• 정형스포츠물리치료학회지
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• 제14권2호
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• pp.73-80
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• 2018

Purpose: This study was evaluated the effects of nucleoplasty and chemonucleolysis, as interventional treatments for herniated intervertebral disc disease, on spinal tissues. Methods: Nucleoplasty using plasma beam and chemonucleolysis with collagenase were conducted on the spinal motion segments that were dissected from of human cadaver spine under fluoroscopic guidance. After the procedure, the intervertebral discs were transected, and the changes in gross findings were examined. Subsequently, the influence of the procedure on the nucleus pulposus, annuls fibrosus, and endplate was analyzed through a pathologic examination. Results: Nucleoplasty was confirmed to eliminate the local range of tissues in nucleus pulposus according to the procedure tract and to not affect other tissues. In chemonucleolysis, we found that collagenase diffused from the surgical site within the nucleus pulposus and was not present in the annulus fibrosus and endplate. Conclusions: The clinically-used interventional treatments that were investigated here were not found to do not cause additional damage to areas other than those targeted.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2002년도 춘계학술대회 논문집
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• pp.146-149
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• 2002

It is reported that the mechanical properties of vertebral trabecular bone depend on the density and the mass of bones. Osteoporosis is a systemic skeletal disease caused by low bone mass and microstructure deterioration of trabecular bone. Silva and Gibson (1997) studied the treatment of age-related bone loss using drug therapy. Vertebroplasty is a minimally invasive surgery for the treatment of osteoporosis vertebrae. This procedure includes puncturing vertebrae and filling with Polymethylmethacrylate (PMMA). However, the relative effect of drug therapy and bone cement for osteoporosis treatment is not reported yet. In this study, several 2D models of human vertebral trabecular bone are analyzed by finite element method. The mechanical behaviors of the vertebral trabecular bone treated by the drug therapy and the bone cement are compared. This study shows that bone cement treatment is more effective strategy than drug therapy to prevent the degradation of bone strength.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권6호
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• pp.251-258
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• 2018

Corticotomy was introduced as a surgical procedure to shorten orthodontic treatment time. Corticotomy removes the cortical bone that strongly resists orthodontic force in the jaw and keeps the marrow bone to maintain blood circulation and continuity of bone tissues to reduce risk of necrosis and facilitate tooth movement. In the 21st century, the concept of regional acceleratory phenomenon was introduced and the development of the skeletal anchorage system using screw and plate enabled application of orthopedic force beyond conventional orthodontic force, so corticotomy has been applied to more cases. Also, various modified methods of minimally invasive techniques have been introduced to reduce the patient's discomfort due to surgical intervention and complications after surgery. We will review the history of corticotomy, its mechanism of action, and various modified procedures and indications.

• Clinical Endoscopy
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• 제55권1호
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• pp.146-149
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• 2022

Lumboperitoneal or ventriculoperitoneal shunt insertion is a standard therapy for hydrocephalus that diverts cerebrospinal fluid from the subarachnoid space into the peritoneal cavity. Gastrointestinal perforations due to this procedure occur rarely; however, accepted treatment strategies have not yet been established. Hence, the most common treatment approaches are open surgery or spontaneous closure without endoscopy. We report the case of a small intestinal perforation in a 73-year-old-woman that occurred after the insertion of a lumboperitoneal shunt. A positive cerebrospinal fluid culture and high cerebrospinal fluid white blood cell count indicated a retrograde bacterial infection, and computed tomography revealed that the peritoneal tip of the shunt catheter was located in the lumen of the gastrointestinal tract. We repaired the perforation endoscopically using an over-the-scope clip, and the patient's recovery was uneventful. Use of an over-the-scope clip could be an effective and minimally invasive treatment for intestinal perforations caused by lumboperitoneal or ventriculoperitoneal shunt insertion.

• 대한족부족관절학회지
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• 제14권1호
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• pp.25-30
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• 2010

Purpose: The purpose of this study was to evaluate the clinical and radiological outcomes of the S.E.R.I. (simple, effective, rapid, inexpensive) operation for the bunionette deformity. Materials and Methods: Between March 2005 and February 2009, 22 patients (26 feet) who had been treated for the bunionette deformity with minimally invasive osteotomy were reviewed retrospectively. Clinically, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, shoes selectivity, disappearance of callus and patient's satisfaction level by Coughlin scoring system were evaluated. Radiologically, the bunionette was classified as four types according to the Fallat classification. The 4-5$^{th}$ intermetatarsal angle (4-5$^{th}$ IMA), the 5$^{th}$ metatarsophalangeal angle (5$^{th}$ MPA) and the length of 5th metatarsal bone (5$^{th}$ MTL) were analyzed at preoperatively and at final follow up visit. Results: VAS improved from $6.8{\pm}1.8$ points to $2.2{\pm}1.8$ points (p<0.05). AOFAS score improved from $54.0{\pm}14.2$ points to $90.0{\pm}4.8$ points (p<0.05). There was no change in shoes selectivity. 9 feet (34.6%) were satisfied with excellent results, 16 feet (61.5%) with good results and 1 foot (3.9%) with fair results. The average 4-5$^{th}$ IMA was corrected from $10.1{\pm}2.3^{\circ}$ to $4.4{\pm}1.7^{\circ}$ (p<0.05). The average 5$^{th}$ MPA was corrected from $11.5{\pm}8.6^{\circ}$ to $-0.1{\pm}4.1^{\circ}$ (p<0.05). The average 5$^{th}$ MTL was changed from $66.1{\pm}4.3$ millimeters to $64.1{\pm}4.4$ millimeters (p=0.069). There was no malunion, nonunion or delayed union and other perioperative complications. Conclusion: S.E.R.I. operation is less invasive and easy technique. This procedure is recommendable for the treatment of the bunionette deformity.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.739-742
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• 2008

Purpose: Breast augmentation is one of the common procedures in plastic surgery today. The shape, size and insertion plane of the implant is decided preoperatively by physical examination of the breast. Pectus excavatum is one of the most common anomalies of chest wall, characterized by a depression of the anterior chest wall. For patients with a mild type of pectus excavatum, the main purpose of the treatment is aesthetic rather than functional improvement. Two most surgical treatment options for skeletal deformity are the Ravitch technique and minimally invasive Nuss repair. Other options for soft tissue repair are implant insertion and autologous soft tissue augmentation. We performed a surgical operation with Nuss procedures and breast augmentation for a patient with mild pectus excavatum and hypoplastic breast. Methods: A 32 year-old female was presented with hypoplastic breast. Preoperative chest CT was performed, showing pectus excavatum. After Nuss procedure, we inserted saline implant(275 cc textured round breast implant, moderate profile) submuscularly to restore adequately projected breast. Results: Patient's postoperative course was uneventful without any complication. After 6 months of follow-up period, the patient had an excellent result, with high patient satisfaction and no complications. Conclusion: For patients with a mild type of pectus excavatum, who do not have cardiopulmonary symptoms and requires for aesthetic improvement, this simple approach with Nuss procedure and breast augmentation achieves excellent aesthetic correction with low complication rate and high patient satisfaction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권4호
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• pp.214-217
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• 2023

Objectives: This case series aims to introduce the nasal floor approach for extracting inverted mesiodens. Materials and Methods: Through a retrospective chart review between January 2022 and February 2023, we included the mesiodens patients using nasal floor approach, and analysis the location of mesiodens from the anterior nasal spine (ANS), total operation time, and complications. Results: Each mesiodens was located 10 to 12 mm from the ANS and was covered with a cortical layer of the nasal floor. All mesiodens were successfully extracted without exposing the adjacent incisors or nasopalatine nerve within 30 minutes from draping to postoperative dressing. Conclusion: The nasal floor approach is an efficient extraction method that reduces bone removal and prevents anatomical damage while removing the mesiodens just below the nasal floor bone.

• Advances in pediatric surgery
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• 제20권2호
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• pp.28-32
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• 2014

Purpose: Laparoscopic appendectomy (LA) has become a gold standard for children even in complicated appendicitis. The purpose of this study was to compare the postoperative surgical site infection rates between laparoscopic and open appendectomy (OA) group in pediatric complicated appendicitis. Methods: A total of 1,158 pediatric patients (age ${\leq}$ 15 years) underwent operation for appendicitis over a period of 8 years. Among these patients, 274 patients (23.7%) were diagnosed with complicated appendicitis by radiologic, operative and pathologic findings, and their clinical outcomes were retrospectively analyzed. Results: Of the 274 patients with complicated appendicitis, 108 patients underwent LA and 166 patients underwent OA. Patients in the LA group returned to oral intake earlier (1.9 days vs. 2.7 days; p<0.01) and had a shorter hospital stay (5.0 days vs. 6.3 days; p<0.01). However, rate of postoperative intra-abdominal infection (organ/space surgical site infection) was higher in the LA group (LA 15/108 [13.9%] vs. OA 12/166 [7.2%]; p<0.01). Readmission rate was also higher in the LA group (LA 9/108 [8.3%] vs. OA 3/166 [1.8%]; p<0.01). Conclusion: The minimally invasive laparoscopic technique has more advantages compared to the open procedure in terms of hospital stay and early recovery. However, intra-abdominal infection and readmission rates were higher in the laparoscopy group. Further studies should be performed to evaluate high rate of organ/space surgical infection rate of laparoscopic procedure in pediatric complicated appendicitis.

• Journal of Chest Surgery
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• 제31권7호
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• pp.697-702
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• 1998

손바닥, 액와부의 다한증은 많은 사람에서 생활의 질에 강한 부정적인 영향을 준다. 기존의 비수술적 치료방법은 이상적이지 못하고 확실한 치료는 상흉부 교감신경절(T2-4) 절제로 얻을 수 있다. 과거에는 전통적인 흉부개방창에 의한 수술이 주요한 방법이었으나 최근에 흉강내시경을 이용해 교감신경절제술을 시행하고 있다. 1995년 1월부터 1997년 8월까지 흉강내시경을 이용해 양측 교감신경절제술을 40명의 환자에서 시행하여서 사망이나 생명을 위협하는 합병증은 없었고 유일한 부작용은 보상성 다한증이었으나 모든 환자에서 만족스러운 증세의 호전을 얻을 수 있었다. 결론적으로 흉강내시경하 제 2, 3, 4 흉부 교감신경절제술은 수장부, 액와부의 다한증 치료에 있어서 효과적이고 안전하며, 경제적인 최소한의 침습성 수술방법이다.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.575-580
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• 2001

Purpose : In general, pineal region tumors are managed by using microsurgical approach or stereoctactic biopsy. However, in selected cases endoscopic approach to pineal lesions might prove to be as effective as microsurgery and less invasive. We report an alternative surgical strategy for managing certain patients with pineal neoplasms that allows treatment of the symptomatic hydrocephalus as well as tumor biopsy under direct vision in the same sitting. Materials and Methods : Twenty-two patients with pineal region tumors with associated hydrocephalus were treated in one session by endoscopic third ventriculostomy and endoscopic tumor biopsy at our institution from October 1996 to January 2000. All patients were retrospectively evaluated. Results : There was no operative mortality. There was one cause of significant bleeding during biopsy, but was controlled endoscopically, and the patient recovered completely without neurologic deficit resulting from intra-operative bleeding. The symptoms related to increased intracranial pressure(ICP) have resolved in all patients, and the need for a shunt is completely eliminated. Histological diagnosis was achieved in 21 of the 22 patients by this procedure. A biopsy was not obtained in one patient. Although this pineal region tumor was seen endoscopically, this could not be biopsied because of technical difficulties in working around an enlarged massa intermedia. The lesions included fourteen germinomas, three mixed germ cell tumors, and one each of the followings: pineocytoma, pineoblastoma, pineocytoma/pineoblastoma(intermediate type), meningioma, and low grade glioma. Five of the 22 patients subsequently underwent formal microsurgical tumor removal. Additional chemotherapy or radiotherapy could then be initiated according to the histological diagnosis. Conclusion : We consider that endoscopy affords a minimally invasive way of reaching three objectives by one-step surgery in the management of pineal region tumors with associated hydrocephalus : 1) cerebrospinal fluid(CSF) sample for analysis of tumour markers and cytology, 2) treatment of hydrocephalus by third ventriculostomy, and 3) several biopsy specimens can be obtained identifying tumors which will require further open surgery or adjuvant radiation and/or chemotherapy. However, complications and morbidities should be emphasized so as to be avoided with further technical experience.