• Title/Summary/Keyword: Efficiency of Surgery

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COR-KNOT-Induced Leaflet Perforation: How It Happens and How to Prevent It: A Case Report

  • Michael Salna;Jack Shanewise;Alex D'Angelo;Isaac George
    • Journal of Chest Surgery
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    • v.57 no.1
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    • pp.96-98
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    • 2024
  • The COR-KNOT suture fastening device has dramatically improved the efficiency of valve suture fixation. Despite its relative ease of use, there are important considerations in deployment to limit the risk of prosthetic valve injury. Herein, we report a case of iatrogenic aortic bioprosthetic insufficiency caused by poorly positioned COR-KNOTs and outline technical strategies to ensure success.

Image-guided surgery and craniofacial applications: mastering the unseen

  • Wang, James C.;Nagy, Laszlo;Demke, Joshua C.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.43.1-43.5
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    • 2015
  • Image-guided surgery potentially enhances intraoperative safety and outcomes in a variety of craniomaxillofacial procedures. We explore the efficiency of one intraoperative navigation system in a single complex craniofacial case, review the initial and recurring costs, and estimate the added cost (e.g., additional setup time, registration). We discuss the potential challenges and benefits of utilizing image-guided surgery in our specific case and its benefits in terms of educational and teaching purposes and compare this with traditional osteotomies that rely on a surgeon's thorough understanding of anatomy coupled with tactile feedback to blindly guide the osteotome during surgery. A 13-year-old presented with untreated syndromic multi-suture synostosis, brachycephaly, severe exorbitism, and midface hypoplasia. For now, initial costs are high, recurring costs are relatively low, and there are perceived benefits of imaged-guided surgery as an excellent teaching tool for visualizing difficult and often unseen anatomy through computerized software and multi-planar real-time images.

Preparation of Microspheres Encapsulating a Recombinant TIMP-1 Adenovirus and their Inhibition of Proliferation of Hepatocellular Carcinoma Cells

  • Xia, Dong;Yao, Hui;Liu, Qing;Xu, Liang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6363-6368
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    • 2012
  • Objective: The study aim was to prepare poly-DL-lactide-poly (PELA) microspheres encapsulating recombinant tissue inhibitors of metalloproteinase-1 (TIMP-1) in an adenovirus to investigate its inhibition on the proliferation of hepatocellular carcinoma cells HepG2. Methods: Microspheres were prepared by encapsulating the recombinant TIMP-1 adenovirus into biodegradable PELA. The particle size, viral load, encapsulation efficiency and in-vitro release were measured. Microspheres were used to infect HepG2 cells, then infection efficiency was examined under a fluorescent microscope and ultrastructural changes assessed by TEM. Expression of TIMP-1 mRNA in HepG2 cells was examined by semi-quantitative RT-PCR and proliferation by MTT and cell growth curve assays. Results: We successfully prepared microspheres encapsulating recombinant TIMP-1 adenovirus with a diameter of $1.965{\mu}m$, an encapsulation efficiency of 60.0%, a viral load of $10.5{\times}10^8/mg$ and approximate 60% of virus release within 120 h, the total releasing time of which was longer than 240 h. The microspheres were confirmed to be non-toxic with blank microspheres. Infected HepG2 cells could stably maintain in-vitro expression of TIMP-1, with significantly effects on biological behaviour Conclusion: PELA microspheres encapsulating a recombinant TIMP-1 adenovirus can markedly inhibit the proliferation of HepG2 cells, which provides an experimental basis for polymer/chemistry-based gene therapy of hepatocellular carcinomas.

The Study on the Relation of the Telecasters's Beauty Service - Focusing on the Appearance Management Behavior, External Image, Self-efficacy - (방송인의 뷰티서비스 관계 연구 - 외모관리 행동, 외적이미지, 자기효능감을 중심으로-)

  • Kim, Min-Shin
    • Journal of the Korea Fashion and Costume Design Association
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    • v.16 no.1
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    • pp.153-167
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    • 2014
  • The purpose of this study is to compare and analyze about the Telecasters's appearance management, external image & awareness on Self-Efficacy. The method of this study is carried out form 2 January 2013 until 20 January. with the 164 telecasters who announcers, voice actors, gag men, singers. The results of the research is summarized below: First, Among the telecasters, singer is the highest awareness of the beauty services importance about the fashion, makeup, hair, skin care, cosmetic surgery. Especially, about the awareness of the beauty services importance about the fashion, makeup, hair, singers> announcers> voice actors> gagmen appear one after another. Second, about the importance awareness of the beauty services importance & the relation of self-efficacy, for announcers, the more higher awareness the fashion, makeup, hair, the higher self-efficacy of the confidence, effective expression, etc.. For voice actors, the more higher awareness the hair, skin care, the fashion, make up, cosmetic surgery, the higher self-efficacy of the new image making, the confidence, task efficiency improvement, etc... For gagmen, the more higher awareness the fashion, hair, skin care, makeup, cosmetic surgery, the higher self-efficacy of the self-expression, the confidence, the new image making, task efficiency improvement, etc.. For singer, the more higher awareness the makeup, hair, cosmetic surgery, skin care, fashion, the higher self-efficacy of the task efficiency improvement, the self-expression, the confidence, the new image making, etc.. Third, about the importance awareness of the appearance management behavior, external image, about the importance awareness of the appearance management behavior, singer is the most higher awareness, announcers> voice actors> gagmen appear one after another. about the importance awareness of the external image, singer is the most higher awareness, voice actor> announcers> gagmen appear after another. The meanings of this study provide the telecasters's image's fields with the effective basic data.

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Single buccal infiltration of high concentration lignocaine versus articaine in maxillary third molar surgery

  • Phyo, Hnin Ei;Chaiyasamut, Teeranut;Kiattavorncharoen, Sirichai;Pairuchvej, Verasak;Bhattarai, Bishwa Prakash;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.203-212
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    • 2020
  • Background: This research evaluated the numbness produced by lignocaine at an equal or higher concentration than that of 4% articaine through a single point of injection for maxillary third molar surgery. This randomized double-blind study was conducted to compare the anesthetic efficiency of 4% lignocaine with that of 4% articaine in impacted maxillary third molar surgery using a single buccal infiltration alone. Methods: The study participants were 30 healthy patients requiring the bilateral surgical removal of symmetrically-positioned maxillary third molars. Using a split-mouth design, each patient randomly received buccal infiltration of 1.7 ml of 4% lignocaine and 1.7 ml of 4% articaine during two separate appointments. After 15 minutes of anesthetic injection, surgery was performed by the same surgeon using a consistent technique on both sides. Pinprick test pain scores of the buccal and palatal gingiva of the maxillary third molar after 10 minutes and 15 minutes latencies, pain scores during the surgery, the need for supplemental anesthesia, and patients' satisfaction with anesthetic efficiency were recorded. Surgery performed without supplemental anesthesia was categorized as successful. Results: The success rates of 4% lignocaine and 4% articaine (83.34% vs. 86.67%, P = 1.00) were not significantly different. Only 5 cases (4 cases in the articaine group and 1 case in the lignocaine group) reported mild pain and pressure sensation (NRS ≤ 1) on probing at the palatal side after 15 minutes of latency (P = 0.25). The pain scores of maxillary third molar surgery in the two groups were not significantly different (P > 0.05). Moreover, the statistical analysis confirmed the comparable patient satisfaction of two study groups (P = 0.284). Conclusion: This study provides evidence that single buccal infiltrations of 4% lignocaine and 4% articaine have comparable anesthetic efficacy and success rates for impacted maxillary third molar surgery. Both 4% lignocaine and 4% articaine can produce effective palatal anesthesia and pain control using buccal infiltration alone after 15 minutes of latency.

The Efficiency of VAC(Vacuum-Assisted Closure) in Non-healing Wound (하지의 난치성 창상치유에 있어 VAC(Vacuum-Assisted Closure)의 유용성)

  • Park, Jung Min;Kwon, Yong Seok;Jung, Ki Hwan;Lee, Keun Cheol;Kim, Seok Kwun;An, Won Suk
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.727-732
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    • 2005
  • The treatment of wounds of the lower extremity caused by diabetes or vascular dysfunction remains a difficult problem for the plastic surgeon. The use of negative pressure in wound healing is a relatively new method to facilitate chronic wound healing by secondary healing. The use of vacuum-assisted closure(VAC) system is purposed to reduce local edema, increase regional blood flow, enhance epithelial migration, preserve a moist wound environment, reduce bacterial colonization, promote granulation tissue formation, and mechanically enhance wound closure. The VAC also can be used as a dressing for anchoring an applied split thickness skin graft. We reviewed the data from 20 consecutive patients with non-healing wound in lower extremity at Dong-A University from March 2002 to December 2004. We used the VAC in 20 patients and compared the results with the control group. In the VAC using group, mean application duration was about 3 weeks and dressing change was done every other day. The follow-up period of patients ranged from 3 months to 30 months with a mean of 17 months. The points of comparison with control group are wound size, granulation tissue proliferation rate, operation method, preoperative time, postoperative healing time, complication, and cost. With those points, we propose to approve the efficiency of the VAC in non-healing wound. As a result, the VAC used in non-healing wound decrease wound size, accelerate granulation tissue formation, do a wound closure with less invasive operation method, make less postoperative complication, can make operation time shorter. Therefore it is cost effect. Our results demonstrate the usefulness of VAC as an adjunct in management of chronic wounds with other extrinsic factors.

Comparative efficiency of the preoperative pterygomandibular space injection of two doses of dexamethasone in mandibular third molar surgery

  • Wanithanont, Pavita;Chaiyasamut, Teeranut;Vongsavan, Kadkao;Bhattarai, Bishwa Prakash;Pairuchvej, Verasak;Kiattavorncharoen, Sirichai;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.1
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    • pp.29-39
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    • 2021
  • Background: Impacted mandibular third molar removal is one of the most commonly performed oral surgical procedures. This procedure can lead to several postoperative complications, such as trismus, facial swelling, and pain, which occur as a result of the inflammatory responses to surgery. This study compared the efficiency of preoperative injections of 4 mg versus 8 mg dexamethasone into the pterygomandibular space to reduce postoperative sequelae. Methods: This was a randomized, prospective, split-mouth, controlled study, including 52 mandibular third molar surgeries in 26 patients. Each patient was randomized to either the 4 mg or 8 mg dexamethasone injection group. Dexamethasone was injected into the pterygomandibular space after numbness from local anesthesia. Data were collected for trismus, facial swelling, visual analog scale (VAS) pain score, and the number of analgesics taken during the evaluation period. The level of significance was set at P < 0.05. Results: Statistically significant differences in postoperative facial swelling (P = 0.031, diff = 1.4 mm) and pain (P = 0.012, diff = 0.020) were found between the 8 mg and 4 mg dexamethasone groups. However, there were no significant differences between the groups for trismus and the total number of analgesics consumed (P > 0.05). Conclusion: Compared to the 4 mg preoperative dexamethasone injection, the 8 mg preoperative dexamethasone injection into the pterygomandibular space was more effective in reducing postoperative swelling and pain following the surgical removal of the impacted mandibular third molar. However, the difference in trismus could not be evaluated clinically. Therefore, the recommendation of administering the 4 mg dexamethasone preoperative injection is optimal in the third molar surgical procedure.

Comparison of Pre and Post-operational Phonatory Aerodynamic Parameters in Vocal Polyp and Vocal Cord Palsy Patients (성대마비 및 성대용종 환자의 수술 전과 후의 공기역학적 변수 비교)

  • Lee, Dahye;Kim, Jaeock;Oh, JaeKoon;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.2
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    • pp.112-116
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    • 2015
  • Background and Objectives : Aerodynamic analysis is an examination which provides information regarding various vocalization measures indicating laryngeal efficiency. Voice evaluation using such examination must be capable of distinguishing between normal to abnormal voice. It also observes variables on aerodynamic characteristics by gender in regards to patients of vocal disorders, especially of vocal cord paralysis and vocal polyp, and compares the conditions before and after surgery. This paper therefore, seeks to build a framework for establishing standard levels of aerodynamical characteristic on vocal disorders. Subjects and Methods : The study was intended for a total number of 20 patients with vocal polyp or unilateral vocal cord paralysis. Those with the vocal polyp underwent laryngomycroscopy surgery and the vocal cord paralysis, vocal fold injection using Restylane. Aerodynamic analysis fulfilled the Maximum sustained Phonation (MXPH) and Voicing Efficiency (VOEF) by using PAS Model 6600 (KayPENTAX, USA). Results : In MXPH, increase in PHOT were evident with vocal polyp after surgery. As for patients with vocal cord paralysis, MAXDB, MEADB, DHODB, PHOT all have increased and MEAP, PEF, MEAF decreased after surgery. In VOEF, patients with vocal cord paralysis who underwent surgery showed increase in MAXDB, MEADB, DHODB, FET100, ARES, but decreases in PEF, TARF. Conclusion : Overall, it can be concluded that patients with the vocal polyp and vocal cord paralysis seemed to get closer to the normal values after than before surgery in majority of measures. This confirms that the function of their vocal cord has improved nearly to normality through operations.

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Cauterizing Effect Animation for Virtual Surgery Medical Simulation (가상 수술 의료 시뮬레이션을 위한 소작 효과 애니메이션 기법)

  • Lee, Jeong-Jin;Lee, Ho;Kye, Hee-Won
    • Journal of Korea Multimedia Society
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    • v.14 no.9
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    • pp.1175-1181
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    • 2011
  • Practice education using virtual medical simulation has been recently introduced to maximize the learning efficiency in clinical environment. Specially, in minimally invasive surgery, the necessity of virtual surgery medical simulation has been substantially increased. Since cauterizing effect occurred frequently in minimally invasive surgery has been represented by simple bleeding, realistic cauterizing effect animation has not been proposed yet. In this paper, we propose realistic real-time cauterizing effect animation. Proposed method changes the individual element of each vertex color of the mesh and uses sigmoid function to impose weights for the smooth color change inside the valid mesh region so that the results of cauterizing effect animation was realistic. In addition, by proposing cauterizing color buffer, overlapped cauterizing effects can be realistically represented. Proposed method greatly improves the sense of the real and absorption in virtual surgery medical simulation so that the education efficiency of doctors and students using medical simulation can be maximized.

Real-time Bleeding Animation for Virtual Surgery Medical Simulation (가상 수술 의료 시뮬레이션을 위한 실시간 출혈 애니메이션 기법)

  • Lee, Jeong-Jin;Seo, Che-Hwan;Lee, Ho;Kye, Hee-Won;Lee, Min-Sun
    • Journal of Korea Multimedia Society
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    • v.15 no.5
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    • pp.664-671
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    • 2012
  • Recently, practice education using virtual medical simulation has been applied to real clinical environment by enhancing the learning efficiency. Specially, in minimally invasive surgery, the necessity of virtual surgery medical simulation has been increased. Realistic bleeding animation, which represents bleeding special effects frequently occurred in virtual medical simulation environment, has not been proposed yet. In this paper, we propose realistic real-time bleeding animation. For bleeding simulation, proposed method calculates main and effective bleeding regions along the main bleeding direction vector to represent naturalistic bleeding effect. In addition, for bleeding rendering, proposed method uses sigmoid function to impose weights of vertex opacities for the smooth opacity change so that the results of bleeding animation is realistic. Proposed method improves the sense of the real and absorption in virtual surgery medical simulation so that the education efficiency of doctors and students using medical simulation can be enhanced.