• 제목/요약/키워드: Efficiency of Surgery

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Can the Zero-Profile Implant Be Used for Anterior Cervical Discectomy and Fusion in Traumatic Subaxial Disc Injury? A Preliminary, Retrospective Study

  • Kim, Tae Hun;Kim, Dae Hyun;Kim, Ki Hong;Kwak, Young Seok;Kwak, Sang Gyu;Choi, Man Kyu
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.574-581
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    • 2018
  • Objective : The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. Methods : Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria. Results : The C2-7 Cobb and operative segmental angles increased by $3.45{\pm}7.61$ and $2.94{\pm}4.59$ in group A; and $2.46{\pm}7.31$ and $2.88{\pm}5.49$ in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria. Conclusion : The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

Efficiency of Footwear and Ventilation Systems of Operating Rooms : How to Choose Suitable Shoes? (환기정도에 따른 수술실용 신발 종류가 수술실 오염에 미치는 영향)

  • Nam, Kyung-Dong;Chung, Hye-Seon;Park, Young-Shin;Won, Jin-Hee;Ju, Mi-Ja;Seong, Hwa-Shin;Lee, Ji-Hyui;Lee, Byung-Hee;Cho, Kyung-Sook;Bae, Jae-Chun
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.72-89
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    • 2000
  • Background : Various types of protective footwear have been used to minimize bacterial contamination in operating rooms. In recent years, debate has arisen concerning the need for use of such protective footwear. This study was designed to provide useful data about choosing shoes most suitable for the surgical environment. Methods : Between November, 1999 and January, 2000, we performed this experimental study by comparing effect of three types of shoes (i.e., disposable shoescover, operating room-restricted shoes, and ordinary shoes) on bacterial contamination of operating rooms equipped with two different ventilation systems (i.e., high air-change, low air-change) respectively. Data were collected during two- hour sham operations in which subjects and their activities were strictly standardized. Bacterial flora were sampled from the study area floor and air colony counts were measured. Results : In experiments involving high air-change ventilation system, there was a significant difference of floor contamination between three types of shoes, but no difference of air contamination. Under low air-change system, there was a significant difference of both floor and air contamination between three types of shoes. Conclusion : The results show that protective footwear would be unnecessary in the operating room with high air-change ventilation system, but it is important to choose suitable shoes carefully under low air-change system. Therefore, the use of outdoor shoes can be considered under high air-change system, but it would seem sensible to apply their first use in less bloody operations at the day surgery center or out-patient department to prevent transfer of body fluid into the outside environment.

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Superficial Esophageal Cancer Treated with Multidisciplinary Care: A Case Report (다학제 접근을 통해 치료에 성공한 표재성 식도암 1례)

  • Oh, Gyu Man;Park, Moo In;Jung, Kyoung Won;Kang, Sung Min;Son, Min Young;Kim, Jae Hyun;Moon, Won;Park, Seun Ja
    • Journal of Digestive Cancer Research
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    • v.8 no.1
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    • pp.71-75
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    • 2020
  • Esophageal cancer is easy to infiltrate and metastasize because esophagus does not have serosa, and is difficult to remove it because esophagus is in the middle of the chest. Because of this, treatments of esophageal cancer do not always follow the guideline. In this situation, efforts to increase treatment efficiency and improve survival rate through multidisciplinary treatment are increasing. In this case, we report the patient with three superficial esophageal cancers (one in cervical esophagus and two in thoracic esophagus). The patient was treated with concurrent chemoradiotherapy instead of surgery through multidisciplinary discussion. The patient reached a complete remission through this discussion. This case is intended to inform the usefulness of multidisciplinary treatment in patients with esophageal cancer.

A Study of Electromagnetic Actuator for Electro-pneumatic Driven Ventricular Assist Device

  • Jung Min Woo;Hwang Chang Mo;Jeong Gi Seok;Kang Jung Soo;Ahn Chi Bum;Kim Kyung Hyun;Lee Jung Joo;Park Yong Doo;Sun Kyung
    • Journal of Biomedical Engineering Research
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    • v.26 no.6
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    • pp.393-398
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    • 2005
  • An electromechanical type is the most useful mechanism in the various pumping mechanisms. It, however, requires a movement converting system including a ball screw, a helical cam, or a solenoid-beam spring, which makes the device complex and may lessen reliability. Thus, the authors have hypothesized that an electromagnetic actuator mechanism can eliminate the movement converting system and that thereby enhance the mechanical reliability and operative simplicity of an electro­pneumatic pump. The purpose of this study was to show a novel application of electromagnetic actuator mechanism in pulsatile pump and to provide preliminary data for further evaluations. The electromagnetic actuator consists of stators with a single winding excitation coil and movers with a high energy density neodymium-iron-boron permanent magnet. A 0.5mm diameter wire was used for the excitation coil, and 1000 turns were wound onto the stators core with parallel. A prototype of extracorporeal electro-pneumatic pump was constructed, and the pump performance tests were performed using a mock system to evaluate the efficiency of the electromagnetic actuator mechanism. When forward and backward electric currents were supplied to the excitation coil, the mover effectively moved back and forth. The nominal stroke length of the actuator was 10mm. The actuator dimension was 120mm in diameter and 65mm in height with a mass of 1.4kg. The prototype pump unit was 150mm in diameter, 150mm in thickness and 4.5kg in weight. The maximum force output was 70N at input current of 4.5A and the maximum pump rate was 150 beats per minute. The maximum output was 2.0 L/minute at a rate of 80bpm when the afterload was 100mmHg. The electromagnetic actuator mechanism was successfully applied to construct the prototype of extracorporeal electro­pneumatic pump. The authors provide the above results as a preliminary data for further studies.

Selection of Surrogates and Analysis of Its Ovulation Status for the Production of Somatic Cell Cloned Piglets (체세포 복제돼지 생산에 있어서 대리모의 선발과 배란상태 분석)

  • Hyun Sang-Hwan;Jeung Yeon-Woo;Lee Eun-Song;Kim Hyun-Wook;Kim Gon-Hyung;Jeung Eui-Bae
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.123-128
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    • 2006
  • Production of cloned pigs by somatic cell nuclear transfer (SCNT) has unlimited value for developing critical biotechnology such as xenotransplantation. Various efforts have been made to establish this technology, and several litters of live piglets have been produced after transfer of SCNT embryos. However, the efficiency is very low compared to piglet production by artificial insemination or natural mating. So far, most studies have been limited to in vitro production of SCNT embryos. This study was conducted to standardize a surrogate recipient (gilts) for transfer of SCNT embryos to improve pregnancy rate. Potential surrogate gilts over 7 months of age were checked for their estrous status by observing external signs; vaginal fluid, vulva redness, vulva swelling, and standing response to back pressure. Viscosity of vaginal fluid was evaluated and classified as none (0), medium (1), and strong (2). Vulva redness and swelling was respectively assessed by none or shrink (0), medium (1), strong (2). Back pressure was estimated by an immediate move (0), standing less than 10 sec (1), and standing over 10 see (2). And then ovulation status of each surrogate was classified as pre-ovulation (PO-17 surrogates), just prior to ovulation (JPO-20 surrogates), in ovulation (IO-12 surrogates), just after ovulation (JAO-14 surrogates) and after ovulation (AO-24 surrogates) at the time of surgery for embryo transfer (ET). Real-time ultrasonographic scanners have been used for pregnancy diagnosis by observing amniotic vesicles. The first pregnancy diagnosis was done on Day 30 after ET and then repeated 2-week interval. In the results, SCNT embryos transferred into JPO surrogates gave better pregnancy rates (45%) than others (4% to 11%) on Day 30 after ET. These result indicates that surrogate gilts in a status just prior to ovulation can offer optimal condition to establish pregnancy by transfer of SCNT pig embryos.

Full mouth rehabilitation using 3D printed crowns and implant assisted removable partial denture for a crossed occlusion: a case report (3D 프린팅 금관과 임플란트 보조 국소의치를 이용한 엇갈린 교합의 전악 수복 증례)

  • Sung-Hoon Lee;Seong-Kyun Kim;Seong-Joo Heo;Jai-Young Koak;Ji-Man Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.367-378
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    • 2023
  • With the recent development of computer-aided design-computer-aided manufacturing technology and 3D printing technology, and the introduction of various digital techniques, the accuracy and efficiency of top-down definitive prosthetic restoration are increasing. In this clinical case, stable occlusion support was obtained through the placement of a total of 9 maxillary and mandibular posterior implants in patient with anterior-posterior crossed occlusion. The edentulous area of the maxillary anterior teeth, which showed a tendency of high resorption of the residual alveolar bone, was restored with a Kennedy Class IV implant assisted removable partial denture to restore soft tissue esthetics. Computed tomography guided surgery was used to place implants in the planned position, double scan technique was used to reflect the stabilized occlusion in the interim restoration stage to the definitive prostheses, and metal 3D printing was used to manufacture the coping and framework. This clinical case reports that efficient and predictable top-down full mouth rehabilitation was achieved using various digital technologies and techniques.

RTN4 3'-UTR Insertion/Deletion Polymorphism and Susceptibility to Non-Small Cell Lung Cancer in Chinese Han Population

  • Lu, De-Yi;Mao, Xu-Hua;Zhou, Ying-Hui;Yan, Xiao-Long;Wang, Wei-Ping;Zheng, Ya-Biao;Xiao, Juan-Juan;Zhang, Ping;Wang, Jian-Guo;Ashwani, Neetika;Ding, Wei-Liang;Jiang, Hua;Shang, Yan;Wang, Ming-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5249-5252
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    • 2014
  • Nogo protein, encoded by gene reticulon-4 (RTN4), includes three major isoforms by different splicing, named Nogo-A Nogo-B and Nogo-C. Nogo proteins play an important role in the apoptosis of cells, especially in tumor cells. RTN4 single nucleotide polymorphisms (SNPs) can influence the efficiency of transcription and translation thus being related with an individual's predisposition to cancer. The CAA insertion/deletion polymorphism (rs34917480) within RTN4 3'-UTR has been reported to be associated with many cancer types. In order to investigate the relationship between this polymorphism and susceptibility to non-small cell lung cancer (NSCLC) in the Chinese population, we conducted the present case-control study including 411 NSCLC patients and 471 unrelated healthy controls. The genotype distributions were significantly different between cases and controls (p=0.014). We found that the del allele could significantly increase NSCLC risk (ins/ins vs ins/del: p=0.007, OR 1.46, 95%CI=1.11-1.93; dominant model: p=0.004, OR 1.47, 95%CI=1.13-1.92 and allele model: p=0.008, OR 1.35, 95%CI=1.08-1.67). This association was stronger in participants over 60 years old, males and smokers. We therefore conclude that the CAA insertion/deletion polymorphism (rs34917480) contributes to non-small cell lung cancer risk in Chinese population. Age, sex and environmental exposure are also related to carcinogenic effects of rs34917480.

The Evaluation of Artificial Lung Using Blood Substitutes (대체혈액을 이용한 인공폐의 평가에 관한 연구)

  • Kim K.B.;Hong S C.;Kim M.H.;Jheong G.R.;Lee S.C.
    • Journal of Biomedical Engineering Research
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    • v.21 no.3 s.61
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    • pp.311-320
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    • 2000
  • In this paper a newly designed oxygenator module was used to perform the experiments for pressure drop and oxygen transport in order to evaluate the efficiency of the artificial lung. Also, distilled water. sodium sulfite solutions used in this experiment were evaluated for the performance of other artificial lungs. Substituted bloods have many advantages over whole blood in studying pressure drop and oxygen uptake. They are relatively inexpensive, and require fewer variables to be controlled. Furthermore, deoxygenation is not necessary when those solutions are used. In addition to these advantages. assays and interpretation of the experimental results are relatively easy. In the case of using the sodium sulfite solution having the same oxygen partial pressure as whole blood. the oxygen transfer rate of the sodium sulfite solution was basically same as that of whole blood. It was concluded in evaluating the function of artificial lungs that the sodium sulfite solution was suited for measuring oxygen transfer rate. In our module, artificial blood was flowed into the outside of hollow fiber membrane. The artificial lung created in this experiment showed that pressure drop was reduced to $1/3\~1/6$ of that compared to the inside-flow case.

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A Study on the Space Composition for Department of Delivery in Regional Public Hospital (지역거점 공공병원의 분만부 공간구성에 관한 연구(1))

  • Park, Kyeong Hyeon;Shin, Hwa Kyoung;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.28 no.3
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    • pp.47-54
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    • 2022
  • Purpose: This study presents the analysis on space usage of delivery departments in regional public hospitals. The results intention is to achieve improvement of the delivery environment for the mothers and newborns regarding exposure prevention and efficient infection control. The purpose of this study is to provide fundamental data for architectural plans and guidelines for the delivery department. Method: The investigation and analysis were based on research papers, legal systems, public medical statistical data, and the architectural floor plan drawing. For research, 20 regional public hospitals with an operating delivery room were excluded. Regarding data accessibility, 15 regional public hospitals were selected. Results: To overcome the increased vulnerability of the delivery department, the research results of basic data is provided for the establishment to address urgent needs and rapid response. Thus, the research results are as follows: Firstly, the delivery department needs to respond promptly according to the type of patients. For example, in a case of emergency surgery, a connected circulation plan with the related departments is needed. Secondly, for the environment of the delivery area, alleviating anxiety is imperative for pregnant patients and guardians, labor, childbirth, and recovery. Therefore, these needs must be addressed for treatment space and circulation. Lastly, the delivery department is classified into three areas for analysis: access area, treatment area, and support area. In most of the delivery departments of the 15 selected hospitals, there is no space for the access and support area except for the labor and delivery rooms in the treatment area. For the access area, a waiting area, changing room for pregnant women and guardians, and a storage space for contaminated linens are required for infection prevention, safety, and efficiency. For the treatment area, childbirth processes and circulation should have space reserved for labor, delivery, recovery, examination, and treatment. In preparation for an emergency during childbirth, emergency response measures and supporting space needs to be established. For the support area, circulation and rooms are to be designed for medical staff support, activity space, storage and transportation of equipment, and urgent medical treatment. Implications: Along with the low fertility rate and the decrease of medical institutions that operate delivery departments, for the purpose of establishing a public medical service system and a healthy medical environment for mothers and newborns, the researched information demonstrates basic data on space plan of delivery departments in regional public hospitals.

EVALUATION OF ECTOPIC BONE FORMATION EFFECT BY DECALCIFIED DEGREE OF ALLOGRAFTS (동종이식골의 탈회정도가 이소성 골형성유도에 미치는 영향)

  • Yun, Hong-Sik;Chin, Byung-Rho;Shin, Hong-In
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.2
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    • pp.139-147
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    • 1998
  • This study has been performed to evaluate the relationship between the remained mineral components in a decalcified bone matrix and an ectopic bone formation efficiency. The freezed rat diaphyseal cortical bones measuring 0.5cm in length were demineralized in heated 0.6N HCl at $60^{\circ}C$ for 5, 10, 15, 20, 25, 30, 35, 40 minutes, respectively, using a controlled heat ultrasonic cleaner. Each 1cc of decalcifying solution taken during decalcification procedure was used to calculate calcium content using calcium dignostics kit under 600nm of spectrophotomer. After decalcification, each specimen was also weighed. Then each prepared specimen was implanted into the dorsal pouch of 24 Sprague-Dawley rats divided into 8 groups by time course. The implants were harvested at 1, 2, and 3 weeks and prepared for routine H-E stain specimens to evaluate osteogenic activity. The results are as follows: 1. There was statistical significant difference in change of calcium concentration up to demineralization of 30 minutes and each allogenic bones decalcifed up to 20 minutes revealed 99.65% of decalcification in average. 2. There was statistical significant difference in change of weight in demineralized allogenic bone up to 20 minutes treatment but, no significant change was noted after that time. 3. The histologic analysis revealed active ectopic bone formation in the implanted allografts demineralized for 20, 25, 30 minutes, respectively. However, the other groups of allografts showed relatively poor osteoinductive activity. These findings suggest that complete decalcification with a minimized degeneration of collagen matrix is necessary to induce maximal osteogenesis by decalcified bone allograft.

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