• Title/Summary/Keyword: Patient-specific guide

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Accuracy of Thoracolumbar Spine K-Wire Placement in Toy, Small and Medium Breed Dogs: Novice Surgeons with 3D Printed Patient-Specific Guide versus an Experienced Surgeon with Freehand Techniques

  • Hwa-Joeng Shin;Hae-Beom Lee;Yoon-Ho Roh
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.294-301
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    • 2022
  • Three-dimensional (3D) printing technique has been widely used for accurate screw and pin placement in orthopedic surgery and neurosurgery. However, there are few reports comparing the accuracy between the patient-specific guides and freehand Kirschner wire (K-wire) placement in toy, small and medium breed dogs. This study aimed to assess the accuracy of 3D printed patient-specific guides (PSGs) in pin insertion in the thoracolumbar vertebrae of toy breed dogs and compare the outcomes between novice and experienced surgeons. The experiment was conducted on the thoracolumbar vertebrae of 21 euthanized toy breed dogs (median weight, 5.95 kg). The optimal insertion angle placement was determined and patient-specific guides for K-wire insertion were designed and 3D printed using computed tomography (CT) and a 3D computer-aided design program of three vertebrae (Thoracic 12-Lumbar 1). K-wire tracts were made by experienced and novice surgeons and compared to assess the accuracy based on postoperative CT. Based on postoperative CT, in the experienced group, 61 out of 63 pins (96.8%) were fully contained inside the vertebral body and lamina, whereas two pins (3.2%) had perforated the vertebral canal (grade 3, 2-4 mm breach). However, all the pins in the novice group were fully contained. The use of 3D printed PSGs for pin insertion in the thoracolumbar region is an accurate and safe alternative to freehand screw placement by novice surgeons in toy, small and medium breed dogs. Operations with 3D printed PSGs allow novice surgeons to achieve better or similar outcomes in accurate placement of pin/screws in vertebrae.

Patient-specific Guides Using 3-dimensional Reconstruction Provide Accuracy and Reproducibility in Reverse Total Shoulder Arthroplasty

  • Yoon, Jong Pil;Kim, Dong Hyun;Jung, Jae Wook;Lee, Chang-Hwa;Min, Seunggi;Lee, Hyun Joo;Kim, Hee-June
    • Clinics in Shoulder and Elbow
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    • v.22 no.1
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    • pp.16-23
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    • 2019
  • Background: We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components. Methods: 20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image. Results: The superoinferior and anteroposterior offset in the glenoid component were $0.42{\pm}0.07$, $0.50{\pm}0.08$ in the conventional group and $0.45{\pm}0.03$, $0.46{\pm}0.02$ in the PSG group. The inclination and version angles were $-1.93^{\circ}{\pm}4.31^{\circ}$, $2.27^{\circ}{\pm}5.91^{\circ}$ and $0.46^{\circ}{\pm}0.02^{\circ}$, $3.38^{\circ}{\pm}2.79^{\circ}$. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were $0.45{\pm}0.12$, $0.48{\pm}0.15$ in the conventional group and $0.46{\pm}0.59$ (p=0.794), $0.46{\pm}0.06$ (p=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment. Conclusions: The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA.

Computed tomography-guided 3D printed patient-specific regional anesthesia

  • Jundt, Jonathon S.;Chow, Christopher C.;Couey, Marcus
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.325-329
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    • 2020
  • Classic anesthetic techniques for the inferior alveolar nerve, lingual nerve, and long buccal nerve blockade are achieved by estimating the intended location for anesthetic deposition based on palpation, inspection, and subsequent correlation for oral anatomical structures. The present article utilizes computed tomography (CT) data to 3D print a guide for repeatable and accurate deposition of a local anesthetic at the ideal location. This technical report aims to anatomically define the ideal location for local anesthetic deposition. This process has the potential to reduce patient discomfort, risk of nerve damage, and failed mandibular anesthesia, as well as to reduce the total anesthetic dose. Lastly, as robotic-based interventions improve, this provides the initial framework for robot-guided regional anesthesia administration in the oral cavity.

Recent advances in the reconstruction of cranio-maxillofacial defects using computer-aided design/computer-aided manufacturing

  • Oh, Ji-hyeon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.2.1-2.7
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    • 2018
  • With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.

Nursing Interventions of the Lupus Patient (루푸스(Lupus) 환자의 간호중재)

  • Kim, Myung-Ja;Sohng, Kyeong-Yae
    • Journal of muscle and joint health
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    • v.2 no.2
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    • pp.197-208
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    • 1995
  • The purpose of this study is to describe specific system manifestations and suggested nursing interventions in patients with lupus. Lupus is a chronic, inflammatory, multisystemic disorder of the immune system. Antibodies are formed which react against the person's own normal tissue. This abnormal response can be very damaging and leads to the many manifestations of the lupus. Lupus can affect any part of the body, and patients experience symptoms in organs involved. So lupus patients have integumentary, blood, central nervous system, eye, gastrointestinal, musculoskeletal, kidney, heart and lining membranes, reproductive system involvement. The courses are unpredictable and very individualized. Lupus varies greatly in severity from mild cases requiring minimal interventions to those in which significant damage occurs to vital organs such as the lungs, heart, kidney and brain which ultimately can be fatal. In addition to direct physical care, the nursing professional has an excellent position from which to support the lupus patient. Patients need assistance with receiving current, accurate information about the disease process and also to be helped in developing realistic expectations and goals. Nursing interventions for the patient with lupus is challenge drawing on at the resources, knowledge and strengths the nursing teams have to offer. Because of the unpredictable, highly individualized and frequently changing the nature of the disease itself as well as the intricacy of the patient's needs. The nurse has a key role in its management. The patient and nurse, working together, have much to offer each other. These are of inestimable value to the patient. As the nurse listens to the patient and learns what problems the patient perceives, can guide the patient in a self-help program that allows to adapt to living with a chronic illness.

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Full mouth rehabilitation of a patient with severe tooth erosion with a digital crown lengthening guide (심한 부식 환자의 디지털 치관연장술 가이드를 이용한 전악 수복 증례)

  • Park, Yunjae;Hong, Seoung-Jin;Paek, Janghyun;Pae, Ahran;Kim, Hyeong-Seob
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.3
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    • pp.280-287
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    • 2019
  • In the oral cavity, the teeth undergo wear and corrosion throughout their lives. Progressive and constant tooth wear is a natural phenomenon of aging, but wear and corrosion due to specific factors are pathological factors. It can cause pathological damage of the occlusal surface, aesthetic problems, dimensional loss and jaw joint disorders. This case is a 26-year-old female patient with general tooth abrasion and erosion on the entire dentition. Diagnostic wax-up was fabricated based on the information including digital facial analysis, physiological stabilization, and evaluation of anterior crown length. Through the digital analysis, the necessary guides for crown lengthening were prepared and the mastication function and esthetics were evaluated by using temporary crowns. Definitive prosthesis was fabricated with the zirconia restorations. The results were satisfactory when they were observed 3 months of follow-up.

Single oblique osteotomy for correction of congenital radial head luxation with concurrent complex angular limb deformity in a dog: a case report

  • Kim, Junhyung;Song, Jaeyong;Kim, Sun-Young;Kang, Byung-Jae
    • Journal of Veterinary Science
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    • v.21 no.4
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    • pp.62.1-62.7
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    • 2020
  • A 5-month old Shih Tzu was diagnosed with congenital elbow luxation and uniapical complex angular deformity of the radius. Single radial oblique and dynamic ulnar osteotomies were performed, using patient-specific 3D-printed osteotomy guide. External skeletal fixation was maintained for three weeks to prevent re-luxation of elbow joint. Three months after the surgery, objective gait analysis indicated markedly improved limb function. In addition, radiograph showed improved congruity of elbow joint and appropriate bone healing. In dogs with congenital radial head luxation and concurrent complex angular deformity, a single oblique osteotomy might be a viable option to preserve bone length and correct the luxation of elbow joint.

Breaking Bad News: Patient Preferences and the Role of Family Members when Delivering a Cancer Diagnosis

  • Rao, Abha;Sunil, Bhuvana;Ekstrand, Maria;Heylen, Elsa;Raju, Girish;Shet, Arun
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1779-1784
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    • 2016
  • Background: Western physicians tend to favour complete disclosure of a cancer diagnosis to the patient, while non-Western physicians tend to limit disclosure and include families in the process; the latter approach is prevalent in clinical oncology practice in India. Few studies, however, have examined patient preferences with respect to disclosure or the role of family members in the process. Materials and Methods: Structured interviews were conducted with patients (N=127) in the medical oncology clinic of a tertiary referral hospital in Bangalore, India. Results: Patients ranged in age from 18-88 (M=52) and were mostly male (59%). Most patients (72%) wanted disclosure of the diagnosis cancer, a preference significantly associated with higher education and English proficiency. A majority wanted their families to be involved in the process. Patients who had wanted and not wanted disclosure differed with respect to their preferences regarding the particulars of disclosure (timing, approach, individuals involved, role of family members). Almost all patients wanted more information concerning their condition, about immediate medical issues such as treatments or side effects, rather than long-term or non-medical issues. Conclusions: While most cancer patients wanted disclosure of their disease, a smaller group wished that their cancer diagnosis had not been disclosed to them. Regardless of this difference in desire for disclosure, both groups sought similar specific information regarding their cancer and largely favoured involvement of close family in decision making. Additional studies evaluating the influence of factors such as disease stage or family relationships could help guide physicians when breaking bad news.

Survey of Life and Dietary Styles on Patients with Gastroesophageal Reflux Disease (역류성 식도질환 환자의 생활습관 및 식습관 조사연구)

  • Kim, Hyun-Soo;Sohn, Minji;Sohn, Uy Dong
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.4
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    • pp.248-254
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    • 2014
  • Objective: It was surveyed how to help patients get better treatment for their disease by making complements based on the survey outcomes when the pharmacists guide how to administer medicine. Methods: A total of 142 gastroesophageal reflux disease (GERD) patients answered the self-answering questions consist of 15 items about their general characteristic, lifestyle and dietary style. The frequency of survey materials was analyzed to find out specific figures of surveyed patient's general characteristic, lifestyle and eating habits. Results: Based on the outcomes on analysis there was no difference between female and male patients. The characteristic based on the age group, as ones grow older, the number of GERD patients also increased. In case on the characteristic in lifestyle, many patients had improper habit to treat GERD. The items were smoking habits, stress control habit, sleeping postures and the way in wearing outfits. In case of postures after having a meal, they had right lifestyle. Patients had improper habit in eating food. They enjoyed pungent food and drinks which can hinder the treatment. In case of the time of having meal, eating habit of meat and vegetables and eating food less than an hour before go to bed, this research showed that they have the right lifestyle. Conclusion: This research indicate that pharmacists give guidance GERD patients to stop smoking that is causative of GERD and guide patients have mental stability, and patients avoid pungent food and drinks such as coffee, soda, chocolates and mint candies.

A study on the minimal acupuncture using a modified guide tube for Korean female participants familiar with acupuncture therapy (침치료에 익숙한 한국의 여자 임상시험 피험자를 대상으로 한 침관 변형을 통한 Minimal acupuncture 경험)

  • Roh, Jin-Ju;Jung, Su-Kyoung;Choi, Min-Sun;Choi, Sun-Mi;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.3
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    • pp.200-212
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    • 2007
  • Purpose: To find objective validity of minimal acupuncture using a modified guide tube as a method to verify the effect of acupuncture. Methods: Subjects of this study were participants of a randomized clinical trial which was practiced to verify the effect of acupuncture on postmenopausal hot flash. There were 2 arms of treatment, one's for active acupuncture group(AG) with manipulation and De qi, the other's for minimal acupuncture group(MG) using a modified guide tube which was designed to give minimal stimulation to the patient. After 8 weeks' treatment followed by 4 weeks' observation, participants were asked to fill in self-report forms on their education, previous experiences of acupuncture, original idea on the efficacy of acupuncture and recognition of blinding. Results: 19 participants of 26 in AG and 19 of 26 in MG completed the self-report form. There was no difference between AG and MG in their education(p=0.5976, Fisher exact test) and previous experiences of acupuncture(p=0.9999, Fisher exact test). In their original ideas on the efficacy of acupuncture, most of AG and MG respondents have been thought that acupuncture is very effective or quite effective, and there was no difference between 2 groups(p=0.5065). 16 of 19 in AG and 14 of 19 in MG believed that they underwent more effective way, there was no statistical difference between 2 groups(p=0.6928, Fisher exact test). Participants believed in undergoing more effective way not because they recognized treatment method, but they were satisfied with the effectiveness of treatment retrospectively. Conclusion: As the result of this study, these authors suggest that minimal acupuncture using a modified guide tube is acceptable as a method to verify the effect of acupuncture in acupuncture-familiar Korean culture. Also further studies on the stimulation-specific effect of minimal acupuncture are demanded.

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