• 제목/요약/키워드: Endoscope

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Endoscopic Third Ventriculostomy for Adult Aqueduct Stenosis : Double Fenestration - A Case Report and Technical Note - (성인 수도관 폐쇄증에 대한 내시경적 제3뇌실 누공술 : 이중개창술 - 증례보고 및 수술수기 -)

  • Shim, Yong-Jin;Ha, Ho-Gyun;Jung, Ho;Kim, Yong-Seog;Park, Moon-Sun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1019-1023
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    • 2000
  • Objective : Endoscopic third ventriculostomy is gaining popularity as a minimally invasive surgical option for certain types of hydrocephalus as an alternative to shunting. The authors have tried to fenestrate down to the subdural space passing through the prepontine cistern to lessen or avoid the chance of redoing due to healing. Materials and Method : A 48-year-old male patient with several years of intractable headache was presented. Magnetic Resonance Image(MRI) of the brain revealed marked ventricular dilatation with stenotic cerebral aqueduct. A 2.3mm flexible steerable endoscope($Neuroview^{(R)}$) was introduced via precoronal route and accessed to the third ventricular floor. Using 3-French Fogarty balloon catheter, thin third ventricular floor and the arachnoid membrane of the prepontine cistern were fenestrated, so called "double fenestration". To confirm the fenestration, subdural compa-rtment of the left abducens nerve was identified during the procedure. Forceful pulsating flow through the orifice convinced the patency of the opening. Results : The patient was discharged on the third postoperative day without any postoperative complications. The postoperative follow-up MRI of the brain, at second and sixth months, clearly demonstrated the flow void through the third ventricular floor. Conclusions : Endoscopic third ventriculostomy was successfully performed on an adult hydrocephalus patient with aqueduct stenosis. The third ventricular floor and arachnoid membrane of the prepontine cistern were fenestrated to achieve double fenestration to minimize the chance for failure. The details of this procedure and results are described.

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Disc and underwriting - A proposal of life underwriter in terms of insurance benefits - (디스크질환과 언더라이팅 -보장급부를 중심으로 고찰한 생명보험 언더라이터의 제안-)

  • Byun, Hye-Jin
    • The Journal of the Korean life insurance medical association
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    • v.27 no.2
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    • pp.96-106
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    • 2008
  • Herniate disc disease is one of the biggest problem in claim of insurance as well as in medical. Herniate disc disease have recently increased, and it is ranked 8th in claim reasons recently. As an underwriter and physical therapist, I want to study interrelationship of insurance and disc disease. I think it is necessary to know about knowledge of medical, so this study is given some space to structure of spine, cause of herniated disc disease, role of disc, methods of classification of disable (McBride method and AMA method), and spine disability stage. disc surgery is divided laparoscope disc surgery and spine surgery. I analysis it some factors- gender, age, occupation, re-surgery, and state of after surgery - through searching medical papers. I suggest below conclusion to underwriter because it can be useful to make questionnaire, and underwriter can expect prognosis. conclusion The negative factors of disc surgery (compare to other cases) were as follows: 1. endoscope disc surgery: $20{\sim}40year$ old man, hospitalization period more than 5 days. 2. spine surgery: $45{\sim}70year$ old woman, hospitalization period more than 15 days. 3. re-surgery experience: exist 4. working condition: a person who draws a small income, non-regular worker, working period is less than 1 year. 5. method of surgery: pedicle screw fixation. spine fusion surgery, artificial disc surgery. 6. post surgery condition: appearance of muscle weakness, paralysis, reference pain, lordosis, kyphosis, and complication. smoker or take a drink.

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Endoscopic Fluorescence Angiography with Indocyanine Green : A Preclinical Study in the Swine

  • Cho, Won-Sang;Kim, Jeong Eun;Kim, Sae Hoon;Kim, Hee Chan;Kang, Uk;Lee, Dae-Sic
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.513-517
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    • 2015
  • Objective : Microscopic indocyanine green (ICG) angiography is useful for identifying the completeness of aneurysm clipping and the preservation of parent arteries and small perforators. Neuroendoscopy is helpful for visualizing structures beyond the straight line of the microscopic view. We evaluated our prototype of endoscopic ICG fluorescence angiography in swine, which we developed in order to combine the merits of microscopic ICG angiography and endoscopy. Methods : Our endoscopic ICG system consists of a camera, a light source, a display and software. This system can simultaneously display real-time visible and near infrared fluorescence imaging on the same monitor. A commercially available endoscope was used, which was 4 mm in diameter and had an angle of $30^{\circ}$. A male crossbred swine was used. Results : Under general anesthesia, a small craniotomy was performed and the brain surface of the swine was exposed. ICG was injected via the ear vein with a bolus dose of 0.3 mg/kg. Visible and ICG fluorescence images of cortical vessels were simultaneously observed on the display monitor at high resolution. The real-time merging of the visible and fluorescent images corresponded well. Conclusion : Simultaneous visible color and ICG fluorescent imaging of the cortical vessels in the swine brain was satisfactory. Technical improvement and clinical implication are expected.

Diagnosis and Treatment of Bronchial Foreign Body by Ventilating Bronchoscopy (환기형 기관지경술을 이용한 기도내 이물의 진단과 치료)

  • Kim, Beom-Gyu;Kang, Jin-Wook;Kim, Young-Jae;Nam, Soon-Yuhl
    • Korean Journal of Bronchoesophagology
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    • v.8 no.2
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    • pp.36-42
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    • 2002
  • Aspirated and ingested foreign bodies continue to present challenges to otolaryngologists. The major discussions were the accurate diagnosis and speedy, safe removal of foreign body. Many diagnostic tools have been tried and removal of foreign bodies has been facilitated by technical improvements with rod lens telescope, video endoscope, flexible fiberoendoscope and safer anesthesia. In spite of these advances, more than 3000 children's death occur per year in the world because of foreign bodies and untold number of parients survive with variable sequelae. In these study, 59 consecutive cases of children and adults with tracheobronchial foreign bodies were reviewed from 1992 to 2001. We studied the history, symptoms, ausculatory radiologic, bronchoscopic finding and post operative complications. 71% (42 cases in 59 cases) of patients had foreign body aspiration history or choking crisis. In 64% (38cases) cough was observed. 81% (48cases) had abnormal finding in chest auscultation and 78% in chest X-ray. Computed tomography was done in 12 cases, all were founded foreign body shadow. Main site of foreign body was right main bronchus (41%, 24cases) and most frequent foreign body was peanut (36% , 21cases) . 4 experienced ICU(intensive care unit) care. 2 cases were failed to remove foreign. In these cases 1 cases was improved by steroid therapy and physical therapy and the other was treated with thoracotomy. We concluded the morbidity and motality were much correlated with speedy decision making and experienced skill of operator.

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Factors Associated with Removal of Impactted Fishbone in Children, Suspected Ingestion

  • Lim, Chun Woo;Park, Min Hwan;Do, Hyun Jeong;Yeom, Jung-Sook;Park, Ji Sook;Park, Eun Sil;Seo, Ji Hyun;Park, Jung Je;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.168-174
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    • 2016
  • Purpose: The management and clinical course in pediatric patients who had ingested foreign body were investigated retrospectively to evaluate the frequency and factor associated with successful removal of fishbone foreign body. Methods: Based on the medical records of patients younger than 15 years old who visited emergency room because of foreign body ingestion from January 1999 to December 2012, the authors reviewed clinical characteristics including type of ingested foreign bodies, time to visits, managements and complications. Results: Fishbone (50.1%) was the most common ingested foreign body in children. Among 416 patients with ingested fishbone, 245 (58.9%) were identified and removed using laryngoscope, rigid or flexible endoscope from pharynx or upper esophagus by otolaryngologists and pediatric gastroenterologists. The kind of ingested fish bone in children was diverse. The mean age of identified and removed fishbone group was 7.39 years old, and higher than that of unidentified fishbone group (5.81 years old, p<0.001). Identified and removed fishbone group had shorter time until hospital visit than the unidentified fishbone group (2.03 vs. 6.47 hours, p<0.001). No complication due to ingested fishbone or procedure occurred. Conclusion: Older age and shorter time from accident to hospital visit were the different factors between success and failure on removal of ingested fish bone in children.

Two Cases of Stomach Cancer in Patients with Head and Neck Cancer (두경부암 환자에 병발된 위암 2예)

  • Kang Jin-Hyoung;Moon Chan-Soo;Kim Hoon-Kyo;Lee Kyung-Shik;Kim Dong-Jip;Yoon Sei-Chul;Cho Seung-Ho;Suh Byung-Do
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.1
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    • pp.25-30
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    • 1992
  • The causes of treatment failure in head and neck cancer are locoregional recurrence, distant metastasis and second primary cancer. The favorite sites of second primary cancer are head and neck, lung and esophagus. But, the incidence of stomach cancer in Korea is the highest of all, high incidence of stomach cancer is expected in head and neck cancer patients. We experienced 2 cases of stomach cancer after successful treatment of primary head and neck cancer at Kang Nam St. Mary's hospital. The first case was a 60-year-old male with nasopharyngeal non-keratinizing carcinoma(stage III, T1N1M0). He received three cycles of induction chemotherapy including cisplatin and 5-fluorouracil followed by radiotherapy which resulted in complete response. Five months after completion of radiotherapy. stomach adenocarcinoma(stage IV, T4N2M1) was diagnosed. He received one cycle of FAM chemotherapy and died 4 months after diagnosis of stomach cancer. The second case was a 50-year-old male with pyriform sinus squamous cell carcinoma(stage II, T2N0M0). He received curative partial pharyngolaryngectomy followed by radiotherapy which result in free of disease. Four months after completion of radiotherapy. stomach adenocarcinoma(stage IV, T4N2M1) was diagnosed. Bypass gastrojejunostomy was performed. The screening test for stomach cancer including upper gastrointestinal X-xay series and/or endoscope of the stomach should be performed periodically for the patients with head and neck cancer in Korea.

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Removal of discoloration materials by water mains cleaning on water distribution pipes (관 세척에 따른 색도성 물질의 제거 효과)

  • Lee, Ho-Min;Choi, Tae-Ho;Yun, Hyun-Woo;Kim, Dong-Hong;Bae, Cheol-Ho
    • Journal of Korean Society of Water and Wastewater
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    • v.34 no.4
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    • pp.267-276
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    • 2020
  • In this study, air scouring cleaning was selected and applied among 5 small blocks (S1~S5) in domestic S cities to analyze the cleaning effect of particles causing discoloration. In order to identify the cleaning effect, 10 locations were selected as water quality investigation point, such as the stagnant or water mains ends. Removal of solids, variation of particle components, weight and concentration were analyzed. And the level of the cleanness of the surface inside water mains using endoscope was investigated. As a result of analysis, the solids discharged after cleaning were mainly sand and gravel, pieces related to pipe materials, and corrosion products. As a result of analyzing the concentrated particles of the filter before and after cleaning, it was found that the change in discoloration on the filter was large. In addition, as a result of comparing the weight and the concentration of the particles, it was found that the particles causing discoloration were significantly removed after cleaning. From the results of the endoscopy, it was confirmed that most of the precipitated and accumulated dark yellow discoloration matters inside water mains were removed through cleaning. Therefore, it seems that the particles causing discoloration in water decreased after cleaning. Therefore, it is expected that, if properly cleaning was applied, matters that cause discoloration can be removed from the water mains, and customer's complaints can also be reduced through water quality improvement.

A classificatory study about the tendency of the patient who visited oriental medical hospital for growth treatment (한방병원에 내원하는 성장 환자의 유형 분류)

  • Han, Kyoung-Hoon;Park, Eun-Jung;Lee, Hai-Ja
    • The Journal of Pediatrics of Korean Medicine
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    • v.20 no.3
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    • pp.161-169
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    • 2006
  • Objectives : Patients who visit oriental medical hospital for growth treatment are increasing. So we aimed to classify the tendency of the patients. Methods : We studied 231 patients who visited Oriental medical hospital for growth treatment from January 2004 to August 2005. We classified sex ratio, height percentile, symptom form of the Oriental medicine, age ratio and developed complication of patients. We used X-ray, endoscope for nasal cavity, blood sample, the Standard Growth Table made by the Korean Association of Pediatrics, 1998. Results : The results which were classified as follows; boys were 50.2 percentile, girls were 49.8 percentile. The classification according to age stage resulted as follows; infant stage 1.3 percentile, preschool age 13.4%, school age 28.6%, rapid growth stage 22.9 percentile, puberty 33.8 percentile. The classification according to height percentile resulted as follows; 3 percentile or under 12.1%, 25 percentile or under 48.9%, 50 percentile or under 25.6%, 75 percentile or under 10.8%, 75 percentile excess 2.6%. The classification according to disease resulted as follows; paranasal sinusitis 12.1 percentile, allergic rhinitis 10 percentile, atopic dermatitis 5.6 percentile, nocturia 3 percentile, convulsion or tic disorder 2.2 percentile, precocious puberty 1.3 percentile, Tuner syndrome 0.9 percentile, developmental disability 0.4 percentile. Conclusions : Sex ratio of children patients who visited Orienatal medical hospital were nearly the same. 13.4% of hospital visit children patients were taller than average. Most of the male children patients were school ages while the female were in puberty. 35.5% of them have developed complication as follows; paranasal sinusitis, allergic rhinitis, atopic dermatitis, nocturia, convulsion or tic disorder, precocious puberty, Tuner syndrome and developmental disability.

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Clinical Evaluation of Mandibular Condyle Fractures (하악 과두 골절 환자의 임상분석)

  • Lim, Hyoung-Sup;Kim, Su-Gwan;Oh, Ji-Su;Jeong, Mi-Ae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.1
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    • pp.53-57
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    • 2012
  • Purpose: This study considered the effects and proper treatments of mandibular condyle fractures by comparing clinical differences and complications according to analysis and treatment plan. Methods: From September 2007 to August 2010, patients who were diagnosed with condylar fracture and monitored for more than 3 months were selected. Cases were divided in a reductive manner and evaluated by type and period of intermaxillary fixation (IMF), status of occlusion and trismus according to the Spiessle/Schroll method. A total 50 patients were examined. Results: The number of the unilateral condyle fractures was 45 and 30 patients had multiple fractures. Type of fracture was categorized by the Spiessle/Schroll method. There were 21 patients with type I, 11 patients with type II, 3 patients with type 3, 10 patients with type V and 5 patients with type VI; there were no patients with a type IV fracture. 11 patients were operated on with open reduction. Among them, 9 patients were type II and 2 patients were type I. For type I patients, an intra-oral approach was conducted with an endoscope and trocar. For 3 of the type II patients, an retromandibular approach was conducted and for the rest of the type II patients, the same approach as type I was used. The periods of IMF were 2.36 weeks (mean) in open reduction group and 2.9 weeks (mean) in closed reduction group and the total mean period is 2.78 weeks. All patients had stable occlusion after removing the IMF. Trismus occurred in 1 patient for open reduction and 5 patients for closed reduction. Facial nerve palsy was observed in one patient postoperatively that resolved after 6 months. Conclusion: In this study, similar prognosis was shown after an open and closed reduction was conducted. Therefore, treatments need to be planned depending on the degree of condyle fracture and the amount of displacement. Additionally, the period of IMF could be shortened with open reduction.

Iatrogenic Intradural Lumbosacral Cyst Following Epiduroscopy

  • Ryu, Kyeong-Sik;Rathi, Nitesh Kumar;Kim, Geol;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.52 no.5
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    • pp.491-494
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    • 2012
  • We report a rare complication of iatrogenic spinal intradural following minimally invasive extradural endoscopic procedues in the lumbo-sacral spines. To our knowledge, intradural cyst following epiduroscopy has not been reported in the literature. A 65-year-old woman with back pain related with previous lumbar disc surgery underwent endoscopic epidural neuroplasty and nerve block, but her back pain much aggravated after this procedure. Postoperative magnetic resonance imaging revealed a large intradural cyst from S1-2 to L2-3 displacing the nerve roots anteriorly. On T1 and T2-weighted image, the signal within the cyst had the same intensity as cerebrospinal fluid. The patient underwent partial laminectomy of L5 and intradural exploration, and fenestration of the cystic wall was accomplished. During operation, the communication between the cyst and subarachnoid space was not identified, and the content of the cyst was the same as that of cerebrospinal fluid. Postoperatively, the pain attenuated immediately. Incidental durotomy which occurred during advancing the endoscope through epidural space may be the cause of formation of the intradural cyst. Intrdural cyst should be considered, if a patient complains of new symptoms such as aggravation of back pain after epiduroscopy. Surgical treatment, simple fenestration of the cyst may lead to improved outcome. All the procedures using epiduroscopy should be performed with caution.