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Volumetric Bone Mineral Density Measurement: for Surgery Specific Bone Volumes (체적골밀도 측정법 동향: 수술부위 골밀도 분석)

  • Lee, Yeon Soo
    • Journal of the Korean Society of Radiology
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    • v.16 no.1
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    • pp.53-59
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    • 2022
  • DEXA, as the standard areal bone mineral density (aBMD) measurement method, often shows an insuficient correlation between aBMDs of the measured bones and referring bones and is inaccurate due to the mass effect. In contrast, quantitative computer tomography (QCT), as a volumetric BMD (vBMD) measurement method, is being advanced so that it uses less radiation before, owing to improved CT device and computer imaging technology. Because dual-energy CTs can modulate the image signals showing tumor or specific chemicals as well as the ability to measure vBMD, they are expanding their application. For pre-checking vBMD of surgeon-specific bone volume at implantation candidate sites, a finite element creation-based local vBMD measurement technique was developed. The local vBMD measurement function for surgeon-specific shape volumes will be added to clinical imaging systems.

Ten Tips for Performing Your First Peer Review: The Next Step for the Aspiring Academic Plastic Surgeon

  • Frendo, Martin;Frithioff, Andreas;Andersen, Steven Arild Wuyts
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.538-542
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    • 2022
  • Performing the first peer review of a plastic surgical research article can be an overwhelming task. However, it is an essential scholarly skill and peer review is used in a multitude of settings: evaluation of journal articles, conference abstracts, and research proposals. Furthermore, peer reviewing provides more than just the opportunity to read and help improve other's work: peer reviewing can improve your own scientific writing. A structured approach is possible and recommended. In these ten tips, we provide guidance on how to successfully conduct the first peer reviews. The ten tips on peer reviewing concern: 1) Appropriateness: are you qualified and prepared to perform the peer review? 2) Familiarization with the journal and its reviewing guidelines; 3) Gathering first impressions of the paper followed by specific tips for reviewing; 4) the abstract and introduction; 5) Materials, methods, and results (including statistical considerations); and 6) discussion, conclusion, and references. Tip 7 concerns writing and structuring the review; Tips 7 and 8 describe how to provide constructive criticism and understanding the limits of your expertise. Finally, Tip 10 details why-and how-you become a peer reviewer. Peer review can be done by any plastic surgeon, not just those interested in an academic career. These ten tips provide useful insights for both the aspiring and the experienced peer reviewer. In conclusion, a systematic approach to peer reviewing is possible and recommended, and can help you getting started to provide quality peer reviews that contribute to moving the field of plastic surgery forward.

Radiation Dose Distribution of a Surgeon and Medical Staff during Orthopedic Balloon Kyphoplasty in Japan

  • Ono, Koji;Kumasawa, Takafumi;Shimatani, Keiichi;Kanou, Masatoshi;Yamaguchi, Ichiro;Kunugita, Naoki
    • Journal of Radiation Protection and Research
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    • v.47 no.2
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    • pp.86-92
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    • 2022
  • Background: The present study investigated the radiation dose distribution of balloon kyphoplasty (BKP) among surgeons and medical staff, and this is the first research to observe such exposure in Japan. Materials and Methods: The study subjects were an orthopedic surgeon (n = 1) and surgical staff (n = 9) who intervened in BKP surgery performed at the National Hospital Organization Disaster Medical Center (Tokyo, Japan) between March 2019 and October 2019. Only disposable protective gloves (0.022 mmPb equivalent thickness or less) and trunk protectors were used, and no protective glasses or thyroid drapes were used. Results and Discussion: The surgery time per vertebral body was 36.2 minutes, and the fluoroscopic time was 6.8 minutes. The average exposure dose per vertebral body was 1.46 mSv for the finger (70 ㎛ dose equivalent), 0.24 mSv for the lens of the eye (3 mm dose equivalent), 0.11 mSv for the neck (10 mm dose equivalent), and 0.03 mSv for the chest (10 mm dose equivalent) under the protective suit.The estimated cumulative radiation exposure dose of 23 cases of BKP was calculated to be 50.37 mSv for the fingers, 8.27 mSv for the lens, 3.91 mSv for the neck, and 1.15 mSv for the chest. Conclusion: It is important to know the exposure dose of orthopedic surgeons, implement measures for exposure reduction, and verify the safety of daily use of radiation during surgery and examination.

Incidence of fistula after primary cleft palate repair: a 25-year assessment of one surgeon's experience

  • Park, Min Suk;Seo, Hyung Joon;Bae, Yong Chan
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.43-49
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    • 2022
  • Background Cleft lip and cleft palate are the most frequent congenital craniofacial deformities, with an incidence of approximately 1 per 700 people. Postoperative palatal fistula is one of the most significant long-term complications. This study investigated the incidence of postoperative palatal fistula and its predictive factors based on 25 years of experience at our hospital. Methods We retrospectively reviewed 636 consecutive palatal repairs performed between January 1996 and October 2020 by a single surgeon. Data from patients' medical records regarding cleft palate repair were analyzed. The preoperative extent of the cleft was evaluated using the Veau classification system, and the cleft palate repair technique was chosen according to the extent of the cleft. SPSS version 25.0 was used for all statistical analyses, and exploratory univariate associations were investigated using the t-test. Results Fistulas occurred in 20 of the 636 patients; thus, the incidence of palatal fistula was 3.1%. The most common fistula location was the hard palate (9/20, 45%), followed by the junction of the hard and soft palate (6/20, 30%) and the soft palate (5/20, 25%). The cleft palate repair technique significantly predicted the incidence of palatal fistula following cleft palate repair (P=0.042). Fistula incidence was significantly higher in patients who underwent surgery using the Furlow double-opposing Z-plasty technique (12.1%) than in cases where the Busan modification (3.0%) or two-flap technique (2.0%) was used. Conclusions The overall incidence of palatal fistulas was 3.1% in this study. Moreover, the technique of cleft palate repair predicted fistula incidence.

Indications and findings of flexible bronchoscopy in trauma field in Korea: a case series

  • Dongsub Noh
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.206-209
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    • 2023
  • Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

Enhancing ketamine anesthesia with midazolam and fentanyl for children's ear surgery: a prospective randomized study

  • Seong Min Han;So Young Kwon;Jang Hyeok In;Jin Deok Joo
    • Journal of Yeungnam Medical Science
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    • v.41 no.3
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    • pp.207-212
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    • 2024
  • Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 ㎍/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion: Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

RIDGE EXPANSION OSTEOTOMY TECHNIQUE FOR IMPLANTATION IN THE MAXILLA (상악골에서 IMPLANT 매식을 위한 치조제 확대 골절단술)

  • Lee, Gi-Hyug;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.149-155
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    • 1997
  • Ridge expansion osteotomy(REO) technique is a simple and more conservation method to widen a narrow alveolar ridge in the maxilla. This method is superior to drilling method in soft and narrow maxillary alveolar ridge and allows the surgeon to widen the ridge in routine office procedure. Therefore, it is the treatment of choice to implant the maxilla with narrow alveolar ridge. This article presents clinical cases and discusses the advantages, rationale and surgical protocol of REO technique.

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Single-Port Thoracic Surgery: A New Direction

  • Ng, Calvin S.H.
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.327-332
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    • 2014
  • Single-port video-assisted thoracic surgery (VATS) has slowly established itself as an alternate surgical approach for the treatment of an increasingly wide range of thoracic conditions. The potential benefits of fewer surgical incisions, better cosmesis, and less postoperative pain and paraesthesia have led to the technique's popularity worldwide. The limited single small incision through which the surgeon has to operate poses challenges that are slowly being addressed by improvements in instrument design. Of note, instruments and video-camera systems that are narrower and angulated have made single-port VATS major lung resection easier to perform and learn. In the future, we may see the development of subcostal or embryonic natural orifice translumenal endoscopic surgery access, evolution in anaesthesia strategies, and cross-discipline imaging-assisted lesion localization for single-port VATS procedures.

Clinical considerations for successful results in FOS(Functional Orthognathic Surgery): Surgery first orthodontic treatment later (임상가를 위한 특집 1 - 성공적인 선 수술 교정 치료를 위한 고려사항)

  • Oh, Chang-Ok
    • The Journal of the Korean dental association
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    • v.50 no.2
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    • pp.58-63
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    • 2012
  • The fundamental principles and the role of surgeons and orthodontists to produce successful results in orthodontic treatment combined with orthognathic surgery is not different from those of conventional procedures and FOS: surgery-first-orthodontic-treatment-later approach. The communication and cooperation between surgeon and orthodontist is of crucial importance. In FOS, the pre-surgical orthodontic preparation is not carried out in the patient's mouth, but in the mounted stone model and in addition to the simulation of tooth movement, to get a precise surgical occlusion, the entire steps of treatment should be simulated on the articulator as well. Right after the surgery, due to the instability of the occlusion, appropriate post operational care should be given according to the surgical technique applied to the mandible by use of final surgical wafer about 8 weeks.

Treatment of Temporomandibular Joint Reankylosis by Submandibular Anchorage Technique with Temporalis Myofascial Flap

  • Kim, Jun-Young;Kim, Jae-Young;Jung, Young-Soo;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.2
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    • pp.78-83
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    • 2014
  • Management of temporomandibular joint (TMJ) ankylosis is challenging for the oral and maxillofacial surgeon because it involves the mouth opening, dentofacial deformity, diet problem, and quality of life. Although surgical techniques to treat TMJ ankylosis have improved, reankylosis is a persistent problem. The temporalis myofascial flap provides good material for interpositional arthroplasty, because of its good vascular supply, anatomic proximity, and adequate thickness. This case report examines the efficacy of submandibular anchorage to prevent reankylosis by inhibiting flap dislocation.