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Role of Intraoperative Angiography in the Surgical Treatment of Cerebral Aneurysms (뇌동맥류의 수술 중 뇌혈관 조영술의 역할)

  • Sim, Jae Hong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.491-499
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    • 2000
  • Objective : In the cerebral aneurysm surgery, the goal is complete circulatory exclusion of the aneurysm without compromise of normal vessels. In an operating room, an operator should confirm the completeness and precision of the surgical result, before closing the wound. Object of this study was to determine which cases require intraoperative angiography. Methods : We reported our experience with 48 intraoperative angiographic studies performed during the surgical treatment of cerebral aneurysm of these 48 cases. There were 5 giant(10.4%), 15 globular(1.5-2.5cm)(31.25%) and 28 saccular(58.3%) aneurysm. We recorded the incidence of unexpected findings, such as residual aneurysms, major vessel occlusions. Using Fischer's exact test, we assessed whether unexpected angiographic findings showed any correlation with aneurysm site, size and clinical findings. Results : In 5 cases(10.4%), we detected unexpected angiographic findings which resulted in clip adjustment. By means of clip adjustment, an operator could restore the flow of two major arterial occlusion(4.2%) and also obliterate three persistent filling aneurysms(6.3%). Globular aneurysm was the only factor to predict unexpected angiographic findings(p<0.05). The subgroup of globular and giant aneurysm has a high risk of occlusion of the parent artery and its branches and/or residual aneurysm. There were two minor complications related to this procedure. Conclusion : Intraoperative assessment makes it possible to recognize and correct the technical defect. Particularly in globular aneurysm, we were able to prevent both the chance for another operation and the risk of postoperative complications.

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Applicability Evaluation of Quantitative Light-Induced Fluorescence-Digital and Cariview in Cries Prediction Study (Quantitative Light-Induced Fluorescence-Digital과 Cariview의 우식예측 연구에 대한 활용도 평가)

  • Lee, Su-Young;Lim, Soon-Ryun;Bae, Hyun-Sook
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.403-409
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    • 2013
  • The purpose of this study was to evaluate the correlation between caries experience, Quantitative Light-Induced Fluorescence-Digital (QLF-D) redings and new caries activity test (Cariview) results in preschool children. Fifty-seven healthy kindergarten children (male 28, female 29) were participated this study. The calibrated dentist investigated the caries experience of children and new caries activity test. Cariview samples were incubated in the activated medium at $37^{\circ}C$ for 48 hours. All QLF-D taking and readings were performed by one experienced and trained operator under identical conditions in a dental unit chair located in a darkened room. Analysis range was limited to the maxillary and mandibular anterior teeth. QLF-D redings (white spot and dental plaque) were analysed using QLF system. The dft index had a relatively high correlation with the QLF-D redings (white spot: r=0.617, simple plaque score: r=0.500) (p<0.01). Also, there was significant correlation between dft index and the Cariview score (r=0.286) (p<0.05). However, the Cariview score had no significant correlation between dt index and ft index (p>0.05). QLF-D can be evaluated objectively the initial caries lesions and dental plaque correlated with caries experience. Therefore, QLF-D will be useful to the study of caries prediction.

Angioembolization performed by trauma surgeons for trauma patients: is it feasible in Korea? A retrospective study

  • Soonseong Kwon;Kyounghwan Kim;Soon Tak Jeong;Joongsuck Kim;Kwanghee Yeo;Ohsang Kwon;Sung Jin Park;Jihun Gwak;Wu Seong Kang
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.28-36
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    • 2024
  • Purpose: Recent advancements in interventional radiology have made angioembolization an invaluable modality in trauma care. Angioembolization is typically performed by interventional radiologists. In this study, we aimed to investigate the safety and efficacy of emergency angioembolization performed by trauma surgeons. Methods: We identified trauma patients who underwent emergency angiography due to significant trauma-related hemorrhage between January 2020 and June 2023 at Jeju Regional Trauma Center. Until May 2022, two dedicated interventional radiologists performed emergency angiography at our center. However, since June 2022, a trauma surgeon with a background and experience in vascular surgery has performed emergency angiography for trauma-related bleeding. The indications for trauma surgeon-performed angiography included significant hemorrhage from liver injury, pelvic injury, splenic injury, or kidney injury. We assessed the angiography results according to the operator of the initial angiographic procedure. The term "failure of the first angioembolization" was defined as rebleeding from any cause, encompassing patients who underwent either re-embolization due to rebleeding or surgery due to rebleeding. Results: No significant differences were found between the interventional radiologists and the trauma surgeon in terms of re-embolization due to rebleeding, surgery due to rebleeding, or the overall failure rate of the first angioembolization. Mortality and morbidity rates were also similar between the two groups. In a multivariable logistic regression analysis evaluating failure after the first angioembolization, pelvic embolization emerged as the sole significant risk factor (adjusted odds ratio, 3.29; 95% confidence interval, 1.05-10.33; P=0.041). Trauma surgeon-performed angioembolization was not deemed a significant risk factor in the multivariable logistic regression model. Conclusions: Trauma surgeons, when equipped with the necessary endovascular skills and experience, can safely perform angioembolization. To further improve quality control, an enhanced training curriculum for trauma surgeons is warranted.