• Title/Summary/Keyword: Guide surgery

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The new classification for fatty-type gynecomastia (lipomastia) and 1000 cases review (지방형 여성형유방증에 대한 새로운 분류와 1000증례)

  • Yoon, Sang Yub;Kang, Min Gu
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.773-778
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    • 2009
  • Purpose: The authors propose the new classification of fatty - type gynecomastia(lipomastia) which can serve as a guide for modifying the periareolar technique. Methods: A retrospective analysis was made of 1000 cases of lipomastia operated on in the last 17 months. The extent of the clinical result, the technique employed, and the complications were observed. On the basis of this review the authors observed that at grade I(fat component < 50 ml, fibroglandular component < 3 g each breast), flattening of the thorax can be achieved by means of stab incision, ultrasound - assisted lipectomy(UAL), scavenging suction - assisted lipectomy(SAL) and tissue shaving. At grade II(50 < < 150 ml, 3 < < 5 g), stab incision, UAL, SAL and pull - out method(POM) using small curved scissors. At grade III(150 < < 300 ml, 5 < < 15 g and prominent inframammary fold(IMF)), minimal incision (5 - 6 mm), UAL, SAL and POM using small angulated scissors, and blunting IMF. At grade IV (300 < < 500 ml, 15 < < 30 g, and glandular ptosis), minimal incision (5 - 6 mm), UAL, SAL, fibroglandular excision using small angulated scissors, cutting IMF and fixation of nipple - areola complex(NAC) becomes necessary. At grade V (> 500 ml, > 30 g and ptosis), small incision (7 - 8 mm), UAL, SAL, fibroglandular excision using large angulated scissors, cutting IMF, upper repositioning of NAC and delayed circumareolar skin reduction or chest lifting becomes necessary. Results: The complications were minimal but there were hematoma (n = 7), infection (n = 3) and hypertrophic scar (n =13). Almost patients were satisfied with the outcome. Conclusion: This simple classification may help in choosing the most suitable treatment, thus avoiding insufficient or invasive treatments and undesirable scars.

The incidence and morphology of maxillary sinus septa in dentate and edentulous maxillae: a cadaveric study with a brief review of the literature

  • Gandhi, Kusum Rajendra;Wabale, Rajendra Namdeo;Siddiqui, Abu Ubaida;Farooqui, Mujjebuddeen Samsudeen
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.1
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    • pp.30-36
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    • 2015
  • Objectives: The aim of this study is to determine the incidence, location, and orientation of maxillary sinus septa in formalin embalmed cadavers. Materials and Methods: The study was conducted on 210 cadaveric heads available in our department. After taking the mid-sagittal section the specimens were opened from the medial aspect and the sinus sinus septa, their anatomical plane, location and dimensions. Results: The mean linear distance between maxillary sinus floor and its anatomical ostium was $26.76{\pm}5.21mm$ and $26.91{\pm}4.96mm$ on right and left side, respectively. A total of 59 maxillary sinus septa (28.1%) were observed in 210 maxillary specimens. Septae were most common, 33 septa (55.9%), in the middle region (between first and second molar tooth) of the sinus cavity. The maxillary sinus membrane (Schneiderian membrane) adhered tightly to the maxillary sinus and over the septae. Significantly more maxillary sinus septa were observed in edentulous maxillae in comparison to the dentate upper jaw. Conclusion: Knowledge of location of maxillary sinus ostium is mandatory for the rhinologist for drainage of secretions in maxillary sinusitis. The morphological details of maxillary sinus septa, particularly their location and anatomical planes, will guide dentists in performance of safe implant surgeries. The maxillary antrum septa of category I and II may complicate the procedure of inversion of bone plate and elevation of sinus membrane during maxillary augmentation surgeries. The category III septa observed in the sagittal plane were embedded by one of the branches of the infraorbital nerve in it, and if accidentally cut will lead to infraorbital nerve palsy in maxillary sinus surgeries.

Determining the Location of Metallic Needle from MR Images Distorted by Susceptibility Difference (자화율 차이로 인해 왜곡된 영상으로부터 금속 바늘의 위치 결정)

  • Kim, Eun-Ju;Kim, Dae-Hong
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.2
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    • pp.87-94
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    • 2010
  • Purpose : To calculate the appearance of the image distortion from metallic artifacts and to determine the location of a metallic needle from a distorted MR image. Materials and Methods : To examine metal artifacts, an infinite metal cylinder in a strong magnetic field are assumed. The cylinder’s axis leaned toward the magnetic field along some arbitrary angle. The Laplace equation for this situation was solved to investigate the magnetic field distortion, and the simulation was performed to evaluation the image artifact caused by both readout and slice-selection gradient field. Using the result of the calculation, the exact locations of the metal cylinder were calculated from acquired images. Results : The distances between the center and the folded point are measured from images and calculated. Percentage errors between the measured and calculated distance were less than 5%, except for one case. Conclusion : The simulation was successfully performed when the metal cylinder was skewed at an arbitrary tilted angle relative to the main magnetic field. This method will make it possible to monitor and guide both biopsy and surgery with real time MRI.

Exocrine Pancreatic Secretion in Response to Electrical Stimulation of Dorsal Raphe Nucleus in Rats (흰쥐에서 배측 봉선핵의 전기자극이 췌장의 외분비기능에 미치는 영향)

  • Suh, Sang-Won;Park, Hyoung-Jin
    • The Korean Journal of Physiology
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    • v.24 no.2
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    • pp.403-411
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    • 1990
  • The present investigation was performed to see a possible influence of the dorsal raphe nucleus (DRN) on pancreatic exocrine secretion in anesthetized rats since the DRN had been known to exert a regulatory mechanism on sympathetic activity which was known to be very important for pancreatic exocrine secretion, particularly in rats. Twenty-nine Sprague-Dawley rats fasted for 24 hours were anesthetized by i.p. injection of 1 g/kg of urethane. The pancreatic duct was cannulated to collect pancreatic juice while bile juice was diverted into the jejunum. The duodenopyloric junction was tightly ligated. After surgery for collection of pancreatic exocrine secretion and recording of carotid blood pressure, a coaxial electrode was stereotaxically inserted in the DRN with a guide of a brain atlas. And then, electrical stimulus of biphasic square wave with 2 v, 2 msec, 40 Hz was applied on the electrode for 10 minutes. Pancreatic volume flow and protein output secreted in 10 min were measured. Either bilateral cervical vagotomy or spinal cord transection at the level of $C4{\sim}C5$ was performed 20 min prior to stimulation of the DRN. 1) Electrical stimulation of the DRN resulted in significant (p<0.05) increase in pancreatic volume flow and protein output. These stimulatory effects were not affected by cervical vagotomy but completely abolished by cervical cord transection. 2) Electrical stimulation of the DRN also resulted in significant (p<0.05) rise of blood pressure of the carotid artery. The hypertensive effect was not affected by cervical vagotomy but completely abolished by cervical cord transection. The results strongly suggest that the DRN, a part of the central serotonergic system, could exert a stimulatory influence on pancreatic exocrine secretion by increasing the sympathetic activity in anesthetized rats.

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Feasibility study on the development of Liquid crystal-optical fiber temperature sensor for minimal invasive laserthermia (LC(Liquid crystal)-광섬유를 이용한 최소 침습적 레이저 온열 치료용 온도 측정 센서의 개발을 위한 기초 연구)

  • Lee, Bong-Soo;Hwang, Young-Muk;Chung, Soon-Cheol
    • Journal of Sensor Science and Technology
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    • v.12 no.5
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    • pp.225-230
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    • 2003
  • Nowadays, laserthermia is widely used to treat malignant tumors with generating heat as the one of minimal invasive surgeries. Generally, the laserthermia probe system consists of the fiber-optic laser and light guides, image guide and temperature sensor. It is very important to measure the temperature of treating tumor and make a stable temperature ($42{\sim}43^{\circ}C$) during the treating time. Therefore, laserthermia probe needs temperature sensor which can measure it exactly and fast. In this study, to develop a new type of temperature sensor with LC(liquid crystal) and optical fiber, the reflectivity of LC according to the temperature changes are measured. Also, the relationships are derived from the results.

Intracisternal Antidepressants Suppressed the Nociceptive Jaw Opening Reflex in Freely Moving Rats

  • Ahn, Dong-Kuk;Kim, Yun-Sook
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.3
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    • pp.307-312
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    • 1998
  • This study was performed to investigate the mechanism of central analgesic effects of antidepressants. Thirty four male rats were anesthetized with pentobarbital sodium (40 mg/kg, ip). A stainless steel guide cannula and a PE tube (PE10) were implanted into the lateral ventricle and cisterna magna area. Stimulating and recording electrodes were implanted into the incisor pulp and anterior digastric muscle. Electrodes were led subcutaneously to the miniature cranial connector sealed on the top of the skull with acrylic resin. The jaw opening reflex was used in freely moving rats, and antidepressants were administered intracisternally in order to eliminate the effects of anesthetic agents on the pain assessment and evaluate the importance of the central action site of antidepressants. After 48 hours of recovery from surgery, digastric electromyogram (dEMG) of freely moving rats was recorded. Electrical shocks (200 ${\mu}sec$ duration, 0.5-2 mA intensity) were delivered at 0.5 Hz to the dental pulp every 2 minute. Intracisternal administration of $15\;{\mu}g$ imipramine suppressed dEMG elicited by noxious electrical stimulation in the tooth pulp to $76{\pm}6%$ control. Intracisternal administration of $30\;{\mu}g$ desipramine, nortriptyline, or imipramine suppressed dEMG remarkably to $48{\pm}2,\;27{\pm}8,\;or\;25{\pm}5%$ of the control, respectively. Naloxone, methysergide, and phentolamine blocked the suppression of dEMG produced by intracisternal antidepressants from $23{\pm}2\;to\;69{\pm}4%,\;from\;32{\pm}5\;to\;80{\pm}9%,\;and\;from\;24{\pm}6\;to\;77{\pm}5%$ of the control, respectively. These results indicate that antidepressants produce antinociception through central mechanisms in the orofacial area. Antinociception of intracisternal antidepressants seems to be mediated by an augmentation of descending pain inhibitory influences on nociceptive pathways.

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What Do Korean Women Know and Want to Know about Thyroid Cancer? A Qualitative Study

  • Lee, Bomyee;Park, Jae Young;Shin, Hye Young;Park, Sang Hee;Choi, Eun-Bi;Yoo, Jisu;Choi, Kui Son;Jun, Jae Kwan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2901-2907
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    • 2016
  • Background: Despite increasing debate about overdiagnosis and overtreatment of thyroid cancer in Korea, information to guide decisions on whether or not to undergo screening for and treatment of abnormal lesions of the thyroid is lacking. Moreover, studies have yet to outline what lay people know and want to know about thyroid cancer. The primary aim of this study was to explore general awareness of thyroid cancer among Korean women, their sources of information, and their satisfaction with the information they are provided. The secondary aim was to investigate information needs about thyroid cancer. Materials and Methods: A qualitative study using focus group interviews was conducted. Twenty-nine women were divided into four groups: (1) participants who had never undergone thyroid ultrasound screening; (2) those who had undergone screening, (3) those who continued to undergo regular check-ups with ultrasonography for benign nodules of the thyroid; and (4) participants who had undergone surgery for thyroid cancer. Results: A widespread lack of awareness of information on thyroid cancer was noted among participants in groups 1 and 2 who were not well aware of thyroid cancer and generally recognized it as a 'good cancer'. Surprisingly, instead of doctors and medical personnel, most participants reported obtaining information from acquaintances and media outlets. Moreover, most participants described dissatisfaction with their experience with screening and a lack of explanation on treatment and test results from medical personnel. Conclusions: Women in Korea seek reliable information on thyroid cancer that could help them to better understand the disease and make informed decisions regarding screening and treatment. More effort is needed from medical personnel to communicate the implications of thyroid cancer, screening results, and treatments thereof to lay people.

Internal Mammary Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer

  • Bi, Zhao;Chen, Peng;Liu, Jingjing;Liu, Yanbing;Qiu, Pengfei;Yang, Qifeng;Zheng, Weizhen;Wang, Yongsheng
    • Journal of Breast Cancer
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    • v.21 no.4
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    • pp.442-446
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    • 2018
  • Purpose: The definition of nodal pathologic complete response (pCR) after a neoadjuvant chemotherapy (NAC) just included the evaluation of axillary lymph node (ALN) without internal mammary lymph node. This study aimed to evaluate the feasibility of internal mammary-sentinel lymph node biopsy (IM-SLNB) in patients with breast cancer who underwent NAC. Methods: From November 2011 to 2017, 179 patients with primary breast cancer who underwent operation after NAC were included in this study. All patients received radiotracer injection with modified injection technology. IM-SLNB would be performed on patients with internal mammary sentinel lymph node (IMSLN) visualization. Results: Among the 158 patients with cN+ disease, the rate of nodal pCR was 36.1% (57/158). Among the 179 patients, the visualization rate of IMSLN was 31.8% (57/179) and was 12.3% (7/57) and 87.7% (50/57) among those with $cN_0$ and cN+ disease, respectively. Furthermore, the detection rate of IMSLN was 31.3% (56/179). The success rate of IM-SLNB was 98.2% (56/57). The IMSLN metastasis rate was 7.1% (4/56), and all of them were accompanied by ALN metastasis. The number of positive ALNs in patients with IMSLN metastasis was 3, 6, 8, and 9. The pathology nodal stage had been changed from $pN_1/pN_2$ to $pN_{3b}$. The pathology stage had been changed from IIA/IIIA to IIIC. Conclusion: Patients with visualization of IMSLN should perform IM-SLNB after NAC, especially for patients with cN+ disease, in order to complete lymph nodal staging. IM-SLNB could further improve the definition of nodal pCR and guide the internal mammary node irradiation.

Digital duplication of provisional prosthesis to fabricate definitive prosthesis for full mouth rehabilitation using double scan technique (잠정수복물의 최종수복물로의 디지털 복제를 통한 완전구강 회복 증례: Double scan technique)

  • Hong, Young-Tack;Koak, Jai-Young;Kim, Seong-Kyun;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.63-70
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    • 2021
  • Using computer-aided design and manufacturing technique improve quality of treatment in many aspect. This case reports the complete mouth rehabilitation of a patient with amelogenesis imperfecta utilizing digital technology. Clinical examination revealed loss of mastication due to insufficient occlusal stop, missing teeth, interdental spacing due to microdontia, insufficient overbite, and etc. Full veneer crowns for teeth were selected, followed by a fixed partial denture and implant placement was done using CAD-CAM guide template with bone graft for partially edentulous space. Definitive restorations were duplicated by double scanning provisional restorations and successfully delivered to the patient. These full mouth rehabilitation procedures resulted in satisfactory outcomes for the patient functionally and aesthetically.

Development and Lessons Learned of Clinical Data Warehouse based on Common Data Model for Drug Surveillance (약물부작용 감시를 위한 공통데이터모델 기반 임상데이터웨어하우스 구축)

  • Mi Jung Rho
    • Korea Journal of Hospital Management
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    • v.28 no.3
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    • pp.1-14
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    • 2023
  • Purposes: It is very important to establish a clinical data warehouse based on a common data model to offset the different data characteristics of each medical institution and for drug surveillance. This study attempted to establish a clinical data warehouse for Dankook university hospital for drug surveillance, and to derive the main items necessary for development. Methodology/Approach: This study extracted the electronic medical record data of Dankook university hospital tracked for 9 years from 2013 (2013.01.01. to 2021.12.31) to build a clinical data warehouse. The extracted data was converted into the Observational Medical Outcomes Partnership Common Data Model (Version 5.4). Data term mapping was performed using the electronic medical record data of Dankook university hospital and the standard term mapping guide. To verify the clinical data warehouse, the use of angiotensin receptor blockers and the incidence of liver toxicity were analyzed, and the results were compared with the analysis of hospital raw data. Findings: This study used a total of 670,933 data from electronic medical records for the Dankook university clinical data warehouse. Excluding the number of overlapping cases among the total number of cases, the target data was mapped into standard terms. Diagnosis (100% of total cases), drug (92.1%), and measurement (94.5%) were standardized. For treatment and surgery, the insurance EDI (electronic data interchange) code was used as it is. Extraction, conversion and loading were completed. R language-based conversion and loading software for the process was developed, and clinical data warehouse construction was completed through data verification. Practical Implications: In this study, a clinical data warehouse for Dankook university hospitals based on a common data model supporting drug surveillance research was established and verified. The results of this study provide guidelines for institutions that want to build a clinical data warehouse in the future by deriving key points necessary for building a clinical data warehouse.

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