• Title/Summary/Keyword: Surgical guidance

검색결과 101건 처리시간 0.025초

급성 아킬레스 건 파열에서의 초음파 이용 (Ultrasonographic Guidance in Acute Achilles Tendon Rupture)

  • 이태훈;이희동;김학준
    • 대한정형외과 초음파학회지
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    • 제8권1호
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    • pp.26-30
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    • 2015
  • 정형외과적 영역에서 족부 족관절 부의의 손상은 흔한 문제이다. 비록 손상들이 생명을 위협하지는 않지만 정확한 진단이나 치료가 지연됐을 시에는 하지의 기능에 장애를 유발 할 수 있으므로 정확한 진단이 장기간의 합병증을 예방 할 수 있다. 초음파는 비용-효과면에서 우수하고 방사선 피폭의 염려가 없으며 연부 조직의 검사에 유용하고 역동적 검사를 시행할 수 있어서 아킬레스건 파열에서 그 유용성이 증가하고 있다. 초음파 영상은 아킬레스건 파열의 진단적 도구이다. 영상의학적 검사 없이 아킬레스건 파열을 진단하기 위해서는 신체 검사와 환자의 병력에 필요하지만 개인 의원에서는 약 20%에서 파열을 놓지는 것으로 알려져 있다. 초음파 영상 하에서 정상적인 섬유 구조의 단절이 아킬레스건 파열의 진단이 되며 실시간으로 족배 굴곡 및 족저 굴곡을 함으로써 단절이 더 확대되는 것을 관찰 할 수 있다. 그리고 수술 후나 보존적인 치료를 시행하는 경우에도 추시 관찰 기간 동안 지속적으로 초음파를 통해 건의 상태를 관찰할 수 있는 유용한 도구이다.

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효과적인 약물전달 시스템을 위한 나노입자 유도 장치 (Nanoparticle Inducing Device for Effective Drug Delivery System)

  • 이총명;한현호;장병한;오은설;기재홍
    • 대한의용생체공학회:의공학회지
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    • 제38권3호
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    • pp.102-110
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    • 2017
  • 본 논문은 자석을 회전시켜 실시간으로 자기장을 변화시키고 그로 인해 특정 조건에서 산화철 나노입자를 side point(피부)보다 center point(심부)에서 더 많이 유도할 수 있다는 가능성을 제시하였다. 향후 연구로 유속에 따른 Critical Magnetic flux density, 시간에 따른 나노입자 축적량, 자기장과 산화철 나노입자의 상호작용을 고려한 실험 설계, 전자석 등을 이용한 자기장조절을 연구하여 실질적인 혈관에서 본 실험을 진행할 계획이다.

진균성 요근 농양의 초음파 유도하 경피적 천자술을 통한 성공적 치료 - 증례보고 - (Fungal Psoas Abscess Successfully Treated by Ultrasonographically Guided Percutaneous Aspiration - A Case Report -)

  • 문상호;김진학;이송;안동기;김대근
    • 대한정형외과 초음파학회지
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    • 제5권1호
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    • pp.36-40
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    • 2012
  • 요근 농양은 전통적으로는 수술적 배농술이 많이 시도되고 있으나 초음파 유도하 경피적 천자술이 효과적인 치료방법이 될 수 있다. 그러나 아직까지 초음파를 이용한 천자술의 유용성에 대해서는 잘 확립되어 있지 않다. 저자들은 진균성 요근 농양을 초음파 유도하 경피적 천자술로 치유하였던 증례를 경험하였기에 문헌 고찰과 함께 보고하고자 한다. 배농은 초음파 영상 하에서 침 천자술로써, 시술로 인한 합병증의 발생 없이 시행하였다. 배농 후 배양에서 Candida Albicans가 동정되었으며 두 번의 천자술과 적절한 항진균제 치료로써 성공적으로 치유할 수 있었다.

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Percutaneous Endoscopic Thoracic Discectomy : Posterolateral Transforaminal Approach

  • Lee, Ho-Yeon;Lee, Sang-Ho;Kim, Dong-Yun;Kong, Byoung-Joon;Ahn, Yong;Shin, Song-Woo
    • Journal of Korean Neurosurgical Society
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    • 제40권1호
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    • pp.58-62
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    • 2006
  • Objective : Development of diagnostic tools has resulted in early detection of thoracic disc herniations[TDH] even when the herniated disc is soft in consistency. In some of the cases, it is considered better not to opt for surgical treatment due to the unduly high morbidity and potential complications associated with conventional approaches. The authors have applied percutaneous endoscopic thoracic discectomy[PETD] technique to soft TDHs in order to avoid the morbidity associated with conventional approaches. Methods : Eight consecutive patients [range, 31 to 75 years] with soft lateral or central TDH [from T2-3 to T11-12] underwent PETD between May 2001 and June 2004. The patient was positioned in a prone position with intravenous sedation and local anesthetic infiltration. The authors introduced a cannula into the thoracic intervertebral foramen using endoscopic foraminoplasty technique. Discectomy was performed with mechanical tools and a laser under continuous endoscopic visualization and flu oroscopic guidance. Functional status was assessed preoperatively and postoperatively using the Oswestry Disability Index[ODI]. Results : The mean ODI scores improved from 52.8 before the surgery to 25.8 at the final follow-up. In cases of myelopathy, long tract signs showed improvement. The mean operative time was 55 minutes, and no patient required conversion to open surgery. Conclusion : The technique allows a smaller incision and less morbidity. Soft TDH is amenable to this minimally invasive approach in selected patients with myeloradiculopathy.

A Morphometric Aspect of the Brachial Plexus in the Periclavicular Region

  • Lee, Jung-Pyo;Chang, Jae-Chil;Cho, Sung-Jin;Park, Hyung-Ki;Choi, Soon-Kwan;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • 제46권2호
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    • pp.130-135
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    • 2009
  • Objective: The purpose of this study was to determine the normal morphometric landmarks of the uniting and dividing points of the brachial plexus (BP) in the periclavicular region to provide useful guidance in surgery of BP injuries. Methods: A total of 20 brachial plexuses were obtained from 10 adult, formalin-fixed cadavers. Distances were measured on the basis of the Chassaignac tubercle (CT), and the most lateral margin of the BP (LMBP) crossing the superior and inferior edge of the clavicle. Results: LMBP was located within 25 mm medially from the midpoint in all subjects. In the supraclavicular region, the upper trunk uniting at 21$\pm$7 mm from the CT, separating into divisions at 42$\pm$5 mm from the CT, and dividing at 19$\pm$4 mm from the LMBP crossing the superior edge of the clavicle. In the infraclavicular region, the distance from the inferior edge of the clavicle to the musculocutaneous nerve (MCN) origin was 49$\pm$12 mm, to the median nerve origin 57$\pm$7 mm, and the ulnar nerve origin 48$\pm$6 mm. From the lateral margin of the pectoralis minor to the MCN origin the distance averaged 3.3$\pm$10 mm. Mean diameter of the MCN was 4.3$\pm$1.1 mm (range, 2.5-6.0) in males (n = 6), and 3.1$\pm$1.5 mm (range, 1.6-4.0) in females (n = 4). Conclusion: We hope these data will aid in understanding the anatomy of the BP and in planning surgical treatment in BP injuries.

혈관결찰기의 성능평가방법으로서 혈관파열압력시험의 유용성 연구 (A Study on the Usability of the Vascular Bursting Pressure Test as a Method of Performance Evaluation of Vessel Sealing)

  • 강보람;박아름;김광택;김선태;이동혁
    • 대한의용생체공학회:의공학회지
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    • 제41권5호
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    • pp.210-218
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    • 2020
  • Vessel sealing is a medical device that converts electrical or ultrasonic energy into thermal energy and leads to seal, coagulate, and cut the vessel by protein modification within the walls or surrounding connective tissues. As most of surgeries have recently been conducted with minimally invasive surgery, the demand and market for vessel sealing are expected to get bigger. However, there is a problem that electrosurgical or ultrasonic surgical is applied and we have a high risk to evaluate the strength of seal, because the collateral and particular standards currently in force follows have not been establish. Therefore, in this study, we investigated some papers studied on the efficacy and safety of the device, the guidance of FDA and test papers previously conducted from 3 individual subject device made in Korea. We found there is a relationship between burst pressure and the performance of the device, therefore, we propose the vascular bursting pressure test for evaluating the safety and performance of the vessel sealing.

디스크의 전기열치료시 수술변수에 관한 연구 (An Investigation on Surgical Parameters for the Treatment of Intervertebral Disc during Electrothermal Therapy)

  • 진의덕;최진승;탁계래;이봉수;이법이
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2006년도 춘계학술대회 논문집
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    • pp.513-514
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    • 2006
  • Recently intradiscal electrothermal therapy is introduced, which is a new and minimally invasive technique fer the treatment of discogenic low back pain. This procedure involves the percutaneous threading of a flexible catheter into the disc under fluoroscopic guidance. The catheter, composed of thermal resistive coil, heats the posterior annulus of the disc, causing contraction of collagen fibers and destruction of afferent nociceptors. This study tries to investigate the effects of the important factors of this procedure such as heat source temperature and heat applying time on the temperature distribution within the intervertebral disc. This study utilized both computer simulation and the experiment for the verification of finite element analysis. FE analysis was carried out with ANSYS v7.0 (ANSYS Inc, USA) using 10,980 number of brick element and 12,551 number of node. The functional spinal units of 5 month old swine were used for the experiment and the temperature was monitored using 10 channel temperature measurement device MV200. Through this study, it was able to analyze the temperature range of inner intervertebral disc by two mechanisms which are known to alleviate pain clinically. The results showed that when the heat source temperature was kept up 80 degree for 1,020 seconds, the temperature of inner annulus reached at 45 degree up to the distance of 15.6mm from heat source, which explains coagulation of inner annulus by heat. When the same heat source was used, the temperature of inner nucleus reached at 60 degree up to the distance of 9mm from heat source, which explains contraction of inner nucleus by heat.

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내시경과 C-arm을 이용한 얼굴 이물질 제거 치험례 (Removal of foreign body on cheek using endoscope and C-arm fluoroscopy)

  • 조영철;장수미;박수원;최병환;하진희;손장호;성일용
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권3호
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    • pp.234-236
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    • 2011
  • Traditional surgery to remove foreign bodies in the face carries a risk of postoperative morbidity with an injury to various anatomical structures, particularly the facial nerve and parotid duct and gland. Endoscopy can be a great aid in the removal of foreign bodies in the maxillofacial region. Surgical intervention using endoscope and/,or intraoperative images can be minimized, allowing the safe and precise removal of foreign bodies, and saving operating time. We report a case of the use of an endoscope and C-arm fluoroscopy guidance system to remove a very small foreign body.

심한 우식을 동반한 골격성 전치부 개방 교합 환자의 전악 수복 증례 (Full-mouth rehabilitation of skeletal anterior open bite with severely decayed dentition: A case report)

  • 김성아;노관태;배아란;우이형
    • 대한치과보철학회지
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    • 제55권1호
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    • pp.79-87
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    • 2017
  • 전치부 개방 교합은 다양한 원인이 복합적으로 작용하고, 진단에 따라 효과적인 치료 계획과 적절한 유지 방법을 선택할 수 있다. 대부분의 경우 교정과 악교정 수술을 통해 안정적인 교합을 얻고, 기능과 심미를 회복한다. 하지만 전체 치열에서 심한 우식증이 있는 경우 광범위한 수복이 필요하게 되므로, 보철 수복을 통해서도 교합을 재형성할 수 있다. 본 증례는 심한 우식을 동반한 골격성 전치부 개방 교합 환자에서 안모 분석 및 진단 납형으로부터 가장 효과적인 치료로 전악 보철 수복을 선택하였다. 교합력을 균등하게 분산하고 심미적인 임시 수복물을 제작하였고, 악간 관계 평가, 혀 등 연조직의 적응, 입술과의 조화를 관찰하고 수정하였다. 충분한 기간 동안 사용한 임시 수복물을 CAD/CAM (Computer-aided design/computer-aided manufacturing)을 이용하여 단일구조 지르코니아 최종 보철물로 이행하였고, 치료 종결 후 3개월 간 주기적으로 관찰하였을 때 만족스러운 결과를 얻었다.

Effectiveness of Multi Interventional Package on Selected Parameters of Metabolic Syndrome among Women - A Pilot Study

  • Elizabeth, Attonassary Jose;Aruna, Swaminathan;Mercy, Parayidathil Joseph
    • 대한간호학회지
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    • 제50권4호
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    • pp.523-532
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    • 2020
  • Purpose: The purpose of the study was to compare the effectiveness of multi interventional package (MIP) and lifestyle interventions (LI) on physiological parameters of women with metabolic syndrome, to compare the effectiveness of MIP and LI on biochemical parameters of women with metabolic syndrome and to compare the effectiveness of MIP and LI on socio-psychological parameters of women with metabolic syndrome. Methods: A quasi experimental nonequivalent control group design with two experimental groups and one control group was used to collect data from 60 self-help group women. Samples were selected by multistage sampling. Reflexology foot massage, dietary modification, moderate intensity exercise and structured education were given to MIP group and dietary modification, moderate intensity exercise and structured education were given to LI group for 12 weeks. Control group received routine care. Demographic and clinical data sheets were used to collect basic information. Knowledge was assessed by a knowledge questionnaire. Physiological (weight, body mass index, waist circumference and blood pressure) and biochemical parameters (HDL, triglycerides and FBS) were assessed before and after the intervention. Results: The study found significant change in the physiological and biochemical parameters of metabolic syndrome as well as knowledge among the MIP group and LI group compared to the control group (p <.001). Conclusion: MIP and LI are effective in controlling the parameters of metabolic syndrome. Hence the guidance may be provided to women with metabolic syndrome for adopting necessary lifestyle changes as well as reflexology foot massage to control the physiological and biochemical parameters of metabolic syndrome.