• The Journal of Korea Robotics Society
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• v.16 no.1
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• pp.64-71
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• 2021

This paper describes a robotic teleoperation system to perform an accurate needle insertion into a cornea for a separation between the stromal layer and Descemet's membrane during deep anterior lamellar Keratoplasty (DALK). The system can reduce the hand tremor of a surgeon by scaling the input motion, which is the control input of the slave robot. Moreover, we utilize corneal applanation to estimate the insertion depth. The proposed system was validated by performing the layer separation using 25 porcine eyes. The average depth of needle insertion was 742 ± 39.8 ㎛ while the target insertion depth was 750 ㎛. Tremor error was reduced from 402 ± 248 ㎛ in the master device to 28.5 ± 21.0 ㎛ in the slave robot. The rate of complete success, partial success, and failure were 60, 28, and 12%, respectively. The experimental results showed that the proposed system was able to reduce the hand tremor of surgeons and perform precise needle insertion during DALK.

• The Korean Journal of Pain
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• v.20 no.1
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• pp.40-45
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• 2007

Background: Caudal block is useful when anesthesia for surgery or treatment for chronic pain is needed, but this procedure has a failure rate of up to 25% even when it performed byan experienced physician. This high failure rate is usually due to improper needle placement. Methods: After gaining approval of the ethics committee, 46 patients received caudal blocks under ultrasound guidance; these were performed after the anatomical structures in the sacral hiatus had been measured with ultrasound. All these procedures were performed by the same anesthesiologist. The position and direction of the needle were identified using fluoroscopy by injecting a radio-opaque contrast through the needle. The time taken from thelidocaine injection to verification of the needle was measured and the planned nerve block was then carried out. Results: All cases of needle insertion into the sacral canal under ultrasound guidance were successful. The average duration of the procedure and the trial count were $134.1{\pm}10.1seconds$ and $1.2{\pm}0.1$, respectively. In 12 of the 46 cases (26%), the needle deviated either left or right in the sacral canal, so the direction of the needle had to be adjusted. The distance between two cornua, the depth of the sacral hiatus and the thickness and length of the sacrococcygeal ligament were $17.1{\pm}0.4$, $3.9{\pm}0.3$, $2.3{\pm}0.1$ and $24.9{\pm}0.9mm$, respectively. Conclusions: Ultrasound guidance can increase the success rate of inserting a needle into the sacral canal. However, even when ultrasound is used, the needle can deviate either left or right in the sacral canal.

• Tuberculosis and Respiratory Diseases
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• v.56 no.6
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• pp.628-637
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• 2004

Background : Percutaneous needle aspiration biopsy(PNAB) of the lung is a safe procedure for diagnosis of various pulmonary diseases but complications such as pneumothorax can occasionally develop. We reviewed the complications arising after PNAB and analysed the risk factors of pneumothorax. Method : We collected data by reviewing medical records and radiographic studies of 403 patients who underwent PNAB of the lung between 1988 and 2002 and analyzed the risk factors of pneumothorax. Result : The incidence of complication was 12.9%, 48 patients with pneumothorax and 4 patients with mild hemoptysis. Among the 48 pneumothorax patients, 35 patients showed mild(<20%) and was treated by only oxygen supply, 11 patients had severe pneumothorax(>50%) and chest tube insertion was done and 2 patients were treated by needle aspiration. As the results of multivariate analysis, size and location of lesion, location of approach, diagnosis of lesion showed no significant relationship, while age and gender of patients(p<0.05) and the depth of approach(p<0.001) were significantly related to pneumothorax. Smoking amount(p<0.001) as well as the smoking history(p<0.005) were also significantly related and the examiner displaying various incidence of pneumothorax from 4.0% to 23.1% among individuals also was a significant independent risk factor(p<0.05). While the average depth of approach for 13 patients treated by chest tube insertion or needle aspiration was $8.2{\pm}1.2cm$, 35 patiens treated only by oxygen supply was $6.7{\pm}1.6cm$ suggesting that the depth of approach was lead to a severe pneumothorax. Conclusion : The independent risk factors of pneumothorax, the most common complication after PNAB, are age and gender of patients, depth of approach, examiner of procedure, smoking history and smoking amount.

• The Journal of Korean Medicine
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• v.35 no.3
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• pp.70-92
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• 2014

Objectives: Due to advance of science and IT technology, high tech imaging equipment like ultrasonography, CT, MRI and PET scan is constantly being developed and progressed; use of these techniques is needed for Korean medicine. Methods: Historical study was undertaken on the evidence of using ultrasonography. Normal organs and various sorts of diseases were also observed by ultrasonography. Results: Korean medicine judges disease of internal organs and condition of health by symptoms of functional disease and organic disease based on anatomical theory. Ultrasonography based on anatomical theory is non-invasive and free from radiation exposure and can be performed directly from clinical practice in real-time. Ultrasonography can be a big help for securing the stability of the internal organs in inserting needles in the thorax and abdomen as well as diagnosing functional and organic diseases based on anatomical theory. Conclusion: We look forward to a great development of scientification and objectification of Korean medicine by using and researching imaging equipment based on anatomical theory as well as ultrasonography.