• Title/Summary/Keyword: surgeon

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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.

Management of Post-lobectomy Bronchopleural-cutaneous Fistula With a Rectus Abdominis Free Flap (폐절제술 후 발생한 기관지늑막 피부루에서 유리 복직근피판을 이용한 치료)

  • Heo, Chan Yeong;Min, Kyung Hee;Eun, Seok Chan;Baek, Rong Min;Cheon, Sang Hoon
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.795-798
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    • 2009
  • Purpose: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural - cutaneous fistula developed after undergoing lobectomy for lung cancer. Methods: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleural - cutaneous fistula. Results: The patient has remained healed for 14 months without any postoperative complications and recurrent infection or fistula. Conclusion: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.

Tactile Response Characteristics of Haptic Displays based on Magneto-Rheological Fluids (MR 유체를 이용한 햅틱 디스플레이의 질감 반응 특성)

  • Jang, Min-Gyu;Choi, Jea-Young;Lee, Chul-Hee
    • Tribology and Lubricants
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    • v.26 no.3
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    • pp.184-189
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    • 2010
  • In this paper, tactile response characteristics in medical haptic interface are investigated to characterize the feeling of contact between the finger skin and the organic tissue when a finger is dragged over tissue. In order to represent the tactile feeling, a prototype tactile display incorporating Magneto-Rheological (MR) fluid has been developed. Tactile display devices simulate the finger's skin to feel the sensations of contact such as compliance, curvature and friction. Thus, the tactile display provides the surface information of organic tissue to the surgeon using different actuating mechanisms ranging from the conventional mechanical motor to the smart material actuators. In order to investigate the compliance feeling of human finger's touch, vertical force responses of the tactile display under the various magnetic fields have been assessed. Also, frictional resistive force responses of the tactile display are investigated to simulate the action of finger's dragging. From the results, different tactile feelings are observed as the applied magnetic field is varied and arrayed magnetic poles combinations. This research gives a smart technology of tactile displaying.

Pulmonary Artery Banding for Ventricular Septal Defect: Report of 2 Cases (심실중격결손의 Pulmonary Banding: 2 치험례)

  • 조범구
    • Journal of Chest Surgery
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    • v.5 no.1
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    • pp.29-34
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    • 1972
  • Interventricular Septal Defect is probably the most common congenital cardiac lesion. Despite rapid technical advances and increasing surgical experience the risk of surgical intervention for correction of Ventricular Septal Defect in infants with pulmonary hypertension remains formidable. Since Sirak et al [1959] reported a succesful case of two stage approach to their surgical correction, it has led to a policy of primary palliation,followed by complete correction as a secondary procedure, after age 3 to 4 years. Most surgeon prefer to perform complete correction of Ventricular Septal Defect when body weight exceeds 30 Lbs. and before development of so-called Eisenmengers complex, for the good postoperative results. Authors report 2 cases of Ventricular Septal Defect with pulmonary hupertenslon, who was underwent pulmonary artery banding as a palliative procedure in the Department of Surgery,Severance Hospital Yonsei University. Case 1:4 year old male, initially a complete correction of Ventricular Septal Defect was attempted by the help of mild hypothermia and extracorporeal circulation. During the procedure of a construction of an extracorporeal by- pass, a sudden cardiac arrest developed. After resuscitation of the heart,pulmonary artery banding was performed as a palliation. On the first postoperative day the patient developed generalized tonic convulsion, cyanosis, vomiting and eventually shock. Patient discharged home after a full recovery. Case 2.: 9 month old female, the pulmonary artery constricted with Teflon patch successfully. After the patients first postoperative day several cyanotic spells developed followed by 3 cardiac arrests. This repeated until when she expired with respiratory failure.

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Warm Sensation of Left lower Extremity as a Complication of Left Stellate Ganglion Block (좌측성상교감신경절차단후(左側星狀交感神經節遮斷後)에 합병증(合倂症)으로 온 좌측하지온감(左側下肢溫感))

  • Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.125-128
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    • 1988
  • A case of the left stellate ganglion block (SGB) with a warm serration of the left lower extremity in a 25-year-old male soldier is presented. During the Korean War, this patient received a penetrating gun shot wound from the right knee through the left abdominal wall, left upper arm and left thumb. He was evacuated to the a marine corps surgical hospital where amputation of the left thumb and an end-to-end anatomosis of the left brachial artery were performed. After surgery, left ulnar and median nerve paralysis and causalgia developed and about 9 months later an upper thoracic ganglionectomy was proposed at the Chin-Hae Navel Hospital. Before the ganglionectomy a stellate ganglion block for diagnostic and prognostic purposes was requested by the surgeon. This block was performed by the supraclavicular anterior approach using 10 ml of 2% procaine. The effect of the block including Horner's syndrome was confirmed 5 minute later in this patient. This patient returned to the ward by walking unassisted 10 minutes after the block, and complained of a warm sensation in the left lower extremity 20 minutes later as well as the left upper arm. This warm sensation in the lower extremity following ipsilateral stellate ganglion block indicates that the local anesthetics solution injected tinto the neck spread down to lumbar sympathetic ganalgion along the fascial membrane of the sympathetic chain as a consequence of the 10 minutes walk.

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Robotic Guidance of Distal Screwing for Intramedullary Nailing Using Optical Tracking System (광학식측정장치를 이용한 금속정 내고정 수술의 원위부 나사체결을 위한 로보틱 유도 시스템)

  • An, Liming;Kim, Woo Young;Ko, Seong Young
    • The Journal of Korea Robotics Society
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    • v.12 no.4
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    • pp.411-418
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    • 2017
  • During the intramedullary nailing procedure, surgeons feel difficulty in manipulation of the X-ray device to align it to axes of nailing holes and suffer from the large radiation exposure from the X-ray device. These problems are caused by the fact the surgeon cannot see the hole's location directly and should use the X-ray device to find the hole's location and direction. In this paper, we proposed the robotic guidance of the distal screwing using an optical tracking system. To track the location of the hole for the distal screwing, the reference marker is attached to the proximal end of an intramedullary nail. To guide the drill's direction robustly, the 6-degree-of-freedom robotic arm is used. The robotic arm is controlled so as to align the drill guiding tool attached the robotic arm with the obtained the hole's location. For the safety, the robot's linear and angular velocities are restricted to the predefined values. The experimental results using the artificial bones showed that the position error and the orientation error were 0.91 mm and $1.64^{\circ}$, respectively. The proposed method is simple and easy to implement, thus it is expected to be adopted easily while reducing the radiation exposure significantly.

Comparative Study on the Protective Functions of Clothes (의복의 보호론에 관한 이론적 고찰)

  • Lim Sook Ja
    • Journal of the Korean Society of Clothing and Textiles
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    • v.9 no.3
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    • pp.71-78
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    • 1985
  • This research is designed to systemize the protection theory as well as to supplement the missing theory by organizing various studies on the protective functions of celothes by domestic and foreign scholers of clothing. Human environments is classified two standpoints : (1) Physical environments, and (2) man built psychological environments including socio-physical environments, socio-biological environments, behavioral environments, socio-psychological environments and institution environments. Clothes acting as a physical protection might be of (1) extreme air temperature: Parka; (2) high relative humidity: raincoat; (3) air movement: windbreaker; (4) radiation: space suit; (5) atmospheric pressure: deep sea diver suit; (6) mechanical agent: bullet proof vest; (7) physical agent: (8) chemical agent: (9) biological agent: surgeon's gown, cap, and mask. Also dresses act to support the body comfort, health and the well-being; corset for bad back patient, wrist band for people with weak wrist, bottom half of pressure suit for people with low blood pressure. Clothes acting as a psychological protection might be of (1) influence of magic and of spirits: (2) moral danger; (3) the general unfriendliness of the world as a whole; a reassurance against the lack of love. Clothes should provide the maximum of satisfaction in accordance with the full recognition of reality. The reality should aim at the formulation of general laws concerning the most pleasing forms, colors, and styles to suit. The complex physiological anatomical and psychological aspects of individual personalities.

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Clinical Analysis of Completion Thyroidectomy in Differentiated Thyroid Carcinoma (갑상선엽절제 후 이차 근치엽절제술을 시행받은 분화성 갑상선암종 환자 23예에 대한 임상적 평가)

  • Kwon Soon-Young
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.1
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    • pp.38-41
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    • 2001
  • Background and Objectives: Thyroid nodules can be diagnosed by FNAB, neck sonography, CT scan, or frozen section with relative accuracy. But some cases, which show no malignancy with those methods, are proved differentiated carcinomas on permanent sections. These false negative results of those diagnostic methods pose difficulties in the surgeon's decision-making process. We analyzed completion thyroidectomies retrospectively in order to make a treatment guideline for thyroid nodules. Materials and Methods: During the last six years, we performed 243 thyroid lobectomies, no evidence of malignancy with preoperative or intraoperative diagnostic methods at the Department of Otolaryngology-Head and Neck Surgery, Ansan and Anam Korea University Hospital. Among these cases, 23 patients (male 6, female 17, mean age 33.4 year old) were proved differentiated thyroid carcinomas on permanent section and we performed completion thyroidectomies. Results: Preoperative FNAB showed seven cases of nodular hyperplasia, 11 cases of follicular adenoma, and five cases of inadequate specimen. Among total 15 cases on frozen section, five cases were nodular hyperplasias, and 10 cases were follicular adenomas. Pathologic results of the permanent section were six cases of papillary cell carcinoma and 17 cases of follicular cell carcinoma. Completion thyroidectomy was performed on all these cases. Conclusion: FNAB and frozen section cannot be sufficient to make the diagnosis of thyroid nodule, we consider that completion thyroidectomy should be performed at the moment with malignant evidence on permanent section.

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Esthetic neck dissection using an endoscope via retroauricular incision: a report of two cases

  • Kim, Jae-Young;Cho, Hoon;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.1
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    • pp.27-31
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    • 2014
  • Various surgical techniques, such as endoscopic surgery and robotic surgery, are developed to optimize the esthetic outcome even in operations for malignancy. A modified face-lift or retroauricular approach are used to minimize postoperative scarring. Recently, robot-assisted surgery is being done in various fields and considered as favorable treatment method by many surgeons. However its high cost is a nonnegligible fraction for many patients. On the other hand, endoscopic surgery, which is cheaper than robotic surgery, is minimally invasive with contentable neck dissection. Although it is a difficult technique for a beginner surgeon due to its limited operation view, we suppose it as an alternative method for robotic surgery. Herein, we report two cases of endoscopic neck dissection via retroauricular incision with a discussion regarding the pros and cons of endoscopic neck dissection.

The Importance of Femoral Hernia in Children (소아 대퇴탈장의 중요성)

  • Han, Seok-Joo;Choi, Bong-Soo;Han, Ai-Ri;Oh, Jung-Tak;Choi, Seung-Hoon;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.6 no.2
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    • pp.124-127
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    • 2000
  • Femoral hernia is very rare in children and is easily misdiagnosed. During a period of three years, three children with femoral hernia were treated by one pediatric surgeon at Severance Hospital. Only one case was diagnosed correctly before surgery, and the others were thought to be either an indirect inguinal hernia or groin mass. Curative hernioplasty (McVay hernioplasty) could be done in only one case at the time of first operation. Diagnosis of femoral hernia in children is a challenge because of rarity and similarity of clinical presentation to indirect inguinal hernia. Co-incidental findings of indirect inguinal hernia sac or patent processus vaginalis during surgery can perpetuate the misdiagnosis. In case of absence of expected indirect inguinal hernia or apparent recurrence of indirect inguinal hernia, one should consider the possibility of femoral hernia.

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