• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.512-526
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• 2021

Peripheral arterial disease is an occlusive condition commonly involving the lower extremity vessels. When the aortoiliac region is affected by this disease, conventional management involves surgical bypass and endovascular treatment has been mainly recommended for patients with focal and simple lesions. It has been common strategy to perform endovascular treatment for selected patients with high surgical risk due to its minimally invasive nature. However, recent advances in the devices and techniques for endovascular treatment have resulted in its utilization for treating patients with various disease status and its clinical outcomes are comparable to those of conventional surgery. This review discusses the current diagnostic strategies for peripheral artery disease in the aortoiliac region, followed by the introduction of techniques and devices, and the role of endovascular treatment.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.733-738
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• 2005

Background: The possibility of incomplete revascularization and development of flow competition after revascularization of the borderline lesion made the hybrid strategy as an option for complete revascularization. Material and Method: From January f998 to July 2004, 25 $(3.2\%)$ patients underwent hybrid revascularization among 782 total OPCAB procedures. Clinical results and angiographic patencies were evalulated. Percutaneous coronary intervention (PCI) was peformed before CABG in 8 patients and after CABG in 47 patients. Result: The causes of PCIs before CABG were to achieve complete revascularization with minimally invasive surgery (n=7) and emergent PCI for culprit lesion (n=1). The indications of PCIs after CABG were high possibility of flow competition in the borderline lesion of right coronary artery territory (n=8), diffuse atheromatous lesion preventing anastomosis of graft (n=5), severe calcified ascending aorta with no more arterial grafi available (n=3), and intramyocardial coronary lesion (n=1). Mean number of distal anastomoses was $2.3\pm1.0$. Mean number of lesions treated by PCI was $1.2\pm0.4$. There was no operative or procedure-related mortality. PCI-related complication was periprocedural myocardial infarction in one patient, and complications related to CABG were transient atrial fibrillation (n=5), perioperative myocardial infarction (n=1), and transient renal dysfunction (n=1). Early postoperative coronary angiography $(1.8{pm}1.6days)$ revealed $100\%$ patency rate of grafts (57/57). The stenosis occurred in one patient performed PCI before CABG, which was successfully treated with re-ballooning. During midterm follow-up (mean; $25{\pm}26$ months), 1 patient died of congestive heart failure. All survivors (n=24) accomplished follow-up coronary angiographics, which showed .all grafts (56/57) were patent except one string sign. In-stent restenosis was developed in 2 patients who received bare metal stents. Conclusion: In selected patients, complete revascularization was achieved with low risk by taking the hybrid strategy.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.80-85
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• 2008

Purpose: To evaluate and compare the outcome between interlocking IM nailing and LCP fixation in the treatment of distal metaphyseal tibial fracture. Materials and Methods: From January 2000 to December 2007, 17 patient were treated by interlocking IM nail and 13 patient were treated by LCP fixation for distal metaphyseal tibial fracture. Results: According to AO classification, there were 2 type A1 fracture (12%), 6 type A2 fracture (36%), 3 type A3 fracture (18%), 4 type B1 fracture (24%), 1 type B3 fracture (6%), 1 type C1 fracture (6%) in interlocking IM nailing group and 1 type A2 fracture (7.7%), 2 type A3 fracture (15.4%), 3 type B1 fracture (23%), 3 type B2 fracture (23%), 3 type C1 fracture (23%), 1 type C2 fracture (7.7%) in LCP fixation group. The clinical functional outcome (according to AOFAS score) is 75.6 point in IM nailing group and 81.5 point in LCP fixation group. In IM nailing group, 65% of patient showed satisfactory result and In LCP fixation group, 77% of patient showed satisfactory result. Conclusion: There is no difference on clinical results between IM nailing and MIPPO (minimal invasive percutaneous plate osteosynthesis) group in the treatment of distal tibia fracture. But MIPPO group have higher subjective satisfactory score and less complication rate. The weakness of our study is a small case number and limited follow-up and we believe a better designed prospective study will be needed.

• Journal of Korean Foot and Ankle Society
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• v.24 no.1
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• pp.19-24
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• 2020

Purpose: Anterolateral minimally invasive plate osteosynthesis (MIPO) was performed to treat patients with distal tibial fractures associated with open fractures or extensive soft tissue injuries, which is limited medial MIPO. The treatment results of the anterolateral MIPO technique were evaluated and analyzed. Materials and Methods: Seventeen patients with distal tibial fractures associated with an open fracture or large bullae formation on the distal tibia medial side were treated with anterolateral MIPO using anterolateral locking plates. Within 24 hours of visiting the emergency room, external fixation was applied, and the medial side wound was managed. After damage control, the anterolateral locking plate was applied using an anterolateral MIPO technique. The union time, nonunion, or malunion were evaluated with regular postoperative radiographs. The ankle range of motion, operative time, blood loss, Iowa score, and wound complications were investigated. Results: Radiological evidence of bony union was obtained in all cases. The mean time to union was 16.7 weeks (12~25 weeks). The mean operation time was 44.0 minutes. Regarding the ankle range of motion, the mean dorsiflexion was 15°, and the mean plantarflexion was 35°. Satisfactory results were obtained in 15 out of 17 cases; five results were classified as excellent, four were good, and six were fair. The mean blood loss was 125.2 mL. Two complications were recorded. Conclusion: In distal tibial fractures with severe medial soft tissue damage caused by high-energy trauma, the staged anterolateral MIPO technique using anterolateral locking plates is a useful alternative treatment to achieving optimal wound care, rapid union with biological fixation, and intra-articular reduction.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.66-72
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• 2010

Purpose: To evaluate the clinical efficacy of the minimally invasive posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2006 to October 2008, we studied retrospectively 45 patients, 56 cases who were treated with minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and AOFAS score, circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 1 was 81, type 2 was 75, type 3 was 69, type 4 was 61. By AOFAS score, Sanders type 1 was 88, type 2 was 82, type 3 was 78, type 4 was 63. And by circle draw test, type 1 was 8.8 cm, type 2 was 8.5 cm, type 3 was 8 cm, type 4 was 6.6 cm. Preoperative Bohler angle and Gissane angle were $7.2^{\circ}$, $98^{\circ}$, and it increased to $21.2^{\circ}$, $116^{\circ}$ after postoperative 1 year. Conclusion: Minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture was considered to be an effective treatment modality.

• Journal of Korean Foot and Ankle Society
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• v.23 no.3
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• pp.116-120
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• 2019

Purpose: This study evaluated the clinical and radiological results of 6.5 mm full threaded cancellous bone screw fixation of calcaneal fractures. Materials and Methods: Thirty seven patients diagnosed with Sanders type II or III calcaneal fractures, who underwent open reduction and internal fixation with a 6.5 mm full threaded cancellous bone screw between August 2014 and August 2017, were analyzed. Both the preoperative and postoperative Böhler angle and Gissane angle were measured radiographically. American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale on the final follow-up were also assessed. Results: The mean age of the patients was 52.7 years and the mean follow-up period was 29.5 months. In the Sanders classification, type II and III were 16 and 24 cases, respectively. The Böhler and Gissane angles improved from 21.2° and 122.6° preoperatively to 21.6° and 120.3°, respectively, in the postoperative radiographs. All cases achieved bony union, and the AOFAS ankle-hindfoot scale was 90.7 and 91.3 in Sanders type II and III, respectively, at the final follow-up. Conclusion: The treatment of calcaneal fractures using a 6.5 mm full threaded cancellous bone screw can reduce the complications with minimally invasive surgery and achieve firm fixation.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.247-253
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• 2001

Objective : In general, to perform posterior lumbar interbody fusion(PLIF), it has been used more invasive procedure than simple discectomy. However we try to perform PLIF with TFC with smaller invasion almost same as in simple discectomy. This study is about its procedure and clinical results. Materials and Methods : The authors retrospectively analyzed 43 cases of minimally invasive PLIF with TFC from July 1998 to May 2000. Operative procedure, operative complication, change of disc height, blood loss, ambulation time, hospitalization period, clinical success rate, and bony fusion rate were analyzed. Results : 40 patients were capable to walk on the 2nd day of the post-operation. The average hospitalization period is 5.6 days. The average blood loss was 0.19L/level with no transfusion or wound drainage. The height of disc changed from 8.84mm to 13.54mm. Clinical success rate is 95% when evaluated by the Prolo's scale. The complication was delayed wound infection(2) and transient paresthesis(1). The bony fusion was shown in 17 patients (94.4%) out of 18 patients who passed one year. Conclusion : As a result of minimally invasive PLIF, pain was decreased and early ambulation and short hospitalization was possible. Complication was similar or lower than other studies, and the bony fusion rate and clinical success rate were also similar during follow-up.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.21 no.1
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• pp.4-22
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• 2012

치경부에 발생된 병소 부위(cervical lesion)는 "우식성 병소(caries lesion)"와 "비우식성 병소(non-caries lesion)"로 분류할 수 있다. 우식성 병소는 구강 내 세균들의 활동에 기인하여 발생된 병소로서 경조직 손상 부위의 수복과 함께 우식이 재발하지 않도록 체계적으로 대응하는 것이 필요하다. 비우식성 병소는 산성 물질, 저작력 및 이물질에 의한 마모 작용과 같은 다양한 원인에 의해 발생될 수 있으며, 수복 치료에 앞서 병소에 발생 원인을 규명하는 것이 중요하다. 먼저 병소 유발 원인에 대한 분석과 이에 대한 적절한 조치를 취한 후에 수복 치료를 시행하는 것이 바람직하다. 심미적인 요구가 높은 치경부 병소의 수복을 위하여 사용될 수 있는 재료는 "불소를 방출하는 재료"와 "불소를 방출하지 않는 재료"로 나뉘어지는데, 세균의 활동에 의해 형성된 우식성 병소의 수복에는 불소를 방출하는 재료를 사용하는 것이 추천된다. 우수한 심미성과 보다 강력한 유지력이 요구되는 경우에는 복합 레진계 수복 재료들을 사용하여 수복하게 되는데, 이 경우에는 "접착 술식(bonding procedure)"이 중요한 역할을 수행하게 된다. "접착 술식"은 수복물의 일차적인 유지 뿐 아니라 지각과민을 해소하고 2차 우식을 방지하며, 궁극적으로 수복물의 수명을 좌우하는 결정적인 역할을 수행한다. 자연 치아를 최대한 보존하고자 하는 "최소침습(minimum intervention)" 개념에 바탕을 두고 세심하게 형성된 와동에 각각의 증례에 최적화된 수복 재료를 선택하여 수복치료를 시행한다면 보다 심미적이고 환자가 편안한 치경부 수복물을 완성할 수 있을 것이다.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.931-933
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• 2006

Robotic assisted surgery in adult patient with congenital ventricular septal defect Since December in 2005, we have done minimally invasive surgeries in selected cases of mitral valve diseases, tricuspid valve diseases, atrial septal defects and atrial fibrillations with the $AESOP^{TM}$ robotic arm. We have had a better surgical view and skill, according to accumulation of the experience of this procedure. Recently, we performed robotic assisted surgery in a 47-year-old female with congenital perimembranous ventricular septal defect.

• Journal of the Korean Society of Radiology
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• v.11 no.2
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• pp.139-144
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• 2017

Percutaneous vertebroplasty (PVP) is increasingly used to treat osteoporotic vertebral fractures, myeloma and osteolytic vertebral metastases. The purpose of this study was to measure the absorbed radiation exposure dose and time during PVP and to assess the possibility of deterministic radiation effects to the operator and patient. The radiation dose and time measure by three pain physicians performed consecutive procedures using the twenty case PVP. Patient's dosimeter placed at the anteroposterior(AP) side was treatment of the vertebra body located in the upper level 2-3 and lateral(LAT) side was flank proximal to C-arm tube of back. Operator's dosimeter placed at the apron outside of upper sternum (thyroid), left chest, lower extremity and apron inside of left chest. Results: Radiation exposure times were $3.6{\pm}0.71min$. Measurements on the Patient radiation dose were AP $121.4{\pm}48.1{\mu}Sv$, LAT side $614.7{\pm}177.1{\mu}Sv$. Operator radiation dose were outside of the lead apron upper sternum $33.7{\pm}7.3{\mu}Sv$, outside of the lead apron chest $49.2{\pm}15.0{\mu}Sv$, outside of the lead apron lower extremity $12.8{\pm}3.8{\mu}Sv$ and inside of the lead apron chest $4.2{\pm}1.4{\mu}Sv$. To escape from the danger of radiation first long distance from the c-arm tube second exposure time reduced second lead apron used fluoroscopy during PVP is more safety patient and operation from the radiation exposure.