• Title/Summary/Keyword: Invasive surgery

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Survey of Sonoanatomic Distances For Lumbar Medial Branch Nerve Blocks in Healthy Volunteers

  • Gharaei, Helen;Imani, Farnad;Solaymani-Dodaran, Masoud
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.133-138
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    • 2014
  • Background: The precise knowledge of anatomy and the region of transverse process (TP) and superior articular processes (AP) and their distance from the skin are important in blocking and treating lumbar facet syndrome. Evaluation of these anatomic distances from 3rd and 5th lumbar vertebrae in both sides and in different body mass index (BMI) in healthy volunteers might improve knowledge of ultrasound (US) lumbar medial branch nerve blocks (LMBB). Methods: Bilateral US in the 3rd and 5th lumbar vertebrae of 64 volunteers carried out and the distance between skin to TP and skin to AP was measured. These distances were compared on both sides and in different BMI groups. The analysis was done using SPSS 11. Analysis of variance was used to compare the means at three vertebral levels (L3-L5) and different BMI groups. P values less than 0.05 were considered statistically significant. The paired t-test was used to compare the mean distance between skin to TP and skin to AP on both sides. Results: The distance between skin to TP and skin to AP of 3rd vertebrae to 5th vertebrae was increased in both right and left sides (P < 0.001) from up to down. The mean distance from skin to TP were greater on the left side compared to the right in all three vertebral levels from L3 to L5 (P values 0.014, 0.024, and 0.006 respectively). The mean distance from skin to TP and the skin to AP was statistically significant in different BMI groups (P < 0.001). Conclusions: We found many anatomic distances which may increase awareness of US guided LMBB.

The Survey of the Patient Received the Epiduroscopic Laser Neural Decompression

  • Jo, Dae Hyun;Yang, Hun Ju
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.27-31
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    • 2013
  • Background: Neuroplasty using a Racz catheter or epiduroscope and percutaneous endoscopic laser discectomy are performed as treatment for chronic refractory low back and/or lower extremity pain, but they are limited in that they cannot completely remove the causing pathology. Lately, epiduroscopic laser neural decompression (ELND) has been receiving attention as an alternative treatment, but there are insufficient reports of results. Hence we aimed to investigate and report the data in our hospital. Methods: Seventy-seven patients were selected who had received ELND via the anterior and posterior epidural approach through the pain clinic in our hospital from March 2011 to July 2012. Their medical records including age, diagnosis, epiduroscopic findings and degree of symptom relief were investigated. The degree of symptom relief following the procedure was categorized into 5 stages of very good (5), good (4), no change (3), bad (2), and very bad (1) at 2 weeks and 1 month after the procedure. Results: The subjects were 30 males and 47 females. Mean age was 54.6 for males and 59.6 for females, so the overall mean age was 58.1 years old, with the youngest being 23 and the oldest 88 years old. In epiduroscopic images of all patients, more than one situation of herniated disc, fibrous tissue and adhesion, or inflammation was observed. Sixty-seven patients (87.0%) showed symptom relief 2 weeks after the procedure and 63 patients (81.8%) showed relief after 1 month. Conclusions: ELND is considered to be an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, and failed back surgery syndrome which cannot be alleviated with existing non-invasive conservative treatment.

Reconstruction of basement membrane in the artificial skin (인공피부 제조시 기저막 재건의 효과)

  • Yi, J.Y.;Park, K.C.;Kim, S.H.;Suh, H.;Son, Y.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.05
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    • pp.335-338
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    • 1996
  • We attempted to reconstruct basement membrane (BM) in between the epidermal compartment and dermal compartment in the artificial skin preparation and examine its effect on the skin architecture as well as on the epidermal differentiation. Laminin, one of the component of BM, stimulate the migration of the basal cells but type IV collagen which is a major component of the mechanical network of BM did not stimulate epidermal migration. However laminin in the presence of type IV collagen at a 1:1 molar ratio did not stimulate epidermal migration but provide nice demarcation between epidermis and dermis. This mixture of laminin and type IV collagen enhanced epidermal differentiation in the artificial skin based on the morphological observation as well as biochemical criteria. The epidermal acquirement of migratory ability on the laminin-rich substrate suggest that this type of unbalance in the expression of the components of BM may prevail in the area of healing tissue and the invasive transition of the tumor. The result in this study provide the technical improvement in the artificial skin preparation and further application of this technique for the reconstruction of other bio-artificial organ.

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Successful emergency transcatheter aortic valve implantation

  • Lee, Jung-Hee;Ji, Ah-Young;Kim, Young Ju;Song, Changho;Jin, Moo-Nyun;Kim, Sun Wook;Hong, Myeong-Ki;Hong, Geu-Ru
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.144-147
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    • 2014
  • Despite the necessity of surgical aortic valve replacement, many patients with symptomatic severe aortic stenosis (AS) cannot undergo surgery because of their severe comorbidities. In these high-risk patients, percutaneous transcatheter aortic valve implantation (TAVI) can be safely accomplished. However, no study has shown that TAVI can be performed for patients with severe AS accompanied by acute decompensated heart failure. In this case report, 1 patient presented a case of severe pulmonary hypertension with decompensated heart failure after diagnosis with severe AS, and was successfully treated via emergency TAVI. Without any invasive treatment, acute decompensated heart failure with severe pulmonary hypertension is common in patients with severe AS, and it can increase mortality rates. In conclusion, TAVI can be considered one of the treatment options for severe as presented as acute decompensated heart failure patients with pulmonary hypertension.

Visualization of Epidermis and Dermal Cells in ex vivo Human Skin Using the Confocal and Two-photon Microscopy

  • Choi, Sang-Hoon;Kim, Wi-Han;Lee, Yong-Joong;Lee, Ho;Lee, Weon-Ju;Yang, Jung-Dug;Shim, Jong-Won;Kim, Jin-Woong
    • Journal of the Optical Society of Korea
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    • v.15 no.1
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    • pp.61-67
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    • 2011
  • The confocal laser scanning microscopy and two-photon microscopy was implemented based on a single laser source and an objective lens. We imaged and compared the morphology of identical sites of ex vivo human skin using both microscopes. The back-scattering emission from the sample provided the contrast for the confocal microscopy. The intrinsic autofluorescence and the second harmonic generation were used as the luminescence source for the two-photon microscopy. The wavelength of the Ti:Sapphire laser was tuned at 710 nm, which corresponds to the excitation peak of NADH and FAD in skin tissue. The various cell layers in the epidermis and the papillary dermis were clearly distinguished by both imaging modalities. The two-photon microscopy more clearly visualized the intercellular region and the nucleus of the cell compared to the confocal microscopy. The fibrous structures in the dermis were more clearly resolved by the confocal microscopy. Numerous cells in papillary dermal layer, as deep as $100\;{\mu}m$, were observed in both CLSM and two-photon microscopy. While most previous studies focused on fibrous structure imaging (collagen and elastin fiber) in the dermis, we demonstrated that the combined imaging with the CLSM and two-photon microscopy can be applied for the non-invasive study of the population, distribution and metabolism of papillary dermal cells in skin.

Control of MR Haptic Simulator Using Novel S-chain Model (새로운 S-Chain 모델을 이용한 MR 햅틱 시뮬레이터 제어)

  • Oh, Jong-Seok
    • Journal of the Korea Convergence Society
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    • v.9 no.11
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    • pp.291-297
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    • 2018
  • Due to difficulty in minimally invasive surgery, training simulator is actively researched. A volumetric deformable organ is created by employing a shape-retaining chain-linked (S-chain) model to realize positioning a human organ model in virtual space. Since the main principle of the S-chain algorithm is that the repulsive force is proportional to the number of chain elements, the calculation time can be increased according to the magnitude of deformation. In this work, the advanced S-chain algorithm is used to calculate the repulsive torque according to spin motion. Finally, haptic architecture was constructed using this S-chain model by incorporating the virtual organ with a real master device, which allows the repulsive force and target position to be transferred to each other. The control performance of S-chain algorithm has been evaluated via experiment.

Comparison of Hemoglobin Correction Effects According to Storage Period and Other Factors in the Transfusion of Packed Red Blood Cells in Neonatal Intensive Care Unit Patients

  • Park, Ji Hyun;Kong, Seom Gim;Hong, Yoo Rha
    • Neonatal Medicine
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    • v.25 no.4
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    • pp.170-177
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    • 2018
  • Purpose: Preterm infants frequently require red blood cell (RBC) transfusions in neonatal intensive care units (NICU). Storage RBCs undergo many changes during storage periods. We aimed to compare the hemoglobin (Hb) correction effect according to the period of RBC storage and investigate the factors influencing Hb correction. Methods: This retrospective study reviewed the medical records of 289 patients who received RBC transfusion more than once in the NICU of Kosin University Gospel Hospital between February 2006 and March 2016. The subjects were classified into two storage groups: short-term (${\leq}7days$, n=88) and long-term (>7 days, n=201), according to the period of RBC storage. We checked Hb levels by complete blood cell count tests conducted within 2 days before and 5 to 9 days after the first transfusion. We compared the Hb difference between the two groups and analyzed the factors influencing Hb correction. Results: Excluding the use of an invasive ventilator, there was no significant difference between the two groups in terms of clinical characteristics. There was no significant difference in the Hb correction effect between the two groups (P=0.537). Birth weight greater than 1,500 g, higher weight at transfusion, and larger volume of transfusion were significant prognostic factors affecting greater changes in Hb. In addition, surgery experience, higher Hb level at transfusion, and additional blood tests were found to be significantly associated with less changes in Hb. Conclusion: The RBC storage period did not affect the Hb correction effect. The Hb correction effect may be diminished in infants with lower birth weight and lower weight at transfusion under unstable clinical conditions.

Parent Perspectives of Diagnostic and Monitoring Tests Undertaken by Their Child with Inflammatory Bowel Disease

  • Ho, Shaun Siong Chung;Keenan, Jacqueline Ilene;Day, Andrew Stewart
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.19-29
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    • 2021
  • Purpose: To assess parent perspectives of the current and potential future tests for their child with inflammatory bowel disease (IBD). Methods: New Zealand parents of a child with IBD were invited to complete an anonymous online survey. Experiences relating to their child's blood or faecal tests, medical imaging (abdominal ultrasound [US], abdominal computerised tomography [CT] and magnetic resonance enterography) and colonoscopy were collected. Perceived attitudes to potential future testing of urine, saliva, and breath, were sought. Results: Twenty-eight parents, 93% female completed the survey, and 86% were aged between 35 and 54 years. Baseline information was provided by parents for 27 of 28 children, 70.3% had Crohn's disease with a mean disease duration of 2.67 years. Blood tests were the most requested and completed tests, while CT was the least ordered and most refused test. Colonoscopy was rated as the least comfortable and generated the most worry. Explanation of test significantly improved parent's levels of understanding when their child had blood, faecal, imaging (US) or colonoscopy tests. Providing an explanation, test invasiveness and the impact of the blood results may have on their child's treatment significantly improved parents' comfort levels. However, explanation of colonoscopy generated a significant parental concerns. Saliva, urine and blood tests were chosen as the most preferred disease monitoring tests. Conclusion: Parents preferred any tests less invasive than colonoscopy for monitoring their child's IBD. Although providing explanation of their child's tests enhanced parents' understanding, it can also affect parents' levels of concern and comfort.

Efficacy of extracorporeal shock wave therapy for pillar pain after open carpal tunnel release: a double-blind, randomized, sham-controlled study

  • Turgut, Mehmet Cenk;Saglam, Gonca;Toy, Serdar
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.315-321
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    • 2021
  • Background: Pillar pain may develop after carpal tunnel release surgery (CTRS). This prospective double-blinded randomized trial investigated the effectiveness of extracorporeal shock wave therapy (ESWT) in pillar pain relief and hand function improvement. Methods: The sample consisted of 60 patients with post-CTRS pillar pain, randomized into two groups. The ESWT group (experimental) received three sessions of ESWT, while the control group received three sessions of sham ESWT, one session per week. Participants were evaluated before treatment, and three weeks, three months, and six months after treatment. The pain was assessed using the visual analogue scale (VAS). Hand functions were assessed using the Michigan hand outcomes questionnaire (MHQ). Results: The ESWT group showed significant improvement in VAS and MHQ scores after treatment at all time points compared to the control group (P < 0.001). Before treatment, the ESWT and control groups had a VAS score of 6.8 ± 1.3 and 6.7 ± 1.0, respectively. Three weeks after treatment, they had a VAS score of 2.8 ± 1.1 and 6.1 ± 1.0, respectively. Six months after treatment, the VAS score was reduced to 1.9 ± 0.9 and 5.1 ± 1.0, respectively. The ESWT group had a MHQ score of 54.4 ± 7.7 before treatment and 73.3 ± 6.8 six months after. The control group had a MHQ score of 54.2 ± 7.1 before treatment and 57.8 ± 4.4 six months after. Conclusions: ESWT is an effective and a safe non-invasive treatment option for pain management and hand functionality in pillar pain.

Extramedullary Plasmacytoma on Unilateral Upper Eyelid in a Shih-Tzu Dog

  • Junyeong Ahn;Jeong-Seop Oh;Hyelin Kim;Nayoung Lee;Kangmoon Seo;Seonmi Kang
    • Journal of Veterinary Clinics
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    • v.40 no.2
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    • pp.158-163
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    • 2023
  • A 9-year-old spayed female Shih-Tzu was presented with a mass on the upper eyelid of the right eye (OD). The eyelid mass continued to enlarge along the eyelid margin and the eyelid skin. Throughout the follow-up examinations, the mass did not affect the palpebral conjunctiva OD. Until 9 months since the mass was first identified, the dog did not show any clinical signs related to the mass. However, after 11 months, the owner complained of the dog's discomfort on OD and decided on surgical excision of the mass. There were no abnormalities in the complete blood count and serum chemistry profiles. The pentagonal resection was performed to completely remove the mass in the eyelid. There were no suspicious findings of metastasis on whole-body computed tomography scan immediately before the surgery. On histopathology and immunohistochemistry for multiple myeloma oncogene-1, the eyelid mass was diagnosed as extramedullary plasmacytoma (EMP). Surgical margin of the mass was clearly cut. No recurrence was observed during the 5-month follow-up. EMPs on the eyelid have rarely been reported in dogs. Although EMP is a benign tumor, the mass showed invasive growth and grew toward the skin rather than the palpebral conjunctiva. No recurrence occurred when surgically removed with clean margins.