• Journal of Gastric Cancer
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• v.23 no.3
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• pp.400-409
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• 2023

Artificial intelligence (AI) has made significant progress in recent years, and many medical fields are attempting to introduce AI technology into clinical practice. Currently, much research is being conducted to evaluate that AI can be incorporated into surgical procedures to make them safer and more efficient, subsequently to obtain better outcomes for patients. In this paper, we review basic AI research regarding surgery and discuss the potential for implementing AI technology in gastric cancer surgery. At present, research and development is focused on AI technologies that assist the surgeon's understandings and judgment during surgery, such as anatomical navigation. AI systems are also being developed to recognize in which the surgical phase is ongoing. Such a surgical phase recognition systems is considered for effective storage of surgical videos and education, in the future, for use in systems to objectively evaluate the skill of surgeons. At this time, it is not considered practical to let AI make intraoperative decisions or move forceps automatically from an ethical standpoint, too. At present, AI research on surgery has various limitations, and it is desirable to develop practical systems that will truly benefit clinical practice in the future.

• Clinical Endoscopy
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• v.57 no.5
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• pp.683-687
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• 2024

Esophageal mucoepidermoid carcinoma (EMEC) is a special subtype of esophageal malignancy, accounting for less than 1% of all cases of primary esophageal carcinoma. Pathologically, it consists of a mixture of adenocarcinoma and squamous cell carcinoma with mucin-secreting cells. Special staining for mucicarmine helps to diagnose EMEC. We present a rare case of EMEC successfully treated via endoscopic submucosal dissection (ESD). A 63-year-old man was referred to our tertiary hospital. On esophagogastroduodenoscopy, a 6-mm-sized subtle reddish depressed lesion was identified in the mid-esophagus. Diagnostic ESD was performed with a high suspicion of carcinoma. Histopathologic findings were consistent with EMEC which was confined to the lamina propria without lymphatic invasion. We plan to do a careful follow-up without administering adjuvant chemotherapy or radiotherapy. Due to the small volume of the lesion, establishing a diagnosis was difficult through forceps biopsy alone. However, by using ESD, we could confirm and successfully treat a rare case of early-stage EMEC.

• Journal of Korean Physical Therapy Science
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• v.14 no.1_4
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• pp.11-23
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• 2007

This study was performed to evaluate the effects of low-intensity ultrasound application to the peripheral nerve injury animal model on enhancement of nerve regeneration and functional recovery. Using aseptic microsurgical techniques, the sciatic nerve of adult male Sprague-Dawley rats was crushed at the outside of right mid-thigh for 30 seconds with fine forceps. Beginning just after surgery, various continuous-wave ultrasound treatments with intensities of 0.2 W/$cm^2$, 0.5 W /$cm^2$ and 1.0 W /$cm^2$ operated at 1 MHz or sham treatment were applied to the opposite inside of the crush site for 1 minute every other day with a transducer moving speed of 2cm/sec. For evaluation of the progress of sciatic nerve regeneration, c-Fos expression in the lumbar spinal cord (L4-5) dorsal horn was investigated. c-fos expression was markedly increased at 1hour after sciatic nerve crush injury, then gradually decreased thereafter. The c-fos expressions were significantly decreased (p<0.05) in all the experimental groups in comparison with the control group until 3days post-crush, and the degrees of decrease were higher in 0.5 W/$cm^2$ and 1 W/$cm^2$ intensity ultrasound application groups. It is suggested that low-intensity ultrasound application to an animal model of sciatic crush injury may suppress pain transmission and promote nerve regeneration, and which may result in delayed progress of muscle atrophy and accelerated progress of muscle recovery and eventually may result in accelerated and improved foot function recovery.

• Journal of Korean Dental Science
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• v.6 no.2
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• pp.58-66
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• 2013

Purpose: The inferior alveolar nerve (IAN) can be damaged as a result of minor oral surgical procedure such as third molar extraction or implant placement. Repair of the injured IAN involves difficulty of access, and research studies are limited to elucidating the process of regeneration by surgical methods. This study sought to establish the rabbit animal model to apply polymeric membrane functionalized with nerve growth factor after a crush lesion for the evaluation of nerve regeneration using the electrophysiologic method. Materials and Methods: The IAN of 2 adult male New Zealand white rabbits (4 nerves) were exposed bilaterally, and crush injury rendered by jeweler's forceps was applied. Nerve conduction velocity was examined electrophysiologically using electromyography before, after, and 4 weeks after the crush injury. To evaluate the regeneration, the pattern of action potential of IAN was recorded, and the characteristics of neurons were histologically observed. Result: After the crush injury, afferent activity decreased in the injured group. Electromyography could not be recorded after four weeks because tissues surrounding the injured nerve collapsed. Decrease in the mean number of axons was observed in the injured part with membrane. Conclusion: Despite the limited result, the present animal model study may provide a possible way to research on the methods of enhancing the recovery of nerve injuries in clinical situations. For clinically widespread acceptance, however, it should gain more consecutive and scientific evidences.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.103-110
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• 1970

It is important to point out that the percental mortality rate of the multiple pregnancy is almost twice of the single pregnancy due mainly to their prematurity and the mothers of twins will also be suffered from the plural births to nurse and take care of them. We therefore studied the incidence, the sex ratio, the types of deliveries, the complications and the percental mortality rate of the twin deliveries in order to promote the development of our field of maternal and child nursing. We selected our materials from the 112 patients who had been admitted and delivered twins in the department of OB. & Gyn. of the S.N.U. Hospital from Jan. 1962 to Dec. 1969. The abstructed results of this study were as follows. 1. The incidence of twins among 7, 731 births was 1:69 2. The occurrence of twins from elder multigravida was 4 to 6 times higher than younger primigravida mothers under 35 years of age. 3. The generational length of 45.5% of all twins was under 38 weeks and the mean birth weight of 1st and 2nd twins were 2, 354.7gm and 2, 215.8gm respectively. 4. The sex ratio of twins was 99 males and 124 females. 5. Presentation of twins: 59 cases (52.69%) were in both vertex. 37 cases (33.03%) in vertex plus breech. 15 cases (13.39%) in both breech and one case (0.89%) in transverse presentation. 6. For the types of deliveries Spontaneous deliveries were in 90 babies (40.6%) Breech extraction in 60 babies (26.3%) Vacuum used in 33 babies (15.0%) Cesarean section in 33 babies (9.8%) Forceps in 9 babies (4.2%) and others such as version and destructive measures in 9 babies (4.1%) 7. Intervals between the 1st and 2nd delivery were analyzed and 93% of 2nd twins were delivered within minutes after 1st delivery. 8. The main complications of twin deliveries were totemic (45.5%), second was postmarital hemorrhage (19.6%) and third was hydrations (7.1%) 9. The mean percental mortality of 1st and 2nd twins was 12.52% and 16.96% respectively of which main cause of death were their prematurity.

• Tuberculosis and Respiratory Diseases
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• v.77 no.4
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• pp.193-196
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• 2014

Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

• Clinical and Experimental Pediatrics
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• v.45 no.6
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• pp.800-803
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• 2002

A two year old male child complained of foreign body sensations bilaterally, and an itching sensation at both upper and lower eyelids for 2 months of duration. He was diagnosed with Phthiriasis palpebrarum after observation of adult louse and nits on slit-lamp examination. The treatment was accomplished by mechanical removal of the lices and nits by forceps and scissors, and then irrigation with 20% fluorescein was done under general anesthesia. Antibiotic eyedrops and ointment were applied to both eyes. The morphologic evaluation was performed with light microscopy and scanning electron microscopy. The follow-up interval was every weeks for one month and no louse or nit was found under slit-lamp examination. So we concluded that the Phthiriasis palpebrarum was eradiated completely. We report a case of Phthriasis palpebrarum had been review of the literatures.

• Journal of Veterinary Clinics
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• v.28 no.1
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• pp.149-153
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• 2011

In this report, laparoscopic ovariohysterectomy (LOHE) was performed on two, healthy, intact female dogs. Three ports, umbilical port for placing the laparoscope and the left and right paramedian instrument ports were placed into the abdominal cavity. First, in order to isolate the right ovary, the vascular pedicle was coagulated by activating the universal bipolar forceps. Then, the pedicle and suspensory ligament were transected by the bipolar electrocauterization scissors. In the same manner, the left ovary was isolated. The uterine body and the uterine arteries were coagulated bilaterally and transected just rostral to the cervix. The isolated ovaries and uterus were exteriorized through the left paramedian instrument port, which was extended by approximately 1 cm to allow for tissue removal. The skin and subcutaneous tissue were closed in a routine manner. Surgical times for LOHE in two dogs were 35, 40 min respectively. Total length of abdominal incision was shorter than 3 cm in two dogs. No clinical complications related to the LOHE were observed during 1.5 years after surgery. The LOHE is an alternative surgical technique that deserves further investigation.

• Journal of Periodontal and Implant Science
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• v.41 no.5
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• pp.253-258
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• 2011

Purpose: Immediate implantation presents challenges regarding site healing, osseointegration, and obtaining complete soft-tissue coverage of the extraction socket, especially in the posterior area. This last issue is addressed herein using the double-membrane (collagen membrane+high-density polytetrafluoroethylene [dPTFE] membrane) technique in two clinical cases of posterior immediate implant placement. Methods: An implant was placed immediately after atraumatically extracting the maxillary posterior tooth. The gap between the coronal portion of the fixture and the adjacent bony walls was filled with allograft material. In addition, a collagen membrane (lower) and dPTFE membrane (upper) were placed in a layer-by-layer manner to enable the closure of the extraction socket without a primary flap closure, thus facilitating the preservation of keratinized mucosa. The upper dPTFE membrane was left exposed for 4 weeks, after which the membrane was gently removed using forceps without flap elevation. Results: There was considerable plaque deposition on the outer surface of the dPTFE membrane but not on the inner surface. Moreover, scanning electron microscopy of the removed membrane revealed only a small amount of bacteria on the inner surface of the membrane. The peri-implant tissue was favorable both clinically and radiographically after a conventional dental-implant healing period. Conclusions: Secondary closure of the extraction socket and immediate guided bone regeneration using the double-membrane technique may produce a good clinical outcome after immediate placement of a dental implant in the posterior area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.3
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• pp.119-123
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• 2015

Objectives: Dentin is composed of many minerals and growth factors. Based on this composition, we studied its effect as a possible regenerative material for alveolar healing. Materials and Methods: This study was conducted using four 2.5-year-old mongrel dogs (male; weight, 25 to 30 kg). The third mandibular premolars were carefully mobilized with a dental elevator and then removed using forceps. The crown portions of the extracted teeth were removed with cutters, and the root portions of the remaining teeth were collectively trimmed as closely as possible to 350 to $500{\mu}m$. Dentin and cementum (DC) chips harvested from the extracted teeth were soaked in blood and packed into the fresh sockets (autograft). Biopsies were performed at the ends of day 14 and day 56 following implantation. Data were expressed as $mean{\pm}standard$ deviation and compared with t-test results. Results: The ratio of $S_A$(bone) to total area of each probe was determined and was $170{\pm}16{\mu}m^2$ for the control group and $71{\pm}14{\mu}m^2$ for the DC group, a significant difference (P <0.05). Conclusion: DC particulate grafts offered no improvement in bone regeneration in alveolar extraction sockets.