• Title/Summary/Keyword: surgical tool

Search Result 267, Processing Time 0.031 seconds

Surgical Perspective of T1799A BRAF Mutation Diagnostic Value in Papillary Thyroid Carcinoma

  • Brahma, Bayu;Yulian, Erwin Danil;Ramli, Muchlis;Setianingsih, Iswari;Gautama, Walta;Brahma, Putri;Sastroasmoro, Sudigdo;Harimurti, Kuntjoro
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.1
    • /
    • pp.31-37
    • /
    • 2013
  • Background: Throughout Indonesia, thyroid cancer is one of the ten commonest malignancies, with papillary thyroid carcinoma (PTC) in our hospital accounting for about 60% of all thyroid nodules. Although fine needle aspiration biopsy (FNAB) is the most reliable diagnostic tool, some nodules are diagnosed as indeterminate and second surgery is common for PTC. The aim of this study was to establish the diagnostic value and feasibility of testing the BRAF T1799A mutation on FNA specimens for improving PTC diagnosis. Materials and Methods: This prospective study enrolled 95 patients with thyroid nodules and future surgery planned. Results of mutational status were compared with surgical pathology diagnosis. Results: Of the 70 cases included in the final analysis, 62.8% were PTC and the prevalence of BRAF mutation was 38.6%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for BRAF mutation analysis were 36%, 100%, 100% and 48%, respectively. With other data findings, nodules with "onset less than 5 year" and "hard consistency" were proven as diagnostic determinants for BRAF mutation with a probability of 62.5%. This mutation was also a significant risk factor for extra-capsular extension. Conclusions: Molecular analysis of the BRAF T1799A mutation in FNAB specimens has high specificity and positive predictive value for PTC. It could be used in the selective patients with clinical characteristics to facilitate PTC diagnosis and for guidance regarding extent of thyroidectomy.

Utilization of desktop 3D printer-fabricated "Cost-Effective" 3D models in orthognathic surgery

  • Narita, Masato;Takaki, Takashi;Shibahara, Takahiko;Iwamoto, Masashi;Yakushiji, Takashi;Kamio, Takashi
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.42
    • /
    • pp.24.1-24.7
    • /
    • 2020
  • Background: In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. Review: We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. Conclusions: In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.

Statistical evaluation of the cleft lip nose deformity image (구순열 환자 코변형(cleft lip nose deformity) 영상의 통계적 평가)

  • Nam, Ki-Chang;Kim, Jin-Tae;Hong, Hyun-Ki;Rah, Dong-Kyun;Kim, Deok-Won
    • Proceedings of the KIEE Conference
    • /
    • 2005.05a
    • /
    • pp.45-47
    • /
    • 2005
  • Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity. Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed on quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three greatly experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis.

  • PDF

Clinical Application of $^{18}F-FDG$ PET in Epilepsy (간질에서의 $^{18}F-FDG$ PET의 임상 이용)

  • Kim, Yu-Kyeong
    • Nuclear Medicine and Molecular Imaging
    • /
    • v.42 no.sup1
    • /
    • pp.172-176
    • /
    • 2008
  • FDG PET has been used as a diagnostic tool for localization of seizure focus for last 2-3 decades. In this article, the clinical usefulness of FDG PET in the management of patients with epilepsy has been reviewed, which provided the evidences to justify the medicare reimbursement for FDG PET in management of patients with epilepsy. Literature review demonstrated that FDG PET provides an important information in localization of seizure focus and determination whether a patients is a surgical candidate or not. FDG PET has been reported to have high diagnostic performance in localization of seizure focus in neocortical epilepsy as well as temporal lobe epilepsy regardless of the presence of structural lesion on MRI. Particularly, FDG PET can provide the additional information when the results from standard diagnositic modality such as interictal or video-monitored EEG, and MRI are inconclusive or discordant, and make to avoid invasive study. Furthermore, the presence of hypometabolism and extent of metabolic extent has been reported as an important predictor for seizure free outcome. However, studies suggested that more accurate localization and better surgical outcome could be expected with multimodal approach by combination of EEG, MRI, and functional studies using FDG PET or perfusion SPECT rather than using a single diagnostic modality in management of patients with epilepsy. Complementary use of FDG PET in management of epilepsy is worth for good surgical outcome in epilepsy patients.

The Effects of Smartphone Application to Educate Patient on Patient Safety in Hospitalized Surgical Patients (위해사건 예방을 위한 수술 환자 교육용 스마트폰 애플리케이션의 효과)

  • Choi, Hyo Jin;Lee, Eunjoo
    • Korean Journal of Adult Nursing
    • /
    • v.29 no.2
    • /
    • pp.154-165
    • /
    • 2017
  • Purpose: This study was designed to evaluate a patient safety application in the prevention of adverse event among surgical patients. Seventy three surgical patients with thirty six of them using the patient safety application and the rest (N=37) were provided educational booklet. Further, the instrument would measure patients' right to know, knowledge about patient safety, and attitude toward patient safety. Methods: The patient safety application was developed by the ADDIE along with input from experts, patients and an extensive literature review. Data were collected from 7 September through 20 October 2015. Results: The experimental group had significantly higher scores in patients' right to know (t=2.01, p=.024), knowledge on patient safety (t=3.80, p<.001) and attitude toward patient safety (t=2.74, p=.004) than those of the control group. Conclusion: The patient safety application developed using Smartphone could be an effective tool enhancing patient involvement in preventing adverse events that may occur to patients. Further studies are recommended with diverse subjects with varying medical conditions.

Statistical Evaluation of the Cleft Lip Nose Deformity Image (구순열 환자 코변형(Cleft Lip Nose Deformity) 영상의 통계적 평가)

  • Kim, Jin-Tae;Nam, Ki-Chang;Hong, Hyun-Ki;Rah, Dong-Kyun;Kim, Deok-Won
    • The Transactions of the Korean Institute of Electrical Engineers D
    • /
    • v.54 no.8
    • /
    • pp.517-520
    • /
    • 2005
  • Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed at quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis

Analysis of microsurgery task for developing microsurgery manipulator (미세수술용 매니퓰레이터의 개발을 위한 미세수술 작업 분석)

  • 송세경;김완수;조형석
    • 제어로봇시스템학회:학술대회논문집
    • /
    • 1997.10a
    • /
    • pp.1631-1634
    • /
    • 1997
  • Since surgery is usually a difficult task because of physiological tremor, eye strain, and tremor, contagious and radioactive hazard, it is necessary to develop micro-surgery telerobotic system using improved tools suitable for their specific tasks. Nowadays the growth of interest on microsurgery and medical applications of robotics has been so rapid. But the medical robots are only practical applications of the industrial robots. This paper identifies five general areas of advanced microsurgery based on the current technological background and expertise, and analyzes the motion, tool and accuracy with respect to microsurgery task, and proposed the criteria to evaluate micro-surgical manipulator. The analysis of microusrgery can be heplful to clarify some basic concept and design of micro-surgical manipulators. With these data we will alos propose an efficient in-parallel-platform manipulator having special kinematic structrue structure suitable for microsurgery.

  • PDF

Delayed Posttraumatic Spinal Epidural Hematoma: Importance of Early Surgical Treatment for Neurologic Deficits

  • Lee, Deok Heon;Oh, Tak-Hyuk;Lee, Jong-Chul;Lim, Kyoung Hoon
    • Journal of Trauma and Injury
    • /
    • v.29 no.4
    • /
    • pp.176-179
    • /
    • 2016
  • Delayed posttraumatic spinal epidural hematoma is an extremely rare disease, and it remains a challenge for surgical teams of trauma centers. Magnetic resonance imaging is an essential tool for early diagnosis, and emergent evacuation of the hematoma is the best choice of treatment. We report the case of a 33-year old man with posttraumatic epidural hematoma in the thoracic spine (T10 and T11 levels), who developed an abrupt-onset paraplegia 5 days after the trauma.

Development of a Robotic Surgery System using General Purpose Robotic Arm and Modular Haptic Controller (범용 로봇팔과 모듈러 햅틱 컨트롤러를 사용한 수술 로봇 시스템 개발)

  • Yi, Jae-Bong;Jin, Sangrok;Yi, Seung-Joon
    • The Journal of Korea Robotics Society
    • /
    • v.15 no.2
    • /
    • pp.131-138
    • /
    • 2020
  • This paper proposes a low-cost robotic surgery system composed of a general purpose robotic arm, an interface for daVinci surgical robot tools and a modular haptic controller utilizing smart actuators. The 7 degree of freedom (DOF) haptic controller is suspended in the air using the gravity compensation, and the 3D position and orientation of the controller endpoint is calculated from the joint readings and the forward kinematics of the haptic controller. Then the joint angles for a general purpose robotic arm is calculated using the analytic inverse kinematics so that that the tooltip reaches the target position through a small incision. Finally, the surgical tool wrist joints angles are calculated to make the tooltip correctly face the desired orientation. The suggested system is implemented and validated using the physical UR5e robotic arm.

Spinal Nerve Root Swelling Mimicking Intervertebral Disc Herniation in Magnetic Resonance Imaging -A Case Report-

  • Kim, Yu-Yil;Lee, Jun-Hak;Kwon, Young-Eun;Gim, Tae-Jun
    • The Korean Journal of Pain
    • /
    • v.23 no.1
    • /
    • pp.51-54
    • /
    • 2010
  • A herniated intervertebral disc is the most common type of soft tissue mass lesion within the lumbar spinal canal. Magnetic resonance imaging (MRI) is a useful tool for the assessment of patients with lower back pain and radiating pain, especially intervertebral disc herniation. MRI findings of intervertebral disc herniation are typical. However, from time to time, despite an apparently classic history and typical MRI findings suggestive of disc herniation, surgical exploration fails to reveal any lesion of an intervertebral disc. Our patient underwent lumbar disc surgery with the preoperative diagnosis of lumbar disc herniation; however, nothing could be found during the surgical procedure, except a swollen nerve root.