• Title/Summary/Keyword: 전방접근법

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Reinforcing Reverse Logistics Activities in Closed-loop Supply Chain Model: Hybrid Genetic Algorithm Approach (폐쇄루프공급망모델에서 역물류 활동 강화: 혼합유전알고리즘 접근법)

  • Yun, YoungSu
    • Journal of Korea Society of Industrial Information Systems
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    • v.26 no.1
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    • pp.55-65
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    • 2021
  • In this paper, a methodology for reinforcing reverse logistics (RL) activities in a closed-loop supply chain (CLSC) model is proposed. For the methodology, the activities of the recovery center (RC) which can be considered as one of the facilities in the RL are reinforced. By the reinforced activities in the RC, the recovered parts and products after checking and recovering processes of the returned product from customer can be reused in the forward logistics (FL) of the CLSC model. A mathematical formulation is suggested for representing the CLSC model with reinforced RL activities, and implemented using a hybrid genetic algorithm (HGA) approach. In numerical experiment, two different scales of the CLSC model are presented and the performance of the HGA approach is compared with those of some conventional approaches. The experimental results show that the former outperforms the latter in most of performance measures. The robustness of the CLSC model is also proved by regulating various rates of the recovered parts and products in the RC.

Femoral Tunnel Obliquity between the Transtibial and Anteromedial Portal Technique in Single Bundle Anterior Cruciate Ligament Reconstruction (전방십자인대 단일 다발 재건술에서 경경골 술기 및 전내측 삽입구를 이용한 대퇴골 터널의 기울기)

  • Lee, Ju-Hong;Park, Jong-Hyuk;Bae, Hyeon-Kyeong;Kim, Jong-Gil;Wang, Sung-Il
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.41-47
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    • 2010
  • Purpose: To compare the obliquity of femoral tunnels prepared with transtibial (TT) versus anteromedial portal technique (AM) using x-ray in single-bundle anterior cruciate ligament (ACL) reconstruction. Materials and Methods: Among one-hundred thirty two patients who were undergoing ACL reconstruction from January 2007 to December 2009, thirty patients using TT and twenty patients using AM, those who had single-bundle ACL reconstruction, were evaluated with plain radiographs including anteroposterior, intercondylar notch and lateral view to compare the obliquity of bone tunnels. Results: The mean coronal obliquity of femoral tunnel for TT was $71^{\circ}$ (range; $65^{\circ}{\sim}77^{\circ}$), while for AM was $51^{\circ}$ (range; $39^{\circ}{\sim}60^{\circ}$) and the mean sagittal obliquity of femoral tunnel for TT was $22.7^{\circ}{\pm}7.8$, while for AM was $30.2^{\circ}{\pm}6.9$, their differences between them were statistically significant (P<0.05). However, there were no differences between two techniques on the tibial tunnel obliquity in coronal and sagittal plane. Conclusion: Anterior cruciate ligament reconstruction using AM portal technique allows more horizontally oriented and divergent femoral tunnel compared to that of transtibial technique. This seems to enable the graft placement into the femoral footprint and preserve the posterior cortical wall.

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Failed Celiac Plexus Block Via the Anterior Approach under CT Guidance -A case report- (전산화단층촬영 유도하에 전방접근법으로 시행한 복강신경총차단의 실패 1예 -증례 보고-)

  • Rhee, Joo-Young;Lee, Jung-Koo;Chung, Jung-Kil;Rhee, Chang-Su
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.130-133
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    • 1998
  • We present our failed case of celiac plexus block using the anterior approach under CT guidance in patient with intolerable abdominal pain originating from pancreatic cancer with celiac invasion. In spite of the proper position of needle, the contrast material was not spread due to the tumoral invasion.

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Thoracoscopic Anterior Release of the Spine in Total en Bloc Spondylectomy for Primary Thoracic Spinal Tumor -A case report- (원발성 흉추종양에 대한 전 척추 일괄 절제술 시 흉강경을 이용한 척추 전방 박리술 -1예 보고-)

  • Cho Deog Gon;Rhyu Kee Won;Kang Yong Koo;Cho Kyu Do;Jo Min Seop;Wang Young Pil
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.80-84
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    • 2006
  • A combined anterolateral and posterior approach with thoracotomy has been recommended as the traditional surgical approach for the tumors of the thoracic spine. Recently, because of the morbidity associated with open thoracotomy, the thoracoscopically assisted surgical technique was introduced successfully in thoracic spinal surgery. Herein, we report a combined surgical technique for giant cell tumor of the thoracic spine (T10) consisting of bilateral thoracoscopic anterior release of the spine followed by a posterior on bloc spondylectomy and reconstruction by orthopedic surgeons. The thoracoscopic spinal surgery is safe and effective alternative for other open thoracotomic procedures in the approach to the anterior thoracic spine, avoiding the disadvantage inherent to thoracotomy.

Mini-open Rotator Cuff Repair Using Anterolateral Approach - Technical Note - (전외측 도달법을 이용한 소절개 회전근 개 봉합술 - 수술 술기 -)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Bae, Ki-Cheor;Lee, Kyung-Jae;Seo, Hyuk-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.49-52
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    • 2010
  • Purpose: We introduce arthroscopically assisted mini-open rotator cuff repair using anterolateral approach. Operative Technique: Placing lateral decubitus position on general anesthesia, a standard arthroscopic glenohumeral examination is performed to evaluate lesions of shoulder joint through posterior and anterior portal. And then arthroscope is placed in the subacromial space and we evaluate the size of the torn tendon and perform arthroscopic acromioplasty through lateral portal. A 3 to 4 cm skin incision is performed from anterolateral edge of acromion to distal and dissected along to raphe between anterior and middle deltoid. A deltoid retractor is then placed, allowing direct visualization of the rotator cuff and humeral head. As torn tendon is tagged by traction suture, we try to anatomical reduction on the footprint and then perform single row or double row repair of the rotator cuff using suture anchors. To prevent avulsion of the deltoid from the acromion, additional sutures by bone tunnel with acromion and deltoid is performed. Conclusion: This technique is useful procedure to get direct approach to anterior portion of supraspinatus tendon and to need lesser deltoid retraction than portal extension approach due to dividing along to raphe between anterior and middle deltoid. Also it provide better visualization of the superior portion of subscapularis and infraspinatus.

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Resection of Ganglion Cyst of the Posterior Cruciate Ligament using Arthroscopic Posterior Trans-septal Approach (관절경하 후격막 통과 도달법을 이용한 후방십자인대 결절종의 치료)

  • Nam, Il-Hyun;Yoo, Yon-Sik;Yun, Ki-Pyo;Ahn, Gil-Yeong
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.31-36
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    • 2004
  • Purpose: We reviewed the effectiveness and the result of arthroscopic resection for ganglion cyst of posterior cruciate ligament(PCL) through the posterior trans-septal approach. Material and Method: Seven patients with symptomatic ganglion cyst of the PCL were treated with arthroscopic resection using posterior trans-septal approach. We analyzed advantages of the posterior trans-septal approach and presence of intra articular problem. Knee function was assessed using the lysholm knee scale. Results: The overall result for the 7 knees were very satisfied in all. We found that four of seven patients had intra articular problems, and past history of trauma could be found in 3 cases. The Lysholm knee scale was increased from average 93.3 points preoperatively to average 97.8 points postoperatively. Conclusion: Arthroscopic posterior trans-septal approach shows an effective technique for complete resection of cyst and evaluation of the combined posterior compartment injury.

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고에너지 이온선을 이용한 분석 기술

  • 김효배;송종한;김희중
    • Journal of the Korean Magnetics Society
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    • v.6 no.2
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    • pp.122-129
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    • 1996
  • Fig. 1에서 보는 바와 같이 수 MeV의 에너지를 가진 입사이온이 고체 시료표면과 충돌했을 때 여러 가지의 상호작용과 과정들이 일어난다. 입사 아온이 표적원자의 원자가전자나 내각전자와 상호작용을 하였을 때 원자를 여기시키거나 이온화시키게 되며 입사 이온이 표적 핵과 매우 가까이 접근했을 때 입사이온과 표적 핵사이에 쿨롱상호작용이나 핵 상호작용이 일어나게 된다. 이러한 여러가지 상호작용의 결과들로부터 분석하고자 하는 시료의 성분, 구조, 상호작용 과정에 대한 정보를 얻을 수 있다. 이러한 고에너지 이온선을 이용한 분석기술로는 Fig. 1에서 보는 바와 같이 후방산란법(BS : Backscattering Spectrometry), 전방산란법(FRS : Forward Recoil Spectrometry), 핵반응법(NRA : Nuclear Reaction Analysis), 양성자여기X선검출법(PIXE : Proton Induced X-ray Emission)등과 이러한 방법들과 같이 조합하여 사용하는 이온 채널링(ion channeling)등이 있다. 본 해설에서는 이러한 분석법중에서도 널리 사용되고 있는 후방산란법과 이온 채널링에 대하여 주로 기술하고자 한다.

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스포츠와 관련된 과사용 증후군 - 슬관절 -

  • Kyung, H.S.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.75-83
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    • 2008
  • 과사용 증후군은 정상적인 조직에 최대하 부하(submaximal stress)가 지속되어 발생하는 것이다. 이와 같은 현상은 연부조직의 접합부(junction)에서 주로 일어나며 힘의 전달이 집중되는 곳, 조직의 역학적 성질이 변화되는 곳, 그리고 성장시 빨리 변화하는 성질이 있는 곳에 주로 생긴다. 근육의 불균형이 과사용 증후군의 가장 많은 원인이다. 과거의 부상 이후 부적절한 재활치료 및 각형성 또는 회전 부정정렬(angular and rotational malalignment) 등이 과사용 증후군의 원인이 될 수 있다. 스포츠 훈련 방법의 실수로도 과사용 증후군이 생길 수 있다. 전방 슬관절 동통시 감별해야 할 질환들은 jumper's knee, 슬개건염 혹은 대퇴 사두건염, Osgood-Schlatter 병, Sinding-Larsen-Johansson 병, 슬개골 연골 연화증, 슬개골 전(prepatellar) 혹은 슬개골 하(infrapatellar) 점액낭염, Hoffa's fat pad의 염증, 그리고 특발성 전방 슬관절 동통 증후군(idiopathic anterior knee pain syndrome)등이 있다. 후방 슬관절 통증의 원인 질환으로는 만성 슬와근 염좌, 슬괵건 점액낭염, 경골 골간단의 피로 골절 등이 포함되며 외측 슬관절 통증의 원인으로는 장경대 충돌 증후군(iliotibial band friction syndrome)등이 있을 수 있다. 이외 과사용 증후군과 관련된 슬관절 통증의 원인으로 다분 슬개골(multipartite patella), 내측 경골 스트레스 증후군(medial tibial stress syndrome), 박리성 골연골염, 반월상 연골의 퇴행성 변화 등이 있을 수 있다. 과사용 증후군의 진단 및 치료의 일반적인 접근법은 다섯가지 단계의 프로그램으로 요약될 수 있다. 첫째, 원인 요소를 확인하고, 둘째, 요소를 변경시키고, 셋째, 통증을 조절하고, 넷째, 능동적 재활을 시키고, 그리고 다섯째, 유지시키는 것이다.

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The Open Surgical Treatment for Stiff Elbow (주관절 구축의 관혈적 치료)

  • Lee, Ji-Ho;Ra, In-Hoo;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.293-298
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    • 2010
  • Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

Arthroscopic Technique of Bone Defect in Anterior Shoulder Instability (골 결손이 동반된 전방 견관절 불안정성에서 관절경적인 수술 술기)

  • Ko, Sang-Hun;Park, Ki-Bong
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.102-108
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    • 2009
  • Purpose: The bone defects that are associated with shoulder anterior instability may be the causes of failure of arthroscopic surgery. For the treatment of traumatic shoulder instability, we tried to determine the arthroscopic techniques that can be used for the bone defect of the glenoid and the humeral head. The purpose of this study is to assess the surgical techniques for the arthroscopic reconstruction of the shoulder with anterior instability and bone defects. Materials and Methods: We analyzed the articles that have been recently published on anterior shoulder instability and we assessed the arthroscopic surgical techniques. We compared the articles and the methods of arthroscopic surgical techniques for treating bone defects of the anteroinferior glenoid and the posterolateral humeral head, which were considered as the causes of recurrence of shoulder instability. Results: There are the anteroinferior bone defects of the glenoid and Hill-Sachs lesions in the bone defects that appear in patients with anterior shoulder instability. These bone defects are currently the causes of failure of arthroscopic surgery. Conclusion: Open shoulder surgery may be the treatment of the choice for a shoulder with instability and significant bone defects of the glenoid and the humeral head. But efforts are being made to overcome the weaknesses of open surgery by the use of arthroscopy.