• Title/Summary/Keyword: semi-surgical

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Delayed Presentation of Self-discovered Breast Cancer Symptoms in Iranian Women: A Qualitative Study

  • Khakbazan, Zohreh;Taghipour, Ali;Roudsari, Robab Latifnejad;Mohammadi, Eesa;Omranipour, Ramesh
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9427-9432
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    • 2014
  • Background: Delayed presentation of symptomatic breast cancer is a public health issue in Iran, making a major contribution to low survival. Despite the importance of this problem, current knowledge is insufficient to inform interventions to shorten patient delay. The aim of this study was to explore factors influencing patient delay in Iranian women with self-discovered breast cancer symptom. Materials and Methods: This qualitative study was conducted during 2012-2013. Purposeful sampling was used to recruit 20 Iranian women with self-discovered symptoms of breast cancer who attended the Cancer Institute of Tehran University of Medical Sciences, Tehran, Iran. Data were collected through semi-structured in-depth audiotaped interviews, which were transcribed and analyzed using conventional content analysis with MAXqda software version 10. Findings: Content analysis of the data revealed four main themes related to the delay in seeking medical help including: 1) attributing symptoms to the benign conditions; 2) conditional health behavior; 3) inhibiting emotional expression; and 4) barriers to access to health care systems. Conclusions: These results suggest that patient delay is influenced by complex and multiple factors. Effective intervention to reduce patient delay for breast cancer should be developed by focusing on improvement of women's medical knowledge, managing patients' emotional expression and reform of the referral system.

A CLINICOSTATICAL STUDY OF JAW CYST BETWEEN 2001${\sim}$2005 (최근 5년간 구강악안면 낭종 환자에 대한 통계학적 검토)

  • Lim, So-Yeon;Yeo, Duck-Sung;Lee, Hyun-Jin;Kim, Hyun-Kyung;An, Kyung-Mi;Sohn, Dong-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.6
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    • pp.588-593
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    • 2006
  • Cyst is pathologic disease develops in hard tissue as well as soft tissue, which is lined by epithelium filled with liquid, semi-liquid, or air. Origins and symptoms of the cyst are various according to region, and symptoms are malocclusion, diversion of root, tooth mobility, periapical swelling, discoloration and lesion expansion, because the odontogenic cysts begin in the numerous rests of odontogenic epithelium. But almost cysts produce no symptoms unless secondary infection occurs. Treatment of small cysts may include extraction, endodontic therapy, and apical surgery. Treatment of a large cysts usually involves surgical removal (enucleation), Marsupialization(a method of decompression) or combination of two before mentioned. Bone graft is done for helping of bone defect healing at the same time of enucleation This clinical research from January 2000 to December 2005, analyzed by the age, sex, classification, size, region, treatment method, whether or not of bone graft of cyst in the jaw in Daegu Catholic University Hospital.

Linked Semi-constrained or Unlinked TER: What We Should Know Before We Use? (연결형, 반구속형 또는 비연결형, 비구속형 주관절 인공 관절 성형술: What We Should Know Before We Use?)

  • Jung, Hong-Jun;Jeon, In-Ho;Chun, Jae-Myeung
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.99-104
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    • 2011
  • Purpose: Total elbow arthroplasty (TEA) is still in its infancy as compared with other forms of arthroplasty. TEA designs have evolved with experience, but comparatively little long-term outcome data is available. This article provides an overview of the current states of linked, unlinked, and convertible total elbow arthroplasty. Material and Method: The designs of total elbow prostheses can be subdivided into three categories: unlinked, linked, and convertible. This article provides an overview of the current states of linked, unlinked, and convertible total elbow arthroplasty. Results and Conclusion: By proper patient selection and by utilizing implant design advances, improvements in cementation techniques, a meticulous surgical technique, and appropriate postoperative rehabilitation, total elbow arthroplasty can provide a high level of patient satisfaction and pain relief.

TREATMENT OF ODONTOGENIC CYST USING DECOMPRESSION (감압술을 이용한 치성 낭종의 치료)

  • Choi, Byung-Jai;Suh, Moon-Sun;Kim, Seong-Oh;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.3
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    • pp.418-422
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    • 2002
  • Cyst is a cavity filled with fluids and semi-fluids that is lined with epithelial cells. Odontogenic cysts are those that form within the jaw which origin from dental follicles, enamel epithelium remnants of the crown, Malassez epithelial cell rest and basal cell layer of the oral epithelium. In such cases, treatment methods such as enucleation, marsupialization, decompression, surgical excision etc. can be used according to the lesion's characteristics, size, relationship with the surrounding tissue, patient's age and developmental status. This case was to report an odontogenic cyst caused by an impacted immature permannent tooth and its treatment. The cyst was removed by decompression. Cystic cavity was healed with bone tissue and the impacted permanent tooth erupted without any recurred cystic lesion.

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Posterior superior alveolar nerve block alone in the extraction of upper third molars: a prospective clinical study

  • Swathi Tummalapalli;Ravi Sekhar M;Naga Malleswara Rao Inturi;Venkata Ramana Murthy V;Rama Krishna Suvvari;Lakshmi Prasanna Polamarasetty
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.4
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    • pp.213-220
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    • 2023
  • Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

Efficacy of a 14Fr Blake Drain for Pleural Drainage Following Video-Assisted Thoracic Surgery (비디오 흉강경 수술에 적용된 14Fr Blake Drain의 효능 분석)

  • Choi, Jinwook;Choi, Ho;Lee, Sungsoo;Moon, Jonghwan;Kim, Jongseok;Chung, Sangho;An, Hyoungwook
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.59-62
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    • 2009
  • Background: Pleural drainage following video-assisted thoracic surgery has traditionally been achieved with largebore, semi-rigid chest tubes. Recent trends in thoracic surgery have been toward less invasive approaches for a variety of diseases. The purpose of this study was to evaluate the safety and efficacy of drainage by means of small, soft, and flexible 14Fr Blake drains. Material and Method: Between December 2007 and March 2008, 14Fr silastic Blake drains were used for drainage of the pleural cavity in 37 patients who underwent a variety of video-assisted thoracic surgical procedures at our institution. Result: The average postoperative length of hospital stay was 3.26 days (range, 2~12 days), Blake drains were left in the pleural space for an average of 3.15 days (range, 1~7 days), and the average amount of drainage was 43.8 ml/day. The maximal amount of blood removed daily by a Brake drain was as much as 290 mL. There were no drain-related complications. Blake drains seemed to cause less pain while in place, and particularly at the time of removal. Conclusion: The use of a Blake drain following minor thoracic surgery appeared to be safe and effective in drainage of fluid or air in the pleural space, and were associated with minimal discomfort.

Thoracoscopic Sympathectomy in Hyperhidrosis (비디오 흉강경을 이용한 다한증 수술의 임상적 고찰)

  • 김동원;배철영;신원선;好돼?;이신영
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1212-1216
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    • 1998
  • Background: Recently thoracoscopic surgery is widely applied in thoracic surgical field and hyperhidrosis is one of the most frequently operated diseases. Material and Method: From June 1997 to February 1998, 30 patients with hyperhidrosis underwent bilateral thoracic sympathectomy under thoracoscopy at Inje University Sanggye Paik Hospital. There were 10 males and 20 females whose mean age was 22.42±6.84 years ranging from 17 to 51. All patients underwent bilateral thoracic sympathectomy under semi-sitting position and two 5 mm sized trocars were inserted. Result: Mean operation time was 52.32±11.72 minutes and the mean elevation of palmar temperature after sympathectomy was 2.17±0.47℃. Eighteen patients(60%) complained compensatory hyperhidrosis. All patients except one were able to discharge at the operation day or postoperative one day. There were no recurrence during follow up from 2 to 8 months(mean 5.30±2.17 months). Conclusion: Thoracoscopic sympathectomy is simple and effective technique in hyperhidrosis and widely applied indication will be necessary. We conclude that further discussion should be made about the resection area and method to get maximal effect and minimal side effect.

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A Convergence Study on the 5-axis Machining Technology using the DICOM Image of the Humerus Bone (위팔뼈 의료용 디지털 영상 및 통신 표준 영상을 이용한 5축 가공기술의 융합적 연구)

  • Yoon, Jae-Ho;Ji, Tae-Jeong;Yoon, Joon;Kim, Hyeong-Gyun
    • Journal of the Korea Convergence Society
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    • v.8 no.11
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    • pp.115-121
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    • 2017
  • The present study aimed to obtain basic knowledge of a customized artificial joint based on the convergence research of Digital Imaging and Communications in Medicine(DICOM) and 5-axis machining technology. In the case of the research method, three-dimensional modeling was generated based on the medical image of the humerus bone, and the shape was machined using a chemical wood material. Then, the anatomical characteristics and the modeling machining computation times were compared. The results showed that the Stereolithography (STL) modeling required twice more time for semi-finishing and 10 times more time for finishing compared to the Initial Graphics Exchange Specification(IGES) modeling. For the 5-axis machining humerus bone, the anatomical structures of the anatomic neck, greater tubercle, lesser tubercle, and intertubercular groove were similar to those in the three-dimensional medical image. In the future, the convergence machining technology, where 5-axis machining of various structures(e.g., the surgical neck undercut of the humerus bone) is performed as described above, can be efficiently applied to the manufacture of a customized joint that pursues the precise model of a human body.

Diagnosis of Ictal Hyperperfusion Using Subtraction Image of Ictal and Interictal Brain Perfusion SPECT (발작기와 발작간기 뇌 관류 SPECT 감산영상을 이용한 간질원인 병소 진단)

  • Lee, Dong Soo;Seo, Jong-Mo;Lee, Jae Sung;Lee, Sang-Kun;Kim, Hyun Jip;Chung, June-Key;Lee, Myung Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.1
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    • pp.20-31
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    • 1998
  • A robust algorithm to disclose and display the difference of ictal and interictal perfusion may facilitate the detection of ictal hyperfusion foci. Diagnostic performance of localizing epileptogenic zones with subtracted SPECT images was compared with the visual diagnosis using ictal and interictal SPECT, MR, or PET. Ietal and interictal Tc-99m-HMPAO cerebral perfusion SPECT images of 48 patients(pts) were processed to get parametric subtracted images. Epileptogenic foci of all pts were diagnosed by seizure free state after resection of epileptogenic zones. In subtraction SPECT, we used normalized difference ratio of pixel counts(ictal-interictal)/interictal ${\times}100%$) after correcting coordinates of ictal and interictal SPECT in semi-automatized 3-dimensional fashion. We found epileptogenic zones in subtraction SPECT and compared the performance with visual diagnosis of ictal and interictal SPECT, MR and PET using post-surgical diagnosis as gold standard. The concordance of subtraction SPECT and ictal-interictal SPECT was moderately good(kappa=0.49). The sensitivity of ictal-interictal SPECT was 73% and that of subtraction SPECT 58%. Positive predictive value of ictal-interictal SPECT was 76% and that of subtraction SPECT was 64%. There was no statistical difference between sensitivity or positive predictive values of subtraction SPECT and ictal-interictal SPECT, MR or PET. Such was also the case when we divided patients into temporal lobe epilepsy and neocortical epilepsy. We conclude that subtraction SPECT we produced had equivalent diagnostic performance compared with ictal-interictal SPECT in localizing epileptogenic zones. Additional value of these subtraction SPECT in clinical interpretation of ictal and interictal SPECT should be further evaluated.

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Semi-quantitative Procalcitonin Assay in Critically ill Patients with Respiratory infections (중환자 호흡 감염에서 반정량적 Procalcitonin 분석)

  • Kim, Ji-Youn;Kim, Cheol-Hong;Park, Sunghoon;Lee, Chang-Youl;Hwang, Yong Il;Choi, Jeong-Hee;Shin, Taerim;Park, Yong-Bum;Jang, Seung-Hun;Lee, Jae Young;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.205-211
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    • 2009
  • Background: Serum procalcitonin level has been considered prognostic during sepsis and septic shock. We investigated the significance of procalcitonin in critically ill patients with respiratory infections. Methods: The patients who had radiographically diagnosed diffuse lung infiltrations were enrolled on a prospective basis. Bronchoalveolar lavage (BAL) fluid for the purpose of quantitative cultures (${\geq}10^4$ cfu/mL) was obtained from all patients. Serum procalcitonin levels determined by PCT-Q kit were measured on BAL day and classified as follows; <0.5 ng/mL, 0.5~2.0 ng/mL, 2.0~10.0 ng/mL and >10.0 ng/mL. We analyzed the patient's characteristics according to outcome; favorable or unfavorable, defined as death. Results: Patients from the following categories were included: medical 17 (47.2%), surgical 9 (25%), and burned 10 (27.8%). APACHE II scores on admission to intensive care unit were 11.5${\pm}$6.89 and 11 (30.6%) had unfavorable outcomes. A procalcitonin level ${\geq}$0.5 ng/mL was in 17 (47.2%) of all. On univariate analysis, the frequencies of burn injury, mechanical ventilation, multiple organ failure, and a procalcitonin level ${\geq}$0.5 ng/mL were more often increased in patients with unfavorable outcomes than in those with favorable outcomes (p<.05). Also, a higher procalcitonin range and ventilator-associated pneumonia (VAP) were more closely associated with an unfavorable outcome (p<.05). However in multivariate analysis, a strong predictor of unfavorable outcome was burn injury (p<.05). A procalcitonin level ${\geq}$0.5 ng/mL was more sensitive in predicting VAP than unfavorable outcome. Conclusion: A higher procalcitonin level seems to be associated with VAP, but further study is required to know that procalcitonin would be a prognostic marker in critically ill patients with respiratory infections.