• Annals of Surgical Treatment and Research
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• 제95권6호
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• pp.297-302
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• 2018

Purpose: Increased robotic surgery is attended by increased reports of complications, largely due to limited operative view and lack of tactile sense. These kinds of obstacles, which seldom occur in open surgery, are challenging for beginner surgeons. To enhance robotic surgery safety, we created an augmented reality (AR) model of the organs around the thyroid glands, and tested the AR model applicability in robotic thyroidectomy. Methods: We created AR images of the thyroid gland, common carotid arteries, trachea, and esophagus using preoperative CT images of a thyroid carcinoma patient. For a preliminary test, we overlaid the AR images on a 3-dimensional printed model at five different angles and evaluated its accuracy using Dice similarity coefficient. We then overlaid the AR images on the real-time operative images during robotic thyroidectomy. Results: The Dice similarity coefficients ranged from 0.984 to 0.9908, and the mean of the five different angles was 0.987. During the entire process of robotic thyroidectomy, the AR images were successfully overlaid on the real-time operative images using manual registration. Conclusion: We successfully demonstrated the use of AR on the operative field during robotic thyroidectomy. Although there are currently limitations, the use of AR in robotic surgery will become more practical as the technology advances and may contribute to the enhancement of surgical safety.

• 한국간담췌외과학회지
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• 제27권1호
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• pp.40-48
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• 2023

Backgrounds/Aims: Timing of resection for synchronous colorectal liver metastasis (CRLM) has been debated for decades. The aim of the present study was to assess the feasibility of simultaneous resection of CRLM in terms of major complications and develop a prediction model for safe resections. Methods: A retrospective single-center study of synchronous, resectable CRLM, operated between 2013 and 2021 was conducted. Upper limit of 95% confidence interval (CI) of major complications (≥ grade IIIA) was set at 40% as the safety threshold. Logistic regression was used to determine predictors of morbidity. Prediction model was internally validated by bootstrap estimates, Harrell's C-index, and correlation of predicted and observed estimates. Results: Ninety-two patients were operated. Of them, 41.3% had rectal cancers. Major hepatectomy (≥ 4 segments) was performed for 25 patients (27.2%). Major complications occurred in 20 patients (21.7%, 95% CI: 13.8%-31.5%). Predictors of complications were the presence of comorbidities and major hepatectomy (area under the ROC curve: 0.692). Unacceptable level of morbidity (≥ 40%) was encountered in patients with comorbidities who underwent major hepatectomy. Conclusions: Simultaneous bowel and CRLM resection appear to be safe. However, caution should be exercised when combining major liver resections with bowel resection in patients with comorbid conditions.

• 한국간담췌외과학회지
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• 제27권2호
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• pp.158-165
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• 2023

Backgrounds/Aims: Within two years of surgery, 70% of resected intrahepatic cholangiocarcinoma (iCCA) recur. Better biomarkers are needed to identify those at risk of "early recurrence" (ER). In this study, we defined ER and investigated whether preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic-inflammatory index were prognostic of both overall relapse and ER after curative hepatectomy for iCCA. Methods: A retrospective cohort of patients who underwent curative-intent hepatectomy for iCCA between 2005 and 2017 were created. The cut-off timepoint for the ER of iCCA was estimated using a piecewise linear regression model. Univariable analyses of recurrence were conducted for the overall, early, and late recurrence periods. For the early and late recurrence periods, multivariable Cox regression with time-varying regression coefficient analysis was used. Results: A total of 113 patients were included in this study. ER was defined as recurrence within 12 months of a curative resection. Among the included patients, 38.1% experienced ER. In the univariable model, a higher preoperative NLR (> 4.3) was significantly associated with an increased risk of recurrence overall and in the first 12 months after curative surgery. In the multivariable model, a higher NLR was associated with a higher recurrence rate overall and in the ER period (≤ 12 months), but not in the late recurrence period. Conclusions: Preoperative NLR was prognostic of both overall recurrence and ER after curative iCCA resection. NLR is easily obtained before and after surgery and should be integrated into ER prediction tools to guide preoperative treatments and intensify postoperative follow-up.

• The Journal of Advanced Prosthodontics
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• 제3권1호
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• pp.51-55
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• 2011

BACKGROUND. Mandibular displacement is a common complication of condylar fracture. In the mandibular displacement due to condylar fracture, it is difficult to restore both esthetics and function without using orthognathic surgery. CASE DESCRIPTION. This clinical report described a full mouth rehabilitation in the patient with bilateral condylar fractures and displaced mandible using bilateral sagittal split ramus osteotomy (BSSRO) and simultaneous dental implant surgery. Mandibular position was determined by model surgery through the diagnostic wax up and restoration of fractured teeth. The precise amount of the mandibular shift can be obtained from the ideal intercuspation of remaining teeth. CLINICAL IMPLICATION. Mandibular displacement by both condylar fractures can be successfully treated by orthognathic surgery. Determination of occlusal plane and visualization from diagnostic wax up are mandatory for mandibular repositioning of model surgery. Stable occlusion and regular recall check up are needed for long-term outcome.

• 간호행정학회지
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• 제8권3호
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• pp.411-430
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• 2002

Purpose : This study was to develop Nursing Process Model of abdominal surgery patient using nursing diagnoses of NANDA, Nursing Interventions Classification(NIC), and Nursing Outcomes Classification(NOC). Method : The data in database were collected from nursing records in sixty patients with abdominal surgery admitted in a university hospital and open questionnaires of thirteen nurses. Systematic nursing process resulting from each nursing diagnoses, most common, was developed by the statistical analysis through database query from clinical database of abdominal surgery patients. Result : 51 nursing diagnoses were identified in abdominal surgery patients. The most commonly occurred nursing diagnoses were Pain, Risk for Infection, Sleep Pattern Disturbance, Hyperthermia, Altered Nutrition: Less Than Body Requirements in order. The linkage lists of NANDA to NIC and NANDA to NOC, and the nursing activities according to nursing diagnoses of abdominal surgery patients were identified in unit. Conclusion : Nursing Process of abdominal surgery patients was comprised of core nursing diagnoses, core nursing interventions, core nursing outcomes which provides the most reliable data in unit and could make nurses facilitate nursing process easily without full consideration of knowledge about nursing language classification system. Therefore, it could support nurses' decision making and recording of nursing process especially in the computerized patient record system if unit nursing process model using standardized nursing language system which contains of their own core nursing process data was developed.

• Journal of Gastric Cancer
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• 제24권3호
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• pp.246-256
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• 2024

Purpose: Peritoneal carcinomatosis (PC) presents a major challenge in the treatment of late-stage, solid tumors, with traditional therapies limited by poor drug penetration. We evaluated a novel hyperthermic pressurized intraperitoneal aerosol chemotherapy (HPIPAC) system using a human abdominal cavity model for its efficacy against AGS gastric cancer cells. Materials and Methods: A model simulating the human abdominal cavity and AGS gastric cancer cell line cultured dishes were used to assess the efficacy of the HPIPAC system. Cell viability was measured to evaluate the impact of HPIPAC under 6 different conditions: heat alone, PIPAC with paclitaxel (PTX), PTX alone, normal saline (NS) alone, heat with NS, and HPIPAC with PTX. Results: Results showed a significant reduction in cell viability with HPIPAC combined with PTX, indicating enhanced cytotoxic effects. Immediately after treatment, the average cell viability was 66.6%, which decreased to 49.2% after 48 hours and to a further 19.6% after 120 hours of incubation, demonstrating the sustained efficacy of the treatment. In contrast, control groups exhibited a recovery in cell viability; heat alone showed cell viability increasing from 90.8% to 94.4%, PIPAC with PTX from 82.7% to 89.7%, PTX only from 73.3% to 74.8%, NS only from 90.9% to 98.3%, and heat with NS from 74.4% to 84.7%. Conclusions: The HPIPAC system with PTX exhibits a promising approach in the treatment of PC in gastric cancer, significantly reducing cell viability. Despite certain limitations, this study highlights the system's potential to enhance treatment outcomes. Future efforts should focus on refining HPIPAC and validating its effectiveness in clinical settings.

• Archives of Plastic Surgery
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• 제35권5호
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• pp.626-629
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• 2008

Purpose: We investigate the possibility of vessel preservation with glycerol and evaluate the potential of preserved gastroepiploic artery as a tool for the microsurgical practice. Methods: In 5 early gastric cancer patients, IRB(No. C-0603-040-170), we gained gastroepiploic artery specimens(5 segments, about 10 cm) after gastrectomy. Each segment was rinsed in a normal saline and subsequently placed in a bottle, containing 50 mL anhydrous glycerol (87%). The bottles were refrigerated at $4^{\circ}C$, the longest preservation time being 5 months. Results: At first glance, no fragmentation was detected and the surface of vessel seemed mild sclerotic. In histological examination, vascular structures remained intact though preservation with glycerol led to a mild atrophy of the smooth muscle in the tunica media. Especially, we found out the elastic fibers and endothelial lining of the intima were preserved until 5 months. Adequate status for using microsurgical practice was also maintained and leakage test was performed successfully with gentian violet ink. Conclusion: Based on the results obtained in this study, the gastroepiploic artery preservation with glycerol as a training model for microvascular anastomosis is a technically very simple procedure and useful for the novice microsurgeon.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어학회 2011년도 제34차 학술대회
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• pp.14-14
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• 2011

• Archives of Plastic Surgery
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• 제40권4호
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• pp.327-329
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• 2013

As a technically demanding skill, microsurgery is taught in the lab, in the form of a course of variable length (depending on the centre). Microsurgical training courses usually use a mixture of non-living and live animal simulation models. In the literature, a plethora of microsurgical training models have been described, ranging from low to high fidelity models. Given the high costs associated with live animal models, cheaper alternatives are coming into vogue. In this paper we describe the use of the chicken aorta as a simple and cost effective low fidelity microsurgical simulation model for training.

• 한국가시화정보학회지
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• 제18권3호
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• pp.96-102
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• 2020

Oral cancer surgery changes the morphologic characteristics of the human upper airway. These changes can affect the flow patterns. In this study, computational fluid dynamics (CFD) simulations with transient solver were performed to numerically investigate the air flows in the human upper airways depending oral cancer surgery. 3D reconstructed models were obtained from 2D CT images of one patient. For the boundary condition, the realistic breathing cycle of human was applied. The hydraulic diameters of cross-sections for post-surgical model are changed greatly along streamwise direction, so these variations can cause higher wall shear stress and flow disturbance compared to pre-surgical model. The recirculation flows observed in the protruding region result in the relatively large pressure drop. These results can be helpful to understand the flow variations after resection surgery of oral cancer.