 강도 3례, 동신호 강도 5례, T2 강조 영상에서 고신호 강도 8례, 그리고 gadolinium 조영 증강된 영상에서는 8례 모두 조영 증가 소견을 보여 주었고, 발생 위치는 횡단면에서 정중부 6례, 외측부 5례, 조갑 외측 추벽 2례, 수지 두수 3례였고, 시상면에서 조갑상 5례, 조갑 기질 5례였다. 수술은 외측 접근법 1례, 조갑을 통한 접근법 9례를 시행하였으며, 모두 변연 절제술을 실시하였다. 수술후 전 예에서 임상 증세는 소실되었으며, 조갑 변형은 1례에서 발견되었으나, 재발은 없었다. 결론 : 수지의 사구종을 진단하는데 임상 증세는 아주 중요하나, 진단이 애매하거나 오랜 기간 동안 증세가 있어온 환자들에게서 비교적 비싼 비용을 지불하더라도 자기 공명 영상을 제한적으로 사용할 경우, 수술전 종물의 정확한 위치 확인 및 진단에 도움을 주는 방법의 하나로 생각한다.

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개심술환자에 있어 혈청 Troponin-T 농도의 변화에 관한 연구 (Changes of Serum Troponin-T Concentrations in Patients with Open Heart Surgery)

  • 박동욱;최석철;김윤규;박종원;조관현
    • Journal of Chest Surgery
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    • 제31권2호
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    • pp.125-133
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    • 1998
  • 이 연구는 심근손상이 예상되는 개심술 환자들을 대상으로 수술에 따른 TnT의 혈중내 농도변화를 추적하여 심근세포 손상의 진단적 지표로서의 유용성을 조사하였고 기존의 효소진단 방법인 CK-MB 백분율 및 LDH1/LDH2비와 유용성을 비교 검토하였다. 본 연구는 1996년 1월부터 1996년 6월까지 인제대학교 부산백병원에서 개심술을 받은 성인 환자 중 술전 혈청 TnT 농도가 정상 범위였던 30명을 선정하여 시간대별 채혈로 시행되었다. 연구의 목적에 따라 환자들을 I 군(대동맥 차단시간 60분 이하, n=15)과 II군(대동맥 차단시간 60분 이상, n=15)으로 나누어 비교 조사하여 다음과 같은 결과를 얻었다. 1. 혈청 TnT의 농도는 양 군 모두 수술 중 상승하여 대동맥 차단의 제거후 유의하게 증가하였다(p<0.001). I 군에서는 술후 1일에 최고치(1.10$\pm$0.19 ng/ml)에 도달하였고 II 군에서는 체외순환 종료시 최고치(1.88$\pm$0.42 ng/ml)에 도달하여 이후 술후 7일까지 양군 모두 대조치에 비해 유의한 증가가 지속되었다(p<0.01). 2. CK-MB/total CK(이하 CK-MB 백분율 이라 함)의 경우 양 군 모두 수술 시작과 함께 유의하게 증가하여(p<0.001) 체외순환 종료시 최고치를 보였고 이후 술후 1일째까지 유의한 상승을 보였으나 술후 3일에는 기준치로 돌아옴으로써 혈청TnT에 비해 민감도가 떨어졌다. 3. LDH1/LDH2비는 수술동안 및 술후시기 전체에 걸쳐 대조치에 비해 유의한 변화가 없었다(p>0.05). 4. 수술동안의 혈청 TnT 농도와 CK-MB 백분율 변화간에는 의미있는 상관관계를 보였다(r=0.64, p<0.05). 5. I 군에 비해 II 군에서 혈청 TnT 농도는 대동맥 차단제거 시작 직전부터 술후 1일까지 유의한 증가를 보여(p<0.05) 대동맥 차단 시간의 지속 정도가 심근세포 손상의 중요한 인자임을 확인할 수 있었다. 결론적으로 혈청 TnT는 심근세포 손상에 있어 유용한 기준지표가 됨으로 향후 급성심근 경색증의 진단 뿐만 아니라 개심술에 따른 심근세포 손상 정도의 예측과 술후 환자의 감시에 표식자로서의 중요성이 기대 되었다.

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