• Title/Summary/Keyword: 수술 계획

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Analytical Osteotomy Model for Three-dimensional Surgical Planning of Opening Wedge High Tibial Osteotomy (개방형 근위경골절골술의 3차원 수술계획을 위한 절골해석모델)

  • Koo, Bon-Yeol;Park, Byoung-Keon;Choi, Dong-Kwon;Kim, Jay-Jung
    • Korean Journal of Computational Design and Engineering
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    • v.18 no.6
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    • pp.385-398
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    • 2013
  • Opening wedge high tibial osteotomy (OWHTO) is widely used to treat unicompartmental osteoarthritis of the knee caused by degenerative deformations of the anatomical axes of the leg. However, since it is difficult to accurately plan the surgical degrees of adjustment such as coronal correction angle and tibial posterior slope angle to align the axes before the actual procedure, a number of studies have proposed analytical models to solve this problem. While previous analytical models for OWHTO were limited to specific cases, this study proposes an analytical osteotomy model (AOM) and a surgical planning system (SPS) that are suitable for a wide range of tibial morphologies and tibia conditions. The validity and generality of the model were verified in a total of 60 OWHTO cases. Results of the test showed that, as predicted, surgical degrees are affected quite significantly by tibia shape and slope of the resected surface. Comparison of the required surgical degrees and the degrees estimated from virtual surgery simulations using AOM showed a very small average difference of $0.118^{\circ}$. SPS, based on AOM, allows the operating surgeon to easily calculate surgical parameters needed to treat a patient.

Measurement of maxillary sinus volume and available alveolar bone height using computed tomography (치과 임플란트 수술 계획시 CT를 이용한 상악동 체적 및 치조골량 측정)

  • Lee Jae-Hak;Han Won-Jeong;Choi Young Hi;Kim Eun-Kyung
    • Imaging Science in Dentistry
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    • v.33 no.1
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    • pp.35-41
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    • 2003
  • Purpose: To aid in determining the volume of graft bone required before a maxillary sinus lift procedure and compare the alveolar bone height measurements taken by panoramic radiographs to those by CT images. Materials and Methods : Data obtained by both panoramic radiographs and CT examination of 25 patients were used in this study. Maxillary sinus volumes from the antral floor to heights of 5 mm, 10 mm, 15 mm, and 20 mm, were calculated. Alveolar bone height was measured on the panoramic images at each maxillary tooth site and corrected by magnification rate (PBH). Available bone height (ABH) and full bone height (FBH) was measured on reconstructed CT images. PBH was compared with ABH and FBH at the maxillary incisors, canines, premolars, and molars. Results: Volumes of the inferior portion of the sinuses were 0.55 ± 0041 ㎤ for 5 mm lifts, 2.11 ± 0.68 ㎤ for 10 mm, 4.26 ± 1.32 ㎤ for 15 mm, 6.95 ± 2.01 ㎤ for 20 mm. For the alveolar bone measurement, measurements by panoramic images were longer than available bone heights determined by CT images at the incisor and canine areas, and shorter than full bone heights on CT images at incisor, premolar, and molar areas (p<0.001). Conclusion: In bone grafting of the maxillary sinus floor, 0.96 ㎤ or more is required for a 5 mm-lift, 2.79 ㎤ or more for a 10 mm-lift, 5.58 ㎤ or more for a 15 mm-lift, and 8.96 ㎤ or more for a 20 mm-lift. Maxillary implant length determined using panoramic radiograph alone could result in underestimation or overestimation, according to the site involved.

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MANDIBULAR EXPANSION IN A CONGENITAL AGLOSSIA PATIENT (선천적 무설증 환자에서의 하악골 확장)

  • Cho, Jae-Yong;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.4
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    • pp.673-677
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    • 2003
  • Congenital aglossia is a very rare condition. The oral manifestations of an aglossia include micrognathia, high arched or cleft palate, defects of the lower lip, an absence of lateral incisors and a mandibular growth deficiency. Although the etiology of congenital aglossia is unclear, both genetic and teratogenic mechanisms have been proposed. Treatment of aglossia patients depends on the nature and severity of the condition which includes surgical rehabilitation of the tongue tip to some extent, orthopedic expansion of the mandible to guide mandibular growth, and mandibular expansion by a distraction osteogenesis. In the present case, a 6 year old female aglossia patient with situs inversus was treated. A bonded hyrax screw was used to increase her mandibular primary intercanine width and intermolar width. A second phase orthodontic and surgical treatment will be possible after some retention phase.

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Image Segmentation of Lung Parenchyma using Improved Deformable Model on Chest Computed Tomography (개선된 가변형 능동모델을 이용한 흉부 컴퓨터단층영상에서 폐 실질의 분할)

  • Kim, Chang-Soo;Choi, Seok-Yoon
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.13 no.10
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    • pp.2163-2170
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    • 2009
  • We present an automated, energy minimized-based method for Lung parenchyma segmenting Chest Computed Tomography(CT) datasets. Deformable model is used for energy minimized segmentation. Quantitative knowledge including expected volume, shape of Chest CT provides more feature constrain to diagnosis or surgery operation planning. Segmentation subdivides an lung image into its consistent regions or objects. Depends on energy-minimizing, the level detail image of subdivision is carried. Segmentation should stop when the objects or region of interest in an application have been detected. The deformable model that has attracted the most attention to date is popularly known as snakes. Snakes or deformable contour models represent a special case of the general multidimensional deformable model theory. This is used extensively in computer vision and image processing applications, particularly to locate object boundaries, in the mean time a new type of external force for deformable models, called gradient vector flow(GVF) was introduced by Xu. Our proposed algorithm of deformable model is new external energy of GVF for exact segmentation. In this paper, Clinical material for experiments shows better results of proposal algorithm in Lung parenchyma segmentation on Chest CT.

Intracerebral Hemorrhage Auto Recognition in Computed Tomography Images (CT 영상에서 뇌출혈의 자동인식)

  • Choi, Seok-Yoon;Kang, Se-Sik;Kim, Chang-Soo;Kim, Jung-Hoon;Kim, Dong-Hyun;Ye, Soo-Young;Ko, Seong-Jin
    • Journal of radiological science and technology
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    • v.36 no.2
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    • pp.141-148
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    • 2013
  • The CT examination sometimes fail to localize the cerebral hemorrhage part depending on the seriousness and may embarrass the pathologist if he/she is not trained enough for emergencies. Therefore, an assisting role is necessary for examination, automatic and quick detection of the cerebral hemorrhage part, and supply of the quantitative information in emergencies. the computer based automatic detection and recognition system may be of a great service to the bleeding part detection. As a result of this research, we succeeded not only in automatic detection of the cerebral hemorrhage part by grafting threshold value handling, morphological operation, and roundness calculation onto the bleeding part but also in development of the PCA based classifier to screen any wrong choice in the detection candidate group. We think if we apply the new developed system to the cerebral hemorrhage patient in his critical condition, it will be very valuable data to the medical team for operation planning.

The Effects of the Gender Role Identity and Gender Stereotypes on the Prejudice Against Male Nurses of Hospital Workers (병원 종사자의 성 역할 정체감과 성 고정관념이 남자간호사에 대한 편견에 미치는 영향)

  • Cho, Ju-Hee;Chang, Chul-Hun;Kim, Sung-Soo
    • The Journal of the Korea Contents Association
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    • v.18 no.12
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    • pp.75-91
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    • 2018
  • As more and more males are participating in the female dominated nursing profession in Korea, they are facing a number of discriminations such as department assignment on the job because of male gender stereotype. The purpose of this study is to examine hospital workers's gender role identity, gender stereotype, and the relationship between those attitudes and gender prejudice against male nurses. The results showed that the androgynous group had lower gender stereotypes and lower prejudice against male nurses than those of the other groups. Hospital workers had a strong tendency to believe that male nurses should work mainly in special departments such as emergency rooms, intensive care units, operating rooms and they think that the male nurses are not fit for caring patients because of the patients' unfamiliarity with male nurses. Gender stereotypes were positively correlated to prejudice against male nurses. Therefore, hospitals should consider developing a detailed plan to encourage a culture of gender equality by tackling the existing prejudice against male nurses so that male nurses can get the same opportunities as female counterparts in terms of department assignment and job promotion.

Full mouth rehabilitation utilizing computer guided implant surgery and CAD/CAM (Computer guided implant surgery와 CAD/CAM을 활용한 전악 수복 증례)

  • Kim, Sungjin;Han, Jung-Suk;Kim, Sung-Hun;Yoon, Hyung-In;Yeo, In-Sung Luke
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.1
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    • pp.57-65
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    • 2019
  • Computer aided design and manufacturing and implant surgery using a guide template improve restoration-driven implant treatment procedures. This case utilized those digital technologies to make definitive prostheses for a patient. According to the work flow of digital dentistry, cone beam computed tomography established the treatment plan, which was followed to make the guide template for implant placement. The template guided the implants to be installed as planned. The customized abutments and surveyed fixed restorations were digitally designed and made. The metal framework of the removable partial denture was cast from resin pattern using an additive manufacturing technique, and the artificial resin teeth were replaced with the zirconia onlays for occlusal stability. These full mouth rehabilitation procedures provided functionally and aesthetically satisfactory results for the patient.

A case of removable partial denture restoration using implant supported surveyed crown in a maxillary edentulous patient (상악 무치악 환자에서 임플란트 지지 서베이드 크라운을 이용한 가철성 국소의치 수복 증례)

  • Seong, Si Young;Choi, Yeon Jo;Ryu, Jae Jun
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.29-36
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    • 2022
  • When planning oral rehabilitation for maxillary edentulous patients, fixed prosthetic restoration using implants, complete denture restoration or overdentures using implants can be considered as treatment methods. In the case of complete denture restoration, it does not require additional surgery and is relatively economical. In the case of implant-supported fixed prostheses, the functional part is generally superior to that of complete denture restoration, but there are cases in which implant placement is clinically difficult. Recently in consideration of the patient's needs and the condition of the remaining alveolar bone, after partial implant placement, a method of restoring with a removable partial denture using implant-supported surveyed crown is also being attempted. This case is a case of performing a removable partial denture restoration using implant-supported surveyed crown in the anterior maxilla, and showing satisfactory esthetic and functional results.

Type 4 Dual Left Anterior Descending Artery: A Case Report of a Rare Congenital Coronary Anomaly (제4형 이중 좌전하행 관상동맥: 드문 선천성 관상동맥 기형에 대한 증례 보고)

  • Seon Woong Jang;Ki Hwan Kim;Byung Hoon Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.428-433
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    • 2024
  • Dual left anterior descending artery (LAD) is a rare congenital coronary artery anomaly with a prevalence of approximately 1% in the general population. To date, 10 types of dual LAD artery anomalies have been reported. Among these, type 4 is one of the rarest. Knowledge and recognition of the dual LAD artery are important for correct diagnosis and planning of coronary bypass surgery and percutaneous coronary intervention. We report a case of a 59-year-old male with type 4 dual LAD artery who presented with dyspepsia and sweating for several months and had approximately 50%-70% stenosis in a major diagonal branch off the short LAD artery.

Preliminary Report of the $1998{\sim}1999$ Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Korea (식도암 방사선 치료에 대한 Patterns of Care Study ($1998{\sim}1999$)의 예비적 결과 분석)

  • Hur, Won-Joo;Choi, Young-Min;Lee, Hyung-Sik;Kim, Jeung-Kee;Kim, Il-Han;Lee, Ho-Jun;Lee, Kyu-Chan;Kim, Jung-Soo;Chun, Mi-Son;Kim, Jin-Hee;Ahn, Yong-Chan;Kim, Sang-Gi;Kim, Bo-Kyung
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.79-92
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    • 2007
  • [ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.