• Title/Summary/Keyword: Invasive procedures

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Alternative practices of achieving anaesthesia for dental procedures: a review

  • Angelo, Zavattini;Polyvios, Charalambous
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.2
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    • pp.79-88
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    • 2018
  • Managing pain and anxiety in patients has always been an essential part of dentistry. To prevent pain, dentists administer local anaesthesia (LA) via a needle injection. Unfortunately, anxiety and fear that arise prior to and/or during injection remains a barrier for many children and adults from receiving dental treatment. There is a constant search for techniques to alleviate the invasive and painful nature of the needle injection. In recent years, researchers have developed alternative methods which enable dental anaesthesia to be less invasive and more patient-friendly. The aim of this review is to highlight the procedures and devices available which may replace the conventional needle-administered local anaesthesia. The most known alternative methods in providing anaesthesia in dentistry are: topical anaesthesia, electronic dental anaesthesia, jet-injectors, iontophoresis, and computerized control local anaesthesia delivery systems. Even though these procedures are well accepted by patients to date, it is the authors' opinion that the effectiveness practicality of such techniques in general dentistry is not without limitations.

Percutaneous Procedures for Trigeminal Neuralgia

  • Chang, Kyung Won;Jung, Hyun Ho;Chang, Jin Woo
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.622-632
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    • 2022
  • Microvascular decompression is the gold standard for the treatment of trigeminal neuralgia (TN). However, percutaneous techniques still play a role in treating patients with TN and offer several important advantages and efficiency in obtaining immediate pain relief, which is also durable in a less invasive and safe manner. Patients' preference for a less invasive method can influence the procedure they will undergo. Neurovascular conflict is not always a prerequisite for patients with TN. In addition, recurrence and failure of the previous procedure can influence the decision to follow the treatment. Therefore, indications for percutaneous procedures for TN persist when patients experience idiopathic and episodic sharp shooting pain. In this review, we provide an overview of percutaneous procedures for TN and its outcome and complication.

The Pringle maneuver in the modern era: A review of techniques for hepatic inflow occlusion in minimally invasive liver resection

  • Omar A. Mownah;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.131-140
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    • 2023
  • During minimally invasive liver resection (MILR), the Pringle maneuver aims to minimize blood loss and provide a clear operative field, thereby identifying intrahepatic structures and facilitating safe parenchymal transection. Several techniques for using the Pringle maneuver in MILR have been described. This review presents various methods which have been reported in the literature. A systematic literature search used the MEDLINE/PubMed database from its earliest records to August 2022 using appropriate search headings and keywords. The primary outcome was identifying techniques for performing hepatic inflow occlusion during laparoscopic/robotic hepatectomy. Inclusion criteria consisted of publications describing technical steps to obtain hepatic inflow occlusion during minimally invasive hepatectomy. A literature search identified 23 relevant publications, and the full texts were examined. The techniques described in the reports can be broadly categorized into three groups: (1) the Rummel-tourniquet technique, (2) vascular clamp use, and (3) the Huang Loop technique. Various techniques have been used in MILR to achieve inflow confinement successfully. The authors prefer the modified Huang Loop technique because it is inexpensive, reliable, and quick to apply or release. Hepatobiliary surgeons are advised to familiarize themselves with these MILR techniques, which have proven effective and safe inflow occlusion.

Embryo sexing methods in bovine and its application in animal breed

  • Bora, Shelema Kelbessa
    • Journal of Animal Reproduction and Biotechnology
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    • v.37 no.2
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    • pp.80-86
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    • 2022
  • The ability to determine the sex of bovine embryos before the transfer is advantageous in livestock management, especially in dairy production, where female calves are preferred in milk industry. The milk production of female and male cattle benefits both the dairy and beef industries. Pre-implantation sexing of embryos also helps with embryo transfer success. There are two approaches for sexing bovine embryos in farm animals: invasive and non-invasive. A non-invasive method of embryo sexing retains the embryo's autonomy and, as a result, is less likely to impair the embryo's ability to move and implant successfully. There are lists of non-invasive embryo sexing such as; Detection of H-Y antigens, X-linked enzymes, and sexing based on embryo cleavage and development. Since it protects the embryo's autonomy, the non-invasive procedure is considered to be the safest. Invasive methods affect an embryo's integrity and are likely to damage the embryo's chances of successful transformation. There are different types of invasive methods such as polymerase chain reaction, detection of male chromatin Y chromosome-specific DNA probes, Loop-mediated isothermal amplification (LAMP), cytological karyotyping, and immunofluorescence (FISH). The PCR approach is highly sensitive, precise, and effective as compared to invasive methods of farm animal embryonic sexing. Invasive procedures, such as cytological karyotyping, have high accuracy but are impractical in the field due to embryonic effectiveness concerns. This technology can be applicable especially in the dairy and beef industry by producing female and male animals respectively. Enhancing selection accuracy and decreasing the multiple ovulation embryo transfer costs.

Clinical Characteristics of Cervical and Thoracic Radiculopathies: Non-Invasive Interventional Therapy (목 및 가슴신경뿌리병증의 임상적 고찰: 비침습적 중재시술치료)

  • Roh, Hakjae;Lee, Sang-Heon;Kim, Byung-Jo
    • Annals of Clinical Neurophysiology
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    • v.10 no.2
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    • pp.83-97
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    • 2008
  • Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.

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Minimally Invasive Multi-Level Posterior Lumbar Interbody Fusion Using a Percutaneously Inserted Spinal Fixation System : Technical Tips, Surgical Outcomes

  • Kim, Hyeun-Sung;Park, Keun-Ho;Ju, Chag-Il;Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.50 no.5
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    • pp.441-445
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    • 2011
  • Objective : There are technical limitations of multi-level posterior pedicle screw fixation performed by the percutaneous technique. The purpose of this study was to describe the surgical technique and outcome of minimally invasive multi-level posterior lumbar interbody fusion (PLIF) and to determine its efficacy. Methods : Forty-two patients who underwent mini-open PLIF using the percutaneous screw fixation system were studied. The mean age of the patients was 59.1 (range, 23 to 78 years). Two levels were involved in 32 cases and three levels in 10 cases. The clinical outcome was assessed using the visual analog scale (VAS) and Low Back Outcome Score (LBOS). Achievement of radiological fusion, intra-operative blood loss, the midline surgical scar and procedure related complications were also analyzed. Results : The mean follow-up period was 25.3 months. The mean LBOS prior to surgery was 34.5, which was improved to 49.1 at the final follow up. The mean pain score (VAS) prior to surgery was 7.5 and it was decreased to 2.9 at the last follow up. The mean estimated blood loss was 238 mL (140-350) for the two level procedures and 387 mL (278-458) for three levels. The midline surgical scar was 6.27 cm for two levels and 8.25 cm for three level procedures. Complications included two cases of asymptomatic medial penetration of the pedicle border. However, there were no signs of neurological deterioration or fusion failure. Conclusion : Multi-level, minimally invasive PLIF can be performed effectively using the percutaneous transpedicular screw fixation system. It can be an alternative to the traditional open procedures.

Role of Invasive Procedures in the Diagnosis and Management of Pulmonary Infiltrates in Patients with Leukemia (백혈병 환자에서 발생한 폐침윤의 진단 및 치료에 있어 침습적 검사의 역할)

  • Kang, Soo-Jung;Park, Sang-Joon;An, Chang-Hyeok;Ahn, Jong-Woon;Kim, Ho-Cheol;Lim, Si-Young;Suh, Gee-Young;Kim, Ho-Joong;Kwon, O-Jung;Lee, Hong-Ghi;Rhee, Chong-H.;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.448-463
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    • 2000
  • Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

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Perspectives on minimally invasive restoration (최소침습수복의 전통과 전망)

  • Yi, Yang-Jin
    • The Journal of the Korean dental association
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    • v.49 no.2
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    • pp.85-94
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    • 2011
  • In the filed of Dentistry, minimally invasive treatment modalities are new trend for conservation of natural teeth. Of them, laminate veneer and resin bonded fixed partial denture belong to restoration procedures. In this review, survival rates of each modalities and cause of unserviceability are analyzed, and criteria for success are presented. To get successful results of minimally invasive restoration, plenty of enamel layer, thin and strong materials, and high bonding strength are essential under cyclically loaded wet oral condition. Newly tried design of minimally invasive technique nowadays have to be evaluated only on the basis of requirement for long-term success.

Pneumonia Incidence Varies by Tracheal Suction Procedures among Caregivers of Patients with Home Mechanical Ventilators (가정용 인공호흡기 적용 신경근육계 희귀난치성 질환자 가족 간호제공자의 기관내 흡인 수행과 폐렴 발생과의 관계)

  • Hwang, Moon Sook;Park, Jin Hee
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.23 no.1
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    • pp.25-33
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    • 2016
  • Purpose: This study aimed to survey caregivers of patients with Neuromuscular Rare and Incurable Disease (NRID) using invasive home mechanical ventilator (HMV), in order to compare the incident rate of pneumonia by tracheal suction procedures used. Method: Participants were 99 family caregivers of NRID patients using HMV. Participants were given a questionnaire consisting of 12 demographic items, 10 items about disease and HMV related characteristics, 11 items about tracheal suction procedures, and 2 items about the incidence of pneumonia. Data were analyzed using chi-square tests and t-tests. Results: The items that predicted the incidence of pneumonia were "change of irrigation saline every suction" (p=.047), "use of aseptic catheter every suction" (p=.004), and "instillation of normal saline before suction" (p=.027). In addition, these items were 47.4%, 51.4%, and 38.8% respectively. Conclusion: Family members caring for NRID patients with invasive HMV should be educated about tracheal suction, especially the necessity of changing irrigation saline after every suction, using the aseptic catheter for every suction, and instillation of normal saline before suction. Medical personnel such as home care nurses should periodically check tracheal suction procedures, and re-educate family caregivers when necessary.

The Development of Classification System of Medical Procedures in Korea (한국표준의료행위 분류체계 개발)

  • Park, Hyoung-Wook;Sohn, Myong-Sei;Kim, Han-Joong;Park, Eun-Cheol;Yu, Seung-Hum
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.877-897
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    • 1996
  • In recent years, the Korean Medical Association has undertaken the feat of establishing the Korean Standard Terminology of Medical Procedures with the dedicated help of 32 medical academic societies. However, because the project is being conducted by several different circles, it has yet to see a clear system of classification. This thesis, therefore, proposes the three principles of scientific properties, usefulness and ideology as the basis for classification system and has developed the Classification System of Medical Procedures in Korea upon their foundation. The methodology and organization of this thesis as follows. First, by adopting scientific classification system of Feinstein(1988), an analysis of the classification systems of the medical procedures in the United States, Japan, Taiwan, WHO was carried out to reveal the framework and the basic principles in each system. Second, the direction of classification system has been constructed by applying the normative principle of medical field in order to show the future direction of the medical field and realize its ideology. Third, a finalized framework for the classification system will be presented as based on the direction of classification system. Of the three basis principles mentioned above, the analysis on the principles of usefulness was left out of this thesis due to the difficulty of establishing specific standards of analysis. The results of the study are as follows. The overall structure of the thesis is aimed at showing the 'Prevention-Therapy-Rehabilitation' quality of comprehensive health care and consists of six chapters; I. Prevention and Health Promotion II. Evaluation and Management III. Diagnostic Procedures IV. Endoscopy V. Therapeutic Procedures VI. Rehabilitation Chapter three Diagnostic Procedures is divided into four parts : Functional Diagnosis, Visual Diagnosis, Pathological Diagnosis, Biopsy and Sampling. Chapter five Therapeutic Procedures is divided into Psychiatry, Non-Invasive Therapy, Invasive Therapy, Anaesthesia and Radiation Oncology. Of these sub-divisions, Functional Diagnosis, Biopsy and Sampling, Endoscopy and Invasive Therapy employs the anatomical system of classification. On the other hand, Visual Diagnosis, Pathological Diagnosis, Anesthesia and Diagnostic Radiology, namely those divisions in which there is little or no overlapping in services with other divisions, used the classification system of its own division. The classification system introduced in this thesis can be further supplemented through the use of the cluster analysis by incorporating the advice and assistance of other specialists.

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