• Title/Summary/Keyword: 미세수술

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Regenerative Endodontic Treatment of Infected Immature Permanent Teeth with Dens Invaginatus : A Report of Two Cases (치내치를 동반한 감염된 미성숙 영구치의 재생형 근관치료)

  • Shin, Gayoung;Lee, Kwanghee;An, Soyoun;Song, Jihyun;Heo, Narang;Ra, Jiyoung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.188-196
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    • 2015
  • Endodontic management of an immature permanent tooth with dens invaginatus poses a challenge to efficient treatment planning for the clinicians. Because it is difficult to shape, disinfect, and seal the canal space effectively, teeth with complex root canal structures often require particularly extensive and thorough treatment approaches. The purpose of this case report was to share clinical insight from the results of short-term follow-ups after regenerative endodontic treatment with a dens invaginatus. Two immature maxillary lateral incisors with Oehlers type I and III dens invaginatus and infected necrotic pulp were treated using regenerative endodontic procedures. For the type III dens invaginatus case, an unusual approach toward redesigning the complex internal structure was taken, in order to have sufficient infection control and sealing. Cone-beam computed tomography (CBCT) and a surgical operating microscope were used to aid visualization and treatment. As a result, regenerative endodontic treatment appears to be effective for managing immature permanent teeth with complex dens invaginatus, and can lead not only to clinical and radiographic resolution, but also increased thickness of the dentinal walls.

Flexible 의료 영상 센서로 적용하기 위한 Flexible ITO substrate의 가스분압 특성 및 Bending의 전기적 특성 연구

  • Gang, Jin-Ho;Hong, Ju-Yeon;Kim, Dae-Guk;O, Gyeong-Min;Heo, Seung-Uk;Nam, Sang-Hui
    • Proceedings of the Korean Vacuum Society Conference
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    • 2013.08a
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    • pp.185-185
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    • 2013
  • 최근 의료 영상 센서는 급속도로 발전을 이룩하여 미세 병변의 위치와 그 크기를 진단하는 데에 많은 이용이 되고 있다. 하지만 기존 flat panel형태의 의료영상 센서는 인체의 굴곡으로 인한 영상 왜곡으로 발전의 한계에 이르고 있는 실정이다. 이 영상 왜곡으로 인한 오진은 환자에게 불필요한 피폭, 수술적 요법, 약물치료 등 환자에게 치명적인 의료사고를 일으킬 수 있다. 이러한 한계를 극복하기 위하여 flexible substrate을 이용한 투명전극들이 의료영상 센서로서의 적용을 연구 되어 졌다. IZO, ITO, FTO 등의 투명전극들 중 Indium Tin Oxide(ITO)는 다른 전극에 비해 높은 투명도와 낮은 저항으로 인하여 다양한 부분에서 널리 이용 되고 있다. 그러나 ITO를 flexible substrate로 적용 시 불충분한 resistivity와 기계적 강도를 지니고 있으며, 유연성을 위해 전극 재료의 두께를 감소시키면 전도성의 문제를 일으키는 단점이 있는 것으로 알려져 있다. 이러한 문제점을 보완 및 해결하기 위하여 본 연구에서는 sputtering magnetron system를 이용하여 polyethylene terephthalate(PET) substrate 위에 ITO을 증착함으로써 전기적 특성을 알아보았다. PET 필름의 크기를 55 절단하였고 증착 온도는 고온에서 수축하는 PET 필름의 물성을 고려하여 $23^{\circ}C$로 설정 하였다. 가스의 분압 비를 Ar는 50ccm으로 고정하고 O2의 비율을 각각 0, 0.2, 0.4, 0.8, 1ccm으로 나눈 후, 비율에 따라 각각 30, 60, 90sec간 sputtering 증착을 하였다. 또한 각각 30, 60, 90sec간 sputtering 증착하여 O2 유량과 sputtering 증착 시간의 변화에 따른 ITO의 전도특성과 유연성에 대한 전도특성을 측정하였다. 유연성을 측정하기 위해선 bending 각도를 각각 $0^{\circ}$ $30^{\circ}$, $45^{\circ}$, $60^{\circ}$로 구부린 후, Two-point probe를 이용하여 변화된 저항을 통해 ITO의 전기적 성질의 변화를 측정 하였다. 측정결과 flexible ITO substrate의 전도특성은 sputtering 증착시간이 증가할수록 저항 값이 낮아지는 것을 확인하였지만, O2 유량이 증가 시 저항이 낮아지다가 다시 증가하는 결과를 알 수 있었다. 본 연구에서는 Ar:O2의 50:0.8의 조건에서 90sec동안 sputtering 증착한 ITO가 131 ${\Omega}/cm^2$의 저항 값이 측정 되었고 다른 조건에서는 164 ${\Omega}/cm^2$에서 4.7 $k{\Omega}/cm^2$까지 저항변화를 가져 Ar:O2의 50:0.8의 조건이 최적화에 좋은 조건이라 판단하였다. 또한 50:0.8의 조건의 ITO의 경우 bending test시에서도 131 ${\Omega}/cm^2$에서 316 ${\Omega}/cm^2$ 정도의 안정적인 저항변화를 가지는 반면 다른 조건에서는 128 ${\Omega}/cm^2$에서 6.63 $k{\Omega}/cm^2$까지의 변화를 나타나 기계적 형상변화에도 분압비가 영향을 주는 것을 확인 할 수 가 있었다. bending 각도에 따른 저항의 변화를 측정하였을 시, 각도 변화에 따라 중심부의 저항 값이 $60^{\circ}$에서 가장 높은 변화가 나타나 전기저항이 높아진 원인을 찾기 위해 Scanning Electron Microscope (SEM)촬영을 한 결과 저항값이 높아짐에 따라 ITO의 압축응력이 작용하는 부근에 Crack이 발생함을 알 수 있었다. 이러한 결과로 flexible ITO substrate의 Crack발생률을 최소화 시키고 bending시 전도성을 유지하기 위해서는 가스의 유량 최적화가 flexible substrate의 기계적형상변화에 대한 ITO의 내구성을 향상시킬 수 있는 해답이 될 것으로 사료된다.

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Reconstruction of the Lower Extremities with the Gracilis Muscle Flap (박근 유리조직을 이용한 하지 재건술)

  • Lee, Jun-Mo;Lee, Ju-Hong
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.62-67
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    • 1998
  • The gracilis muscle is well suited to small and medium-sized soft tissue defects that cannot be adequately handled by simple rotational flaps and it will conform well to irregular contours, can be split longitudinally at both ends to allow cavities and awkwardly shaped spaces and can be transferred in part or in whole. The gracilis muscle used as a free muscle or musculocutaneous flap is small with a long, narrow contour and its vascular pedicle is a terminal branch of the medial femoral circumflex artery and vein. The aims of soft tissue reconstruction are to cover soft tissue defects, to clear up infection and to prepare for further surgical procedures. Authors have performed 12 gracilis muscle flaps in the lower extremities at Chonbuk National University Hospital from June 1994 through March 1998. The results were as follows. 1. 11 cases of 12(91.7%) were sustained from the crushing injury and secondary complications from the traffic accident. 2. The microsurgical anastomosis of one artery and two veins have performed in 6 cases(50%) of 12 and 11(91.7%) cases of 12 were successful at the third postoperative week and in the final result. 3. Gracilis muscle flap is the infetion-resistant and aesthetically acceptable performed in the lower leg 1/3 and the foot.

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Pedicled Deep Inferior Epigastric Perforator Flap for Treatment of Dystrophic Epidermolysis Bullosa-Associated Squamous Cell Carcinoma in the Groin - Case Report - (심부하복벽동맥 천공지 유경 피판을 이용한 이영양성 수포성 표피박리증에 합병된 서혜부 편평 세포 상피암의 치료 - 증례 보고 -)

  • Kim, Kyung-Pil;Kim, Ji-Hoon;Kim, Eui-Sik;Hwang, Jae-Ha;Kim, Kwang-Seog;Lee, Sam-Yong
    • Archives of Reconstructive Microsurgery
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    • v.19 no.2
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    • pp.97-100
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    • 2010
  • Purpose: Epidermolysis bullosa is a rare genetic disease, characterized by the presence of extremely fragile skin and formation of recurrent blister resulting from even a minor mechanical injury. Squamous cell carcinoma (SCC) is recognized as a complication of the chronic scarring associated with dystrophic epidermolysis bullosa (DEB). When a soft tissue defect happens in a patient with epidermolysis bullosa, it is difficult to cover it with a skin graft or a flap. We describe the successful use of a pedicled deep inferior epigastric perforator flap for the reconstruction of SCC associated with DEB in the groin. Methods: A 29-year-old man diagnosed with DEB at birth sustained an ulcer increasing in the right groin for the last 7 months. Under general anesthesia, the mass lesion and lymph nodes were removed and the resulting defect was covered with a pedicled deep inferior epigastric perforator flap. Results: The flap survived completely and his postoperative course was uneventful. Histopathological examination revealed a SCC in the right groin and malignant tumor cells in the removed lymph nodes as well. Additional positron emission tomogram showed a malignant lesion in the ileocecal area with regional lymph node metastasis. The patient was referred to an oncologist for chemotheraphy, but the patient refused to take it. During a 4-month follow-up period, there was no recurrence in the right groin. Conclusion: We suggest that perforator flaps can be considered as a reliable alternative for the reconstruction of soft tissue defects in a patient with DEB.

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Reliability of OperaVOXTM against Multi-Dimensional Voice Program to Assess Voice Quality before and after Laryngeal Microsurgery in Patient with Vocal Polyp (성대 용종 환자의 후두미세수술 전후 음성 평가에서 OperaVOXTM와 Multi-Dimensional Voice Program 간의 신뢰도 연구)

  • Kim, Sun Woo;Kim, So Yean;Cho, Jae Kyung;Jin, Sung Min;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.2
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    • pp.71-77
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    • 2020
  • Background and Objectives OperaVOXTM (Oxford Wave Research Ltd.) is a portable voice analysis software package designed for use with iOS devices. As a relatively cheap, portable and easily accessible form of acoustic analysis, OperaVOXTM may be more clinically useful than laboratory-based software in many situations. The aim of this study was to evaluate the agreement between OperaVOXTM and Multi-Dimensional Voice Program (MDVP; Computerized Speech Lab) to assess voice quality before and after laryngeal microsurgery in patient with vocal polyp. Materials and Method Twenty patients who had undergone laryngeal microsurgery for vocal polyp were enrolled in this study. Preoperative and postoperative voices were assessed by acoustic analysis using MDVP and OperaVOXTM. A five-seconds recording of vowel /a/ was used to measure fundamental frequency (F0), jitter, shimmer and noise-to-harmonic ratio (NHR). Results Several acoustic parameters of MDVP and OperaVOXTM related to short-term variability showed significant improvement. While pre-operative value of F0, jitter, shimmer, NHR was 155.75 Hz (male: 125.37 Hz, female: 183.37 Hz), 2.20%, 6.28%, 0.16, post-operative values of these parameter was 164.34 Hz (male: 129.42 Hz, female: 199.26 Hz), 2.15%, 5.18%, 0.14 Hz in MDVP. While pre-operative value of F0, jitter, shimmer, NHR was 168.26 Hz (male: 135.16 Hz, female: 201.37 Hz), 2.27%, 6.95%, 0.26, post-operative values of these parameters was 162.72 Hz (male: 128.267 Hz, female: 197.18 Hz), 1.71%, 5.36%, 0.20 in OperaVOXTM. There was high intersoftware agreement for F0, jitter, shimmer with intraclass correlation coefficient. Conclusion Our results showed that the short-term variability of acoustic parameters in both MDVP and OperaVOXTM were useful for the objective assessment of voice quality in patients who received laryngeal microsurgery. OperaVOXTM is comparable to MDVP and has high intersoftware reliability with MDVP in measuring the F0, jitter, and shimmer

Effects of Self-care Program on Exercise performance Self-Efficay, Self-care Knowledge, Self-care Performance in Patients with Lumbar Discectomy (자가간호프로그램이 요추간판제거술 환자의 운동이행 자기효능감, 자가간호지식, 자가간호이행에 미치는 효과)

  • Jeong, Jin-Hee;Lee, Hye-Kyung
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.3
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    • pp.891-902
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    • 2021
  • This study is an experimental study to confirm the effect of self-care program on exercise performance self-efficacy, Knowledge of self-management and Performance of self-management in patients with lumbar disc removal. The subjects were 26 inpatients in the experimental group and 27 in the control group as inpatients at the D City Material Spine Hospital. The collected material was analyzed using the SPSS 25.0 program with mean, percentage, standard deviation, t-test, x2-test, Independent t-test, and repeated measures ANOVA. Hypothesis that after self-care program mediation, the experimental group had higher scores for orthosis management knowledge (p<.001) and daily life management knowledge (p=.005) as time passed compared to the unprovided control group. The hypothesis is that the experimental group provided with the self-care program has a performance of orthosis management(p=.011), higher degree of orthosis management performance (p=.011) and daily life management performance (p=.007) than the non-provided control group. Was supported. There, it was confirmed that it is an effective self-care program that can be easily applied at home to patients with lumbar disc removal from the day before surgery to after discharge.

Verification of the Protective Effect of Functional Shielding Cream for the Prevention of X-ray Low-dose Exposure (X-ray 저선량 피폭방지를 위한 기능성 차폐크림의 방어 효과 검증)

  • Seon-Chil Kim
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.497-506
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    • 2023
  • In the case of radiation workers in medical institutions, radiation exposure is made for patient protection and accurate procedures, so they have a problem of low dose exposure. Low-dose radiation exposure occurs mainly in parts of the body other than the Apron area, and the most frequent place is the skin of the back of the hand. In particular, since the medical personnel's hands require senses and fine movements during the procedure, they are defenseless in the radiation exposure area and are at risk of exposure. It can solve the problem of shielding such as lead gloves, and it is difficult to use by suggesting the activity of the hand during the procedure. To solve this problem, a shielding cream capable of obtaining a functional radiation protection effect was developed and its shielding performance was compared with lead equivalent of 0.1 mmPb. In the process of manufacturing shielding cream, the shielding performance was improved by adding a defoaming process to reduce air holes to increase the density of the cream. Therefore, the shielding cream using barium sulfate as the main material has a lower shielding rate than the lead plate, and in the realm of effective energy, it is 59%, At high effective energy, a difference of about 37% was shown, indicating that there is a functional radiation protection effect. The advantage is that it can be used directly on the skin, and it is considered that it can be used before wearing surgical gloves and has a permanent protective effect.

Effect of Mask Wearing and Type on Cardiopulmonary Resuscitation Accuracy, Fatigue and Physiological Changes

  • Sung-Hwan Bang;Hyo-Suk Song;Gyu-Sik Shim;Hee-Jeong Ahn
    • Journal of the Korea Society of Computer and Information
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    • v.28 no.7
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    • pp.113-120
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    • 2023
  • The purpose of this study was the accuracy of cardiac compression, fatigue, and physiological changes of the rescuer for different mask type in cardiopulmonary resuscitation(CPR). Data collection was from 9 to 12 May 2022, the participants were a total of 24 paramedic students with a BLS provider at D University. The students participated in an experiment in which 12 students each wore a surgical mask (Dental mask) and a fine particle 94% blocking mask (KF94 mask) and performed CPR for 2 minutes over a total of 7 times. As a result of the study, in the analysis of the quality of the rescuer's chest compression according to the type of mask, there was a significant difference in the compression speed (F=24.91, p<.001) and bad compression hand position (F=14.54, p=.024) in the group wearing the KF94, Fatigue showed significant differences in both the Dental mask group (F=51.16, p<.001) and the KF94 mask group (F=63.49, p<.001). Among the physiological changes, heart rate showed a significant difference between the Dental mask group (F=34.79, p<.001) and the KF94 mask group (F=35.55, p<.001), and the respiratory rate showed a significant difference between the Dental mask group (F=25.02, p=.001) and the KF94 mask group(F=23.02, p=.002). Therefore, in order to improve the quality of efficient chest compression and reduce the fatigue and physiological changes of rescuers, it will be necessary for rescuers to wear suitable personal protective equipment.

Training of Radiofrequency Ablation for Thyroid Nodules in Korea: Current and Future Perspective (국내의 갑상선 고주파 절제술에 대한 교육: 현황 및 미래 전망)

  • Hye Shin Ahn;So Lyung Jung;Jung Hwan Baek;Jin Yong Sung;Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1009-1016
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    • 2023
  • Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. In Korea, RFA for thyroid nodules was first performed in 2002, and a large population study was published in 2008. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed its first recommendations for RFA in 2009, which were revised in 2012 and 2018. The KSThR guideline was the first guideline for RFA of thyroid nodules worldwide and has become a guideline for physicians to perform thyroid RFA in Korea and other countries around the world. These guidelines have contributed significantly to the establishment and widespread use of RFA worldwide. In addition, since 2015, the KSThR has conducted intensive hands-on courses depending on the level of the participants. In this article, the authors introduce the history of eduction for RFA conducted by the KSThR and describe the learning curve of RFA and current training programs in Korea, along with future directions for training programs.

Prognostic Value of the Expression of p53 and bcl-2 in Non-Small Cell Lung Cancer (비소세포폐암에서 p53과 bcl-2의 발현이 예후에 미치는 영향)

  • Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Keum, Joo-Seob;Kong, Gu;Lee, Jung-Dal
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.962-974
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    • 1998
  • Background: Alteration of p53 tumor suppressor genes is most frequently identified in human neoplasms, including lung carcinoma. It is well known that bcl-2 oncoprotein protects cells from apoptosis. Recent studies have demonstrated that bcl-2 expression is associated with favorable prognosis for patients with non-small cell lung carcinoma. However, the precise biologic role of bcl-2 in the development of these tumors is still obscure. p53 and bcl-2 have important regulatory influence in the apoptotic pathway and thus their relationship is of interest in tumorigenesis, especially lung cancer. Purpose: The author investigated to know the prognostic significance of the expression of p53 and bcl-2 in radically resected non-small cell lung cancer. Method: 84 cases of formalin-fixed paraffin-embedded blocks from resected primary non-small cell lung cancer from 1980 to 1994 at Hanyang University Hospital were available for both clinical follow-up and immunohistochemical staining using monoclonal antibodies for p53 and bcl-2. Results : The histologic classification of the tumor was based on WHO criteria., and the specimens included 45 squamous cell carcinomas(53.6%), 28 adeonocarcinomas(33.3%) and 11 large cell carcinomas(13.1 %). p53 immunoreactivity was noted in 47 cases of 84 cases(56.0%). bcl-2 immunoreactivity was noted in 15 cases of 84 cases(17.9%). The mean survival duration was $64.23{\pm}10.73$ months in bcl-2 positive group and $35.28{\pm}4$. 39 months in bcl-2 negative group. The bcl-2 expression was significantly correlated with survival in radically resected non-small cell lung cancer patients(p=0.03). The mean survival duration was $34.71{\pm}6.12$ months in p53 positive group and $45.35{\pm}6.30$ months in p53 negative group(p=0.21). The p53 expression was not predictive for survival. There was no correlation between combination of the different status of p53 and bcl-2 expression in our study. Conclusions : The interaction and the regulation of new biologic markers, such as those involved in the apoptotic pathway, are complex. bcl-2 overexpression is a good prognostic factor in non-small cell lung cancer and p53 expression is not significantly associated with the prognostic factor in non-small cell lung cancer.

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