• Title/Summary/Keyword: Model surgery

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Impedance Model based Bilateral Control for Force reflection of a Laparoscopic Surgery Robot (복강경 수술 로봇의 힘 반향을 위한 임피던스 모델 기반의 양방향 제어)

  • Yoon, Sung-Min;Kim, Won-Jae;Lee, Min-Cheol
    • Journal of Institute of Control, Robotics and Systems
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    • v.20 no.8
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    • pp.801-806
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    • 2014
  • LAS (Laparoscopy Assisted Surgery) has been substituted alternatively for traditional open surgery. However, when using a commercialized robot assisted laparoscopic such as Da Vinci, surgeons have encountered some problems due to having to depend only on information by visual feedback. To solve this problem, a haptic function is required. In order to realize the haptic teleoperation system, a force feedback and bilateral control system are needed. Previous research showed that the perturbation value estimated by a SPO (Sliding Perturbation Observer) followed a reaction force that loaded on the surgical robot instrument. Thus, in this paper, the force feedback problem of surgical robots is solved through the reaction force estimation method. This paper then introduces the possibility of the haptic function realization of a laparoscopic surgery robot using a bilateral control system. For bilateral control, the master uses an impedance control and the slave uses a SMC (Sliding Mode Control). The experiment results show that a torque and force sensorless teleoperation system can be implemented using a bilateral control structure.

EVALUATION OF THE AVAILABILITY OF SURGICAL TREATMENT OBJECTIVE(STO) USING SUBMENTOVERTEX(SMV) VIEW (이하두정 방사선 사진을 이용한 악교정수술 계획의 유용성에 대한 평가)

  • Kim, Bum-Soo;Kim, Jong-Wan;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.5
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    • pp.324-328
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    • 2009
  • Submentovertex(SMV) projection shows the base of skull, positions of mandibular condyle and zygomatic arches. We would like to investigate how to use SMV and evaluate its availability for the construction of the plan for orthognathic surgery of mandible prognathism and asymmetry. Preoperative Surgical Treatment Objective(STO) using SMV was performed to 12 patients, who visited to Seoul National University Bundang Hospital with chief complaints like mandible prognathism or asymmetry from Dec 2007 to Feb 2009. Surgical splint was made of stone model repositioned according to STO using SMV. We estimate the change in skeletal midline and the stability of occlusion through superposition between preoperative and postoperative SMV. It was effective on the amount of mandible movement and the correction of mandibular asymmetry, while the facial asymmetry involved with maxilla was excluded. It was concluded that STO using SMV is available and predictable method for not only the setback of prognathic mandible but also the correction of mandible asymmetry accurately.

Microsurgery Training for the Twenty-First Century

  • Myers, Simon Richard;Froschauer, Stefan;Akelina, Yelena;Tos, Pierluigi;Kim, Jeong Tae;Ghanem, Ali M.
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.302-303
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    • 2013
  • Current educational interventions and training courses in microsurgery are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess current training tools in microsurgery education and devise alternative methods that would enhance training. Simulation is an increasingly important tool for educators because, whilst facilitating improved technical proficiency, it provides a way to reduce risks to both trainees and patients. The International Microsurgery Simulation Society has been founded in 2012 in order to consolidate the global effort in promoting excellence in microsurgical training. The society's aim to achieve standarisation of microsurgical training worldwide could be realised through the development of evidence based educational interventions and sharing best practices.

Surgical Management of a Mandible Subcondylar Fracture

  • Kang, Dong Hee
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.284-290
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    • 2012
  • Open reduction and anatomic reduction can create better function for the temporomandibular joint, compared with closed treatment in mandible fracture surgery. Therefore, the double miniplate fixation technique via mini-retromandibular incision was used in order to make the most stable fixation when performing subcondylar fracture surgery. Those approaches provide good visualization of the subcondyle from the posterior edge of the ramus, allow the surgeon to work perpendicularly to the fracture, and enable direct fracture management. Understanding the biomechanical load in the fixation of subcondylar fractures is also necessary in order to optimize fixation methods. Therefore, we measured the biomechanical loads of four different plate fixation techniques in the experimental model regarding mandibular subcondylar fractures. It was found that the loads measured in the two-plate fixation group with one dynamic compression plate (DCP) and one adaption plate showed the highest deformation and failure loads among the four fixation groups. The loads measured in the one DCP plate fixation group showed higher deformation and failure loads than the loads measured in the two adaption plate fixation group. Therefore, we conclude that the selection of the high profile plate (DCP) is also important in order to create a stable load in the subcondylar fracture.

Xenografted Tumorigenesis in the oral vestibule of nude mice by Snail transfection: Histological and immunohistochemical study

  • Kim, Moon-Key;Lee, Eun-Ha;Kim, Jin;Yook, Jong-In;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.4
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    • pp.199-204
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    • 2009
  • Purpose: The purpose of this study is to investigate the epithelial-mesenchymal transition (EMT) induced by Snail transcription factor and Snail-transfected in vivo tumors with histopathological features. Materials and methods: We induced in vivo xenografted tumorigenesis in the oral vestibules of nude mice by a Snail transfected HaCaT cell line and investigated morphological and immunohistochemical features in Snail expressive tumors. Results: We identified tumor masses in 14 out of 15 nude mice in the HaCaT-Snail cell inoculation group, but no tumors were present in any of the HaCaT cell inoculation group. Induced tumors showed features of poorly differentiated carcinoma with invasion to neighboring muscles and bones. The HaCaT-Snail tumors showed decreased expressions of E-cadherin and cytokeratin, but showed increased expressions of vimentin and N-cadherin. Discussion: The Snail transfected xenograft can improve productivity of malignant tumors, show various histopathological features including invasive growth, and aid in the investigation of tumor progression and the interaction with surrounding tissues.

Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes

  • Gerrard, Adam Daniel;Charalambous, Charalambos P.
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.356-363
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    • 2018
  • Purpose: A meta-analysis was performed to assess the outcomes following surgical intervention for medial knee plica. Materials and Methods: A literature search of Medline, EMBASE, CINAHL and Cochrane CENTRAL was performed using relevant key words. The primary outcome was patient-reported postoperative scores of "good" and "excellent". Meta-analyses were performed using a random effects model. Results: The literature search identified 731 articles. After removing duplicates and those not meeting the inclusion criteria, 12 articles reporting on a total of 643 knees were included for analysis, and of these, 7 articles including 235 knees were used for meta-analysis. The overall rate of good and excellent outcomes following surgery was estimated at 84.2% (95% confidence interval [CI], 72.8-91.4). In those cases that had non-surgical therapy prior to surgery, the rate of good and excellent outcomes of surgery was estimated at 76.1% (95% CI, 60.1-87). Conclusions: Arthroscopic surgical management of symptomatic medial knee plica results in favourable outcomes. Our results suggest that arthroscopic surgical excision should be considered as a treatment modality in patients with pathological medial plica disease of the knee either as a first-line treatment or when symptoms have not responded to non-surgical interventions. Level of Evidence: IV.

Influence of biodegradable polymer membrane on new bone formation and biodegradation of biphasic bone substitutes: an animal mandibular defect model study

  • Ku, Jeong-Kui;Kim, Young-Kyun;Yun, Pil-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.34.1-34.7
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    • 2020
  • Purpose: The purpose of this study was to evaluate the influence of biodegradable polycaprolactone membrane on new bone formation and the biodegradation of biphasic alloplastic bone substitutes using animal models. Materials and methods: In this study, bony defect was formed at the canine mandible of 8 mm in diameter, and the defects were filled with Osteon II. The experimental groups were covered with Osteoguide as barrier membrane, and the control groups were closed without membrane coverage. The proportion of new bone and residual bone graft material was measured histologically and histomorphometrically at postoperative 4 and 8 weeks. Results: At 4 weeks, the new bone proportion was similar between the groups. The proportion of remaining graft volume was 27.58 ± 6.26 and 20.01 ± 4.68% on control and experimental groups, respectively (P < 0.05). There was no significant difference between the two groups in new bone formation and the amount of residual bone graft material at 8 weeks. Conclusion: The biopolymer membrane contributes to early biodegradation of biphasic bone substitutes in the jaw defect but it does not affect the bone formation capacity of the bone graft.

Upregulation of Carbonyl Reductase 1 by Nrf2 as a Potential Therapeutic Intervention for Ischemia/Reperfusion Injury during Liver Transplantation

  • Kwon, Jae Hyun;Lee, Jooyoung;Kim, Jiye;Kirchner, Varvara A.;Jo, Yong Hwa;Miura, Takeshi;Kim, Nayoung;Song, Gi-Won;Hwang, Shin;Lee, Sung-Gyu;Yoon, Young-In;Tak, Eunyoung
    • Molecules and Cells
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    • v.42 no.9
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    • pp.672-685
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    • 2019
  • Currently, liver transplantation is the only available remedy for patients with end-stage liver disease. Conservation of transplanted liver graft is the most important issue as it directly related to patient survival. Carbonyl reductase 1 (CBR1) protects cells against oxidative stress and cell death by inactivating cellular membrane-derived lipid aldehydes. Ischemia-reperfusion (I/R) injury during living-donor liver transplantation is known to form reactive oxygen species. Thus, the objective of this study was to investigate whether CBR1 transcription might be increased during liver I/R injury and whether such increase might protect liver against I/R injury. Our results revealed that transcription factor Nrf2 could induce CBR1 transcription in liver of mice during I/R. Pre-treatment with sulforaphane, an activator of Nrf2, increased CBR1 expression, decreased liver enzymes such as aspartate aminotransferase and alanine transaminase, and reduced I/R-related pathological changes. Using oxygen-glucose deprivation and recovery model of human normal liver cell line, it was found that oxidative stress markers and lipid peroxidation products were significantly lowered in cells overexpressing CBR1. Conversely, CBR1 knockdown cells expressed elevated levels of oxidative stress proteins compared to the parental cell line. We also observed that Nrf2 and CBR1 were overexpressed during liver transplantation in clinical samples. These results suggest that CBR1 expression during liver I/R injury is regulated by transcription factor Nrf2. In addition, CBR1 can reduce free radicals and prevent lipid peroxidation. Taken together, CBR1 induction might be a therapeutic strategy for relieving liver I/R injury during liver transplantation.

Prognosis of Recurrence after Complete Resection in Early-Stage Non-Small Cell Lung Cancer

  • Choi, Pil Jo;Jeong, Sang Seok;Yoon, Sung Sil
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.449-456
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    • 2013
  • Background: Tumor recurrence is the most common cause of treatment failure, even after complete resection of early-stage non-small cell lung cancer (NSCLC). In this study, we investigated the prognosis of patients with early recurrence in order to identify independent risk factors related to early recurrence. Methods: Between February 1995 and December 2012, 242 patients who underwent surgical resection for stage I NSCLC at Dong-A University Hospital were reviewed. The factors predicting overall survival (OS) and early recurrence were investigated. We also investigated the relationship between the patterns and period of recurrence and clinicopathological factors. Results: For patients with stage IA and IB NSCLC, the 5-year OS rate was 75.7% and 57.3% (p=0.006), respectively. A multivariate Cox proportional hazards model demonstrated that gender (p=0.004), comorbidity number (p=0.038), resection type (p=0.002), and tumor size (p=0.022) were the statistically significant predictors of OS. Moreover, the multivariate analysis revealed that smoking history (p=0.023) and histologic grade (p=0.012) were the independent predictors of early recurrence. Additionally, only histologic grade (poor differentiation) was found to be significantly associated with a higher frequency of distant metastasis; there was no relationship between the patterns and period of recurrence and clinicopathological factors. Conclusion: The present study demonstrated that smoking history and histologic grade were independent prognostic factors for early recurrence within two years in patients with early-stage NSCLC. Patients with these predictive factors may be good candidates for adjuvant therapy.