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Cavernous Hemangioma of the Esophagus - One Case Report - (식도 해면상 혈관종 - 1례 보고 -)

  • 목형균;신호승;홍기우
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.851-854
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    • 1999
  • Hemangioma in the esophagus is an uncommon tumor. There have only been about 30 cases reported in the world literatures. It occurs predominantly in men and although majority are asymptomatic, may cause bleeding and dysphagia. Hemangioma in the esophagus was diagnosed with a barium swallowed esophagography and endoscopy. The main treatment modes recommended are surgery and endoscopic resection. We experienced one case of cav ernous hemangioma occurring at the distal esophagus. The patient was a forty-six year old male with dysphagia and indigestion. Barium esophagogram showed a filling defect at the distal portion. Esophagoscopy showed a bluish polypoid mass. Surgical resection was per formed and the pathologic diagnosis was confirmed as cavernous hemangioma. Postoperative course was uneventful and the patient had been followed up without any problems.

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Is there any determinant for successful distraction osteogenesis of the mandible in hemifacial microsomia patients? (반안면왜소증 환자의 하악골 신장술시 치료결과의 차이에 기여하는 인자)

  • Baek Seung-Hak
    • Korean Journal of Cleft Lip And Palate
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    • v.7 no.2
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    • pp.77-91
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    • 2004
  • 본 연구의 목적은 반안면왜소증 환자의 하악골 신장술시 초기 치아골격 특성들 중에서 치료결과의 차이에 기여하는 인자를 찾는 것이다. 치료전의 치아골격 특성, 골신장술의 효과와 그 유지상태를 관찰하기 위하여 골신장술 직전(T0), 직후(T1), 추적 2년후(T2)에 측모와 정모 두부방사선 계측사진을 촬영하여 전후방, 수직치아, 비대칭 항목들을 계측하였다. T2 시기의 계측 결과에 따라서 환자들을 1군(양호군, 10명)과 2군(불량군, 9명)으로 분류하였다. 두 군에서 각 시기와 T0-T1, T1-T2 동안의 변화량의 차이를 Mann-Whitney U test, Wilcoxon signed independent t-test, rank test, ANOVA test를 사용하여 분석하였다. pruzansky type이 골신 장술의 성공과 실패 여부와 관계가 깊게 나타났다. T0 시기에 2군은 1군에 비하여 하악골이 후방위치되었고, 하악지 고경(ramus height)이 짧았고, 하악각(gonial angle)이 컸으며, 이환측 하악지가 내측경사되었고, 이환측으로의 이부변위(chin point deviation)가 크게 나타났다. 1군에서 골신장술의 주요한 효과는 하악지 고경의 증가, 하악골의 전방위치, 하악각의 증가, articular angle의 감소에 따른 하약골의 반시계방향 회전, 이환측의 하악지 경사의 증가, 교합면경사와 이부변위의 개선으로 나타났다. 그러나 2군에서는 골신장술을 시행했을 때 1군에 비하여 하악골이 시계방향으로 회전되었고 하악지 고경의 증가량이 작게 나타났다. T2 시기에 2군에서는 하악골의 반시계방향 회전이 나타났고, 하악지 성장이 일어나지 않았으나, 1군은 반대의 경향을 보였다. 이러한 인자들이 골신장술 결과의 차이에 기여하는 것으로 생각된다.

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Modified Blalock-Taussig Shunt for the Patients with Complex Congenital Heart Defects in Early Infancy (조기 영아기에 시행된 복합 심기형 환자들에서의 변형 Blalock-Taussig 단락술)

  • Lim Hong Gook;Kim Woong-Han;Hwang Seong Wook;Lee Cheul;Kim Chong Whan;Lee Chang-Ha
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.335-348
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    • 2005
  • Background: This retrospective review examines the preoperative condition, postoperative course, mortality and cause of death for the patients who underwent modified Blalock-Taussig shunt for complex congenital heart defects in early infancy. Material and Method: Fifty eight patients underwent modified Blalock-Taussig shunts from January 2000 to November 2003. The mean age at operation was $23.1\pm16.2$ days ($5\~81\;days$), and the mean body weight was $3.4\pm0.7\;kg\;(2.1\~4.3\;kg)$. Indications for surgery were pulmonary atresia with ventricular septal defect in 12 cases, pulmonary atresia with intact ventricular septum in 17, single ventricle (SV) in 18, and hypoplastic left heart syndrome (HLHS) in 11. Total anomalous pulmonary venous return (TAPVR) was associated with SV in 4 cases. Result: There were 11 ($19.0\%$) early, and 5 ($10.6\%$) late deaths. Causes of early death included low cardiac output in 9, arrhythmia in 1, and multiorgan failure in 1. Late deaths resulted from pneumonia in 2, hypoxia in 1, and sepsis in 1. Risk factors influencing mortality were preoperative pulmonary hypertension, metabolic acidosis, use of cardiopulmonary bypass, HLHS and TAPVR. Twenty four patients ($41.4\%$) had hemodynamic instability during the 48 postoperative-hours. Six patients underwent shunt revision for occlusion, and 1 shunt division for pulmonary overflow. Conclusion: Modified Blalock-Taussig shunt for complex congenital heart defects in early infancy had satisfactory results except in high risk groups. Many patients had early postoperative hemodynamic instability, which means that continuous close observation and management are mandatory in this period. Aggressive management may appear warranted based on understanding of hemodynamic changes for high risk groups.

Placement of an Intraocular Silicone Prosthesis with Evisceration in a Dog with Refractory Glaucoma (난치성 녹내장을 지닌 개에서 안구내용제거술을 통한 안구 내 실리콘 보철물 적용 1례)

  • Kim, Kyung-Hee;Kim, Joon-Young;Choi, Young-Min;Lee, Jong-Hoon;Park, Chang-Hee;Lee, Jung-Ha;Lee, Young-Sun;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.610-613
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    • 2010
  • An 8-year-old male dog weighing 7.9 kg was referred to us for evaluation of exophthalmos and corneal edema of the left eye, on which cataract surgery had been performed 3 years prior. On ophthalmic examination, the left eye showed an extremely high intraocular pressure (47 mmHg), with no menace response, dazzle reflex, or pupillary light reflex. The dog was treated with systemic and topical glaucoma medications. After treatment, corneal edema decreased but IOP did not return to within acceptable limits. Seventeen months later, the dog presented with hyphema, episcleral congestion, and corneal edema attributable to accidental trauma. The owner wished to maintain an attractive ocular appearance, and an intraocular silicone prosthesis (ISP) was thus inserted after the evisceration. Three months postoperatively, a corneal ulcer was detected, but this resolved successfully after prescription of appropriate medication. One year after surgery, no complications related to surgery were evident.

Clinical Analysis of Surgical Results and Preoperative Management of Acute Aortic Dissection (급성 대동맥박리증의 수술성적 및 수술전 처치에 대한 임상적 고찰)

  • 현성열;박국양;이재웅;이창하;전양빈;박철현;염석란;신종환;민순식
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.876-881
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    • 2002
  • Acute aortic dissection associated with high mortality rate has an extremely poor prognosis if early diagnosis and treatment are not received. Recently, with advanced computed tomography and echocardiography, diagnostic rate is higher and early operation is possible. Therefore preoperative medical therapy at ER(emergency room) lowered the mortality rate. This study was done to analyze the results with preoperative management at ER and operations, retrospectively. Material and Method: A series of 42 patients treated surgically for acute aortic dissections from 1991 to 2001 were included in this study. There were 18 males and 24 females. Mean age was 51.1 years. The admission course through emergency and outpatient department(OPD) was 34 and 8 respectively. Result: 26 patients underwent ascending aorta replacement-7 combined aortic valve replacements, 7 patients underwent descending aorta replacements and 9 patients received Bentall's operation. At emergency department, 20 patients received antihypertensive drugs and $\beta$-receptor blockers and 6 patients died. 22 patients did not receive antihypertensive and $\beta$-receptor block drugs and 10 patients died. There were 16(38%) overall deaths. Conclusion: Early diagnosis at ER or OPD is essential for acute aortic dissection, and it is important to select the most appropriate noninvasive interventions as possible. Therefore, preoperative drug therapy at ER is suggested according the patient conditions.

Short Term and Midterm Surgical Results for Infective Endocarditis - Does Wide Debridement and Reconstruction Affect the Post Operative Mortality and Morbidity? (90년대 중반 이후 시행한 감염성 심내막염의 중단기 수술 성적)

  • Yie, Kil-Soo;Oh, Sam-Sae;Kim, Jae-Hyun;Shinn, Sung-Ho;Kim, Jong-Hwan;Kim, Soo-Cheol;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.341-350
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    • 2007
  • Background: We present here the early and midterm surgical results for infective endocarditis and we especially focus on the effect of aggressive reconstruction or root implantation after wide debridement. Material and Method: Between January 1995 and Jun 2006, we enrolled 79 adult infective endocarditis patients who underwent surgical treatment. There were 63 and 16 native and prosthetic valve endocarditis cases, respectively. They included 27 cases of culture negative endocarditis. With performing valve replacement or repair, 28 of the patient underwent a more aggressive surgical option, for example, aortic root replacement or reconstruction, or heart base reconstruction etc. Result: There were statistical relationships between the in-hospital mortality and staphylococcal infection, urgent-based operation and operation during the active phase of endocarditis. Wide debridement and aggressive reconstruction were not related to either the post operative mortality or the early morbidity. Culture negative endocarditis was not related to the postoperative mortality and morbidity. Conclusion: Physicians must pay attention to patients' medical treatment during the preoperative period of the infective endocarditis. If surgery is considered for treating infective endocarditis, it should be performed before the downhill course of the disease so that the surgical outcome is improved. Wide debridement and more aggressive reconstruction are also warranted.

An Architecture of the Military Aircraft Safety Check System Using 4th Industrial Revolution Technology (4차 산업혁명기술을 활용한 군 항공기 안전점검 체계 설계)

  • Eom, Jung-Ho
    • Convergence Security Journal
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    • v.20 no.2
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    • pp.145-153
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    • 2020
  • The aviation safety policy master plan is promoting the development of aviation safety management technology applying the 4th industrial revolution technology with the goal of establishing a flawless aviation safety management system and establishing a future aviation safety infrastructure. The master plan includes the establishment of various aviation safety management systems such as aircraft fault management using AI & Big data and flight training system using VR/AR. Currently, the Air Force is promoting a flight safety management system using new technology under the goal of building smart air force. Therefore, this study intends to apply the 4th Industrial Revolution technology to the aircraft condition check system that finally checks the safety of the aircraft before flight. The Air Force conducts airframe flaw checks and pre-flight aircraft check. In this study, we architect the airframe flaw check system using AI and drones, and the pre-flight aircraft condition check system using the IoT and big data for more precise and detailed check of aircraft condition and flawlessness check.

전(電)력질주 - 효성 전력 퍼포먼스유니트

  • 대한전기협회
    • JOURNAL OF ELECTRICAL WORLD
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    • s.450
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    • pp.72-77
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    • 2014
  • 1962년 당시 중공업 불모지였던 이 땅에 본격적인 중공업 시대를 개막한 효성은 반세기를 훌쩍 넘긴 오늘에 이르기까지 끊임없는 변화와 개혁을 통해 세계적인 기업으로 발전해 왔다. 중전기기 신제품 개발에 힘을 기울여온 효성의 발자취는 우리나라 전력산업의 발전과 궤를 같이 하고 있다고 할 정도로 효성은 국내 전력산업사(史)에 있어 빼놓을 수 없는 존재이다. 154kV 환상망 구축사업의 중추적 역할 수행, 345kV 전력기자재 최초 납품, 765kV 초고압 변압기 국내 최초 개발 및 수출, 800kV급 2점절 초고압 차단기(GIS, Gas Insulated Switchgear) 세계 최초 개발, 1,100kV 극초고압 GIS 국내 최초 순수 독자 개발 등 효성의 초고압 분야는 화려한 역사를 자랑한다. 그러나 최근 들어 세계 초고압 분야의 시장 성장세가 둔화되고 있다. 이에 비단 효성 뿐 아니라 국내 초고압 관련 기업들의 움직임도 주춤한 상태다. 문제는 이러한 난관을 어떻게 빨리 헤쳐 나가느냐에 있는데, 효성이 선택한 방법은 '고객제일주의'와 '신기술 개발'이다. 이는 기본 중의 기본이지만, 이 기본을 준수하기가 얼마나 어려운지는 모두 알 것이다. 즉 50여년 전 아무 것도 없는 중공업 분야에서 새로운 역사를 창조하겠다던 '초심'으로 돌아가 지금부터 다시 새 역사를 써나가겠다는 의지를 불태우고 있는 것이다. 그 중심에 우뚝 서 효성의 초고압 전력 분야를 책임지고 있는 전력 퍼포먼스유니트를 소개한다.

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The Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Treatment-Resistant Tourette's Syndrome among Children and Adolescents : An Open-Label Study (치료저항성 뚜렛장애를 가진 소아청소년에서 저빈도 반복적 경두개자기자극술의 효과 : 오픈 라벨 연구)

  • Lee, Young-Ji;Chae, Jin Hyuk;Seo, Wan Seok
    • Journal of the Korean society of biological therapies in psychiatry
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    • v.24 no.3
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    • pp.239-246
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    • 2018
  • 목 적 : 본 연구의 목적은 치료저항성 뚜렛장애를 가진 소아 청소년들에 대해서 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술의 효과를 평가하는 것이다. 방 법 : 이 연구는 미국정신의학회 진단기준 및 통계편람, 제 4판을 기준으로 뚜렛장애로 진단받은 10명의 소아 청소년(평균연령 $12.56{\pm}1.04$세)을 대상으로 하였다. 모든 참가자들은 1년 이상 지속적으로 충분한 용량의 약물치료를 받았음에도 불구하고 한국판 예일 틱 증상 평가척도(YGTSS) 20점 이상, 임상인상척도(CGI-TS) 4점 이상을 받았다. 참가자들은 보조운동영역을 표적으로 1 Hz 반복적 경두개자기자극 치료를 매일 20분간 받았으며, 총 20회 치료를 받았다. YGTSS, CGI-TS 및 이상반응 체크리스트는 연구 시작 전과 연구 시작 후 4, 8, 12주에 시행되었다. 결 과 : 틱 증상은 연구 12주차까지 호전된 상태로 지속되었으며, YGTSS와 CGI-TS가 통계적으로 유의하게 감소하였다. 특히 음성 틱 점수의 감소가 운동 틱 점수의 변화보다 전체 YGTSS 점수의 감소에 큰 역할을 한 것으로 나타났다. 그리고 전체 10명의 참가자 중 9명이 심각한 부작용 없이 연구를 끝까지 완료하였다. 결 론 : 본 연구는 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술이 치료 저항성 뚜렛장애를 가진 소아 청소년들에게 효과적이고 안전한 치료도구가 될 수 있음을 시사한다. 이러한 반복적 경두개자기자극술의 치료효과를 확정하기 위해서는 보다 많은 환자를 대상으로 한 잘 통제된 연구가 필요할 것이다.

Arthroscopic Anterior Cruciate Ligament Reconstruction using Fresh Frozen Achilles Allograft - Clinical results, 2nd look Arthroscopic and Histologic findings - (신선 동결 아킬레스 동종건을 이용한 전방 십자 인대 재건술 - 임상적 결과, 2차 관절경 및 조직학적 소견 -)

  • Chun Churl Hong;Ha Dae Ho;Choi Min Kyu;You Son Soo
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.7-12
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    • 2001
  • Purpose : We observed usability of allograft by evaluating the clinical results, second look arthroscopic and histologic findings at last follow up after anterior cruciate ligament(ACL) reconstruction using by fresh frozen Achilles allograft. Materials and Methods : We analyzed in 58 patients(59 cases) by subjective and objective parameters, Telos stress arthrometer and Modified Feagin Scoring System. The average age and follow up period was 25 years(ranging from 18 to 49 years), and 15 months(ranging from 12 to 19 months). Among them we studied second look arthroscopic and histologic findings in 16 patients. Results : The mean Lysholm Score wits improved from 60 to 88.2 as well the anterior translation was improved from 7.1 min to 2.3mm at last follow up. The second look arthroscopic findings were close to normal in ligament thickness, tension and showed revasculization at the holly attachment site. Light microscope(LM) findings showed dense cellularity like a normal ligament. In electron microscope(EM) collagen fibrils showed parallel arrangement longitudinally and unimodal pattern diameter close to normal tissue in the transverse section. Conclusion : We think that the fresh frozen Achilles allograft is a good substitution of autograft in cruciate ligament reconstruction.

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