• Title/Summary/Keyword: Surgical device

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Clinical Efficacy of a Mouth-Exercising Device Adjunct to Local Ointment, Intra-Lesional Injections and Surgical Treatment for Oral Submucous Fibrosis: a Randomized Controlled Trial

  • Patil, Pravinkumar;Hazarey, Vinay;Chaudhari, Rekha;Nimbalkar-Patil, Smita
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1255-1259
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    • 2016
  • Background: Oral physiotherapy or mouth exercise is considered to be an adjunct but mandatory treatment modality for oral submucous fibrosis (OSMF). This study planned to evaluate the clinical efficacy of a newly designed mouth exercising device (MED) in OSMF patients receiving local ointment, intra-lesional drugs and surgical treatment. Materials and Methods: A total of 231 OSMF patients were selected and treated with basic regime including topical corticosteroids, oral antioxidants and the icecream-stick exercise regime and allotted randomly to two equal groups A and B. Group-A patients were additionally given MED. Subgroups A1 and B1 patients with an inter-incisal distance (IID) 20-35mm were not given any additional therapy; subgroup A2 and B2 patients (IID 20-35mm) were treated additionally with intra-lesional injections. Subgroups A3 and B3 with IID<20mm were managed surgically. IID was measured at baseline and at 6 months recall. The change in IID measurements was calculated and statistically analyzed using 2-way ANOVA and Tukeys multiple post hoc analysis. Results: Average improvement in IID after six months of recall visits was observed to be 8.4 mm in subgroup-A1 (n-53) compared to 5.5 mm in B1(n-50) (p<0.01). The IID improvement in subgroup-A2 was found to be 9.3mm (n-46) compared to 5.1 mm in B2 (n-48) (p<0.01). In the surgery group, mouth opening improvement was observed to be 9.6 mm in subgroup A3 (n-18) compared to 4.8 mm for B3 (n-16) (p<0.01). Conclusions: Use of the MED appears to be effective for increasing oral opening in OMSF patients in conjunction with local, injection and/or surgical treatment.

Safe and Simplified Salvage Technique for Exposed Implantable Cardiac Electronic Devices under Local Anesthesia

  • Jung, Chang Young;Kim, Tae Gon;Kim, Sung-Eun;Chung, Kyu-Jin;Lee, Jun Ho;Kim, Yong-Ha
    • Archives of Plastic Surgery
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    • v.44 no.1
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    • pp.42-47
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    • 2017
  • Background Skin erosion is a dire complication of implantable cardiac pacemakers and defibrillators. Classical treatments involve removal of the entire generator and lead systems, however, these may result in fatal complications. In this study, we present our experience with a simplified salvage technique for exposed implantable cardiac electronic devices (ICEDs) without removing the implanted device, in an attempt to reduce the risks and complication rates associated with this condition. Methods The records of 10 patients who experienced direct ICED exposure between January 2012 and December 2015 were retrospectively reviewed. The following surgical procedure was performed in all patients: removal of skin erosion and capsule, creation of a new pocket at least 1.0-1.5 cm inferior to its original position, migration of the ICED to the new pocket, and insertion of closed-suction drainage. Patients with gross local sepsis or septicemia were excluded from this study. Results Seven patients had cardiac pacemakers and the other 3 had implantable cardiac defibrillators. The time from primary ICED placement to exposure ranged from 0.3 to 151 months (mean, 29 months. Postoperative follow-up in this series ranged from 8 to 31 months (mean follow-up, 22 months). Among the 10 patients, none presented with any signs of overt infection or cutaneous lesions, except 1 patient with hematoma on postoperative day 5. The hematoma was successfully treated by surgical removal and repositioning of the closed-suction drainage. Conclusions Based on our experience, salvage of exposed ICEDs is possible without removing the device in selected patients.

Risk Factors of Medical Device-Related Pressure Ulcer in Intensive Care Units (중환자실 의료기기 관련 욕창의 위험요인)

  • Koo, MiJee;Sim, YoungA;Kang, InSoon
    • Journal of Korean Academy of Nursing
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    • v.49 no.1
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    • pp.36-45
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    • 2019
  • Purpose: The purpose of this study was to identify the characteristics of and risk factors for medical-device-related pressure ulcer (MDRPU) development in intensive care units. Methods: A prospective cohort study design was used, and the participants were 253 adult patients who had stayed in medical and surgical intensive care units. Data were collected regarding the application of medical devices and MDRPU-related characteristics over a period of six months from June to November, 2017. Data were analyzed using independent t-test, ${\chi}^2-test$, Fisher's exact test, and binary logistic regression analysis with the SPSS 21.0 program. Results: Among the 253 participants, MDRPUs occurred in 51 (19.8%) participants. The results of the logistic regression analysis showed that the risk factors for MDRPUs were the use of endotracheal tubes (OR=5.79, 95% CI: 1.66~20.20), having had surgery (OR=2.95, 95% CI: 1.11~7.77), being in a semi-coma/coma (OR=5.79, 95% CI: 1.04~32.05), and sedation (OR=5.54, 95% CI: 1.39~22.19). Conclusion: On the basis of the study results, it is effectively facilitated by nurses when they care for patients with MDRPUs in intensive care units and the results are expected to be of help in preventive education for MDRPU development as well as preparing the base data for intervention studies.

A Study on the Dataset Construction and Model Application for Detecting Surgical Gauze in C-Arm Imaging Using Artificial Intelligence (인공지능을 활용한 C-Arm에서 수술용 거즈 검출을 위한 데이터셋 구축 및 검출모델 적용에 관한 연구)

  • Kim, Jin Yeop;Hwang, Ho Seong;Lee, Joo Byung;Choi, Yong Jin;Lee, Kang Seok;Kim, Ho Chul
    • Journal of Biomedical Engineering Research
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    • v.43 no.4
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    • pp.290-297
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    • 2022
  • During surgery, Surgical instruments are often left behind due to accidents. Most of these are surgical gauze, so radioactive non-permeable gauze (X-ray gauze) is used for preventing of accidents which gauze is left in the body. This gauze is divided into wire and pad type. If it is confirmed that the gauze remains in the body, gauze must be detected by radiologist's reading by imaging using a mobile X-ray device. But most of operating rooms are not equipped with a mobile X-ray device, but equipped C-Arm equipment, which is of poorer quality than mobile X-ray equipment and furthermore it takes time to read them. In this study, Use C-Arm equipment to acquire gauze image for detection and Build dataset using artificial intelligence and select a detection model to Assist with the relatively low image quality and the reading of radiology specialists. mAP@50 and detection time are used as indicators for performance evaluation. The result is that two-class gauze detection dataset is more accurate and YOLOv5 model mAP@50 is 93.4% and detection time is 11.7 ms.

Comparative Analysis of Muscle Activities for Upper Extremity During Resistance Exercises Using Variable and Elastic Loads (가변부하 및 탄성부하를 이용한 저항성 기구 운동 시 발현되는 상지근육의 근 활동치 비교분석)

  • Lim, Young-Tae
    • Korean Journal of Applied Biomechanics
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    • v.16 no.2
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    • pp.37-44
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    • 2006
  • The purposes of this study were to analyze and compare EMG activities of the pectoralis major, biceps brachii, triceps brachii, and brachioradialis muscles during biceps curls using a VRT device and an elastic tubing. Fifteen male college students were recruited as subjects and they performed 10-RM and 20-RM biceps curls. For each load and device condition, the mean and peak normalized EMG levels during different phases of a biceps curl were computed. For each load and phase, paired t-test (p.05) was used to find the significant difference between two devices. ANOVA with repeated measures was also used to find the significant difference among phases in terms of EMG values for each muscle. For each load and device condition, the peak and mean EMG levels during different phases of a biceps curl were computed The significant differences between devices were found in biceps brachii for EA, MD, LD phases, and triceps brachii muscles for all phases, respectively. However, no differences were found among phases for any muscle. This indicated that elastic band could have a similar characteristics of VRT. High antagonistic muscle activity as a function of injury prevention which found particularly in VRT device may suggest that elastic tubing can be a safer training device than VRT. This also imply that elastic tubing could be very effective as a home exercise tool for rehabilitation patients and elderly people.

Correction of a Wide Alveolar Cleft with Reverse L osteotomy and Liou Alveolar Distractor (역 L 형 절골술과 Liou 신연기를 이용한 넓은 치조열의 교정)

  • Lee, Myung Chul;Lew, Dae Hyun;Park, Beyoung Yun;Kwon, Soon Man
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.445-449
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    • 2009
  • Purpose: A successful surgical treatment for a wide alveolar cleft with bone graft is difficult to achieve due to several factors such as the limitation of gingivoperiosteal flap, the presence of large scar tissues, and the poor blood circulation. To overcome these problems, alveolar distraction osteogenesis using Liou alveolar distraction device was applied. We analyzed the consequences of this surgical treatment. Method: Between 2006 January and 2007 August, we have conducted analysis on the methods and consequences of Liou alveolar distraction osteogenesis for 6 patients. The age of patients was 12 years and 6 months in average. The follow up period was 19 months in average. The Reverse L osteotomy followed by the placement of the Liou alveolar distraction device was performed. After serial distraction, the distractor was removed after 5 months of the process of osteogenesis, and the result was analyzed using the computed tomography and the x-ray films of the alveolar bone and the teeth. Results: The alveolar cleft with 12.5 mm in average width was filled with 8.5 mm of newly formed bone tissue in average width after 5 months of osteogenesis. Among the 6 cases, 5 required the additional bone graft and 1 case only required the gingivoperioplasty. The newly formed bone tissues did not show any signs of bone resorption. However, a considerable degree of teeth displacement was shown. Conclusion: For the alveolar cleft too wide to be reconstructed by a general bone graft, it is strongly recommended to perform the reverse L osteotomy of the cleft side with Liou alveolar distraction device to initiate the alveolar osteogenesis. However, the migrated teeth showed some degree of relapse, thus, the orthodontic treatment is essential following the distraction osteogenesis treatment.

Follow-up Comparison of Two Different Types of Anterior Thoracolumbar Instrumentations in Trauma Cases : Z-plate vs. Kaneda Device

  • Park, Jung-Keun;Kim, Keun-Su
    • Journal of Korean Neurosurgical Society
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    • v.41 no.2
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    • pp.77-81
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    • 2007
  • Objective : In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. Methods : A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 [M:F=5:9, average age=37] and 12 [M:F=9:3, average age=41] patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrument associated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. Results : Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the follow up period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. No Intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. Conclusion : We think that Kaneda device [rod type] is stronger than Z-plate [plate type] to keep the spinal stability after anterior thoracolumbar surgery.

Development of the closed-loop Joule-Thomson cryoablation device for long area cooling

  • Lee, Cheonkyu;Park, Inmyong;Yoo, Donggyu;Jeong, Sangkwon;Park, Sang Woo
    • Progress in Superconductivity and Cryogenics
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    • v.15 no.3
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    • pp.40-48
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    • 2013
  • Cryoablation device is a surgical instrument to produce the cooling effect to destroy detrimental biological tissue by utilizing low temperature around 110 K. Usually, this device has the concentrated cooling region, so that it is suitable for concentrated and thick target. Accordingly, it is hard to apply this device for the target which is distributed and thin target. In this study, the design procedure of a closed-loop cryoablation device with multiple J-T expansion part is developed for the treatment of incompetent of great saphenous vein. The developed cyoablation device is designed with the analysis of 1-dimensional (1-D) bio-heat equation. The energy balance is considered to determine the minimum mass flow rate of refrigerant for consecutive flow boiling to develop the uniform cooling temperature. Azeotropic mixed refrigerant R410A and zeotropic mixed refrigerant (MR) of R22 ($CHClF_2$) and R23 ($CHF_3$) are utilized as operating fluids of the developed cryoablation device to form the sufficient temperature and to verify the quality of the inside of cryoablation probe. The experimental results of R410A and the zeotropic MR show the temperature non-uniformity over the range are $244.8K{\pm}2.7K$ and $239.8K{\pm}4.7K$ respectively. The experimental results demonstrate that the probe experiences the consecutive flow boiling over the target range of 200 mm.

Application of Calibration Techniques to Enhance Accuracy of Markerless Surgical Robotic System for Intracerebral Hematoma Surgery (뇌혈종 제거 수술을 위한 무마커 수술 유도 로봇 시스템의 정확도 향상을 위한 캘리브레이션 기법)

  • Park, Kyusic;Yoon, Hyon Min;Shin, Sangkyun;Cho, Hyunchul;Kim, Youngjun;Kim, Laehyun;Lee, Deukhee
    • Korean Journal of Computational Design and Engineering
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    • v.20 no.3
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    • pp.246-253
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    • 2015
  • In this paper, we propose calibration methods that can be applied to the markerless surgical robotic system for Intracerebral Hematoma (ICH) Surgery. This surgical robotic system does not require additional process of patient imaging but only uses CT images that are initially taken for a diagnosis purpose. Furthermore, the system applies markerless registration method other than using stereotactic frames. Thus, in overall, our system has many advantages when compared to other conventional ICH surgeries in that they are non-invasive, much less exposed to radiation exposure, and most importantly reduces a total operation time. In the paper, we specifically focus on the application of calibration methods and their verification which is one of the most critical factors that determine the accuracy of the system. We implemented three applications of calibration methods between the coordinates of robot's end-effector and the coordinates of 3D facial surface scanner, based on the hand-eye calibration method. Phantom tests were conducted to validate the feasibility and accuracy of our proposed calibration methods and the surgical robotic system.

Development of Cholecystectomy Simulation for Laparoscopic Surgery Training (복강경수술 훈련용 담낭 절제술 시뮬레이션 개발)

  • Kim, Young-Jun;Roy, Frederick;Lee, Seung-Bin;Seo, Joon-Ho;Lee, Deuk-Hee;Park, Se-Hyung
    • Korean Journal of Computational Design and Engineering
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    • v.17 no.5
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    • pp.303-311
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    • 2012
  • Laparoscopic surgery is a surgical procedure which uses long laparoscopic instruments through tiny holes in abdomen while watching images from a laparoscopic camera through umbilicus. Laparoscopic surgeries have many advantages rather than open surgeries, however it is hard to learn the surgical skills for laparoscopic surgery. Recently, some virtual simulation systems for laparoscopic surgery are developed to train novice surgeons or resident surgeons. In this study, we introduce the techniques that we developed for laparoscopic surgical training simulator for cholecystectomy (gallbladder removal), which is one of the most frequently performed by laparoscopic surgery. The techniques for cholecystectomy simulation include modeling of human organs (liver, gallbladder, bile ducts, etc.), real-time deformable body calculation, realistic 3D visualization of surgical scene, high-fidelity haptic rendering and haptic device technology, and so on. We propose each simulation technique for the laparoscopic cholecystectomy procedures such as identifying cystic duct and cystic artery to clamp and cut, dissecting connective tissues between the gallbladder and liver. In this paper, we describe the techniques and discuss about the results of the proposed cholecystectomy simulation for laparoscopic surgical training.