• Title/Summary/Keyword: Model surgery

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Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis

  • Colak, Ozlem;Kankaya, Yuksel;Sungur, Nezih;Ozer, Kadri;Gursoy, Koray;Serbetci, Kemal;Kocer, Ugur
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.228-234
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    • 2019
  • Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model. Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded. Results The maximum tensile strength until failure was $44.6{\pm}4.3N$ in group 1, $35.7{\pm}5.2N$ in group 2, and $56.7{\pm}17.3N$ in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05). Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options.

Analysis of Scoliosis Correction Effects according to Instrumentation Devices using a Finite Element Model (유한요소 모델을 이용한 척추 측만증 교정 시 교정 기구에 따른 효과 분석)

  • 김영은;손창규;이광희;최형연;이춘기
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.8
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    • pp.157-163
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    • 2004
  • Scoliosis is a complex musculoskeletal dieses requiring 3-D treatment with surgical instrumentation. To investigate the effects of correction surgery, a finite element model of personalized model of the scoliotic spine that will allow the design of clinical test providing optimal estimation of the post-operation results was developed. Three dimensional skeletal parts, such as vertebrae, clavicle and scapular were modeled as rigid bodies with keeping their morphologies. Kinematical joints and spring elements were adapted to represent the inter-vertebral disc and ligaments respectively. With this model, two types of surgery procedure, distraction procedure with Harrington device and rod derotation procedure with pedicle screw and rod system had been carried out. The obtained simulation results were comparatively corresponding to the post operational outcomes and successfully demonstrated qualitative analysis of surgical effectiveness. From this analysis, it has been found that the preparing of appropriate rod curvature and its insertion was more important than just performing the excessive derotation for scoliosis correction.

Lack of Influence of an XRCC3 Gene Polymorphism on Oral Cancer Susceptibility: Meta-analysis

  • Zhang, En-Jiao;Cui, Zhi-Gang;Xu, Zhong-Fei;Duan, Wei-Yi;Huang, Shao-Hui;Tan, Xue-Xin;Yin, Zhi-Hua;Sun, Chang-Fu;Lu, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10329-10334
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    • 2015
  • Background: To systematically summarize the association between the X-ray repair cross complementing 3 (XRCC3) gene polymorphism and oral cancer susceptibility by meta-analysis. Materials and Methods: Databases including PubMed, EMbase, CNKI, VIP and WanFang Data were searched to identify case-control studies concerning the association between an XRCC3 gene polymorphism and the risk of oral cancer from the inception to June 2014. Two reviewers independently screened the literature according to the criteria, extracted the data and assessed the quality. Then meta-analysis was performed using Stata 11.0 software. Results: Seven published case-control studies including 775 patients with oral cancer and 1922 controls were selected. Associations between the rs861539 polymorphism and overall oral cancer risk were not statistically significant in all kinds of comparison models (CT vs CC: OR=0.94, 95%CI=0.74-1.18; TT vs CC: OR=0.94, 95%CI=0.64-1.38; dominant model: OR=0.95, 95%CI=0.76-1.18; recessive model: OR=0.94, 95%CI=0.69-1.29; allele T vs C: OR=0.97, 95%CI=0.84-1.11). In the stratified analysis by ethnicity, no significant associations were found among Asians and Caucasians. On stratification by tumor type, no significant associations were found for cancer and oral premalignant lesions. Conclusions: The XRCC3 gene polymorphism was not found to be associated with the risk of oral cancer. Considering the limited quality of the included case-control studies, more high quality studies with large sample size are needed to verify the above conclusion.

Effect of 4-hexylresorcinol on Blood Coagulation and Healing of Injured Vessel in a Rat Model

  • Park, Yong-Tae;Park, Si-Yeok;Kim, Min-Keun;Kim, Seong-Gon;Park, Young-Wook;Kwon, Kwang-Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.5
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    • pp.284-293
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    • 2013
  • Purpose: For reconstruction of craniomaxillofacial defects caused by tumor, trauma, infection etc, free flap transplantation with microvascular surgery is a very useful method. Thrombus formation at the anastomosis site is the major cause of graft failure. 4-Hexylresorcinol (4-HR) is generally known as an antiseptic and antiparasitic agent. This study was conducted in order to evaluate the effect of 4-HR on blood coagulation in vitro. In addition, we investigated thrombus formation and endothelial repair of an injured vessel in an animal model. Methods: In the in vitro experiment, we compared blood coagulation time between the 4-HR treated group and normal blood. Thirty rats were used for in vivo animal experiments. After exposure of the right femoral vein, a micro vessel clamp was placed and the femoral vein was intentionally cut. Microvascular anastomosis was performed on all rats using 10-0 nylon under microscopy. The animals were divided into two groups. In the experimental group (n=15), 4-HR (250 mg/kg) mixed with olive oil (10 mL/kg) was administered per os daily. Animals in the control group (n=15) were given olive oil only. The animals were sacrificed at three days, seven days, and fourteen days after surgery and rat femoral vein samples were taken. Vascular patency and thrombus formation were investigated just before sacrifice. Histologic analysis was performed under a microscope. Results: Results of an in vitro blood coagulation test showed that coagulation time was delayed in the 4-HR treated group. The results obtained from an in vivo 4-HR administered rat model showed that the patency of all experimental groups was better at thirty minutes, seven days, and fourteen days after microvascular anastomosis than that of the control group at seven and fourteen days after anastomosis, and the amount of thrombus in the experimental groups was much less than that of the control group. Endothelial repair was observed in the histologic analysis. Conclusion: Findings of this study demonstrated that blood coagulation was delayed in the vitro 4-HR treated group. In addition, good vascular patency, anti-thrombotic effect, and repair of venous endothelial cells were observed in the vivo 4-HR administered rat group.

Novel Resectable Myocardial Model Using Hybrid Three-Dimensional Printing and Silicone Molding for Mock Myectomy for Apical Hypertrophic Cardiomyopathy

  • Wooil Kim;Minje Lim;You Joung Jang;Hyun Jung Koo;Joon-Won Kang;Sung-Ho Jung;Dong Hyun Yang
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1054-1065
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    • 2021
  • Objective: We implemented a novel resectable myocardial model for mock myectomy using a hybrid method of three-dimensional (3D) printing and silicone molding for patients with apical hypertrophic cardiomyopathy (ApHCM). Materials and Methods: From January 2019 through May 2020, 3D models from three patients with ApHCM were generated using the end-diastolic cardiac CT phase image. After computer-aided designing of measures to prevent structural deformation during silicone injection into molding, 3D printing was performed to reproduce anatomic details and molds for the left ventricular (LV) myocardial mass. We compared the myocardial thickness of each cardiac segment and the LV myocardial mass and cavity volumes between the myocardial model images and cardiac CT images. The surgeon performed mock surgery, and we compared the volume and weight of the resected silicone and myocardium. Results: During the mock surgery, the surgeon could determine an ideal site for the incision and the optimal extent of myocardial resection. The mean differences in the measured myocardial thickness of the model (0.3, 1.0, 6.9, and 7.3 mm in the basal, midventricular, apical segments, and apex, respectively) and volume of the LV myocardial mass and chamber (36.9 mL and 14.8 mL, 2.9 mL and -9.4 mL, and 6.0 mL and -3.0 mL in basal, mid-ventricular and apical segments, respectively) were consistent with cardiac CT. The volume and weight of the resected silicone were similar to those of the resected myocardium (6 mL [6.2 g] of silicone and 5 mL [5.3 g] of the myocardium in patient 2; 12 mL [12.5 g] of silicone and 11.2 mL [11.8 g] of the myocardium in patient 3). Conclusion: Our 3D model created using hybrid 3D printing and silicone molding may be useful for determining the extent of surgery and planning surgery guided by a rehearsal platform for ApHCM.

Galectin-9 Acts as a Prognostic Factor with Antimetastatic Potential in Hepatocellular Carcinoma

  • Zhang, Zhao-Yang;Dong, Jia-Hong;Chen, Yong-Wei;Wang, Xian-Qiang;Li, Chong-Hui;Wang, Jian;Wang, Guo-Qiang;Li, Hai-Lin;Wang, Xue-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2503-2509
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    • 2012
  • Considerable research has been conducted concerning galectin-9 and carcinomas, but little information is available about any relation with the hepatocellular carcinoma. In this study, we employed a small interfering RNA (siRNA) targeting galectin-9 to down-regulate the expression in HepG2 cells. As a result, after galectin-9 expression was reduced, cell aggregation was suppressed, while other behaviour such as the proliferation, adhesion and invasion to ECM, cell-endothelial adhesion and transendothelial invasion of the cells were markedly enhanced. When tumors of 200 patients with hepatocellular carcinoma were tested for galectin-9 expression by immunohistochemistry, binding levels demonstrated intimate correlations with the histopathologic grade, lymph node metastasis, vascular invasion and intrahepatic metastasis (P<0.05). Moreover, survival analysis indicated that patients with galectin-9 expression had much longer survival time than those with negative lesions, and the Log-rank test indicated that this difference was statistical significant (P<0.0001). The Cox proportional hazards model suggested that negative galectin-9 expression in hepatocellular carcinoma represented a significant risk factor for patient survival. We propose that galectin-9 might be a new prognostic factor with antimetastatic potential in patients with hepatocellular carcinoma.

Clinical changes of TMD and condyle stability after two jaw surgery with and without preceding TMD treatments in class III patients

  • Yoon, Sang-Yong;Song, Jae-Min;Kim, Yong-Deok;Chung, In-Kyo;Shin, Sang-Hun;Pusan Korea Pusan National University
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.9.1-9.7
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    • 2015
  • Background: This study are to identify the symptomatic changes and condylar stability after 2 jaw surgery without preceding treatments for Temporomandibular joints(TMJ) in class III patients with the TMJ symptoms; and to assess therapeutic effect of 2 jaw surgery and the necessity of preceding treatment for alleviation of TMJ symptoms. Methods: 30 prognathic patients with preexisting TMJ symptoms were divided into 2 groups according to presence or absence of preceding treatments before the surgery. We evaluated symptomatic changes on both TMJ by questionnaires and clinical examinations. And we reconstructed 3D cone beam computed tomography images before 2 jaw surgery, immediately after the surgery, and 6 months or more after the surgery with SimPlant software, and analyzed the stability of condylar position on 3D reconstruction model. Significances were assessed by the Wilcoxon signed rank test on SPSS ver. 20.0. Results: Both groups had favorable changes of TMJ symptoms after orthognathic surgery. And postoperative position of condyle had good stability during follow-up period. Conclusion: 2 jaw surgery without preceding treatments for TMD can have therapeutic effect for TMD patients with class III malocclusion.

Survival benefit of neoadjuvant FOLFIRINOX for patients with borderline resectable pancreatic cancer

  • Evelyn Waugh;Juan Glinka;Daniel Breadner;Rachel Liu;Ephraim Tang;Laura Allen;Stephen Welch;Ken Leslie;Anton Skaro
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.229-237
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    • 2024
  • Backgrounds/Aims: While patients with borderline resectable pancreatic cancer (BRPC) are a target population for neoadjuvant chemotherapy (NAC), formal guidelines for neoadjuvant therapy are lacking. We assessed the perioperative and oncological outcomes in patients with BRPC undergoing NAC with FOLFIRINOX for patients undergoing upfront surgery (US). Methods: The AHPBA criteria for borderline resectability and/or a CA19-9 level > 100 µ/mL defined borderline resectable tumors retrieved from a prospectively populated institutional registry from 2007 to 2020. The primary outcome was overall survival (OS) at 1 and 3 years. A Cox Proportional Hazard model based on intention to treat was used. A receiver-operator characteristics (ROC) curve was constructed to assess the discriminatory capability of the use of CA19-9 > 100 µ/mL to predict resectability and mortality. Results: Forty BRPC patients underwent NAC, while 46 underwent US. The median OS with NAC was 19.8 months (interquartile range [IQR], 10.3-44.24) vs. 10.6 months (IQR, 6.37-17.6) with US. At 1 year, 70% of the NAC group and 41.3% of the US group survived (p = 0.008). At 3 years, 42.5 % of the NAC group and 10.9% of the US group survived (p = 0.001). NAC significantly reduced the hazard of death (adjusted hazard ratio, 0.20; 95% confidence interval, 0.07-0.54; p = 0.001). CA19-9 > 100 µ/mL showed poor discrimination in predicting mortality, but was a moderate predictor of resectability. Conclusions: We found a survival benefit of NAC with FOLFIRINOX for BRPC. Greater pre-treatment of CA19-9 and multivessel involvement on initial imaging were associated with progression of the disease following NAC.