• Journal of the Korean Society of Radiology
• /
• v.82 no.3
• /
• pp.527-540
• /
• 2021

Peripheral arterial occlusive disease (PAOD) of the femoropopliteal artery is commonly caused by atherosclerosis. It can present with varying clinical symptoms depending on the degree of disease, ranging from intermittent claudication to critical limb ischemia and tissue loss. Therefore, appropriate and timely treatment is required to improve symptoms and salvage the affected limbs. Interventional approaches for femoropopliteal arterial disease commonly include percutaneous transluminal angioplasty, atherectomy, and stent placement. Over the years, endovascular recanalization has been widely performed for treating PAOD due to continuous developments in its techniques and availability of dedicated devices with the inherent advantage of being minimal invasive. In this review, we introduce various types of endovascular treatment methods, discuss the results of clinical research from existing literature, and illustrate the treatment procedures using representative images.

• Journal of the Korean Society of Radiology
• /
• v.82 no.3
• /
• pp.670-681
• /
• 2021

Purpose This study aimed to investigate the optimal threshold value in Hounsfield units (HU) on CT to detect the solid components of pulmonary subsolid nodules using pathologic invasive foci as reference. Materials and Methods Thin-section non-enhanced chest CT scans of 25 patients with pathologically confirmed minimally invasive adenocarcinoma were retrospectively reviewed. On CT images, the solid portion was defined as the area with higher attenuation than various HU thresholds ranging from -600 to -100 HU in 50-HU intervals. The solid portion was measured as the largest diameter on axial images and as the maximum diameter on multiplanar reconstruction images. A linear mixed model was used to evaluate bias in each threshold by using the pathological size of invasive foci as reference. Results At a threshold of -400 HU, the biases were lowest between the largest/maximum diameter of the solid portion of subsolid nodule and the size of invasive foci of the pathological specimen, with 0.388 and -0.0176, respectively. They showed insignificant difference (p = 0.2682, p = 0.963, respectively) at a threshold of -400 HU. Conclusion For quantitative analysis, -400 HU may be the optimal threshold to define the solid portion of subsolid nodules as a surrogate marker of invasive foci.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.27 no.1
• /
• pp.18-23
• /
• 2018

With the increasing demand for esthetics and minimum intervention concept, people want to restore the fractured tooth with direct composite restoration. But even now, many dentists hesitate to do the direct resin restoration in the anterior region and shift the responsibility to dental technicians. This article describes each steps in restoring Class IV cavity. To obtain an esthetic result in anterior restoration, layering technique is mandatory and clinical tips suggested in this article would be useful.

• Journal of radiological science and technology
• /
• v.37 no.3
• /
• pp.203-209
• /
• 2014

Usefulness and clinical availability for surgery efficiency were evaluated by conducting pre-operative planning with a model manufactured by desktop 3D printer by using clavicle CT image. The patient-customized clavicle fracture model was manufactured by desktop 3D printer of FDM wire laminated processing method by converting the CT image into STL file in Open Source DICOM Viewer Osirix. Also, the model of the original shape before damaged was restored and manufactured by Mirror technique based on STL file of not fractured clavicle of the other side by using the symmetry feature of the human body. For the model, the position and size, degree of the fracture was equally printed out. Using the clavicle model directly manufactured with low cost and less time in Department of Radiology is considered to be useful because it can reduce secondary damage during surgery and increase surgery efficiency with Minimal invasive percutaneous plate osteosynthesis(MIPO).

• Journal of Chest Surgery
• /
• v.41 no.5
• /
• pp.568-572
• /
• 2008

Background: Minimally invasive surgery is currently popular, but this has been applied very sparingly to cardiac surgery because of some limitations. Our study evaluated the safety and efficacy of atrial septal defect (ASD) closure through a video-assisted mini-thoracotomy. Material and Method: Fifteen patients were analyzed. Their mean age was $31{\pm}6$ years. The mean ASD size was $24{\pm}5mm$ and there were 3 cases of significant tricuspid regurgitation. The working window was made through the right 4th intercostal space via a $4{\sim}5cm$ inframammary skin incision, CPB was conducted with performing peripheral cannulation. After cardioplegic arrest, the ASDs were closed with a patch (n=11) or direct sutures (n=4), and the procedures were assisted by using a thoracoscope. There were 3 cases of tricuspid repair and 1 case of mitral valve repair. The mean CPB time and aortic occlusion time were $160{\pm}47\;and\;70{\pm}26 $minutes, respectively. Result: There was no mortality, but there were 3 minor complications (one pneumothorax, one wound dehiscence and one arrhythmia). The mean hospital stay was $5.9{\pm}1.8$ days. The mean follow-up duration was $10.7{\pm}6.4$ months. The follow-up echocardiogram noted no residual ASD or significant tricuspid regurgitation. Three patients suffered from pain or numbness. Conclusion: This study showed satisfactory clinical and cosmetic results. Although the operative time is still too long, more experience and specialized equipment would make this technique a good option for treating ASD.

• Journal of Chest Surgery
• /
• v.33 no.11
• /
• pp.898-903
• /
• 2000

배경 및 목적: 최근 비디오 흉강경술은 최소 침습적인 수술 방법으로서 자연 기흉의 일반적 치료법으로 인정되고 있으나 비교적 높은 재발율과 비용-효용 관계에 대해서는 논란이 있다. 비디오 흉강경을 이용한 기포 절제술 후의 재발율은 평균 5-10%정도로 보고되고 있으며 이는 개흉술에 비해 상당히 높은 것이다. 또한 국내 의료 실정에서의 개흉술과 비디오 흉강경술의 비용효용에 대한 비교 통계는 없는 상황이다. 대상 및 방법: 1997년 1월부터 1999년 7월까지 일차성 자연기흉으로 성균관 의대 강북삼성병원 흉부외과에서 수술을 시행한 173예를 대상으로 후향적 조사하였다. 비디오 흉강경술로 시행한 104예와 개흉술로 시행한 69예를 양군으로 나누어 성별 및 연령, 발병부위, 수술의 적응증, 수술시간, 술 후 흉관 삽입기간 및 재원 일수, 술후 합병증, 재발율, 수술 경비 및 총치료경비 등을 비교하였다. 결과: 양군의 성별, 연령, 발병부위 등에는 차이가 없었다. 수술 시간은 흉강경군이 73.1$\pm$29.5분, 개흉군이 141$\pm$52분이었다.(p<0.05). 술 후 평균 흉관의 거치기간 및 재원일수는 흉강경군이 각각 3.93일 및 7.5일, 개흉군이 7.0일 및 13.4일이었다.(P<0.05, P<0.05). 술 후 재발한 경우가 비디오 흉강경군에서 6예(5.6%), 개흉군에서 1예(1.4%) 있었다(P<0.05). 본원에서 시행한 비디오 흉강경술과 개흉술의 비교에서 수술로 발생하는 비용은 비디오 흉강경군이 유의하게 높았으나 (1,202,192$\pm$178,992원, 1,005,669$\pm$311,531원; P<0.05) 총 치료비의 비교에서는 유의한 차이가 없었다.(1,946,110$\pm$487,440원, 1,793,912$\pm$308,079원; P=0.18). 결론: 비용 효용관계 및 재발율은 병원마다의 수술 수기 및 퇴원 정책등에 따라서 다소간의 차이가 있을 수 있으나 본원의 조사 결과에서는 비디오 흉강경술이 개흉술에 비해 비용-효과가 있다고 볼 수 없으며 재발율도 높았다.

• Journal of Chest Surgery
• /
• v.41 no.6
• /
• pp.772-776
• /
• 2008

The indications and applications of arthroscopic surgery for the knee joint have increased with the development in surgical techniques and the improvement of arthroscopic equipment. The use of arthroscopic surgery has led to a significant decrease in morbidity for the patient with intra-articular abnormalities, in terms of both the diagnosis and the surgical treatments. Even though arthroscopy is a minimally invasive technique with relatively low morbidity, it is not without risk of complications, of which neurovascular complications are among the most serious and devastating. Here we report on 2 cases of popliteal artery injury during arthroscopic knee surgery and its specific diagnosis and treatment.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.1
• /
• pp.102-107
• /
• 2009

In clinical pediatric dentistry, we have many chances to encounter the white spot like incipient enamel lesions on the mesial surfaces of the 1st molars with direct vision, especially just after the 2nd primary molars were exfoliated. But it was thought highly desirable to assess if these lesions are properly and effectively managed yet. This study aims at surveying the prevalence of incipient lesions on the mesial surfaces of the 1st molars in children through direct observation and examining the suitability of adhesive sealing on them as a pilot trial in searching for their proper management. 1. Among the 124 mesial surfaces of the 1st molars examined, 34% were sound, 53% had incipient carious lesions and 13% had cavitated lesions. 2. In the sectional views of the specimens, 20% showed microleakage after thermo-cycling and it was thought not recommendable as a permanent method. Therefore in order to effectively fight against the incipient caries lesions in children‘s permanent teeth, it was thought proper not to rely on any one method, but to perform reinforcing oral hygiene and promotion of remineralization in combination with therapeutic sealing which is stronger in short-term sealing effect. Although therapeutic sealing has been considered as the core in minimally invasive concept to treat the white spot lesions, its long-term clinical trials have not been suggested. Continuous research is strongly required for making this approach to acquire permanent nature, especially in regards of proper pretreatment and high molecular materials deeply penetrable into enamel.

• Clinical and Experimental Pediatrics
• /
• v.49 no.3
• /
• pp.268-272
• /
• 2006

Purpose : The reinfection rate of H. pylori reported before $^{13}C$-urea breath test($^{13}C$-UBT) era was higher than that of the post $^{13}C$-UBT era. Children are usually reluctant to receive invasive endoscopic evaluation for the reinfection of H. pylori, particularly when they are asymptomatic. The aim of the study is to discover the reinfection rate by different diagnostic tests, and to find out what causes the difference. Methods : Children confirmed to be eradicated from H. pylori were included in the study. Reinfection was evaluated by endoscopic biopsy based tests(n=34, mean age $11.5{\pm}3.7$ years) and/or a $^{13}C$-UBT(n=38, mean age $10.0{\pm}3.6$ years) at the time of 18 months after eradication. At first visit, H. pylori infection had been diagnosed by positive results from a rapid urease test, Giemsa stain and Warthin-Starry stain and/or a positive culture. Eradication was defined as negative results from all above tests 1-3 months after eradication therapy. Results : Reinfection rate by endoscopic biopsy based tests was 35.3 percent(12/34). All patients had abdominal symptoms(P=0.000). Reinfection rate was 13.2 percent(5/38) by a $^{13}C$-UBT. Reinfection rate was higher in children with abdominal symptoms(P=0.008). There was no evidence that reinfection rate depended on the sex(P=0.694), age(P=0.827), diseases(peptic ulcers vs gastritis, P=0.730) and eradication regimen(P=0.087). Conclusion : Helocibacter pylori reinfection rate in Korean children was 13.2 percent per 18 months by a non-invasive test or $^{13}C$-UBT. Accurate determinations of the reinfection rate in children is affected by the compliance of the diagnostic tests. Non-invasive tests should be considered to investigate the reinfection rate in children.

• Journal of Veterinary Clinics
• /
• v.28 no.5
• /
• pp.497-505
• /
• 2011

Natural orifice transluminal endoscopic surgery is a newly emerging technique recently, with its many potential advantages in clinical practice. Cholecystectomy by Hybrid NOTES in this work, performed with single working channel endoscope in conjunction with a laparoscopic grasping forceps in dogs, is a "bridge" between laparoscopic procedure and pure NOTES. Three different approaches for cholecystectomy were carried out; transgastric, transcolonic and transvaginal. In all three approaches, abdominal opening was made by a 5 mm trocar, followed by making pneumoperitoneum of 4 mmHg with $CO_2$ insufflator. Transgastric cholecystectomy, single working channel endoscope was advanced to the peritoneal cavity through gastric incision in antral region made by endoscopic needle knife. Endoscope was retroflexed to visualize the gall bladder. Transcolonic access, incision for endoscopic entry was done at right ventral wall of descending colon, 15 cm inside from the anus. Incision in transvaginal access was made at right-ventral region, just caudal to the caudal tubercle. With the simple traction by the laparoscopic grasping forceps, good visualization of surgical field was obtained in all three groups. Cystic duct and artery were ligated with endoclips; for complete gall bladder dissection from liver, L-knife was used. Closure of incision sites were done in transgastric and transcolonic cholecystectomy by endoclips, not in transvaginal approach.