• Title/Summary/Keyword: Surgical Simulation

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In vivo 3D Kinematics of Axis of Rotation in Malunited Monteggia Fracture Dislocation

  • Kim, Eugene;Park, Se-Jin;Jeong, Haw-Jae;Ahn, Jin Whan;Shin, Hun-Kyu;Park, Jai Hyung;Lee, Mi Yeon;Tsuyoshi, Murase;Sumika, Ikemototo;Kazuomi, Sugamoto;Choi, Young-Min
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.25-30
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    • 2014
  • Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.

Application of Three-Dimensional Printed Models in Congenital Heart Surgery: Surgeon's Perspective (선천성 심기형의 수술에 있어서 삼차원 프린팅 모델의 적용: 심장외과의사의 관점)

  • Hyungtae Kim;Ki Seok Choo;Si Chan Sung;Kwang Ho Choi;Hyoung Doo Lee;Hoon Ko;Joung-Hee Byun;Byung Hee Cho
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.310-323
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    • 2020
  • To treat congenital heart disease, it is important to understand the anatomical structure correctly. Three-dimensional (3D) printed models of the heart effectively demonstrate the structural features of congenital heart disease. Occasionally, the exact characteristics of complex cardiac malformations are difficult to identify on conventional computed tomography, magnetic resonance imaging, and echocardiography, and the use of 3D printed models can help overcome their limitations. Recently, 3D printed models have been used for congenital heart disease education, preoperative simulation, and decision-making processes. In addition, we will pave the way for the development of this technology in the future and discuss various aspects of its use, such as the development of surgical techniques and training of cardiac surgeons.

Availability and Reproducibility Evaluation of High-dose-rate Intraluminal Brachytherapy for Unresectable Recurrent Cholangiocarcinoma (재발한 간담도암 환자에서 시행 한 high-dose-rate intraluminal brachytherapy의 유용성 및 재현성 평가)

  • Park, Ju-Kyeong;Lee, Seung-Hun;Cha, Seok-Yong;Kim, Yang-Su;Lee, Sun-Young
    • Journal of the Korean Society of Radiology
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    • v.6 no.2
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    • pp.151-157
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    • 2012
  • General treatment for cholangiocarcinoma is complete surgical resection. However recurrence is common in those patients. In most of cases the purpose of the treatment for patients with recurrent is palliative. Therefore we adopt intraluminal catheter to treat a recurrent patient with high-dose-rate intraluminal brachytherapy. This study aims to evaluate the treatment procedure and set-up reproducibility of intraluminal brachytherapy in the recurrent patient. Study patient was diagnosed at rcT1N0M0 and undergone intraluminal brachytherapy after Arrow Sheath insertion. 3 Gy was delivered in every fraction with a total dose of 30 Gy. We planned dose normalization at distal, proximal and central axis point of narrowed bile duct far from 1 cm. To evaluate set-up reproducibility, we measured distance between distal, proximal treatment target volume point and anterior surface of the thoracic vertebral body respectively for five times before every treatment with dummy seed insertion. Mean distance between distal, proximal treatment target volume point and anterior surface of 10th and 11th thoracic vertebral bodies is 0.5 cm, 6.1 cm and standard deviation is 0.06, 0.08 respectively. In addition, set-up reproducibility was maintained significantly. The patient has been alive with no evidence of disease recurrence for more than a year and has not yet reported severe complications. In conclusion, high-dose-rate intraluminal brachytherapy for unresectable recurrence of cholangiocarcinoma maintains high set-up reproducibility without severe side effects.

Role of Radiation Therapy for Stage III Thymoma (제 3기 흉선종에서 방사선치료의 역할)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.16-20
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    • 2001
  • Purpose : To evaluate the effectiveness and tolerance of the postoperative radiation therapy for patients with Stage III thymoma and to define the optimal radiotherapeutic regimen Materials and Methods : We retrospectively analyzed the records of 24 patients with Stage III thymoma who were referred for postoperative radiation therapy in our institution from June, 1987 to May, 1999. Surgical therapy consisted of total resection in one patient, subtotal resection in seventeen, and biopsy alone in six patients. Age of the patients was ranged from 20 to 62 years with mean age of 47 years. Male to female ratio was 14 to 10. Radiation therapy was delivered with linear accelerator producing either 6 MeV or 10 MeV photons. The irradiated volume included anterior mediastinum and known residual disease. The supraclavicular fossae were not irradiated. The delivered total dose was ranged from 30 to 56 Gy. One patient received 30 Gy and eighteen patients received minimum of 50 Gy. Follow up period was ranged from 12 months to 8 years with median follow up of 40 months. Results : The overall local control rate for entire group of patients was $67\%$ at 5 years. The cumulative local failure rates at one, three and five year were $18\%,\;28\%\;and\;33\%$, respectively. In patients treated with subtotal resection and biopsy alone, local control rate was $76\%\;and\;33\%$, respectively. The actuarial observed survival rate at 5 years was $57\%$, and actuarial adjusted survival at 5 years was $72\%$. The difference between 5 year survival rates for patients treated with subtotal resection and biopsy alone was not statistically significant $(62\%\;vs\;30\%)$. Conclusion : We might conclude that postoperative radiation therapy was safe and effective treatment for patients with Stage III thymoma. Postoperative radiation therapy is recommended in cases where tumor margin is close or incomplete resection is accomplished.

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