• Title/Summary/Keyword: Surgical light

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Trabeculectomy Using Mitomycin C in Aphakic and Pseudophakic Eyes (무수정체안과 인공수정체안에 대한 Mitomycin C를 이용한 일차 섬유주절제술의 효과)

  • Son, Jun-Hyuk;Cha, Soon-Cheol
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.232-242
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    • 2007
  • Background : The safety and efficacy of trabeculectomy with Mitomycin C (MMC) for surgical treatment in aphakic and pseudophaic eyes were retrospectively evaluated. Materials and Methods : The authors reviewed 51 eyes of 45 patients who had been followed up for at least 6 months after trabeculectomy using MMC for aphakic and pseudophakic eyes. The success rate and complications were analyzed. The success criteria included intraocular pressures of 21 mmHg or less with or without glaucoma medications and no loss of light perception. Surgical failure was defined as a postoperative loss of light perception in patients with preoperative vision better than light perception, additional glaucoma surgery, or phthisis bulbi in patients with preoperative vision of no light perception. Results : The average follow up period was 27.7 months and the intraocular pressure was controlled under 21 mmHg in 36 eyes of 51 (70.6%) after the procedure with or without medication for glaucoma. Using the Kaplan-Meier survival analysis, the cumulative success rate at the 3-, 6-, 12-, 24- and 36-month intervals were 98.0%, 94.1%, 91.9%, 83.4% and 75.5%, respectively. The complications observed were hyphema (4 eyes), serous choroidal detachment (4 eyes), hypotony (3 eyes), and endophthalmitis (1 eye). Conclusion : Trabeculectomy using Mitomycin C for the treatment of aphakic and pseudophaic eyes was safe and effective.

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Effect on Wond Healing of Low Power Generating Laser Irradiation on Artificially Produced Wounds of Rabbits (저출력 레이저광선이 가토의 손상치유에 미치는 영향)

  • Young-Jin Park;Choung-Youl Kim
    • Journal of Oral Medicine and Pain
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    • v.19 no.1
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    • pp.73-91
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    • 1994
  • The author used rabbits in order to examine the effect of Ga-As low power generating semiconductor laser on artificially produced injuries of experimental animals. Artificially produced injuries include surgical wound of 3mm length, 2mm depth in size on ventral skin surface of rabbit and buccal mucosa, and electrical injury formed on opposite side of skin and buccal mucosa by electrical cauterization of same length and depth, and chemical injury formed by FC(Formocresol) solution applied on the anterior dorsal part of tongue. And then, on the experimental group, Ga-As laser was irradiated beginning on the day after the wound formation and continued to irradiate every each other day for five minutes. After1, 3, 6, 9, 13th day, certain number of animals of control and experimental group were sacrified, and wound site tissue was excised to make samples and was observed under light microscope. The following is the conclusions after comparing the healing procedure of experimental and control group. The following results were obtained : 1. Inflammation was decreased more rapidly in the experimental group than the control group. 2. In the surgical, the electrical and the chemical injuries in the oral mucosa, re-epithelialization was completed more rapidly in the experimental group than the control group. In the electrical injury on the skin, re-epithelialization was completed about 6 days after wound formation on both groups. 3. In the electrical and the surgical injuries on the oral mucosa, granulation tissue formation started at 3 days after injury on both groups, but in the chemical injury, it was completed about 3 days faster in the control group than the experimental group. In the surgical wound on the skin, it was completed about 9 days after injury, but faster in the experimental group. In the electrical injury on the skin, it was faster in the control group than the experimental group. 4. In the electrical and the surgical injuries on the oral mucosa, fibrosis was started at 6~9 days after injury on both groups, but regeneration of connective tissue in the experimental group was observed much more than the control group. 5. When comparing the effect of wound healing on skin and oral mucosa of control and experimental group, granulation tissue formation and re-epithelialization in the oral mucosa was more vigorous. In conclusion, the difference of timing and the sequence of wound healing process(inflammation, re-epithelialization, granulation tissue formation, fibrosis) following Laser irradiation between control and experimental group was not observed, but the healing tissue was observed much more in the Laser irradiated group.

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Film Image Transfer System (FITS): An Efficient Method for Proper Positioning of Orthodontic Mini-implants

  • Go, Taek-Su;Kim, Seong-Hun;Nelson, Gerald
    • Journal of Korean Dental Science
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    • v.4 no.1
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    • pp.20-25
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    • 2011
  • Purpose: To describe the newly developed Film image transfer system (FITS) for proper positioning of the orthodontic mini-implant in the narrow interdental space and considerations for better application. Materials and Methods: A patient who was planning to have orthodontic mini-implant treatment on the posterior maxilla was recruited to assess the feasibility of FITS. Dental radiographic film and bite record was taken. And then the film image was transferred on the photographic emulsion coated model using transfer light through film projector (enlarger). After exposing the photo emulsion coating on the model, the image was developed with a working solution for a paper developer and fixed. The surgical guide for the mini-implant was fabricated from the transported FITS data. Results: The completed surgical guide was easily placed intraorally, and allowed a simple and rapid placement of the mini-implant. The site of the implant placement was accurate as planned position. Conclusion: In the reported case, The FITS technique represents an effort to minimize risk to the patient and produce consistently good results based upon accurate information about the anatomy of the implant site.

Laparoscope Manipulator Control for Minimally Invasive Surgery (최소침습수술을 위한 복강경 매니퓰레이터 제어)

  • Kim, Soo-Hyun;Kim, Kwang-Gi;Jo, Yung-Ho
    • Journal of Institute of Control, Robotics and Systems
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    • v.17 no.7
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    • pp.685-696
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    • 2011
  • An efficient laparoscope manipulator robot was designed to automatically control the position of laparoscope via a passive joint on end-effector position. The end position of the manipulator is controlled to have corresponding velocity defined in the global coordinate space using laparoscopic visual information. Desired spatial position of laparoscope was derived from detected positions of surgical instrument tips, then the clinical viewing plane was moved by visual servoing task. The laparoscope manipulator is advantageous for automatically maintaining clinically important views in the laparoscopic image without any additional operator. A laparoscope is mounted to a holder which is linked to four degree of freedom manipulator via universal joint-type passive rings connection. No change in the design of laparoscope or manipulator is necessary for its application to surgery assistant robot system. Expanded working space and surgical efficiency were accomplished by implementing slant linking structure between laparoscope and manipulator. To ensure reliable positioning accuracy and controllability, the motion of laparoscope in an abdominal space through trocar was inspected using geometrical analysis. A designed laparoscope manipulating robot system can be easily set up and controlled in an operation room since it has a few subsidiary devices such as a laparoscope light source regulator, a control PC, and a power supply.

EFFECTS OF PREOPERATIVE AND POSTOPERATIVE RADIATION ON THE HEALING OF SURGICAL WOUND (술전 및 술후 방사선조사가 백서 배부 창상치유에 미치는 영향)

  • Byun, Chang-Soon;Chung, In-kyuo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.2
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    • pp.21-33
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    • 1990
  • This study was performed to evaluate the effects of preoperative and postoperative radiation on the healing of surgical wound and the relationship between surgery-radiation interaval histopathologically. Experimental animals were 64 rats of Sprague-Dawely strain weighing about 180grams. In postoperative radiation group, a single dose of 1000 rads irradiation was delivered on 1,2,3, weeks after incision and 24 animals were sacrificed on the 1st, 3rd, 7th, and 14th day after radiation. In preoperative radiation group incision was performed on 1,2,3,4 weeks after a single dose of 1000 rads and 32 animals were sacrificed on the 1st, 3rd, 7th, and 14th after incision. Tissue specimens were prepared as usual methods and stained with hematoxyline-eosin for ordinary light microscopy. Histopathologic study revealed the following favorable results : 1. In 2 and 3 weeks radiation group after incision, the healing process was unaffected by radiation. 2. In 1 week radiation group after incision, the healing process was slightly retarded, as compared with 2,3 weeks radiation group after incision. 3. In 1,2 and 3 weeks incision group after radiation, the healing process appeared about 7 days later than that of control group. 4. In 4 weeks incision after radiation, the healing process was unaffected by radiation.

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Endoscopic Endonasal Transsphenoidal Resection of Solitary Extramedullary Plasmacytoma in the Sphenoid Sinus with Destruction of Skull Base

  • Park, Sung-Hoon;Kim, Young-Zoon;Lee, Eun-Hee;Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
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    • v.46 no.2
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    • pp.156-160
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    • 2009
  • Solitary extramedullary plasmacytomas are isolated plasma cell tumors of soft tissue that typically do not metastasize. They are rare and account for 4% of all plasma cell tumors. To our knowledge, only 14 cases of solitary extramedullary plasmacytomas in the sphenoid sinus have been reported. A 32-year-old man presented to our department with complaint of ocular pain in the right eyeball and diplopia. Physical and neurological examinations revealed intact and prompt direct and indirect light reflexes in both pupils and limitation of extraocular muscle movement seen with the lateral gaze of the right eyeball. Magnetic resonance imaging suggested the presence of mucocele or mycetoma, therefore surgical resection was performed with endoscopic endonasal transsphenoidal approach. Histopathology was consistent with plasmacytoma. Systemic work-up did not show any evidence of metastasis and the sphenoid sinus was the sole tumor site, and therefore the diagnosis of solitary extramedullary plasmacytoma was confirmed. We report a rare case of solitary extramedullary plasmacytoma in the sphenoid sinus with successful treatment using the endoscopic endonasal transsphenoidal resection and adjuvant radiotherapy.

The Effects of Iridoid Compounds on Wound Healing (Iridoid 화합물이 창상 치유에 미치는 영향)

  • Lee, Sung-Woo;Kho, Hong-Seop;Lee, Sang-Goo
    • Journal of Oral Medicine and Pain
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    • v.24 no.2
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    • pp.137-143
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    • 1999
  • Aucubin, the natural product, which is isolated from Aucuba japonica, has a variety of pharmacological effects such as liver-protective function, inhibition of liver RNA and protein biosynthesis, hypotensive activity and antimicrobial effect, etc. This study was performed to investigate the effects of iridoid compounds on wound healing. The author prepared 0.1% aucubin solution and 0.1% aucubin ointment as an active form, aucubigenin to which aucubin was converted by ${\beta}$-glucosidase. Artificial surgical wound was made on either 1cm lateral side of the dorsal midline along the axis of spine of Sprague-Dawley rats under sterile technique. Application of 0.1% aucubin solution or 0.1% aucubin ointment to surgical wound was done daily. Light microscopic examination was performed on the postsurgical 3 days, 5 days, and 9 days. The 0.1% aucubin solution group epithelialized earlier than the control group and the fibrosis of granulation tissue of both aucubin groups were more prominent than the control group. Collectively, this study suggests the possibility of aucubin as a topical agent. Further research should be performed on the mechanism of aucubin on wound healing and proper formulation for effective topical agents.

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Deep Brain Stimulation for Controlling Refractory Epilepsy: a Clinical Perspective (난치성 뇌전증 치료를 위한 심부뇌자극술: 임상적 관점에서)

  • Kim, Woo Jun;Shon, Young-Min
    • Annals of Clinical Neurophysiology
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    • v.14 no.2
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    • pp.59-63
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    • 2012
  • Epilepsy has continued to provide challenges to epileptologists, as a significant proportion of patients continue to suffer from seizures despite medical and surgical treatments. Deep brain stimulation (DBS) has emerged as a new therapeutic modality that has the potential to improve quality of life and occasionally be curative for patients with medically refractory epilepsy who are not surgical candidates. Several groups have used DBS in drug-resistant epilepsy cases for which resective surgery cannot be applied. The promising subcortical brain structures are anterior and centromedian nucleus of the thalamus, subthalamic nucleus, and other nuclei to treat epilepsy in light of previous clinical and experimental data. Recently two randomized trials of neurostimulation for controlling refractory epilepsy employed the strategies to stimulate electrodes placed on both anterior thalamic nuclei or near seizure foci in response to electroencephalographically detected epileptiform activity. However, the more large-scale, long-term clinical trials which elucidates optimal stimulation parameters, ideal selection criteria for epilepsy DBS should be performed before long. In order to continue to advance the frontier of this field, it is imperative to have a good grasp of the current body of knowledge.

Thoracic Epidural Anesthesia for Upper Abdominal Surgery and Postoperative Pain Control (상복부 수술을 위한 흉추 경막외 마취와 술후 통증관리)

  • Choi, Kyu-Taek;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.66-71
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    • 1989
  • It has been standard practice in many institutions to use a combination of a light general anesthesia and an epidural block for lower abdominal and pelvic surgery. This combination of a balanced anesthesia can provide various benefits to the patient such as less bleeding in the surgical field, the use of a lower concentration of general anesthetics, less muscle relaxant, and post operative pain management. However, there are several problems associated with hemodynamics such as bradycardia and hypotension etc. In order to block the pain of the high surgical area with a lumbar epidural puncture postoperatively, a large volume of local anesthetic is required and consequently an extensive blockade of sympathetic, sensory and motor functions can occur causing motor weakness, numbness and postural hypotension. Therefore, the patient is unable to have early ambulation postoperatively. In this study, thoracic epidural catheterization was undertaken to locate the tip of the catheter exactly at the surgical level for upper abdominal surgery, and was followed by general anesthesia. Twenty-one patients scheduled for upper abdominal surgery were selected. Fifteen of them had hepatobiliary operations and the remaining 6 had gastrectomies. Thoracic epidural punctures were performed mostly at T9-T10 (57.1%) and T8-T9. Neuromuscular blocking agents were not used in half of the cases and the, mean doses of relaxant were $3.5{\pm}1.0mg$ in gastrectomies, and $2.7{\pm}0.9mg$ in cases of hepatobiliary operation. Epidural morphine was injected 1 hour before the end of the operation for postoperative pain control. Eight patients did not require additional analgesics and the mean dose of epidural morphine was $2.2{\pm}0.9mg$, and 13 cases were given 0.125% epidural bupivacaine when patients complained of pain. Their initial doses of epidural morphine were $1.9{\pm}0.4mg$ and the mean duration of bupivacaine was 6 hours 20 minutes${\pm}40$ minutes. In conclusion. thoracic epidural analgesia is valuable to reduce postoperative pain in patients with upper abdominal surgery, However, it is not easy to maintain this balanced anesthesia with high epidural analgesia-and light general anesthesia for upper abdominal surgery because of marked hemodynamic changes. Therefore, further practice will be required.

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Surgical Management of Massive Cerebral Infarction

  • Huh, Jun-Suk;Shin, Hyung-Shik;Shin, Jun-Jae;Kim, Tae-Hong;Hwang, Yong-Soon;Park, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.331-336
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    • 2007
  • Objective : The aim of this study was to analyze the treatment results and prognostic factors in patients with massive cerebral infarction who underwent decompressive craniectomy. Methods : From January 2000 to December 2005, we performed decompressive craniectomy in 24 patients with massive cerebral infarction. We retrospectively reviewed the medical records, radiological findings, initial clinical assessment using the Glasgow Coma Scale, serial computerized tomography (CT) with measurement of midline and septum pellucidum shift, and cerebral infarction territories. Patients were evaluated based on the following factors : the pre- and post-operative midline shifting on CT scan, infarction area or its dominancy, consciousness level, pupillary light reflex and Glasgow Outcome Scale. Results : All 24 patients (11 men, 13 women; mean age, 63 years; right middle cerebral artery (MCA) territory, 17 patients; left MCA territory, 7 patients) were treated with large decompressive craniectomy and duroplasty. The average time interval between the onset of symptoms and surgical decompression was 2.5 days. The mean Glasgow Coma Scale was 12.4 on admission and 8.3 preoperatively. Of the 24 surgically treated patients, the good outcome group (Group 2 : GOS 4-5) comprised 9 cases and the poor outcome group (Group1 : GOS 1-3) comprised 15 cases. Conclusion : We consider decompressive craniectomy for large hemispheric infarction as a life-saving procedure. Good preoperative GCS, late clinical deterioration, small size of the infarction area, absence of anisocoria, and preoperative midline shift less than 11mm were considered to be positive predictors of good outcome. Careful patient selection based on the above-mentioned factors and early operation may improve the functional outcome of surgical management for large hemispheric infarction.