• Title/Summary/Keyword: less-invasive treatment

Search Result 171, Processing Time 0.042 seconds

Recent Advances in Surgery for Atrial Fibrillation (심방세동의 최신 외과적 치료)

  • Lee, Dong-Hyup;Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
    • /
    • v.22 no.1
    • /
    • pp.13-26
    • /
    • 2005
  • Atrial fibrillation (AF) is the most common cardiac rhythm disturbance, which carries significant cardiovascular morbidity and mortality. The medical treatment for AF is cumbersome and unsatisfactory, which has highlighted the need to develop alternative treatments for AF. The recent discovery that AF is often initiated by atrial ectopic beats has resulted in treatments designed to target the ectopic sources, particularly those within the pulmonary veins. Building on the pioneering work of Cox et al., a recent reported series demonstrated the feasibility of treating patients undergoing cardiac surgery for other structural heart diseases with limited, left-atrial ablation lesion sets using alternative energy sources. As less complex modifications of the Maze procedure have been developed, a number of energy sources have been introduced to create of electrically isolating lesions within the atria. These sources have been used both endocardially in arrest heart procedures as well as epicardially in a beating heart setting. This review summarizes the recent advances in surgery for AF that will aid in the development of an effective, minimally invasive surgical procedure to cure patients with AF.

  • PDF

Comparison of IVF-ET outcomes in patients with hydrosalpinx pretreated with either sclerotherapy or laparoscopic salpingectomy

  • Na, Eun Duc;Cha, Dong Hyun;Cho, Jung Hyun;Kim, Mi Kyoung
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.39 no.4
    • /
    • pp.182-186
    • /
    • 2012
  • Objective: Many studies have demonstrated that hydrosalpinx has a detrimental effect on the outcome of IVF. Treating hydrosalpinges prior to the IVF procedure in women with hydrosalpinges is thought to improve the likelihood of successful IVF outcome. Vaginal ultrasound-guided aspiration of hydrosalpinx fluid (HSF) with injection of the sclerosing agent in situ might be simpler than invasive procedures like salpingectomy. Therefore, we carried out a retrospective study on the effects of ultrasound-guided HSF aspiration and injection of the sclerosing agent of ultrasonically diagnosed hydrosalpinx on IVF outcome. Methods: In our retrospective study, 97 tubal factor infertile female patients that underwent IVF treatment between January 2005 and December 2012 at the Reproductive Medicine Center of CHA Hospital were divided into two study groups. Fifty-six patients underwent interventional ultrasound sclerotherapy (group 1), and the remaining 41 patients received laparoscopic salpingectomy (group 2) before IVF. We compared the IVF outcomes of the two groups. Results: The results showed that ultrasound-guided HSF aspiration and sclerotherapy have IVF outcomes comparable to laparoscopic salpingectomy. Conclusion: Interventional ultrasound guided sclerotherapy before IVF is an effective and less invasive prophylactic intervention alternative to salpingectomy with hydrosalpinx.

Clinical case using The platinum foil Technique (백금박 라미네이트를 이용한 임상증례)

  • Kim, sun kyu;Shin, jun hyouk
    • Journal of the Korean Academy of Esthetic Dentistry
    • /
    • v.29 no.1
    • /
    • pp.4-12
    • /
    • 2020
  • Recently, according to the concept of minimal invasive, there have been many opportunities for restoration treatment with porcelain laminate veneers that are less invasive and can ideally improve esthetics. Patients also visit the laminate well, and patients also want to reduce the amount of teeth cut, so the choice of the entire trimming crown is decreasing. Therefore, various techniques of laminate are required. Most dental clinicians seem to have negative images of laminates such as risk of fracture, margin pigmentation and dropout. However, this situation is due to incorrect adhesion manipulation and lack of inspection of the occlusal relationship, and there is no problem with the Porcelain Laminate Veneer itself. The purpose and scope of adaptation leading to the success of porcelain laminate veneer will be introduced.

Endovenous 980-nm Diode Laser Treatment of Incompetent Great Saphenous Vein (정맥 내 980-nm 다이오드 레이저를 이용한 대복재정맥 역류의 치료)

  • Kim, Kun-Il;Jo, Tae-Jun;Lee, Jae-Woong;Hong, Ki-Woo;Lee, Won-Yong
    • Journal of Chest Surgery
    • /
    • v.40 no.2 s.271
    • /
    • pp.97-102
    • /
    • 2007
  • Background: Endovenous laser treatment has recently been introduced as a less invasive technique, with many good results reported, A 980-nm diode laser was used on the great saphenous vein (GSV) occlusions in patients with varicose veins, due to GSV reflux, and the therapeutic effects analyzed. Material and Method: Between September 2003 and February 2006, 238 patients (332 cases) with GSV reflux underwent endovenous laser treatment with a 980-nm diode laser. Operative procedures were simultaneous endovenous laser treatment and ambulatory phlebectomy. The preoperative clinical findings, postoperative complications and postoperative duplex US follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were ecchymosis in almost cases, paresthesia 68 cases (20.5%) and skin burn in 3 cases (0.9%). Follow up duplex US revealed 26 and 10 cases at 1 and 3 months of GSV reflux or partial recanalization, with therapeutic success rates of 91.3 and 87.9%, respectively. Conclusion: The treatment of GSV occlusion with an endovenous laser is less invasive than traditional GSV stripping, but relatively high recanalization was experienced, possibly due to inadequate laser power, laser fiber pullback speed or an extremely dilated GSV. However, continuous attempts will be required to reduce the recanalization after the procedure, with accurate follow up using duplex US.

Endoscopic Management of Pineal Region Tumors with Associated Hydrocephalus (수두증을 동반한 송과체 부위 종양에 대한 내시경적 치료)

  • Kim, Jeong Hoon;Ra, Young Shin;Kim, Joon Soo;Ahn, Jae Sung;Kim, Chang Jin;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
    • /
    • v.30 no.5
    • /
    • pp.575-580
    • /
    • 2001
  • Purpose : In general, pineal region tumors are managed by using microsurgical approach or stereoctactic biopsy. However, in selected cases endoscopic approach to pineal lesions might prove to be as effective as microsurgery and less invasive. We report an alternative surgical strategy for managing certain patients with pineal neoplasms that allows treatment of the symptomatic hydrocephalus as well as tumor biopsy under direct vision in the same sitting. Materials and Methods : Twenty-two patients with pineal region tumors with associated hydrocephalus were treated in one session by endoscopic third ventriculostomy and endoscopic tumor biopsy at our institution from October 1996 to January 2000. All patients were retrospectively evaluated. Results : There was no operative mortality. There was one cause of significant bleeding during biopsy, but was controlled endoscopically, and the patient recovered completely without neurologic deficit resulting from intra-operative bleeding. The symptoms related to increased intracranial pressure(ICP) have resolved in all patients, and the need for a shunt is completely eliminated. Histological diagnosis was achieved in 21 of the 22 patients by this procedure. A biopsy was not obtained in one patient. Although this pineal region tumor was seen endoscopically, this could not be biopsied because of technical difficulties in working around an enlarged massa intermedia. The lesions included fourteen germinomas, three mixed germ cell tumors, and one each of the followings: pineocytoma, pineoblastoma, pineocytoma/pineoblastoma(intermediate type), meningioma, and low grade glioma. Five of the 22 patients subsequently underwent formal microsurgical tumor removal. Additional chemotherapy or radiotherapy could then be initiated according to the histological diagnosis. Conclusion : We consider that endoscopy affords a minimally invasive way of reaching three objectives by one-step surgery in the management of pineal region tumors with associated hydrocephalus : 1) cerebrospinal fluid(CSF) sample for analysis of tumour markers and cytology, 2) treatment of hydrocephalus by third ventriculostomy, and 3) several biopsy specimens can be obtained identifying tumors which will require further open surgery or adjuvant radiation and/or chemotherapy. However, complications and morbidities should be emphasized so as to be avoided with further technical experience.

  • PDF

The evaluation of maximum bite force in the occlusal rehabilitation of patient with Angle Class III malocclusion: a case report

  • Karakis, Duygu;Kaymak, Dilek;Dogan, Arife
    • The Journal of Advanced Prosthodontics
    • /
    • v.5 no.3
    • /
    • pp.364-368
    • /
    • 2013
  • The case report describes the occlusal rehabilitation of a male patient with Angle Class III malocclusion and its effect on maximum bite force. The main complaints of patient were masticatory difficulty and poor esthetic. The patient's expectations from the treatment were a good esthetic and function with a less invasive and relatively promptly way. Therefore, increasing of the occlusal vertical dimension (OVD) and then restoring the maxillary and mandibular teeth was chosen by the patient among the treatment options. At the beginning of treatment maximum bite force of patient was measured. Then an occlusal splint was provided to evaluate the adaptation of the patient to the altered OVD. Full mouth rehabilitation with metal ceramic restorations was made. After the completion of full mouth restoration, bite force measurement was repeated and patient exhibited increased maximum bite force. Full mouth restorative treatment in a patient with Class III malocclusion could be an effective treatment approach to resolve esthetic concern and to improve masticatory function related to maximum bite force.

Gamma Knife Radiosurgery for Trigeminal Neuralgia : Review and Update

  • Lee, Seunghoon;Lee, Jung-Il
    • Journal of Korean Neurosurgical Society
    • /
    • v.65 no.5
    • /
    • pp.633-639
    • /
    • 2022
  • Accurate diagnosis of trigeminal neuralgia (TN) is the starting point for optimal treatment. Gamma knife radiosurgery (GKRS) is currently regarded as one of the first-line treatment options for medically refractory TN. GKRS is a less invasive treatment with a low risk of complications than other surgical procedures that provides a favorable pain control Barrow Neurological Institute (BNI) I-IIIb rate of >75% at short-term follow-up. Drawbacks of GKRS include the latency period before pain relief and higher recurrence rate compared with microvascular decompression. Therefore, repeat treatment is necessary if the initial GKRS was effective but followed by recurrence. The concept of dose rate and the biologically effective dose of radiation has been actively studied in radiation oncology and is also applied in GKRS for TN to achieve high safety and efficacy by prescribing the optimal dose. Recent progress in functional imaging, such as diffusion tensor imaging, enables us to understand the pathophysiology of TN and predict the clinical outcome after GKRS. Here, we review TN, GKRS, and recent updates, especially in the concepts of radiation dose, diffusion tensor imaging studies, and repeat treatment in GKRS for TN.

Carpal Tunnel Syndrome Caused by Lipofibromatous Hamartoma of the Median Nerve

  • Roh, Youn-Tae;Song, Seok-Whan;Jeong, Changhoon;Kang, Younghoon;Park, Il-Jung
    • Journal of Korean Neurosurgical Society
    • /
    • v.63 no.5
    • /
    • pp.664-670
    • /
    • 2020
  • Lipofibromatous hamartoma (LFH) is a rare tumor of the peripheral nerves, which usually involves the median nerve. The authors reported on two rare cases of carpal tunnel syndrome due to LFH of the median nerve. A 49-year-old female patient complained of the mass and symptoms consistent with LFH. Magnetic resonance imaging (MRI) showed typical LFH findings. The symptoms were successfully ameliorated with carpal tunnel release and external neurolysis. A 37-year-old female patient complained of weakening thumb abduction and the mass where the MRI showed atypical findings. Opponensplasty and debulking operations were performed after which thumb abduction was improved; however, neurological sequelae remained. LFH of the median nerve is managed on a case-by-case basis as treatment guidelines are not very clearly defined yet. However, the less invasive treatment such as carpal tunnel release and external neurolysis than more aggressive surgical treatment should be recommended as a treatment option.

The Effect of Indwelling Silk Suture Following Aspiration in the Treatment of Chronic Lateral Malleolar Bursitis (흡입 후 견 봉합사 거치를 통한 만성 족관절 외과 점액낭염의 치료)

  • Lee, Bong-Jin;Lee, Sung-Rak;Kim, Seong-Tae
    • Journal of Korean Foot and Ankle Society
    • /
    • v.9 no.1
    • /
    • pp.38-41
    • /
    • 2005
  • Purpose: To evaluate the drainage effect of silk suture following aspiration of the bursa as an early treatment of chronic lateral malleolar bursitis. Materials and Methods: Thirteen cases, which have over two weeks of history and over one year of follow-up, were investigated. The average duration of follow-up was 16.4 months. The average symptom duration before introduction into this study was 7.8 weeks. With an aseptic technique, the aspiration of the bursa was done with 18G needle and syringe and then the insertion of silk suture through the aspiration needle was performed. The amount of drainage was identified two or three times in a week and stitch out was done at the cessation of drainage. Over one year follow-up, recurrence, infection, pain, and limitation of range of motion were investigated by telephone interview. Results: Redness around the insertion site of silk suture was found in all cases, but there was no development of active infection or recurrence. The average duration of treatment is 10.4 days. Conclusion: The drainage with silk suture following aspiration of the bursa is less invasive and very effective method in the early treatment of chronic lateral malleolar bursitis.

  • PDF

Therapeutic Considerations of Percutaneous Sacroplasty for the Sacral Insufficiency Fracture

  • Choi, Kyung-Mi;Song, Joon-Ho;Ahn, Sung-Ki;Choi, Hyun-Chul
    • Journal of Korean Neurosurgical Society
    • /
    • v.47 no.1
    • /
    • pp.58-63
    • /
    • 2010
  • Sacral insufficiency fracture is a debilitating injury not easily found in general radiologic examinations and is rarely diagnosed, since its symptoms are obscure. It is known to frequently occur in patients with osteoporosis, but the treatment has not yet been established and various kinds of treatment methods are being attempted. Sacroplasty is sometimes performed by applying percutaneous vertebroplasty which is known to be a less invasive treatment. Since the course of diagnosis of sacral insufficiency fracture is difficult and clear guidelines for treatments have not yet been established, many spine surgeons fail to diagnose patients or speculate on treatment methods. We report our experience in diagnosing a sacral insufficiency fracture in a 54-year-old healthy female patient using MRI and treating her with sacroplasty. From a therapeutic point of view, we then cover the usefulness, effects and characteristics relating to the complications of sacroplasty, along with literature review.