• Title/Summary/Keyword: Medical indications

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Vascularized Bone Graft Reconstruction for Upper Extremity Defects: A Review

  • Ava G. Chappell;Matthew D. Ramsey;Parinaz J. Dabestani;Jason H. Ko
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.82-95
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    • 2023
  • Upper extremity reconstruction may pose clinical challenges for surgeons due to the often-critical, complex functional demands of the damaged and/or missing structures. The advent of vascularized bone grafts (VBGs) has aided in reconstruction of upper extremity (UE) defects due to their superior regenerative properties compared with nonvascularized bone grafts, ability to reconstruct large bony defects, and multiple donor site options. VBGs may be pedicled or free transfers and have the potential for composite tissue transfers when bone and soft tissue are needed. This article provides a comprehensive up-to-date review of VBGs, the commonly reported donor sites, and their indications for the treatment of specific UE defects.

A hybrid evaluation of information entropy meta-heuristic model and unascertained measurement theory for tennis motion tracking

  • Zhong, Yongfeng;Liang, Xiaojun
    • Advances in nano research
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    • v.12 no.3
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    • pp.263-279
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    • 2022
  • In this research, the physical education training quality was investigated using the entropy model to compute variance associated with a random value (a strong tool). The entropy and undefined estimation principles are used to extract the greatest entropy of information dependent on the index system. In the study of tennis motion tracking from a dynamic viewpoint, such stages are utilized to improve the perception of the players' achievement (Lv et al. 2020). Six female tennis players served on the right side (50 cm from the T point). The initial flat serve from T point was the movement under consideration, and the entropy was utilized to weigh all indications. As a result, a multi-index measurement vector is stabilized, followed by the confidence level to determine the structural plane establishment range. As a result, the use of the unascertained measuring technique of information entropy showed an excellent approach to assessing athlete performance more accurately than traditional ways, enabling coaches and athletes to enhance their movements successfully.

Ultrasound-Guided Intervention for Breast Lesions (유방 병변에 대한 초음파 유도하 중재 시술)

  • Eun Young Ko
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.332-344
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    • 2023
  • The role of ultrasound-guided interventions in the diagnosis and treatment of breast lesions is gaining importance and prevalence, particularly as the instances of non-palpable breast lesion detection, breast-conserving surgery, and neoadjuvant chemotherapy are increasing. This review attempts to summarize the types and techniques of breast ultrasound-guided interventional procedures, such as biopsy, tissue marker insertion, and preoperative localization, and their indications. Furthermore, we highlight the pro and cons of the most commonly used procedures with the intention of promoting their use in clinical practice.

Superior capsular reconstruction for irreparable rotator cuff tear: a review of current methods

  • Seok Won Chung;Dong-Hyun Kim;Hyun Joo Lee;Won Ki Hong;Seung Ho Chung;Jong Pil Yoon
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.438-444
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    • 2023
  • Irreparable massive rotator cuff tears can significantly impact daily life; and these types of tears can be difficult to repair completely, especially in younger patients who are more active and have higher functional requirements. Since its introduction by Mihata and the colleagues, superior capsular reconstruction (SCR) has gained popularity in the treatment of irreparable massive rotator cuff tears and has shown promising short-term results. A variety of studies have focused on the clinical and biomechanical outcomes of this procedure. This article reviews the biomechanics, indications for the surgical procedure, graft options, surgical technique, and rehabilitation from SCR.

A Study on Safety and Performance Evaluation of Smart All-in-one Cardiopulmonary Assist Device (스마트올인원 심폐순환보조장치의 안전성 및 성능평가에 관한 연구)

  • Park, Junhyun;Ho, YeJi;Lee, Yerim;Lee, Duck Hee;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.40 no.5
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    • pp.197-205
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    • 2019
  • The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

A Web-based Survey on Korean Medical Doctor's Prescription Status of Jaungo (자운고의 한의사 처방 현황에 대한 웹기반 설문조사)

  • Kang, Min-Seo;Kim, Min-Hee;Jang, Bo-Hyoung;Choi, In Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.31 no.2
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    • pp.24-39
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    • 2018
  • Objectives : The purpose of this survey is to examine Korean medical doctor's prescription status of Jaungo. Methods : The questionnaire was distributed via e-mail to Korean medical doctors who were registered in the association of Korean medicine from December 26th 2017 to February 5th 2018. We screened out respondents who didn't meet screening criteria. Results : Total 325 respondents completed answers, and the computerized data were analyzed. 74.7% of respondents were provided Jaungo from outside (extramural herbal dispensaries, pharmaceutical company). Almost all of the respondents (98.2%) were prescribing Jaungo in the form of ointment, and the cream container was the most commonly used container. In chief Indications of Jaungo were skin dryness (83.1%), pruritus (67.7%), burns (64.0%), and atopic dermatitis (60.9%). More than 60% of the respondents were prescribing Jaungo without additional herbs or additives. Most of patients were educated to apply Jaungo thinly to the affected area once or twice a day or frequently. Reason for dissatisfaction about Jaungo of patient were due to staining clothes (59.1%), offensive smell (44.0%), and poor texture (26.5%). Conclusions : Jaungo is a topical herbal agent frequently used in the Korean medicine. This is the first survey figure out current status of topical herbal agent in Korean medical doctors. The result of this study would contribute to progressing treatment method using topical herbal agent.

Complementary Management of Residual Intracranial Aneurysms after Endovascular or Surgical Treatment

  • Shin, Byoung-Gook;Kim, Jong-Soo;Hong, Seung-Chyul;Roh, Hong-Gee
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.179-186
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    • 2005
  • Objective: The purpose of this paper is to report our experiences in managing seventeen cases of residual intracranial aneurysms following surgical or endovascular treatment and discuss the incidence of residual aneurysms, the indications and technique of retreatment of residual aneurysms. Methods: During a period of 42 months, we treated 391 aneurysms in 339 patients with microsurgical clipping or GDC embolization as a primary treatment. In 39 of them, follow-up angiography revealed residual aneurysms and seventeen of whom were retreated. There were eleven cases in ACoA, three cases in distal ICA, one, in each of MCA, ACA and basilar artery. We reviewed retrospectively the clinical notes, operation records and cerebral angiograms of seventeen patients who had been treated for residual aneurysms. Results: Complementary treatment was performed in 8 cases by means of surgery and in 9 cases by means of GDC embolization. There were eleven females and six males with an age variation between 29 and 78 years. The mean duration of angiographic follow-up was 17.3 months. Of the seventeen cases that were treated for residual aneurysms, fourteen achieved complete occlusion. Of 17 retreated patients, fifteen patients had good recovery according to the Glasgow Outcome Scale. Conclusion: When occlusion after endovascular or surgical treatment is incomplete, a new multidisciplinary approach should be carried out. Given our experiences, we recommend coil embolization of the choice in cases that the residual aneurysmal neck had been narrowed by previous clipping. On the other hand, if the residual aneurysm has enough space to clip but not enough to coil, we recommend the microsurgical clipping.

Laparoscopic Nissen Fundoplication in Children for Treatment of Gastroesophageal Reflux Disease (소아 위식도 역류에서 시행한 복강경 Nissen식 위바닥 주름술)

  • Nam, So-Hyun;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.13 no.1
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    • pp.13-22
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    • 2007
  • Fundoplication is accepted as an effective treatment of gastroesophageal reflux disease. The recent results of laparoscopic fundoplication demonstrated safety and less morbidity, shorter hospital stay and less pulmonary complication compared to the open operation. Laparoscopic fundoplication has been our first choice of operation for gastroesophageal reflux disease since 2003. Among 29 cases, there were 2 conversion cases because of severe distension of transverse colon and hepatomegaly. We studied 27 consecutive patients operated upon from January 2003 through December 2004. There were 15 boys and 12 girls, ages from 1.5 months to 12 years (median 25.3 months). Body weight ranged from 2.9 kg to 37 kg (median 9.8 kg). Neurological abnormalities were present in 23 patients. Indications for surgery included medically refractory reflux associated with vomiting, pneumopathy, otorhinolaryngologic pathology, failure to thrive, esophagitis, apnea and bradycardia. We used 4-5 trocars of 5 mm or 12 mm with $30^{\circ}$ telescope and performed the Nissen technique in all patients. In neurological impaired patients, gastrostomy tube was placed at the time of fundoplication. Median operative time was 130 minutes (70 - 300 minutes). There was no mortality nor intraoperative complication. Twenty-six patients were followed for median of 19 months (8 - 31 months). Four patients (15.4 %), who were all neurological impaired, developed recurrent symptoms of gastroesophageal reflux disease. Two of these patients had reoperation (1 laparoscopic approach, 1 open method). There were significant increases in body weight in 11 patients after fundoplication. Laparoscopic fundoplication is acceptable as a safe and effective method for gastroesophageal reflux disease.

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Two Cases of Perforated Typhlitis in Acute Lymphocytic Leukemia (급성 림프구성 백혈병에 합병된 천공성 typhlitis)

  • Park, Woo-Hyun;Ahn, Keun-Soo;Choi, Soon-Ok
    • Advances in pediatric surgery
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    • v.7 no.1
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    • pp.59-63
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    • 2001
  • The authors, over the last 6 months, have treated 2 patients with perforated typhlitis complicating acute lymphocytic leukemia (ALL) with good outcome. The first patient was a 13-year-old male who developed intermittent high fever, abdominal pain, abdominal distention and diarrhea during the course of maintenance chemotherapy. The peripheral leukocyte ranged from 230-470/$mm^3$. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal and ascending colonic walls and subsequent ragged perforation of the posterior wall of the cecum. He survived after treatment by right hemicolectomy and aggressive supportive measures. The patient case was a 3 year-old female who developed intermittent high fever, right lower abdominal pain, a mass, and watery diarrhea during the course of maintenance chemotherapy. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal wall (6-15mm in thickness) and subsequent small perforation of the posterior wall of the cecum with thick-walled localized abscess. She has recovered completely after aggressive medical management. We learned two lessons from our experience treating these patients:1) early diagnosis provided by a high index of suspicion and the use of ultra sonogram or CT scan is essential. And 2) although perforation is one of the surgical indications for the treatment of typhlitis, it is possible to manage the perforation nonoperatively in selected cases with localized abscess.

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Use of Cardiac Computed Tomography for Ventricular Volumetry in Late Postoperative Patients with Tetralogy of Fallot

  • Kim, Ho Jin;Mun, Da Na;Goo, Hyun Woo;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.71-77
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    • 2017
  • Background: Cardiac computed tomography (CT) has emerged as an alternative to magnetic resonance imaging (MRI) for ventricular volumetry. However, the clinical use of cardiac CT requires external validation. Methods: Both cardiac CT and MRI were performed prior to pulmonary valve implantation (PVI) in 11 patients (median age, 19 years) who had undergone total correction of tetralogy of Fallot during infancy. The simplified contouring method (MRI) and semiautomatic 3-dimensional region-growing method (CT) were used to measure ventricular volumes. Results: All volumetric indices measured by CT and MRI generally correlated well with each other, except for the left ventricular end-systolic volume index (LV-ESVI), which showed the following correlations with the other indices: the right ventricular end-diastolic volume index (RV-EDVI) (r=0.88, p<0.001), the right ventricular end-systolic volume index (RV-ESVI) (r=0.84, p=0.001), the left ventricular end-diastolic volume index (LV-EDVI) (r=0.90, p=0.001), and the LV-ESVI (r=0.55, p=0.079). While the EDVIs measured by CT were significantly larger than those measured by MRI (median RV-EDVI: $197mL/m^2$ vs. $175mL/m^2$, p=0.008; median LV-EDVI: $94mL/m^2$ vs. $92mL/m^2$, p=0.026), no significant differences were found for the RV-ESVI or LV-ESVI. Conclusion: The EDVIs measured by cardiac CT were greater than those measured by MRI, whereas the ESVIs measured by CT and MRI were comparable. The volumetric characteristics of these 2 diagnostic modalities should be taken into account when indications for late PVI after tetralogy of Fallot repair are assessed.