• Title/Summary/Keyword: 수술주기

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Target Localization and Dose Delivery Verification used a Water Phantom in Stereotactic Radiosurgery (정위적 방사선 수술에서 물팬텀을 이용한 목표점 및 전달 선량확인)

  • Kang, Young-Nam;Lee, Dong-Jun;Kwon, Soo-Il;Kwon, Yang
    • Progress in Medical Physics
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    • v.7 no.2
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    • pp.19-28
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    • 1996
  • It is important that the precise decision of the region and the accurate delivery of radiation dose required for treatment in the stereotactic radiosurgery. In this research, radiosurgery was carried with Leksell streotactic frame(LSF) which is especially developed water phantom to verify in experiment. Leksell Gamma Knife and LSF are used in radiosurgery is the spherical water phantom has the thickness of 2 mm, the radius of 160mm. The film for target localization and ionchamber for dose delivery was used in measurement instruments We compare the coordinate of target which is initialized by biplannar film with simple X-ray to the coordinate of film measured directly. The calculated dose by computer simulation and the measured dose by ionization chamber are compared. In this research, the target localization has the range ${\pm}$0.3mm for the acceptable error range and the absolute dose is :${\pm}$0.3mm for the acceptable error range. This research shows that the values measured by using the especially manufactured phantom are included the acceptable error range. Thus, this water phantom will be used continuously in the periodic quality assurance of Gamma Knife Unit and Leksell Stereotactic Frame.

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Predicting Financial Success of a Movie Using Bayesian Choice Model (베이지안 선택 모형을 이용한 영화흥행 예측)

  • Lee Gyeong-Jae;Jang U-Jin
    • Proceedings of the Korean Operations and Management Science Society Conference
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    • 2006.05a
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    • pp.1851-1856
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    • 2006
  • 영화는 대표적인 경험재로 가치판단이 주관적이고 제품 수명주기가 매우 짧아 예측의 불확실성이 높기 때문에 이를 정량적인 방법으로 모형화하기는 쉽지 않다. 이러한 한계점에도 불구하고 한 영화의 상업적 성공을 예측하는 것은 영화 제작자나 배급사, 극장 등 모든 주체에게 수익과 직결되는 중요한 문제이기 때문에 지금까지 다양한 통계 모형이 제시되었다. 그러나 이들 모형의 대부분은 영화흥행에는 영향을 미치나 측정할 수 없는 효과를 반영하지 못한다거나, 추정 모수의 효과가 모든 영화에 대해서 같다는 동일성 가정으로 인해 영화간 이질성을 고려하지 못하고 있다. 따라서, 본 연구에서는 추정 모수의 사전분포를 모호사전분포로 정의함으로써 변수들의 불확실성을 반영할 수 있고, 영화간 이질성을 고려할 수 있는 베이지안 선택 모형을 제안하였다. 모수의 사후분포는 마코프체인 몬테카를로 기법인 깁스 샘플러를 이용하여 추정하였다. 또한, 감독, 배우, 장르 등의 영화 별 속성 변수뿐만 아니라, 입소문에 의한 영화관람 결정 등의 구전효과와 경쟁영화의 개봉으로 인한 효과를 반영할 수 있는 변수를 추가하여 모형의 정확성을 높였다. 2005년과 2006년 상반기에 상영된 영화를 바탕으로 모형을 구축하고 인공신경망 모형과 비교한 결과, 전체적인 예측 정확도에서는 인공신경망 모형과 비슷한 결과를 보이나 상업적으로 성공한 영화를 예측하는 데에는 베이지안 선택모형이 보다 더 우수한 것으로 나타났다. 또한, 개봉 주의 경쟁심화 정도 및 개봉 첫 주의 스크린 수 등이 영화 흥행에 가장 중요한 변수로 나타났으며, 영화 개봉 전 그 영화에 대한 기대치가 높을수록 흥행 성적 또한 좋음을 알 수 있었다. 배우의 힘 및 계절성, 영화 평점 등은 이질성을 고려하지 않은 전체수준에서는 통계적으로 유의하지 않은 것으로 나타났으나, 그룹 간 이질성을 반영한 모형에서는 어느 정도 흥행한 영화를 만들기 위해서는 고려되어야 할 요소로 나타났다.렇지 않을 경우 적절한 벤치마킹 대상을 도출할 때까지 추가적인 분석과정을 반복한다. 제안한 방법을 통하여 조직은 기술적 생산 가능성 외에도 다양한 조직 운영 관점에서 적절한 벤치마킹 대상을 선정할 수 있으며, 이에 따른 목표를 수립할 수 있을 것으로 기대한다. 또한 더 나아가 global efficiency 관점에서 효율적 조직이 되기 위하여 단계적인 벤치마킹 대상 선정과 이에 따른 목표를 수립하는데도 유용하리라 판단된다.$1.20{\pm}0.37L$, 72시간에 $1.33{\pm}0.33L$로 유의한 차이를 보였으므로(F=6.153, P=0.004), 술 후 폐환기능 회복에 효과가 있다. 4) 실험군과 대조군의 수술 후 노력성 폐활량은 수술 후 72시간에서 실험군이 $1.90{\pm}0.61L$, 대조군이 $1.51{\pm}0.38L$로 유의한 차이를 보였다(t=2.620, P=0.013). 5) 실험군과 대조군의 수술 후 일초 노력성 호기량은 수술 후 24시간에서 $1.33{\pm}0.56L,\;1.00{\ge}0.28L$로 유의한 차이를 보였고(t=2.530, P=0.017), 술 후 72시간에서 $1.72{\pm}0.65L,\;1.33{\pm}0.3L$로 유의한 차이를 보였다(t=2.540, P=0.016). 6) 대상자의 술 후 폐환기능에 영향을 미치는 요인은 성별로 나타났다. 이에 따른 폐환기능의 차이를 보면, 실험군의 술 후 노력성 폐활량이 48시간에 남자($1.78{\pm}0.61L$)가 여자($1.27{\pm}0.45L$)보다 더 높게 나타났으며 (t=2.170, P=0.042), 72시간에도 역시 남자($2.16{\pm}0.56L$)가 여자($1.50{\pm}0.47L$)보다 더

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Survey on the Perceptions for Dental Implant Surgery and Maintenance Care (치과 임플랜트 상담 환자의 임플랜트 수술 및 유지관리에 대한 인식도 조사)

  • Park, Hong-Ryurn
    • Journal of dental hygiene science
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    • v.7 no.3
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    • pp.167-177
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    • 2007
  • The purpose of this study was to obtain basic data for dental implants prosthetic maintenance care after analysis perceptions of dental implants. A question was used to questionnaire by 210 dental patients at five dental clinics in the Jinju-city. In conclusion, 1. The knowledge level about implant is 'Never'(35.7%). 2. A feeling of unrest during implant surgery is 'pain'(37.6%). 3. The expectation level about dental implants function is 70% of natural teeth(36.2%). 4. The main function of implant teeth is 'mastication'(70.5%). 5. The implant hygiene supplies for the dental implants maintenance is 'proximal brush'(60%). 6. The important maintenance attitude for the dental implants is 'regularly dental examination'(42.9%). 7. The interval regularly for implant examination is 'six monthly'(44.8%).

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Causes and Clinical Outcomes of Congenital Hydronephrosis (신생아 수신증의 원인과 임상 경과에 대한 고찰)

  • Kang Hyun-Young;Chang Mea-Young;Lee Jae-Ho
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.69-75
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    • 2005
  • Purpose : The most important management of congenital hydronephrosis consists of the early diagnosis and evaluation of the pathologic abnormalities of congenital hydronephrosis. This study was conducted to investigate the different causes of hydronephrosis and its clinical outcome. Methods : 54 live neonates who were hospitalized and diagnosed with congenital hydronephrosis at Chungnam National University Hospital from Aug. 1998 to Aug. 2003 were retrospectively analyzed. Results : Hydronephrosis(renal pelvic AP diameter $gt;5 mm) was postnatally detected in 54 cases(2.1%) among 2,539 neonates who were hospitalized from Aug. 1998 to Aug. 2003. There were three times more males than females. Additional imaging studies revealed that ureteropelvic junction obstruction was the most common postnatal diagnosis(48.7%), followed by multicystic dysplastic kidney, vesicoureteral reflux and duplication kidney with ureterocele. Spontaneous regression of hydronephrosis was revealed in 25 renal units(75.8% ) of mild hydronephrosis, 14 renal units of moderate hydronephrosis and 1 renal unit of severe hydronephrosis. Operative correction were carried out in 14 renal units(70%) of severe hydronephrosls. Conclusion : The most common established cause of congenital hydronephrosis in this study was ureteropelvic junction obstruction. There are many cases of spontaneous regression in mild to moderate congenital hydronephrosis. Urinary tract infections occur in many neonates with hydronephrosis. Therefore, early detection and evaluation of congenital hydronephrosis and continuous follow-up at regular intervals are necessary for conservation of renal function. (J Korean Soc Pediatr Nephrol 2005;9:69-75)

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Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.168-175
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    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

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Result of Tracheal Resection and End-to-end Anastomosis (기관 절제 및 단단문합술의 성적 고찰)

  • 유양기;박승일;박순익;김용희;박기성;김동관;최인철
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.267-272
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    • 2003
  • Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

Midterm Results of Mitral Valve Repair by the New Chordae Formation Technique (승모판막 폐쇄부전증에서 신건삭 형성술을 이용한 판막 성형술의 임상분석)

  • Lee, Jae-Won;Lim, Han-Jung;Jung, Sung-Ho;Kim, Kun-Il;Choo, Suk-Jung;Song, Hyun;Song, Meung-Gun
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.329-337
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    • 2001
  • 배경: 승포판 전엽이나 교련 또는 여러 판엽에 걸쳐 광범위한 병변으로 인한 승모판 역류의 경우 수술수기에 대한 뚜렷한 정립이 되어 있지 않은 실정이다. 최근 이러한 병변의 승모판 역류의 경우 PTEE(Polytetrafluro-ethylene)을 이용한 신건삭 형성술의 시행이 점차 늘고 있다. 이에 저자들은 PTEE를 이용한 신건삭 형성술이 승모판 성형술에 어떠한 영향을 미치는지 알아보고자 하였다. 대상 및 방법: 1994년 1월부터 1999년 12월까지 승모판막 성형술을 시행 받은 322명의 환자 중에서 신건삭 형성술을 이용하여 승모판 성형술을 시행한 144례(I군)과 신건삭 형성술 이외의 방법으로 승모판 성형술을 시행한 178례(II군)를 대상으로 하였다. 두 군에서 수술 직후ㅘ 수술 후 6개월, 1년 및 1년 단위로 주기적인 심초음파를 시행하였고 이를 통계적 검정하였다. 결과: 같은 기간 승모판 성형술은 승모판막 폐쇄 부전증으로 내원한 환자의 95%(306)에서 추적 관찰이 가능하였다. 두 구난에 수술 전 혈류 역학적인 차이를 보이지 않았고, 수술 전 평균 승모판막 폐쇄 부전의 정도는 I군이 3.8$\pm$0.4, II군이 3.6$\pm$0.3였으나 수술 후 추적 관찰에서 각각 1.3$\pm$0.9와 1.1$\pm$0.7 정도의 양호한 판막 성형술의 결과를 보였고 승모판막 면적의변화나 승모판막에서의 평균 압력차이 등 혈류 역학적인 결과에도 차이를 보이고 있지 않았다. 술 후 3명(0.9%)의 조기 사망과 4명 (1.2%)의 후기 사망이 있었으나 두 군간의 차이는 보이지 않았다. 만기 생존율( 93.7$\pm$3.3 vs 88.0$\pm$1.95) 및 판막살패가 발생하기 않을 확률( 93.7$\pm$3.6 vs 93.3$\pm$3.4%) 과 재수술이 필요치 않을 활률(99.3$\pm$0.7 vs 96.0$\pm$1.9%), 색전증, 감염성 심내막염, 판막과 관련된 합병증 발생률 등에서 두 군간에 의미 있는 차이는 없었다. 전엽과 후엽에서 신건삭 형성술을 시행한 환자에서는 통계학적인 차이가 없었다(p=0.29) 결론: 신건삭 형성술을 이용한 승모판 성형술은 승모판 성형술의 증가(r=0.98, p<0.01)를 가져 왔을 뿐만 아니라 내구성과 안정성에 있어 기존의 안전화된 수술 수기와 견줄만하다. 특히 이러한 신건삭 형성술은 승모판 전엽에 병변이 있는 경우와 교련부 및 여러 엽에 광범위한 병변으로 인하여 재건술이 어려운 경우에도 승모판 재건을 가능하게 하는 우수한 수술 수리가 사료된다.

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Clinical managements of implant periapical lesions: a report of three cases with five to twelve years of follow-up (임플란트 근단 병소의 임상적 접근 방법: 5 - 12년간의 증례 보고)

  • Kim, Hyun Ju;Park, Se Hwan;Chang, Beom-Seok;Um, Heung-Sik;Lee, Jae-Kwan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.2
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    • pp.150-157
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    • 2015
  • The purpose of this report is to suggest clinical managements of implant periapical lesions by presenting three clinical cases managed by either the infected form or the inactive form with the follow-up period of five to twelve years. One patient with no clinical symptom was regarded as inactive form. Two patients having pain were regarded as infected form and have been under the systemic antibiotic therapy. In one patient, the symptom subsided and the size of radiolucent lesion decreased. However, the other patient showed increased size of lesion causing the implant unstable, which leaded to remove the implant and to replace it. There was neither additional increase of the lesion nor functional problem for all three. It is important to detect implant periapical lesion in early stage before jeopardizing the stable implant and manage properly using systemic antibiotic therapy and surgical approach if needed, depending on infected form and inactive form.

Video-Assisted Thoracic Surgery for Pulmonary Endometriosis -Report of 1 Case- (흉강경을 이용한 폐 자궁내막증의 절제 -1예 보고-)

  • Cho, Seong Joon;Rhyu, Se Min;Kim, Woo Jin;Lee, Seung-Joon;Kim, Yeon Soo
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.576-580
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    • 2006
  • Pulmonary endometriosis is an uncommon disease, and usually detected by catamenial hemoptysis. Treatment of pulmonary endometriosis may be medical(hormone therapy) or surgical. Since hormone therapy may cause sterility, most of patients who wish to conceive usually choose surgical resection. Although video-assisted thoracic surgery(VATS) has advantage of small scar, reducing postoperative pain and shortening hospital stay, it is not easy to locate the precise lesion and resect whole endometrial tissue not to be remained. 17 years old female with catamenial hemoptysis was treated sucessfully with a partial resection of the lung using VATS, and has been asymptomatic for 7months since the operation.

ACUTE AIRWAY OBSTRUCTION IN AN INFANT WITH TREACHER COLLINS SYNDROME: REPORT OF A CASE (Treacher Collins 증후군 환아에서 급성 기도 폐색)

  • Ryu, Sun-Youl;Seo, Il-Young;Hwang, Ung;Kim, Sun-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.422-427
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    • 2004
  • Treacher Collins syndrome is inherited as an autosomal dominant trait with variable penetrance. It shows a marked variability even in the same family. This syndrome is developmental defect affecting the branchial arches. It is not usually associated with acute respiratory distress, but has symptoms of microtia, hypoplastic zygomatic bones, hypoplastic mandibular rami, and bilateral coloboma. It usually requires an emergency operation immediately after the birth. We experienced an infant with Treacher Collins syndrome who showed retrognathia, glossoptosis, microtia, and cleft palate. Intermittent cyanosis, depression of the chest, respiratory difficulty associated with airway obstruction, and swallowing difficulty were also observed. To relieve severe upper airway obstruction caused by retrognathia and glossoptosis, we simultaneously performed tongue-lip adhesion and subperiosteal release of the floor of the mouth. The respiratory and swallowing difficulties were relieved and the tongue repositioned anteriorly. We report the present case with a review of the literature.