• Title/Summary/Keyword: Soft-tissue procedure

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Derivation of a Monte Carlo Estimator for Dose Equivalent (몬테칼로법을 위한 선량당량 산정법의 도출)

  • Lee, Jai-Ki
    • Journal of Radiation Protection and Research
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    • v.10 no.2
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    • pp.89-95
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    • 1985
  • An alternative estimator for dose equivalent was derived. The original LET distribution concept was transformed into a charged particle fluence spectrum concept along with the definition of an average quality factor named slowing-down averaged quality factor by adopting the continuous slowing down approximation. With the alternative estimator, the dose equivalent delivered into a receptor located in a given radiation field can be directly and conveniently estimated in a Monte Carlo procedure. The slowing-down averaged quality factors for the energy range below 10 MeV were evaluated and tabulated for the charged particles which may be generated from the interactions of neutron with the nuclei composing soft tissue.

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Development of Intelligent Robot for Anastomosis of Intestine (대장 소장 원형문합수술을 위한 지능형 로봇개발)

  • Kwun Y.M.;Hong J.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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    • pp.139-143
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    • 2005
  • As increasing gastrointestinal pathologies, general and thoracic surgeries using circular staplers have been dramatically increased. Because of convenience for surgical procedure, recently, various circular staplers for anastomosis have been used widely. Since the circular staplers conventional have used the displacement control method, however, the anastomosis could have various biomechanical conditions. To do that, biomechanical system of gastrointestinal soft tissue should be examined to control the anastomotic condition. In this study, a new intelligent robot used in circular anastomosis. The intelligent robot driven by a stepper motor and controlled by a digital signal processor.

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Infection of Thyroid Cyst Occurring 1 Month after Fine-Needle Aspiration in an Immunocompetent Patient

  • Park, Jung Kyu;Jeon, Eon Ju
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.182-188
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    • 2018
  • Fine-needle aspiration (FNA) with ultrasonography is considered a minimally invasive and safe procedure. Complications of it are infrequent and occur immediately or within a few days after FNA. Such complications may occur mainly in patients with underlying problems. We here report a rare case of thyroid cystic nodule infection occurring 1 month after FNA in an immunocompetent patient and serial sonographic findings in this patient. A 33-year-old woman with a cystic nodule including partially isoechoic solid areas on the right thyroid gland complained of difficulty swallowing and painful sensations in the right neck 1 month after FNA. On follow-up examination, the cystic nodule and perithyroidal soft tissue were suspicious of infection. The possibility of infection after FNA should be considered even if the patient is immunocompetent in order to prompt evaluation and immediate management with empirical antibiotic therapy to avoid life-threatening complications.

Basic Rules of Incision in Periodontal Flap Preparation (임상가를 위한 특집 3 - 치주판막 절개의 기본원리)

  • Shin, Seung-Il
    • The Journal of the Korean dental association
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    • v.50 no.8
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    • pp.474-481
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    • 2012
  • The periodontal flap surgery is the most widely utilized surgical procedure to reduce the pocket depth and to access the subgingival root surfaces for scaling and root planing. The diagnosis of the periodontal lesion and the objective of the surgery will dictate the type of flap procedure which will be utilized to obtain the best result. The incisions, type of flap and the selection of suturing design must be planned and executed to fit the problem. Periodontal flaps are designed to preserve gingival integrity and to gain access to root surfaces for residual calculus removal and to thoroughly remove granulation tissue so bone defects can be visualized and treated. Gentle and efficient procedures result in optimum healing and minimal postoperative pain. When flaps need to be repositioned apically or less often, coronally, then the flaps must sit passively at the appropriate level before suturing. To ensure this, buccal and lingual flaps need to be elevated beyond the mucogingival junction so the elasticity of the mucosa allows for flap mobility. Sometimes it may be necessary to extend the flap elevation apically with a split incision approach to minimize the effect of the less elastic periosteum. Vertical incisions can aid in flap positioning by allow ing the clinician to suture the flap at a different level to the adjacent untreated gingiva. In osseous periodontal surgery, flaps are apically positioned to minimize postoperative pocket depth. In regenerative periodontal surgery including implant surgery, soft tissue cove rage of bony defects, graft materials, membranes, and bio logic agents is important so sulcular incisions and light suturing techniques are crucial.

Reconstruction after Wide Excision of Malignant Soft Tissue Tumor in Ankle and Foot (족관절 및 족부에 발생한 연부 조직 악성 종양의 광범위 절제술 후 재건술)

  • Kwon, Young-Ho;Cho, Yool;Kim, Jae-Do;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.33-43
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    • 2008
  • Purpose: To evaluate the clinical usability of reconstructive methods, and how to select flap after wide excision of malignant soft tissue tumor in ankle and foot. Materials and Methods: The 15 cases shown in the 14 patients (In case of a male patient, reconstruction was performed two times due to local recurrence.) with malignant soft tissue tumor in ankle and foot, who underwent reconstruction after wide excision from March 2000 until March 2007. Oncologic, surgical and functional results were evaluated. Results: The method of reconstruction used were anterolateral thigh perforator flap (5cases), Reversed superficial sural artery flap (4 cases), dorsalis pedis flap (3 cases), local flap (3cases). The defect, mean size was $5.5{\times}5.7\;cm$, was reconstructed with rotation flap or free flap, mean size was $5.9{\times}6.0\;cm$, skin graft for remnant. The mean operation time was 310 minutes (120~540 minutes); it took 256 minutes to reconstruct by rotation flap, and 420 minutes by free flap. As oncologic results, 7 patients were no evidence of disease, 6 patients were alive with disease and 1 patient was expired by pulmonary metastasis at the time of the last follow-up. 4 patients had local recurrence and 4 pateints had distant metastases. As functional results, 14 patients were evaluated with average score of 68.8% using the system of the Musculoskeletal Tumor Society. Conclusion: The dorsalis pedis and reverse superficial sural artery rotation flap which is easy procedure, has less complication and takes short operation time, can be primarily considered to reconstruct a small defect. And the anterolateral thigh perforator flap is suitable for coverage of a large defects after wide excision of malignant soft tissue tumor in ankle and foot.

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APPLICATION OF THERMOFORMED APPLIANCES IN PEDIATRIC DENTISTRY (소아치과 임상에서의 Thermoformed Appliance의 적용)

  • Kim, Shin;Jeong, Tae-Sung;Yang, Chul-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.539-544
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    • 1998
  • Thermoformed appliance, which has been recently introduced for dental usage, is an appliance made of thermoformed sheets and formed with positive or negative pressure under heat. Thermoplastic material is a kind of plastics and can be repeatedly softened by heat. It is classified into hard elastic foil, hard/soft compound foil and soft elastic foil, including BIOPLAST, BIOCRYL, IMPRELON, etc. It has been developed in 1969 and is available in various thickness, shape and color. There are two types of Vacuum former for thermoplastic materials; the pressure type and suction type. The former is much better than the latter for fabrication of various appliances due to its higher pressure. The authors have applied these appliances to some cases - chin cap, active retainer, individual Fluoride tray, mouth protector, bracket transfer mask, bruxism splint(night guard), Essix appliance - by pressure type Vacuum former($Biostar^{(R)}$). The thermoplastic appliances have numerous advantages such as simple procedure, short working time, clean and transparent product, less objectionable taste. But its outstanding advantage would be its excellent biocompatibility bacause it has no monomer and hence no tissue irritation. Although there is some limitations in its usage, it can be used widely for various purposes especaily for pediatric dentistry.

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Usefulness Evaluation of Artifacts by Bone Cement of Percutaneous Vertebroplasty Performed Patients and CT Correction Method in Spine SPECT/CT Examinations (척추 뼈 SPECT/CT검사에서 경피적 척추성형술 시행 환자의 골 시멘트로 인한 인공물과 CT보정방법의 유용성 평가)

  • Kim, Ji-Hyeon;Park, Hoon-Hee;Lee, Juyoung;Nam-Kung, Sik;Son, Hyeon-Soo;Park, Sang-Ryoon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.49-61
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    • 2014
  • Purpose: With the aging of the population, the attack rate of osteoporotic vertebral compression fracture is in the increasing trend, and percutaneous vertebroplasty (PVP) is the most commonly performed standardized treatment. Although there is a research report of the excellence of usefulness of the SPECT/CT examination in terns of the exact diagnosis before and after the procedure, the bone cement material used in the procedure influences the image quality by forming an artifact in the CT image. Therefore, the objective of the research lies on evaluating the effect the bone cement gives to a SPECT/CT image. Materials and Methods: The images were acquired by inserting a model cement to each cylinder, after setting the background (3.6 kBq/mL), hot cylinder (29.6 kBq/mL) and cold cylinder (water) to the NEMA-1994 phantom. It was reconstructed with Astonish (Iterative: 4 Subset: 16), and non attenuation correction (NAC), attenuation correction (AC+SC-) and attenuation and scatter correction (AC+SC+) were used for the CT correction method. The mean count by each correction method and the count change ratio by the existence of the cement material were compared and the contrast recovery coefficient (CRC) was obtained. Additionally, the bone/soft tissue ratio (B/S ratio) was obtained after measuring the mean count of the 4 places including the soft tissue(spine erector muscle) after dividing the vertebral body into fracture region, normal region and cement by selecting the 20 patients those have performed PVP from the 107 patients diagnosed of compression fracture. Results: The mean count by the existence of a cement material showed the rate of increase of 12.4%, 6.5%, 1.5% at the hot cylinder of the phantom by NAC, AC+SC- and AC+SC+ when cement existed, 75.2%, 85.4%, 102.9% at the cold cylinder, 13.6%, 18.2%, 9.1% at the background, 33.1%, 41.4%, 63.5% at the fracture region of the clinical image, 53.1%, 61.6%, 67.7% at the normal region and 10.0%, 4.7%, 3.6% at the soft tissue. Meanwhile, a relative count reduction could be verified at the cement adjacent part at the inside of the cylinder, and the phantom image on the lesion and the count increase ratio of the clinical image showed a contrary phase. CRC implying the contrast ratio and B/S ratio was improved in the order of NAC, AC+SC-, AC+SC+, and was constant without a big change in the cold cylinder of the phantom. AC+SC- for the quantitative count, and AC+SC+ for the contrast ratio was analyzed to be the highest. Conclusion: It is considered to be useful in a clinical diagnosis if the application of AC+SC+ that improves the contrast ratio is combined, as it increases the noise count of the soft tissue and the scatter region as well along with the effect of the bone cement in contrast to the fact that the use of AC+SC- in the spine SPECT/CT examination of a PVP performed patient drastically increases the image count and enables a high density of image of the lesion(fracture).

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HEALING PATTERN OF BONE REGERNERATION IN PERIIMPLANT SPACE AFTER IMMEDIATE IMPLANT PLACEMENT;AN EXPERIMENTAL STUDY IN DOGS (발치후 즉시 임프란트 식립시 임프란트 주위공간의 치유양상에 관한 실험적 연구)

  • Choi, Mee-Sook;Kim, Jong-Eon;Kang, Bo-Won;Kim, Sung-Moon;Rim, Jae-Suk;Kwon, Jong-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.499-507
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    • 1994
  • The aim of this experiment is to compare the healing process of extraction sockets after immediate implant placement with those using autogenous bone grafts and guided tissue regeneration with Gore-Tex. The first lower premolars and the second premolars of six experimental dogs were extracted and Stryker fin type implants were placed into the extraction sockets immediately after extraction. In the control group, any graft materials were'not used and the dead space around implants was left in itself and covered with only periosteum. In the experimental group A, implants were covered with Gore tex without any bone grafts, and in the experimental group B, the dead space around implants was filled with the bone chips gained from drilling procedure. Each experimental dogs were sacrificed at the 1st, 2nd, 3rd, 6th, and 8th week and the specimens were observed by gross examination, radiological examination, and light microscopic examination. The following results were obtained. 1. Well healed soft tissue and no mobility of the implants were observed in control and two experimental groups. 2. In the radiogical examination, radiopacity around implants had been increased gradually. 3. In the microscopic examination, there were good healing process and active new bone formation in both in the experimental groups, Especially the more amount of new bone formation occurred in the experimental group B using bone chips. 4. Bone chip grafts and guided tissue regeneration (GTR) using Gore-Tex may be one of the successful methods in the immediate implantation.

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Role of Muscle Free Flap in the Salvage of Complicated Scalp Wounds and Infected Prosthetic Dura

  • Han, Dae Hee;Park, Myong Chul;Park, Dong Ha;Song, Hyunsuk;Lee, Il Jae
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.735-741
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    • 2013
  • Background The prosthetic dura is an essential element in the protection of the cranial parenchyma and prevention of cerebrospinal fluid leakage. Although prosthetic dura are widely used in neurosurgery, they occasionally provoke infection, which can be a major concern after neurosurgical treatment. However, removal of the prosthetic dura carries a risk of brain parenchyma injury and cerebrospinal fluid leakage. The salvage of infected prosthetic dural material has not been adequately addressed in the literature. In this study, we demonstrate the value of the combination of a meticulous surgical debridement of necrotic tissue and simultaneous muscle free flap for intractable postoperative epidural abscess without removal of the infected prosthetic dura. Methods Between 2010 and 2012, we reviewed the data of 11 patients with persistent infection on the prosthetic dura. The epidural infections each occurred after a neurosurgical procedure, and there was soft tissue necrosis with the disclosure of the underlying prosthetic dura and dead bone around the scalp wound. To salvage the infected prosthetic dura, meticulous debridement and a muscle free flap were performed. Results All 11 patients experienced complete recovery from the complicated wound problem without the need for further surgical intervention. No signs of prosthetic dural infection were observed during the mean follow-up period of 11 months. Conclusions The combination of a meticulous surgical debridement and coverage with a muscle free flap is an effective treatment for salvage of infected prosthetic dura.

A novel amnion-chorion allograft membrane combined with a coronally advanced flap: a minimally invasive surgical therapy to regenerate interdental papillary soft tissue recession - a six-month postoperative image analysis-based clinical trial

  • Pitale, Unnati;Pal, Pritish Chandra;Boyapati, Ramanarayana;Bali, Ashish;Varma, Manish;Khetarpal, Shaleen
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.6
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    • pp.438-444
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    • 2021
  • Objectives: Loss of the interdental papilla is multi-factorial and creates a multitude of problems. Autogenous connective tissue/biomaterial-based regeneration has been attempted for decades to reconstitute the black space created due to the loss of papilla. The aim of this present study was to regenerate papillary recession defects using an amnion-chorion membrane (ACM) allograft and to evaluate the clinical outcome up to six months postoperatively. Materials and Methods: Twenty patients with 25 Nordland and Tarnow's Class I/II interdental papillary recession defects were treated with ACM and coronal advancement of the gingivo-papillary unit via a semilunar incision on the labial aspect followed by a sulcular incision in the area of interest. A photographic image analysis was carried out using the GNU Image Manipulation software program from the baseline to three and six months postoperatively. The black triangle height (BTH) and the black triangle width (BTW) were calculated using the pixel size and were then converted into millimeters. The mean and standard deviation values were determined at baseline and then again at three and six months postoperatively. The probability values (P<0.05 and P≤0.01) were considered statistically significant and highly significant, respectively. An analysis of variance and post hoc Bonferroni test were carried out to compare the mean values. Results: Our evaluation of the BTH and BTW showed a statistically and highly significant difference from the baseline until both three and six months postoperatively (P=0.01). A post hoc Bonferroni test disclosed a statistically significant variance from the baseline until three and six months postoperatively (P<0.05) and a non-significant difference from three to six months after the procedure (P≥0.05). Conclusion: An ACM allograft in conjunction with a coronally advanced flap could be a suitable minimally invasive alternative for papillary regeneration.