• Title/Summary/Keyword: proximal methods

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Efficacy of an assistive guide tube for improved endoscopic access to gastrointestinal lesions: an in vivo study in a porcine model

  • Dong Seok Lee;Jeong-Sik Byeon;Sang Gyun Kim;Ji Won Kim;Kook Lae Lee;Ji Bong Jeong;Yong Jin Jung;Hyoun Woo Kang
    • Clinical Endoscopy
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    • v.57 no.1
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    • pp.82-88
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    • 2024
  • Background/Aims: Guide tube-assisted endoscopy for procedures that require repeated endoscopic access is safer and more effective than conventional endoscopy. However, its effectiveness has not been confirmed in animal studies. We assessed the usefulness of guide tube-assisted endoscopic procedures in an in vivo porcine model. Methods: Five different guide tube-assisted endoscopic procedures were performed by experienced endoscopists on a pig weighing 32 kg. To evaluate the efficacy of these procedures, we compared the endoscopic approach time when a guide tube was used to that when it was not. Additional endoscopic procedures using a guide tube were performed, including multiple foreign body extractions, multiple polypectomies, and multiple submucosal dissections. To evaluate safety, we compared the insertion force into the proximal esophagus between the guide tube and conventional overtube methods. Results: Using the endoscopic approach with a guide tube required a shorter average approach time to reach the three target lesions than when using the endoscopic approach without a guide tube (p<0.001). Compared to the conventional overtube method, the guide tube method produced a lower average resistance during insertion into the upper esophagus (p<0.001). Conclusions: Guide tube-assisted endoscopic procedures are effective and safe for repeated endoscopic access in an in vivo porcine model.

Studies of the Effects of Acupuncture Stimulation at Huatuo Jiaji(EX B2) Points on Axonal Regeneration of Injured Sciatic Nerve in the Rats (화타협척혈 침자극에 의한 손상 말초신경의 재생효과에 관한 연구)

  • Kim, Dae-Feel;Park, Young-Hoi;Keum, Dong-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.4
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    • pp.39-61
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    • 2008
  • Objectives : The present study was performed to investigate whether acupuncture stimulation in the rats affected regeneration properties of the injured sciatic nerve. A differential effect of acupuncture stimulation on the one point near the spinal nerve root controlling sciatic nerve activity and the other point in the peripheral area subordinated by injured nerve was compared. Materials and Methods: Rat sciatic nerves were injured by crush, and the effects on axonal regeneration on injured sciatic nerves were evaluated by acupuncture stimulation at two different regions. In proximal acupuncture stimulation group, acupuncture stimulation was performed on Huatuo Jiaji(EX B2) points located from L5 to S1 vertebral levels to stimulate the nearest spinal nerve root that innervates sciatic nerves. In distal acupuncture stimulation group, acupuncture stimulation was performed on Zusanli(ST 36) and Weizhong(BL 40) points to stimulate at peripheral area dominated by injured sciatic nerves. Acupuncture stimulation was given every other days for 1 or 2 weeks. Sciatic nerve tissues collected from acupuncture stimulation experimental groups, injury control group, and intact animal group were used for protein analysis by Western blotting or Hoechst nuclear staining. To determine axonal regeneration, Dil fluorescence dye was injected into the sciatic nerve 0.5 cm distal to the injury site in individual animal groups and Dil-labeled cells by retrograde tracing were measured in the DRG at lumbar 5 or in the spinal cord. DRG sensory neurons prepared from individual animal groups were used to measure the extent of neurite outgrowth and for immunofluorescence staining with anti-GAP-43 antibody. Results : Animal groups given proximal or distal acupuncture stimulation showed upregulation of GAP-43 and Cdc2 protein levels in the sciatic nerve at 7 days after injury. Cdk2 protein levels were strongly induced by nerve injury, but did not show changes by acupuncture stimulation. Phospho-Erk1/2 protein levels were elevated by acupuncture stimulation above those present in the injury control animals. These increase in regeneration-associated protein levels appeared to be related with increase cell proliferation in the injured sciatic nerves. Hoechst 33258 staining of sciatic nerve tissue to visualize nuclei of individual cells showed increased Schwann cell number in the distal portion of the injured nerve 7 and 14 days after injury and further increases by acupuncture stimulation particularly at the proximal position. Measurement of axonal regeneration by retrograde tracing showed significantly increased Dil-labeled cells in proximal acupuncture stimulation group compared to distal acupuncture stimulation group and injury control group. Finally, an evaluation of axonal regeneration by retrograde tracing showed increased number of Dil labeled cells in the DRG at lumbar 5 or in the ventral horn of the spinal cord at lower thoracic level at 7 days after nerve injury. Conclusions : The present data show that the proximal acupuncture stimulation at Huatuo Jiaji(EX B2) points governing injured sciatic nerves was more effective for axonal regeneration than the distal acupuncture stimulation. Further studies on functional recovery or associated molecular mechanisms should be critical for developing animal models and clinical applications.

Early Result of Demineralized Bone Matrix (DBM, Genesis$^{(R)}$) in Bone Defect after Operative Treatment of Benign Bone Tumor (양성 골 종양의 수술적 치료 후 발생한 골 결손에서 탈무기화 골 기질(DBM, Genesis$^{(R)}$)의 단기 결과)

  • Seo, Hyun Je;Chung, So Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.2
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    • pp.56-63
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    • 2013
  • Purpose: This study was performed to evaluate the efficiency of demineralized bone matrix (DBM, Genesis$^{(R)}$) used for bone defect after operative traetment of benign bone tumors by clinical and radiological methods. Materials and Methods: DBM was used to treat bone defect after operative treatment of benign tumor from February 2012 to May 2013. Total 25 benign bone tumor cases (15 males, and 10 females) with mean age of 30.3 were studied. The diagnoses were solitary bone cyst in 9 cases, non ossifying fibroma in 5, fibrous dysplasia in 5, aneurysmal bone cyst in 3 and enchondroma in 3. In categorization by location of tumor, there were 5 cases of distal femur, 4 of proximal tibia, 3 of proximal femur, 3 of proximal humerus, 3 of phalanx, 2 of distal radius, 2 of hip bone, 2 of calcaneus, and 1 of scapula. Autogenous bone was used with DBM in 6 cases, and only DBM used in 19 cases. Mean periods of follow up were 8.7 months (range: 6 to 14 months). Amount of graft resorption and bone formation was observed with compare of post operation radiograph and the difference was shown by percentage. Resorption level was measured by DBM level which could be observed from simple x-ray, and bone formation level by bone trabecular formation level at impaired site. Results: Twenty three cases of total 25 cases showed bone union. In the 23 cases, more than 98% DBM resorption was observed after mean 4.3 months, and more than 98% bone formation was observed after mean 6.9 months. Lesser bone defect sizes showed faster bone formation and it was statistically significant (p=0.036). But other comparative studies on other factors such as, sex, age of patients and combination of autogenous bone were no statistically significant differences in graft resorption and bone formation. And there was no significant complication in periods of follow-up. Conclusion: Demineralized Bone Matrix (Genesis$^{(R)}$) is thought to be useful treatment for bone defect after operative treatment of benign bone tumor, however longer follow-up periods appears to be needed.

Evaluation of Prosthetic Reconstruction in Lower Extremity (하지 골 종양에서 종양 대치물을 이용한 사지 구제술의 평가)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Koo, Ki-Hyoung;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.1-11
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    • 2002
  • Purpose : We evaluated the radiological and functional results of prosthetic reconstruction for locally aggressive benign and malignant tumor in the lower extremity. Materials and Methods : Eighty eight patients were followed up for an average 76 months(22~174). We examined the survival rate of prosthesis, and evaluated the final result by MSTS functional score and ISOLS radiological implants evaluation system. They were statistically analyzed according to the age(<20 year vs. ${\geq}$20 year), fixation methods, amount of bony resection, chemotherapy, local recurrence, and presence of metastasis. Results : The 5 year prosthetic survival rates were 100% in the proximal femur, 83.3% in the distal femur, 81.9% in the proximal tibia. Mean total functional scores were 73.3%, 72%, 68.7%, respectively. In distal femur, the non-chemotherapeutic group was superior in the prosthetic survival rate. Recurrence or metastasis affected the functions in the distal femur and proximal tibia. In the radiological evaluation of the distal femur, older patients over 20 years of age and with cement fixation were superior in bone remodeling(p<0.05). Postoperative infection and radiological loosening were the main causes of the prosthetic failure. Conclusion : The prosthetic reconstruction in the lower extremity led to good clinical and radiological results. Amount of bony resection, chemotherapy, recurrence and metastasis seemed to influence the prosthetic survival, and long-term follow-up will be necessary to investigate more significant prognostic factors.

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Beneficial Effect of Scutellaria Balicalensis Georgi Extract ont-Buthylhydroperoxide-Induced Inhibition of Organic Cation in Rabbit Renal Cortical Slices (황금약침액(黃芩藥鍼液)이 토끼의 신장절편에서 t-BHP로 유발된 유기양이온의 이동장애에 미치는 영향(影響))

  • Jo, Mee-hyeong;Jang, Kyung-jeon
    • Journal of Acupuncture Research
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    • v.18 no.4
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    • pp.143-151
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    • 2001
  • Objective : This study was undertaken to determine whether Scutellaria balicalensis Georgi (SbG) extract exerts the protective effect against oxidant-induced alterations in organic cation transport in the renal proximal tubule. Methods : Organic cation transport was estimated by examining alterations in tetraethylammon - ium(TEA) uptake in rabbit renal cortical slices. The slices were treated with 0.2 mM tBHP for 60 min at $37^{\circ}C$. tBHP caused an inhibition in TEA uptake by renal cortical slices. Such an effect was accompanied by depressed Na+-K+-ATPase activity and ATP depletion. tBHP also induced a significant increase in LDH release. Results : SbG prevented tBHP-induced inhibition of TEA uptake in a dose-dependent manner at the concentration ranges of 0.05-0.1%. tBHP-induced inhibition of Na+-K+-ATPase activity and ATP depletion were significantly prevented by 0.05% SbG. tBHP-induced LDH release also was blocked by SbG. tBHP caused a significant increase in lipid peroxidation and its effect was prevented by SbG. Conclusion : These results suggest that SbG prevents oxidant-induced alterations in organic cation transport in rabbit renal cortical slices. Such protective effects of SbG may be attributed to inhibition of peroxidation of membrane lipid.

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Diagnostic accuracy of Insight intraoral film on dental caries (Kodak Insight 구내필름의 치아우식증 진단능에 대한 연구)

  • Yoon Young Nam;Lee Sang-Rae;Lee Byung-Do
    • Imaging Science in Dentistry
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    • v.34 no.1
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    • pp.19-23
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    • 2004
  • Purpose: To compare the diagnostic accuracy of Kodak Insight film with other intra-oral films in the detection of dental caries. Materials and Methods : Periapical radiographs of 99 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were made on Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Kodak Insight films and automatically processed. Six dentists examined the presence of dental caries using a five-point confidence rating scale and compared the diagnostic accuracy by ROC (Receiver Operating Characteristic) analysis and ANOVA test. Results: The sensitivity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.84, 0.77, 0.75 and 0.79 respectively. The specificity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.97. 0.95. 0.96 and 0.94 respectively. The mean ROC areas (Az) of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.917, 0.910, 0.894, 0.909 respectively. There was no significant differences between Az of Insight film and other films (p = 0.178). Conclusion: Theses results suggested that Kodak Insight film have the comparative diagnostic accuracy of dental caries with Ultraspeed and Ektaspeed films.

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Histochemical study on the endochondral ossification of the native Korean cattle femur (한우 대퇴골의 연골내골화에 관한 조직화학적 연구)

  • Kim, Soo-myung;Yang, Hong-hyun;Paik, Young-ki
    • Korean Journal of Veterinary Research
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    • v.31 no.2
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    • pp.143-154
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    • 1991
  • The present study was undertaken to provide basic data on fetal endochondral ossification for the native Korean cattle femur. This study was determined to the both earliest stages of chondrification and ossification by histochemical methods. The forty-five pairs of femur, from a series of embryos and fetuses ranging from 11 to 100mm in crown-rump(C-R) length, were used. These samples were divided into 9 groups. The groupings were based on C-R length, as the first grouping being 11~20mm, the second grouping being 21~30mm and so on. The results were as follows: 1. Alcianophility and PAS reaction were markedly increased in the perichondrium and interterritorial matrix in the 3rd group(C-R length 31~40mm). These reactions were decreased in the territorial matrix and in the adjacent area to the cartilage canal in the 5th group(C-R length 51~60mm). 2. Calcium deposits and collagen substances were observed initially in the 3rd group(C-R length 31~40mm). The calcium deposits and calcified cores were observed in the trabeculae of the proximal epiphyseal plate of the femur in the 8th group(C-R length 81~90mm).

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C2 Segmental-Type Vertebral Artery Diagnosed Using Computed Tomographic Angiography

  • Kim, Myoung Soo
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.194-200
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    • 2018
  • Objective : Sometimes a vertebral artery (VA) enters the spinal canal via the C1-2 intervertebral space, a variation regarded as a C2 segmental-type VA. This paper describes the anatomy of the C2 segmental-type VA and reviews its clinical importance. Methods : Between March 2014 and November 2015, 3386 patients underwent computed tomographic angiography. I identified C2 segmental-type VAs, associated vascular variation, the origin of ipsilateral posterior inferior cerebellar arteries (PICAs), and the clinical symptoms associated with C2 segmental-type VAs. The origin of an ipsilateral PICA is divided into 5 types. A type 1 PICA originates from ipsilateral VAs coursing suboccipitally (IVASO), a type 2 originates from ipsilateral proximal C2 segmental-type VAs, a type 3 originates from ipsilateral distal C2 segmental-type VAs. For type 4, the PICA does not originate from an ipsilateral VA. For type 5, the PICA is the terminal end of an ipsilateral C2 segmental-type VA. Results : One hundred thirteen patients had 121 C2 segmental-type VAs; 47 were associated with an IVASO, and 74 were not. Four type 1, 13 type 2, 60 type 3, 42 type 4, and two type 5 PICAs were identified. Only one patient showed symptoms associated with a C2 segmental-type VA, being a 71-year-old man presenting with a C2 segmental-type VA infarction. Conclusion : For C2 segmental-type VAs, the ipsilateral IVASO and origin of the PICA are important for predicting the outcome of this type of VA infarction.

Neuroprotective Effect of Semen Persicae in Middle Cerebral Artery Occlusion Rats (도인(桃仁)의 중대뇌동맥 폐색 유발 흰쥐에서 신경보호 효과)

  • Song, Mi-Young;Kim, Ho-Jun;Lee, Myeong-Jong
    • The Journal of Korean Medicine
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    • v.30 no.2
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    • pp.117-126
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    • 2009
  • Objectives: This study was performed to investigate the effects of Semen Persicae (SP) on infarct volume, COX-2 protein expression in the middle cerebral artery occlusion (MCAo) rats. Methods: Twenty-eight rats were randomly assigned to four groups (MCAo experimental group, MCAo control group, sham experimental group, control group). The middle cerebral artery (MCA) was occluded in the MCAo group by proximal focal cerebral ischemia rat model, while the MCA was not occluded in the sham group. SP extraction was administrated for 4 days to each experimental group. Neuroprotective effects were investigated by measurement of brain damage using 2, 3, 5-triphenyltetrazolium chloride staining and analysis of COX-2 protein expression by western blotting. Results: The occurrence of infarct volume in the SP oral administration group decreased compared to the control group. COX-2 protein expression in the SP oral administration group decreased compared to the control group. Conclusions: The present study demonstrates the effect of SP in reducing infarct volume and decreasing COX-2 expression.

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SURGICAL TREATMENT OF LARGE CYST ON THE MANDIBLE BY USING SAGGITAL SPLIT RAMUS OSTEOTOMY (하악골에 발생한 거대 낭종에서 하악지 시상분할골절단술을 이용한 외과적 치료)

  • Park, Hong-Ju;Ryu, Jae-Young;Kook, Min-Suk;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.1
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    • pp.100-107
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    • 2008
  • First of all a good surgical access is considered among various approach methods to the cystic lesion. A poor surgical access can lead to a failure of the whole treatment. A sagittal split ramus osteotomy (SSRO) on the large cyst occurring in the mandibular ramus lets us not only reduce operation time, but can additionally contribute to a good visual field. In addition, a merit exists that it lets this operating method provide soft tissue adhesion for proximal and distal segment and decrease post operative necrosis. We experienced three cases of a large cyst on the mandibular angle and ramus. By employing a sagittal splitting of the mandible, it provided good surgical access and operation results without recurrence during a follow-up period. The surgical technique described may be helpful in treating similar large cysts.