• 제목/요약/키워드: semi-surgical

검색결과 40건 처리시간 0.022초

Temporary Semi-Jailing Technique for Coil Embolization of Wide-Neck Aneurysm with Small Caliber Parent Artery Following Incomplete Clipping

  • Byun, Jun Soo;Kim, Jae Kyun;Lee, Hwa Yeon;Hwang, Sung Nam
    • Journal of Korean Neurosurgical Society
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    • 제53권4호
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    • pp.241-244
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    • 2013
  • The authors describe the use of a self-expandable stent in a temporary deployment for treatment of a very wide-neck A1 segment of anterior cerebral artery (ACA) aneurysm following incomplete clipping. A 39-year-old hypertensive man presenting with seizure-like movement underwent computed tomography, which showed acute subarachnoid hemorrhage and an A1 segment of ACA aneurysm with superior and inferior projection. He underwent surgical clipping of the aneurysm, but superior and posterior portion of wide-neck aneurysm remained. We decided to treat the remnant aneurysm using an endovascular modality. After selection of the aneurysm, coil packing was performed assisted by the temporary semi-jailing technique. The Enterprise stent (Cordis Neurovascular, Miami, FL, USA) was deployed and recaptured repeatedly for angiography to ensure safety of the small caliber parent artery. Successful semi-deployment and recapture of the stent allowed subtotal coil occlusion of the aneurysm with good anatomic and clinical results. No complications were encountered. The stent could be recaptured up to the point where the proximal end of the stent marker was aligned with distal marker band of the microcatheter, approximately 70% of the stent length. The temporary semi-jailing technique is feasible for wide-neck aneurysm with small caliber parent artery.

정형외과 영역에서 로봇수술 (Robotic Surgery in the Orthopedic Field)

  • 이우석;정우석
    • 대한정형외과학회지
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    • 제53권6호
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    • pp.459-465
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    • 2018
  • 정형외과 수술의 임상적 결과에 영향을 미치는 요소는 여러 가지가 있지만 수술적 수기가 가장 중요한 요인이며 로봇공학은 술기를 보다 정확하고 일관되게 수행하기 위해 도입되었다. 정형외과 영역에서는 20년 전부터 로봇수술을 사용하였으나 실용성 문제와 합병증의 발생으로 일부 로봇은 도태되었으며 단점을 개선한 로봇이 소개되고 있다. 대부분의 로봇수술은 인공관절수술 분야에서 시행되었고 치환물의 정렬과 위치 선정에서 우수한 것으로 보고되고 있다. 그러나 임상적 결과의 우수성, 실용성, 가성비 등의 측면에서 제한점이 있고 일부 로봇수술에서는 합병증 발생 빈도가 높다는 보고가 있었다. 초기 로봇수술은 수술자의 개입 없이 계획된 수술이 진행되는 능동형 로봇수술이 주를 이루었으나 최근에는 수술과정에서 실시간 피드백을 통해 술자가 술 전 계획을 변경할 수 있고, 햅틱 경계 내에서 제한된 골절제를 함으로써 주요 혈관, 신경, 인대 등의 손상을 최소화할 수 있는 반능동형 로봇수술이 소개되고 있다.

Volumetric CT Texture Analysis of Intrahepatic Mass-Forming Cholangiocarcinoma for the Prediction of Postoperative Outcomes: Fully Automatic Tumor Segmentation Versus Semi-Automatic Segmentation

  • Sungeun Park;Jeong Min Lee;Junghoan Park;Jihyuk Lee;Jae Seok Bae;Jae Hyun Kim;Ijin Joo
    • Korean Journal of Radiology
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    • 제22권11호
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    • pp.1797-1808
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    • 2021
  • Objective: To determine whether volumetric CT texture analysis (CTTA) using fully automatic tumor segmentation can help predict recurrence-free survival (RFS) in patients with intrahepatic mass-forming cholangiocarcinomas (IMCCs) after surgical resection. Materials and Methods: This retrospective study analyzed the preoperative CT scans of 89 patients with IMCCs (64 male; 25 female; mean age, 62.1 years; range, 38-78 years) who underwent surgical resection between January 2005 and December 2016. Volumetric CTTA of IMCCs was performed in late arterial phase images using both fully automatic and semi-automatic liver tumor segmentation techniques. The time spent on segmentation and texture analysis was compared, and the first-order and second-order texture parameters and shape features were extracted. The reliability of CTTA parameters between the techniques was evaluated using intraclass correlation coefficients (ICCs). Intra- and interobserver reproducibility of volumetric CTTAs were also obtained using ICCs. Cox proportional hazard regression were used to predict RFS using CTTA parameters and clinicopathological parameters. Results: The time spent on fully automatic tumor segmentation and CTTA was significantly shorter than that for semi-automatic segmentation: mean ± standard deviation of 1 minutes 37 seconds ± 50 seconds vs. 10 minutes 48 seconds ± 13 minutes 44 seconds (p < 0.001). ICCs of the texture features between the two techniques ranged from 0.215 to 0.980. ICCs for the intraobserver and interobserver reproducibility using fully automatic segmentation were 0.601-0.997 and 0.177-0.984, respectively. Multivariable analysis identified lower first-order mean (hazard ratio [HR], 0.982; p = 0.010), larger pathologic tumor size (HR, 1.171; p < 0.001), and positive lymph node involvement (HR, 2.193; p = 0.014) as significant parameters for shorter RFS using fully automatic segmentation. Conclusion: Volumetric CTTA parameters obtained using fully automatic segmentation could be utilized as prognostic markers in patients with IMCC, with comparable reproducibility in significantly less time compared with semi-automatic segmentation.

Concurrent Nocardia Related Brain Abscess and Semi-Invasive Pulmonary Aspergillosis in an Immunocompetent Patient

  • Joung, Mi-Kyong;Kong, Doo-Sik;Song, Jae-Hoon;Peck, Kyong-Ran
    • Journal of Korean Neurosurgical Society
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    • 제49권5호
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    • pp.305-307
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    • 2011
  • We describe here the first case of a concurrent brain abscess caused by Norcardia spp. and semi-invasive pulmonary aspergillosis in an immunocompetent patient. After one year of appropriate antimicrobial therapy and surgical drainage of the brain abscess, the nocardia brain abscess and pulmonary aspergillosis have resolved.

심미적인 부위에서의 외과적 정출술 (Surgical extrusion in aesthetic area)

  • 박현규;박진우;서조영;이재목
    • Journal of Periodontal and Implant Science
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    • 제37권2호
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    • pp.287-295
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    • 2007
  • As a general treatment modality of subgingival tooth defect in aethetic area, implant or crown and bridge therapy after extraction of affected tooth can be used. But as more conservative treatment, crown lengthening can be considered and not to lose periodontal attachment and impair aethetic appearance, surgical extrusion can be considered as a treatment of choice. In this case report, 3 cases of surgical extrusion was represented and appropriate time for initiation of endodontic treatment according to the post-surgical tooth mobility was investigated. In 8 patient who has subgingival tooth defect in aethetic area, intracrevicular incision is performed and flap was reflected with care not to injure interproximal papillae. With forcep or periotome, tooth was luxated and sutured in properely extruded position according to biologic width with or without $180^{\circ}$ rotation. 8 cases show favorable short and long term results. In some cases, surgical extrusion with $180^{\circ}$ rotation can minimized extent of extrusion and semi-rigid fixation without apical bone graft seems to secure good prognosis. In 8 cases, endodontic treatment started about 3 weeks after surgery. This time corresponds with the moment when mobility of extruded tooth became 1 degree and this results concide with other previous reports. If it is done on adequate case selection and surgical technique, surgical extrusion seems to be a good treatment modalilty to replace the implant restoration in aethetic area.

폴리오르소에스텔을 이용한 나록손의 반고형 이식제제의 방출, 생체적합성 및 약물동력학적 연구 (Release, Biocompatibility and Pharmacokinetics of Semi-solid Naloxone Implants of Poly(ortho ester))

  • 임상희;박주애;김길수
    • Journal of Pharmaceutical Investigation
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    • 제29권1호
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    • pp.21-27
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    • 1999
  • Semi-solid poly(ortho esters) (POE) were prepared to provide bioerodible carriers for sustained drug delivery systems of naloxone (NLX) in the treatment of narcotic addiction. As the POE have viscous behavior at room temperature, a significant advantage of this polymer is that it can be injected without any surgical intervention. The POE was synthesized by a transesterification reaction between 1,2,6-hexanetriol and trimethyl orthoacetate, and the structure of the polymer was confirmed by IR. The in vitro release of the drug from POE was studied. The release rate of NLX decreased with increasing intrinsic viscosities of the polymer. In vivo biocompatibility studies were carried out in rats with NLX loaded POE. Histopathological analysis showed that NLX implants are well-tolerated by rats when used subcutaneously. Pharmacokinetic studies of POE-NLX implants of two different viscosities were carried out in rabbits. In all cases, plasma concentrations of NLX were maintained over 1 ng/ml for at least 168 hours, but initial burst effect was observed. Mean residence time(MRT) was found to depend on the viscosity of the polymer.

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폴리오르소에스터를 이용한 니페디핀의 반고형 이식제제의 제조 및 평가 (Preparation and Evaluation of Semi-Solid Nifedipine Implants of Poly(ortho esters))

  • 이새별;박주애;이승진;김길수
    • Journal of Pharmaceutical Investigation
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    • 제29권2호
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    • pp.93-98
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    • 1999
  • Semi-solid poly(ortho esters) (POE) were prepared to provide bioerodible carriers for sustained drug delivery systems of nifedipine in the treatment of cardiovascular disease. As the POE has viscous behavior at room temperature, a significant advantage of this polymer is that it can be injected without any surgical intervention. The POE was synthesized by a transesterification reaction between 1,2,6-hexanetriol and trimethyl orthoacetate and the nifedipine release from POE was studied in vitro. The release rate of nifedipine decreased with increasing the amount of nifedipine and the diethanolamine dispersed in the polymer. But the excess amounts, above 3%, of diethanolamine retarded the release of nifedipine. In vivo biocompatibility studies were carried out in rats with nifedipine loaded POE. Histopathological analysis showed that nifedipine loaded POE implants were well-tolerated by rats when used subcutaneously. In case of the rats implanted POE containing diethanolamine, tissue necrosis and inflammation were occured. Pharmacokinetic studies of nifedipine loaded POE implants were carried out in rabbits. In all cases, plasma concentrations of nifedipine were maintained over 15 ng/ml for at least 360 hours and biological half $life(t_{1/2})$ and mean residence time(MRT) were increased by addition of diethanolamine.

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수술통합시스템 시뮬레이터 개발과 자동조명시스템의 설계 (Development of simulator for Computer-integrated Robotic Surgery system and Design of its Auto-illumination system)

  • 이수강;정구봉;이병주;김희국
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2004년도 학술대회 논문집 정보 및 제어부문
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    • pp.456-458
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    • 2004
  • Recent medical robot systems perform surgery operations, by following the preplanned trajectory and surgical procedures. Depending on the complexity of surgery operations, they are operated in manual, semi-automatic or full automatic mode. To improve the performance of those medical robot systems, development of the simulator and more advanced auto-illumination system, in which intensity of light, direction and focal point can be controlled automatically according to the varied environments during surgical operations. are required. Therefore, in this paper, the simulator for SPINEBOT system which is a computer-intergrated robotic surgery system are developed. And further, an auto-illumination system which will be integrated to the SPINEBOT system is investigated and its preliminary design is described.

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Development of Fully-Implantable Middle Ear Hearing Device with Differential Floating Mass Transducer : Current Status

  • Cho Jin-Ho;Park Il-Yong;Lee Sang-Heun
    • 대한의용생체공학회:의공학회지
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    • 제26권5호
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    • pp.309-317
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    • 2005
  • It is expected that fully-implantable middle-ear hearing devices (FIMEHDs) will soon be available with the advantages of complete concealment, easy surgical implantation, and low power operation to resolve the problems of semi-implantable middle-ear hearing devices (SIMEHDs) such as discomfort of wearing an external device and replacement of battery. Over the last 3 years, a Korean research team at Kyungpook National University has developed an FIMEHD called ACRHS-1 based on a differential floating mass transducer (DFMT). The main research focus was functional improvement, the establishment of easy surgical procedures for implantation, miniaturization, and a low-power operation. Accordingly, this paper reviews the overall system architecture, functions, and experimental results for ACRHS-1 and its related accessories, including a wireless battery charger and remote controller.