• Title/Summary/Keyword: Surgical result

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The Comparison Consideration on Experimental Articles about Melanoma Published in Journals of Korean Medicine (국내 한의학계에 보고된 흑색종 관련 실험적 연구들의 비교 고찰)

  • Kwon, Kang;Kim, Nam-Kwen;Kim, Sung-Young;Lee, Dong-Jin;Kim, Chul-Yun;Seo, Hyung-Sik
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.28 no.3
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    • pp.30-47
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    • 2015
  • Objective : Melanoma is a very critical and devastating disease. Although many people have depended on surgical operation in melanoma treatment, they have placed importance on non-invasive methods constantly. So we planned to establish a research methodology by analysing existing articles containing conservative melanoma treatments in Journals of Korean Medicine published in Korea.Methods : Using search words of anti-cancer, B16, cancer, lung metastasis, melanoma, metastasis, S-100, SK-MEL, tumor, tyrosinase, we collected 26 articles by searching internet portal sites as following;Using search words of anti-cancer, B16, cancer, lung metastasis, melanoma, metastasis, S-100, SK-MEL, tumor, tyrosinase, we collected 26 articles by searching internet portal sites as followinghttp://oasis.kiom.re.kr,http://www.koreantk.com,http://www.riss.kr,http://www.dbpia.co.kr,http://www.ndsl.kr,http://kiss.kstudy.com,http://www.naver.com,http://www.google.com.Result : The number of articles is 26 and in the year of 2003, 2004 is ranked the highest number in publication. The journal of acupuncture & moxibustion society ranked the highest(30.8%). 2 and 4 authors ranked the highest(26.9%) in number of authors. T-test ranked the highest(58.1%) in statistics methods. P.O. med indicated in 11 articles and Pharmacopuncture in 15 articles. B16 murine melanoma cell was indicated in 25 articles by cancer-induced methods. In measurement, T cell activity was indicated in 14 articles, NK activity in 4 articles, IL-2 in 6 articles, apoptosis in 1 article, lung metastasis in 14 articles.Conclusion : Considering overall results, it is necessary to diversify cancer-induced methods and measurement methods in experimental melanoma research.

Reduction of Radiation Exposure by Modifying Imaging Manner and Fluoroscopic Settings during Percutaneous Pedicle Screw Insertion

  • Kim, Hyun Jun;Park, Eun Soo;Lee, Sang Ho;Park, Chan Hong;Chung, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.933-943
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    • 2021
  • Objective : Percutaneous pedicle screw (PPS) fixation is a needle based procedure that requires fluoroscopic image guidance. Consequently, radiation exposure is inevitable for patients, surgeons, and operation room staff. We hypothesize that reducing the production of radiation emission will result in reduced radiation exposure for everyone in the operation room. Research was performed to evaluate reduction of radiation exposure by modifying imaging manner and mode of radiation source. Methods : A total of 170 patients (680 screws) who underwent fusion surgery with PPS fixation from September 2019 to March 2020 were analyzed in this study. Personal dosimeters (Polimaster Ltd.) were worn at the collar outside a lead apron to measure radiation exposure. Patients were assigned to four groups based on imaging manner of fluoroscopy and radiation modification (pulse mode with reduced dose) : continuous use without radiation modification (group 1, n=34), intermittent use without radiation modification (group 2, n=54), continuous use with radiation modification (group 3, n=26), and intermittent use with radiation modification (group 4, n=56). Post hoc Tukey Honest significant difference test was used for individual comparisons of radiation exposure/screw and fluoroscopic time/screw. Results : The average radiation exposure/screw was 71.45±45.75 µSv/screw for group 1, 18.77±11.51 µSv/screw for group 2, 19.58±7.00 µSv/screw for group 3, and 4.26±2.89 µSv/screw for group 4. By changing imaging manner from continuous multiple shot to intermittent single shot, 73.7% radiation reduction was achieved in the no radiation modification groups (groups 1, 2), and 78.2% radiation reduction was achieved in the radiation modification groups (groups 3, 4). Radiation source modification from continuous mode with standard dose to pulse mode with reduced dose resulted in 72.6% radiation reduction in continuous imaging groups (groups 1, 3) and 77.3% radiation reduction in intermittent imaging groups (groups 2, 4). The average radiation exposure/screw was reduced 94.1% by changing imaging manner and modifying radiation source from continuous imaging with standard fluoroscopy setting (group 1) to intermittent imaging with modified fluoroscopy setting (group 4). A total of 680 screws were reviewed postoperatively, and 99.3% (675) were evaluated as pedicle breach grade 0 (<2 mm). Conclusion : The average radiation exposure/screw for a spinal surgeon can be reduced 94.1% by changing imaging manner and modifying radiation source from real-time imaging with standard dose to intermittent imaging with modified dose. These modifications can be instantly applied to any procedure using fluoroscopic guidance and may reduce the overall radiation exposure of spine surgeons.

Effectiveness after Designation of a Trauma Center: Experience with Operating a Trauma Team at a Private Hospital

  • Kim, Kyoung Hwan;Han, Sung Ho;Chon, Soon-Ho;Kim, Joongsuck;Kwon, Oh Sang;Lee, Min Koo;Lee, Hohyoung
    • Journal of Trauma and Injury
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    • v.32 no.1
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    • pp.1-7
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    • 2019
  • Purpose: The present study aimed to evaluate the influence of how the trauma care system applied on the management of trauma patient within the region. Methods: We divided the patients in a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in the Halla Hospital after designation of a trauma center. We compared annual general characteristics, injury severity score, the average numbers of the major trauma patients, clinical outcomes of the emergency department, and mortality rates between the two groups. Results: No significant differences were found in the annual patients' average age ($54.1{\pm}20.0$ vs. $52.8{\pm}18.2$, p=0.201), transportation pathways (p=0.462), injury mechanism (p=0.486), injury severity score (22.93 vs. 23.96, p=0.877), emergency room (ER) stay in minutes (199.17 vs. 194.29, p=0.935), time to operation or procedure in minutes (154.07 vs. 142.1, p=0.767), time interval to intensive care unit (ICU) in minutes (219.54 vs. 237.13, p=0.662). The W score and Z score indicated better outcomes in post-trauma system group than in pre-trauma system group (W scores, 2.186 vs. 2.027; Z scores, 2.189 vs. 1.928). However, when analyzing survival rates for each department, in the neurosurgery department, in comparison with W score and Z score, both W score were positive and Z core was higher than +1.96. (pre-trauma group: 3.426, 2.335 vs. post-trauma group: 4.17, 1.967). In other than the neurosurgery department, W score was positive after selection, but Z score was less than +1.96, which is not a meaningful outcome of treatment (pre-trauma group: -0.358, -0.271 vs. post-trauma group: 1.071, 0.958). Conclusions: There were significant increases in patient numbers and improvement in survival rate after the introduction of the trauma system. However, there were no remarkable change in ER stay, time to ICU admission, time interval to emergent procedure or operation, and survival rates except neurosurgery. To achieve meaningful survival rates and the result of the rise of the trauma index, we will need to secure sufficient manpower, including specialists in various surgical area as well as rapid establishment of the trauma center.

Intraoperative Neurophysiological Monitoring and Neuromuscular Anesthesia Depth Monitoring (수술 중 신경계 추적 감시 검사와 근 이완 마취 심도의 측정)

  • Kim, Sang-Hun;Park, Soon-Bu;Kang, Hyo-Chan;Park, Sang-Ku
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.4
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    • pp.317-326
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    • 2020
  • Deep blocking of consciousness alone does not prevent a reaction to severe stimuli, and copious amounts of pain medication do not guarantee unconsciousness. Therefore, anesthesia must satisfy both: the loss of consciousness as well as muscle relaxation. Muscle relaxants improve the intra-bronchial intubation, surgical field of vision, and operating conditions, while simultaneously reducing the dose of inhalation or intravenous anesthesia. Muscle relaxants are also very important for breathing management during controlled mechanical ventilation during surgery. Excessive dosage of such muscle relaxants may therefore affect neurological examinations during surgery, but an insufficient dosage will result in movement of the patient during the procedure. Hence, muscle relaxation anesthesia depth and neurophysiological monitoring during surgery are closely related. Using excessive muscle relaxants is disadvantageous, since neurophysiological examinations during surgery could be hindered, and eliminating the effects of complete muscle relaxation after surgery is challenging. In the operation of neurophysiological monitoring during the operation, the anesthesiologist administers muscle relaxant based on what standard, it is hoped that the examination will be performed more smoothly by examining the trends in the world as well as domestic and global trends in maintaining muscle relaxant.

Diagnosis of the growth status and actual condition of the remaining old trees in the village - Focused on Hyeongok-myeon in Gyeongju-si - (마을 내 잔존 노거수의 생육현황 및 실태진단 - 경주시 현곡면을 중심으로 -)

  • Kim, Young-Hun;Deng, Bei-Jia;Chen, Geng;You, Ju-Han
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.23 no.6
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    • pp.109-123
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    • 2020
  • The purpose of this study is to provide basic data for the establishment of future countermeasures by diagnosing the growth status and actual condition of undesignated old trees distributed in Hyeongok-myeon, Gyeongju, Gyeongsangbuk-do. The number of old trees surveyed was 2 weeks in Gajeong-ri, 2 weeks in Haguri, 3 weeks in Nae-Tae-ri, 1 week in Nawon-ri, 6 weeks in Oryu-ri, 3 weeks in Sangguri, and 2 weeks in Sohyeon-ri, The trees species composition was 6 trees Celtis sinensis Pers., 1 Diospyros lotus L. trees, 4 trees Salix chaenomeloides Kimura trees, 2 Styphnolobium japonicum L. trees, and 7 Zelkova serrata (Thunb.) Makino trees. Growth status is 7.1~22.0m in height, 14.6~25.1m in long axis, 10.2~19.2m in short axis, root diameter is 76.0~236.4cm, diamter at breast height is 67.0~220.0cm, soil acidity is pH4.9~7.0, soil The hardness was measured to be 4.0-27.0mm. The result grade of the scoring data of health information is represented by monitoring generally, monitoring critically, and absolute monitoring, and it was confirmed that out of the 20 trees population in Hyeongok-myeon, the general monitoring grade was 7 weeks, the major monitoring grade was 13 weeks, and there was no absolute monitoring grade. Accordingly, the number of old trees of the general surveillance level was maintained at the current level, and ecological surgical operations were introduced for the major surveillance level, but the case of village forests should be different, and sequential treatments were the old tree urgently needed. The level and bark of the target tree, the state of the crown, the root exposure, the presence of pests and pests, the vitality and the ground condition, the degree of pollution are normal, poor, or very poor, operation and protection management, soil improvement, removal of cover, and disinfection were urgently needed for the old trees with the surveyed data. In order to compensate for these matters, continuous monitoring and management measures for the old number should be sought.

Change in the Alignment and Distal Junctional Kyphosis Development after Posterior Cervical Spinal Fusion Surgery for Cervical Spondylotic Myelopathy - Risk Factor Analysis

  • Lee, Jung Jae;Park, Jin Hoon;Oh, Young Gyu;Shin, Hong Kyung;Park, Byong Gon
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.549-557
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    • 2022
  • Objective : This study analyzed the risk factors in patients who developed distal junctional kyphosis (DJK) after posterior cervical fusion. Methods : We retrospectively analyzed the clinical and radiographic outcomes of 64 patients, aged ≥18 years (51 and 13 male and female patients, respectively), who underwent single-staged multilevel (3-6 levels) posterior cervical fusion surgery due to multiple cervical spondylotic myelopathy. The surgeries were performed by a single spinal surgeon between January 2012 and December 2017. Demographic data, clinical outcomes, and radiological results were collected. We divided the patients into a DJK group and a non-DJK group according to the presence of DJK and investigated the risk factors by comparing the differences between the two groups. Results : Of the 64 patients, 13 developed DJK. No significant differences in clinical results were observed between the two groups before and immediately after the surgery. At the final follow-up, a higher visual analog score for neck pain was observed in the DJK group compared to the non-DJK group (p<0.01). The DJK group had a significantly lower T1 slope and a significantly higher C2-7 sagittal vertical axis (SVA) before surgery compared to the non-DJK group (p=0.03 and p<0.01, respectively). Immediately after surgery, the difference between the two groups decreased and no significant difference was observed. However, at the last follow-up, a significantly higher C2-7 SVA was observed in the DJK group (p<0.01). At the last follow up, there is no discrepancy in T1S-CL. In multiple logistic regression analysis, preoperative higher C2-7 SVA and preoperative lower T1 slope were identified as independent risk factors (p=0.03 and p<0.01, respectively). As a result, it was confirmed that DJK occurred along the process of returning to preoperative values. Conclusion : DJK can be considered to be caused by cervical misalignment due to excessive change in the surgical site in patients with low T1 slope and high C2-7 SVA before surgery. This also affects the clinical outcome after surgery. It is recommended to refrain from excessive segmental lordosis changes during multilevel cervical post fusion surgery, especially in patients with a small preoperative T1 slope and a large SVA value.

Approach to prosthetic treatment for patients with open bite due to mandibular displacement: Case report (하악변위로 인한 개방교합 환자의 보철치료: 증례보고)

  • Seo, Min-Gyung;Chi, Seung-Seok;Ko, Kyung-Ho;Park, Chan-Jin;Cho, Lee-Ra;Huh, Yoon-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.420-430
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    • 2022
  • Open bite is accompanied by decrease in tooth contact and overbite, and causes collapse of occlusal plane, mastication difficulties, speech disorders, changes in appearance, and lower occlusal force than normal. Open bite caused by temporomandibular joint disorder in adults with complete occlusion must be corrected after removal or stabilization of the causative factors. Orthodontic treatment, occlusal adjustment, prosthetic treatment, and surgical treatment can be the option of occlusal correction. This report describes about estimating the cause of occlusion change in two patients who developed an open bite due to mandibular displacement in adults with complete occlusion and different treatment approaches accordingly. In one patient, satisfactory result was obtained in functional and esthetic aspects through occlusal adjustment after stabilization of the temporomandibular joint.

Complete denture rehabilitation of partially glossectomized patient using palatal augmentation prosthesis: A case report (부분 혀 절제술을 받은 완전 무치악 환자에서 구개증대보철물을 이용한 수복 증례)

  • Hyeon-Kyeong Lee;Na-Hong Kim;Hee-Won Jang;Sun-Young Yim;Keun-Woo Lee;Sung-Yong Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.82-89
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    • 2023
  • The tongue is one of the most common sites of oral cancer. Glossectomy is known as the gold standard for tongue cancer treatment. However, surgical removal can lead to reduced mobility of the tongue and the patients may have difficulty performing normal oral functions like swallowing and pronunciation. Therefore, additional prosthetic consideration to supplement the function of the impaired tongue is needed for oral rehabilitation of such patients. Palatal augmentation prosthesis helps the tongue to reach the palate by lowering the position of the palatal polished surface. The oral functions of the patients with limited tongue mobility can be improved by the prosthesis. In this case, palatal augmented maxillary denture and conventional mandibular denture were fabricated for the completely edentulous patient with reduced tongue mobility after glossectomy due to tongue cancer. As a result, the oral functions of the patient were improved with the prosthesis.

A case of distichiasis treatment using electroepilation in a dog (개에서 전기제모술을 이용한 첩모중생의 치료 1례)

  • Myeong-Gon, Kang;Dong-Hyun, Han;Sei-Myoung, Han;Eun-Gyeom, Jung;Gyeong-Min, Kim;Shin-Ho, Lee;Yoon-Joo, Shin;Ju-Bin, Kang;Dong-Bin, Lee;Phil-Ok, Koh;Jae-Hyeon, Cho;Chung-Kil, Won;Chung-Hui, Kim
    • Korean Journal of Veterinary Service
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    • v.45 no.4
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    • pp.325-330
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    • 2022
  • Distichiasis is one of the diseases commonly encountered in companion animals, and these abnormal eyelashes cause corneal ulcers, continuous eye irritation, eye pain, glare, epiphora, foreign body sensation and can cause corneal opacity and vision loss in severe cases. In this study, an eyelash epilation needle for animals was developed and applied to a real case, and the results were observed. In a case of corneal ulcer caused by distichiasis of a 2-year-old Shih Tzu, a high-frequency surgical instrument for animals was converted into an electric epilation needle to attempt a procedure to destroy the eyelash hair follicles on the upper eyelid. A epilation needle was developed to have a diameter of 0.1 mm and a length of 4 mm at the end of the handle of DOCTANZ 400, an electrosurgical instrument for animals only. In the procedure, 2~3 mm of an epilation needle was inserted into the hair follicle, and 1 watt of electric power was applied to the hair follicle for about 5 sec. to carry out electrolysis until white bubbles were generated around the meibomian glands thereby destroying the hair follicle. As a result, no eyelashes grew any longer in the treated area indicating that the treatment was successful. It is hoped that the method developed in this study will be applied so that it will be widely used as a treatment method for distichiasis in companion animals that can be frequently seen hereafter.

Effect of Mask Wearing and Type on Cardiopulmonary Resuscitation Accuracy, Fatigue and Physiological Changes

  • Sung-Hwan Bang;Hyo-Suk Song;Gyu-Sik Shim;Hee-Jeong Ahn
    • Journal of the Korea Society of Computer and Information
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    • v.28 no.7
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    • pp.113-120
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    • 2023
  • The purpose of this study was the accuracy of cardiac compression, fatigue, and physiological changes of the rescuer for different mask type in cardiopulmonary resuscitation(CPR). Data collection was from 9 to 12 May 2022, the participants were a total of 24 paramedic students with a BLS provider at D University. The students participated in an experiment in which 12 students each wore a surgical mask (Dental mask) and a fine particle 94% blocking mask (KF94 mask) and performed CPR for 2 minutes over a total of 7 times. As a result of the study, in the analysis of the quality of the rescuer's chest compression according to the type of mask, there was a significant difference in the compression speed (F=24.91, p<.001) and bad compression hand position (F=14.54, p=.024) in the group wearing the KF94, Fatigue showed significant differences in both the Dental mask group (F=51.16, p<.001) and the KF94 mask group (F=63.49, p<.001). Among the physiological changes, heart rate showed a significant difference between the Dental mask group (F=34.79, p<.001) and the KF94 mask group (F=35.55, p<.001), and the respiratory rate showed a significant difference between the Dental mask group (F=25.02, p=.001) and the KF94 mask group(F=23.02, p=.002). Therefore, in order to improve the quality of efficient chest compression and reduce the fatigue and physiological changes of rescuers, it will be necessary for rescuers to wear suitable personal protective equipment.