• Title/Summary/Keyword: medical approach

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Comparison of the clinical results between endoscopically assisted transoral approach and retromandibular approach for surgical treatment of mandibular subcondyle fracture

  • Lee, Woo-Yul;Cho, Jin-Yong;Yang, Sung-Won
    • The Journal of the Korean dental association
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    • v.54 no.12
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    • pp.1045-1054
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    • 2016
  • Purpose : Aim of this study is to describe and compare clinical results and complications epending on the surgical approaches for the mandibular subcondyle fracture Materials and methods : The patients who had been diagnosed as the mandibular subcondyle fracture and underwent open reduction and internal fixation from May 2009 to December 2014 were included. They were divided into two groups depending on the surgical approaches; endoscopically assisted transoral approach and retromandibular approach. Association between the preoperative fracture classification and post-operative results was reviewed depending on the surgical approaches. Results : The number of patients selected in this study was 33. Eighteen patients (male 7, female 11) underwent open reduction and internal fixation via retromandibular approach and fifteen patients (male 12, female 3) underwent open reduction and internal fixation via endoscopically assisted transoral approach. The mean age, follow up period, and operation time were $44.29{\pm}15.19years$, $9.97{\pm}7.82months$, and $161{\pm}89.44minutes$. Post-operative results were all "good" state in the retromandibular approach group regardless of the fracture classification but two patients in the endoscopically assisted transoral approach group underwent re-operation due to "poor" results. The fracture types of two were classified as displacement and lateral override at the same time. There was no statistically significant difference between two groups. Three patients in the retromandibular approach group had experienced facial nerve palsy (17%) temporarily. No one showed malocclusion in this study. There was no significant difference on the complications such as temporomandibular disorder, local infection, and condyle resorption depending on the surgical approaches. Conclusion : In this study, there was no significant difference on the complications between the two groups but retromandibular approach has advantage over endoscopically assisted transoral approach in case of the severely displaced subcondyle fracture.

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RECONSTRUCTION OF ANTERIOR TEMPORAL DEPRESSION AFTER THE CORONAL APPROACH (Coronal approach 시행 후 발생한 측두부 함몰의 재건)

  • Kim, Il-Kyu;Ryu, Seong-Hyun;Kim, Jae-Woo;Kim, Dong-Soo;Choi, Jin-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.2
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    • pp.183-187
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    • 2005
  • The coronal approach has been used for over a century by neurosurgeons to access to the anterior cranium. Indications for the coronal approach expanded from use in the correction of congenital skeletal anomalies to applications in acute maxillofacial trauma and secondary deformity correction, oncologic surgery and reconstruction, and esthetic surgery. Complications were such as injury to frontal branch of the facial nerve, motor nerve paralysis, hematoma under flap, trismus, ptosis, epiphora, infection and anterior temporal depression. $Medpor^{(R)}$ is made up of dense polyethylene connected in porous structures. It is easily shapable without collapsing the pores due to it's hardness and tissue growth takes place at the porosities. Based on these advantages, $Medpor^{(R)}$ has been used in augmentation and restoration in craniofacial defect. A temporal depression after the coronal approach for treatment of Le Fort III fracture was successfully reconstruction with $Medpor^{(R)}$ and we report this case with review of literature.

The comparison of two different intraarticular injections using a sonographic anterolateral approach in patients with osteoarthritic knee

  • Choi, Jin Wook;Lee, Jun Ho;Ki, Minjong;Kim, Myung Jong;Kang, Sehrin;Lee, Juhyung;Lee, Jun-Rae;Han, Young-Jin;Son, Ji-Seon
    • The Korean Journal of Pain
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    • v.31 no.4
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    • pp.289-295
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    • 2018
  • Background: The intraarticular (IA) injection has become popular for the management of the osteoarthritic knee without an effusion. The success rate of IA injection would be better if it was able to be visually confirmed. We hypothesized that an anterolateral approach, which targets the synovial membrane of the lateral condyle using ultrasound, would provide an equivalent alternative to the anterolateral approach, targeting the synovial membrane of the medial condyle for IA injection of the knee. Methods: A total of 96 knees with osteoarthritis were randomized placed into the two groups, which were group I (anterolateral approach to the medial condyle) and group II (anterolateral approach to the lateral condyle). The primary outcome was to compare the success rate of the two methods of IA injection. The required length of the needle for injection was also measured and compared. Pain intensity was assessed using the Numeric Rating Scale in order to evaluate the success of injection. Results: There were no significant differences in the success rate between both groups. The success rate of group I and group II were 87.8% (95%, CI 78.7-97.0) and 91.5% (95%, CI 83.6-99.5), respectively (P = 0.549). The needle depth was $5.0{\pm}0.8$ (3.0 to 6.1 cm) in group I, and $3.0{\pm}0.8$ (1.5 to 5 cm) in group II (P < 0.001). Conclusions: The anterolateral approach to the lateral femoral condyle, using ultrasound, is an alternative method to the approach targeting the medial femoral condyle, using shorter needle.

A Case of Hypoglossal Neurilemmoma Resected Via Burr-hole Craniectomy

  • Kim, Young-Jin;Ko, Yong;Yi, Hyeong-Joong;Oh, Suck-Jun
    • Journal of Korean Neurosurgical Society
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    • v.41 no.1
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    • pp.43-46
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    • 2007
  • Hypoglossal neurilemmoma is extremely rare. Intracranial hypoglossal neurilemmoma has been reported to the present most commonly as a space-occupying lesion with symptoms of raised intracranial pressure. A 68-year-old women presented with deviation of the tongue to the left on protrusion. Preoperative radiological images revealed an extra-axial mass in and around the hypoglossal canal. The tumor was totally resected via retrosigmoid suboccipital approach with burrhole craniectomy. Histopathological examination verified a neurilemmoma. She had no neurologic abnormality except hypoglossal palsy which recovered completely in six months. Retrosigmoid suboccipital approach with burrhole craniectomy can be an useful approach in intracranial hypoglossal neurilemmoma without extracranial extension or with minimal extracranial extension into the hypoglossal canal.

Results of Microsurgical Anterolateral Tunnel Approach for Cervical Disc Herniation (경추간판탈출증에 대한 미세 전측방 Tunnel Approach의 결과)

  • Jang, Woo-Young;Kim, Keun-Soo;Lee, Jung-Chung;Kim, Chul-Jin;Choi, Ha-Young;Xuan, Xiu-Nan;Han, Dong-Han
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.600-604
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    • 2001
  • Objective : The authors report the microsurgical anterolateral tunnel approach for the treatment of the cervical disc diseases and its postoperative surgical results. Methods : All surgical procedures followed the method of classical microsurgical anterior discectomy. Small tunnel(7-8mm) was made on the disc space reaching to the posterior longitudinal ligament. The disc materials and bony spurs were removed through this tunnel. Thirty-one patients of cervical disc herniation(24 cases with pure disc herniation, 7 cases with combined cervical spondylosis) were evaluated on the symptoms, conformation in plain X-ray, C-T, and MRI. The follow up time was over 2 years. Results : Postoperatively the result(following the out come scale) was excellent and good in Twenty-nine patients. One with fair result showed remnant disc particle and spur and another one is combined with cord contusion. One patient with lesion in C 3-4 space and two cervicothoracic junction showed excellent result. Two patients with osteoporosis also showed good results. Cervical spine curvature and disc space height were not changed on the plain X-ray and MRI in all patients. Twenty-nine patients were discharged within 3 days after surgery without any postoperative complications. Conclusions : The microsurgical anterolateral tunnel approach could be indicated for the treatment of patients with cervical disc diseases and with difficulty in achieving interbody fusion(the higher cervical level and cervicothoracic junction, osteoporosis etc.).

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Comparison between Lateral Supraorbital Approach and Pterional Approach in the Surgical Treatment of Unruptured Intracranial Aneurysms

  • Cha, Ki-Chul;Hong, Seung-Chyul;Kim, Jong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.51 no.6
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    • pp.334-337
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    • 2012
  • Objective : The lateral supraorbital (LSO) approach is a modified method of the classic pterional approach and it has advantages of short skin incision and small craniotomy compared with the pterional approach. This study was designed to compare the two approaches in the surgical treatment of unruptured intracranial aneurysms. Methods : We retrospectively reviewed 122 patients with 137 unruptured intracranial aneurysms treated by clipping, from July 2009 to April 2011. Between August 2010 and April 2011, 61 patients were treated by clipping via the lateral supraorbital approach and the same number of patients treated by clipping via the pterional approach were retrospectively enrolled. We analyzed the two groups and compared demographic, radiologic and clinical variables. Results : The mean age of patients in the two groups was 54.6 years (LSO group) and 55.7 years (Pterion group). The mean duration of hospitalization was shorter in the LSO group than in the Pterion group (7.9 days vs. 9.0 days, p=0.125) and the mean operation time was also significantly shorter in the LSO group (117.1 minutes vs. 164.3 minutes, p<0.001). Furthermore, the mean craniotomy area was much smaller in the LSO group (1275.4 $mm^2$ vs. 2858.9 $mm^2$, p<0.001). The two groups showed similar distributions of aneurysm location and postoperative complications. Conclusion : The lateral supraorbital approach for the clipping of unruptured intracranial aneurysm could be a good alternative to the classic pterional approach.

Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome

  • Hosseinian, Mohammad Ali;Loron, Ali Gharibi;Soleimanifard, Yalda
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.36-40
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    • 2017
  • Background: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. In this study, we have compared the complications arising during the supraclavicular and the transaxillary approaches to determine the appropriate approach for TOS surgery. Methods: In this study, 448 patients with symptoms of TOS were assessed. The male-to-female ratio was approximately 1:4, and the mean age was 34.5 years. Overall, 102 operations were performed, including unilateral, bilateral, and reoperations, and the patients were retrospectively evaluated. Of the 102 patients, 63 underwent the supraclavicular approach, 32 underwent the transaxillary approach, and 7 underwent the transaxillary approach followed by the supraclavicular approach. Complications were evaluated over 24 months. Results: The prevalence of pneumothorax, hemothorax, and vessel injuries in the transaxillary and the supraclavicular approaches was equal. We found more permanent and transient brachial plexus injuries in the case of the transaxillary approach than in the case of the supraclavicular approach, but the difference was not statistically significant. Persistent pain and symptoms were significantly more common in patients who underwent the transaxillary approach (p<0.05). Conclusion: The supraclavicular approach seems to be the more effective technique of the two because it offers the surgeon better access to the brachial plexus and a direct view. This approach for a TOS operation offers a better surgical outcome and lower reoperation rates than the transaxillary method. Our results showed the supraclavicular approach to be the preferred method for TOS operations.

A Study on the Medical Devices in Korea, U.S., and China (한.미.중 의료기기에 관한연구)

  • Bae, Hong Kyun
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.59
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    • pp.181-205
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    • 2013
  • This study has analyzed the international trade flow of medical devices in Korea, China, and U.S. more theoretically and systematically through a mutual connection of the medical device export structure of Korea and the import structure of China and U.S. organically, with an intensity approach on the bilateral international trade flow. Also, it is meaningful to find a solution to boost exports of Korea to China and U.S.. Therefore in this study, we recognize the importance of the medical device market in China and U.S., which is the main competition for Korea and its market, and look into the trade situation of these three countries. We also look into the relative market stream and the trade intensity of the main medical devices in Korea, China and U.S., and seek measures for the steady growth of the medical device market in these three countries.

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Evaluation of Present Status from Health Technology Assessment(HTA) through case analysis in dentistry (치의학분야 사례분석을 통한 신의료기술평가 현황 평가)

  • Son, Gi Tae;Yang, Seung-Min
    • The Journal of the Korean dental association
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    • v.57 no.6
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    • pp.316-324
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    • 2019
  • The new medical technology assessment system has a basic goal of protecting the public's health rights and promoting the development of the new medical technology with safe and effective medical technology that has been scientifically proven. The purpose of this study is to contribute to the activation of the new medical technology evaluation system by analyzing the application cases of the dental field after the implementation of the new medical technology evaluation system and proposing an efficient approach to approach the new medical technology evaluation system. The number of related literature and medical technology evaluation results are not significant in dental applications, the number of cases and the length of follow-up period of the relevant medical technology adopted as the new medical technology was far higher. As the speed of medical technology development increases, medical technology is expected to develop in the dental field as well. To introduce the medical technology to the clinical site, access to the correct direction of evidence is required to collect and objectify data at the medical site in order to prepare a literary basis for the medical technology.

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An Architecture and Software Process for the Convergence of Heterogeneous Medical Recording Contents (이질적인 의무기록 콘텐츠의 융합을 위한 시스템 아키텍처와 소프트웨어 프로세스)

  • Kim, Jong-Ho
    • Journal of Digital Contents Society
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    • v.12 no.4
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    • pp.501-510
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    • 2011
  • Most of electronic medical record systems which have been built in Korean hospitals are based on source oriented medical record approach. These systems hardly satisfy diverse objectives owing to the innate imperfections in system architecture and development methodology. Thus, the hybrid of source oriented and problem oriented approach is highly desirable. The purpose of this study is to present an architecture and methodology required to construct hybrid electronic medical record system and to develop a prototype based on them. Analyzing the clinical processes and data requirements of problem oriented medical record approach we developed a software process model as weel as an architecture model which consists of legacy system, clinical data repository, problem list database, prospective plan database, user interface, and synchronization procedures.