• Title/Summary/Keyword: 축소 수술

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수캐의 요도결석 수술법

  • 좌등 강;삼판화덕
    • Journal of the korean veterinary medical association
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    • v.21 no.12
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    • pp.728-731
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    • 1985
  • 웅견의 요도결석에 대해서 실험견을 사용하여, 포피저부요도루조성술을 실시하고 4주후 병리조직학적 검사를 한 결과, 요도루작성에 있어서 가장 큰 어려움이었던 창구의 축소가 거의 없고, 음경백막과 요도점막의 유합상태가 좋은것을 확인하였으며, 이 수술방법을 임상에 활용하여 보았다.

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Absent Pulmonary Valve with Intact Ventricular Septum, PDA. ASD (온전한 심실중격을 가진 폐동맥판막무형성증, 동맥관개존, 심방중격결손의 수술치험 1례)

  • 유지훈;박계현;이영탁;박표원;전태국
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.590-593
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    • 2002
  • Absent pulmonary valve syndrome with intact ventricular septum(APVS with IVS) is a rare congenital anomaly. The severe form of this syndrome, characterized by severe respiratory distress presented soon after birth, has been attributed to the compression of the airways caused by aneurysmal dilatation of pulmonary artery. Several operative treatments such as pulmonary valve insertion, or reductive angioplasty of pulmonary artery have been applied. We present a 3-day-old male who showed improvement after PDA ligation, reductive angioplasty of pulmonary artery, pulmonary valve reconstruction, and ASD closure.

Design and Implementation of Remote Diagnosis Support System for Surgery Simulation on Clubfoot (소아만곡족 수술 시뮬레이션을 위한 원격 진단보조시스템 설계 및 구현)

  • 홍헬렌
    • Proceedings of the Korea Society for Simulation Conference
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    • 1998.10a
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    • pp.192-195
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    • 1998
  • 족부(足部)의 구조적 복잡성으로 인하여 부상이나 질병을 진단하거나 수술계획을 수립하는데 있어 많은 어려움이 있다. 본 논문에서는 소아만곡족(小兒巒曲足) 수술 시뮬레이션을 위한 원격 진단보조시스템을 설계하고 구현하였다. 본 시스템은 족부를 구성하는 뼈간의 관계를 정의하고 기형 정도를 파악하기 위하여 일련의 2차원 진단 영상들을 공간적으로 구성하여 입체적 영상을 생성하고, 이동, 회전, 확대/축소, 컬러링과 같은 다양한 조작 기능을 제공한다. 본 개발 시스템은 원격 수술 시뮬레이션을 위하여 클라이언트-서버 구조로 이루어졌으며, 시스템 간 사용되는 메시지 처리를 위한 진단 제어 관리기, 족부별 가시화 및 조작을 위한 수술 시뮬레이션 관리기, 원격 사용을 위한 통신망 제어기, 그리고 각종 환자 정보를 위한 데이터베이스 관리기로 구성된다. 또한 범용의 데스크탑 컴퓨터 상에서 사용자 인터페이스를 통하여 서버에 접속하여 진단보조시스템을 사용함으로써 보다 많은 사용자들이 동시에 사용할 수 있는 이점이 있다.

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Aortic Root Reconstruction for Aortic Insufficiency Developed after Fontal Operation - 1 case - (Fontan 수술후 발생한 대동맥판막역류에 대한 aortic root의 재 건술 - 1례 보고 -)

  • Kyung, Mon-Chol;Whang, Song-Wok;Lee, Chol;Kim, Yung-Jin
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.137-140
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    • 2002
  • Aortic regurgitation in the pediatrics who had previous cardiac surgery is increased with their improved longterm survival rate and their complexity of heart disease. So the need of aortic valve surgery in pediatrics is also on the increase. A 10-year old boy was admitted for progressive cyanosis and dyspnea on exertion(DOE). The patient had been underwent lateral tunnel Fontan operation before. Echocardiography and cardiac catheterization study revealed hepatic vein drained to pulmonary atrium via intrahepatic collaterals, moderate atrioventricular regurgitation, and severe aortic regurgitation due to aortic root dilation. We report a case who had aortic root reconstruction, valvuloplasty of the atrioventricular valve, and hepatic vein ligation successfully Cyanosis and DOE was dramatically improved after the operation

The Necessity of Early Adjuvant Radiotherapy for Better Outcomes in the Treatment of a Desmoid Tumor (데스모이드 종양에 대한 조기 방사선치료의 필요성)

  • Lee, Me-Yeon;Chang, Ah-Ram;Kim, Hak-Jae;Kim, Kyu-Bo;Kim, Jin-Ho;Park, Charn-Il;Ha, Sung-Whan;Wu, Hong-Gyun;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.201-205
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    • 2007
  • Purpose: This retrospective study was conducted to assess outcome and to determine the prognostic factors in patients with a desmoid tumor treated with postoperative radiotherapy. Materials and Methods: Twenty-seven patients with a desmoid tumor who were treated with postoperative radiotherapy between June 1984 and October 2005 were analyzed. There were 13 male and 14 female patients. The age of the patients ranged from 3 to 79 years (median age, 28 years). Tumors were located in an extra-abdominal area (21 cases), and in the abdominal walls (6 cases). The tumor size ranged from 2.5 to 25 cm (median size, 7.5 cm) in the largest linear dimension. Thirteen cases received radiotherapy after initial surgery, and 14 recurrent cases received radiotherapy after additional surgery. The total radiation dose given was $45{\sim}66$ Gy (median dose, 59.4 Gy), and the fraction size was $1.8{\sim}2.0$ Gy. Results: The median follow-up period was 61 months (range, $12{\sim}203$ months). Two patients developed local progression and six patients experienced local recurrence. The 5-year disease-free survival rate and the 5-year progression-free survival rate were 61 % and 70%, respectively. Wide local excision was associated with better disease free survival with statistical significance (p=0.028). Radiotherapy after initial surgery (p=0.046) and a higher radiation dose of more than 60 Gy (p=0.049) were associated with better progression free survival with statistical significance. At the time of the last follow-up, the number of additional surgeries was higher in patients that received radiotherapy after reoperation (p<0.001). Conclusion: Radiotherapy after the initial operation improved local control and decreased the number of subsequent operations. Thus, postoperative radiotherapy after an initial operation is recommended in patients with a high risk of recurrence for a desmoid tumor.

Numerical Modeling of Local Scour Around a Coffer Dam (물막이댐 주변에서의 국부세굴현상 모의)

  • Noh, Joon woo;Kim, Woo Gu
    • Proceedings of the Korea Water Resources Association Conference
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    • 2004.05b
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    • pp.419-423
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    • 2004
  • 하상변동은 유속에 의해 얻어지는 전단력에 직접적으로 영향을 받게 된다. 특히 교대나 교각, 그 밖에 수제공 등을 비롯한 수공구조물의 설치에 의하여 흐름단면이 급격히 감소되는 구간에서는 이러한 현상이 매우 활발하게 일어나게 되는데 이는 국부세굴의 직접적인 원인이 되기도 한다. 본 논문에서는 단면축소에 기인한 유속증가에 의해서 발생되는 국부세굴현상을 2차원 유한요소 모델을 사용하여 모의하고 주변의 전반적인 하상변동현상을 규명해 보았다. 먼저 2차원 흐름모형으로부터 유속성분을 구하고 전단력을 구한 다음 소류사 이동공식을 적용한 하상토 보존방정식을 풀이함으로써 국부세굴에 따른 하상의 변동을 수치모델로 예측할 수 있게 된다. 본 논문에서는 유한요소법을 이용, 하상토 보존방정식을 계산한 다음 일정시간동안 모델수행을 통해서 변동이 거의 없을 때까지 하상의 변동사항을 순차적으로 모의하고 예측해 보았다. 적합한 구간을 선정하여 단면축소에 기인한 유속증가로 인한 국부 세굴을 모의하기 위하여 본 모델을 개발, 적용하였다. 미국 미시시피 강에서 Lock & Dam No. 26을 교체하는 제 1단계 작업 중 물막이댐 건설로 인하여 흐름단면이 약 $50\%$ 감소하게 된다. 주로 단면축소 구간을 적용대상으로 선정하여 물막이댐 주변의 하상변동을 모의한 다음 실제 관측치와 비교하여 본 모델의 효용성을 입증하였다. 모형은 기본적으로 유한요소법을 이용해서 하상토 보존 방정식을 풀이한 것으로 van Rijn 소류사 이동공식을 적용하였다. 세굴현상에 기인한 수심증가로 인한 전단력 감소현상도 흐름의 연속조건을 도입하여 모의가능 하게끔 작성하였다.. 상대적으로 적은 것으로 분석되었다. 이번 연구를 통하여 WEP 모형이 유역 물순환 해석에 적절한 모형임을 확인할 수 있었으면, 향후 청계천 유역의 물리적 특성에 대한 매개변수와 인공계 물순환 자료의 보완을 통해 보다 향상된 모의가 가능할 것으로 판단된다. 하였던 Cd과 Mg이 Ca 및 Ca과 vitamin D의 동시(同時) 급여(給與)로 감소(減少)하였고 Cu는 전체적(金體的)으로 변화(變化)가 없었으며 Zn은 Cd 급여(給與)로 감소(減少)하였으나 Ca과 vitamin D의 급여(給與)에 의하여 증가(增加)하였고 Ca은 Ca과 viamin D의 급여(給輿)로 유의(有意)하게 증가(增加)하였다. 신장(腎臟)중의 무기질(無機質) 함량(含量)은 Cd급여(給輿)로 Cu, Mg은 감소(滅少)하였으나 Ca, Zn은 변화(變化)가 없었고 Ca 및 Ca과 Vitamin D의 급여(給與)로 Cd, CU, Zn은 증가(增加)하였다.ce area)는 수술 전100.8$\pm$25.6 mm/$m^{2}$에서 79.3$\pm$ 15.8 mm/$m^{2}$로 감소한 소견을 보였다. 승모판 성형술은 전 승모판엽 탈출증이 있는 두 환아에서 동시에 시행하였다. 수술 후 1년 내 시행한 심초음파에서 모든 환아에서 단지 경등도 이하의 승모판 폐쇄 부전 소견을 보였다. 수술 후 조기 사망은 없었으며, 합병증으로는 유미흉이 한 명에서 있었다. 술 후 10개월째 허혈성 확장성 심근증이 호전되지 않아 Dor 술식을 시행한 후 사망한 예를 제외한 나머지 6명은 특이 증상 없이 정상 생활 중이다 결론:

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Clinical Experience of Countouring Fasciocutaneous Flap Using Ultrasound Assisted Liposuction (유리 근막 피판 수술 후 초음파 지방 흡입술을 이용한 피판 축소술의 임상경험)

  • Kim, Tae-Gon;Hong, Joon-Pio;Chung, Yoon-Kyu
    • Archives of Reconstructive Microsurgery
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    • v.12 no.2
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    • pp.99-104
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    • 2003
  • Liposuction is a useful method for debulking free flap. Recently, ultrasound assisted liposuction(UAL) has been reported to have many advantages over conventional suction-assisted lipectomy. We applied the UAL to debulk free fasciocutaneous flap of the forehead and lower extremities. The result was satisfactory and there was no significant complications worth noting. Although the cost can be expensive, it has many advantages such as less blood loss, larger amount of fat aspirate and better skin contraction. We can conclude that UAL can be a useful alternative method to debulk free fasciocutaneous flap.

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Mitral Valve Repair for Congenital Mitral Regurgitation in Children (선천성 승모판막 페쇄부전증이 있는 소아에서 승모판막 성형술에 대한 임상적 고찰)

  • Kim, Kun-Woo;Choi, Chang-Hyu;Park, Kook-Yang;Jung, Mi-Jin;Park, Chul-Hyun;Jeon, Yang-Bin;Lee, Jae-Ik
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.292-298
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    • 2009
  • Background: Surgery for mitral valve disease in children carries both technical and clinical difficulties that are due to both the wide spectrum of morphologic abnormalities and the high incidence of associated cardiac anomalies. The purpose of this study is to assess the outcome of mitral valve surgery for treating congenital mitral regurgitation in children. Material and Method: From 1997 to 2007, 22 children (mean age: 5.4 years) who had congenital mitral regurgitation underwent mitral valve repair. The median age of the patients was 5.4 years old and four patients (18%) were under 12 months of age. 15 patients (68%) had cardiac anomalies. There were 13 cases of ventricular septal defect, 1 case of atrial septal defect and 1 case of supravalvar aortic stenosis. The grade of the preoperative mitral valve regurgitation was II in 4 patients, III in 15 patients and IV in 3. The regurgitation was due to leaflet prolapse in 12 patients, annular dilatation in 4 patients and restrictive leaflet motion in 5 patients. The preoperative MV Z-value and the regurgitation grade were compared with those obtained at follow-up. Result: MV repair was possible in all the patients. 19 patients required reduction annuloplasty and 18 patients required valvuloplasty that included shortening of the chordae, papillary muscle splitting, artificial chordae insertion and cleft closure. There were no early or late deaths. The mitral valve regurgitation after surgery was improved in all patients (absent=10, grade I=5, II=5, III=2). MV repair resulted in reduction of the mitral valve Z-value ($2.2{\pm}2.1$ vs. $0.7{\pm}2.3$, respectively, p<0.01). During the mid-term follow-up period of 3.68 years, reoperation was done in three patients (one with repair and two with replacement) and three patients showed mild progression of their mitral reguration. Conclusion: our experience indicates that mitral valve repair in children with congenital mitral valve regurgitation is an effective and reliable surgical method with a low reoperation rate. A good postoperative outcome can be obtained by preoperatively recognizing the intrinsic mitral valve pathophysiology detected on echocardiography and with the well-designed, aggressive application of the various reconstruction techniques.

Recent Perspectives on Oncoplastic Breast Surgery in Korea (우리나라의 종양성형학적 유방암 수술에 대한 최신 동향)

  • Kang, Taewoo
    • Journal of Life Science
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    • v.30 no.6
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    • pp.563-569
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    • 2020
  • Oncoplastic surgery (OPS) combines oncologically safe tumor resection with aesthetically satisfying reconstruction of defects using established plastic surgery techniques. OPS is characterized by initial excision as extensive as is beneficial for oncological safety, and, once sufficient resection is complete, displacement or replacement techniques are selected based on remnant volume. The size of the lesion and the individual patient are important factors when considering the appropriate approach, and when pre-operative imaging, including MRI, is used to determine the technique, the complete removal of cancer cells by permanent pathology is essential. A frozen section is used during the operation to reduce the reoperation rate, but it is difficult to cover the entire margin surface theoretically and even harder in practice. A recent report about adequate margins has empowered OPS in its oncological safety. Considering the patients to whom each modality could be applied, basic breast volume is an important factor, and this is influenced by ethnic differences. In Europe or the US, for example, the average breast size is 36D (600 ㎤) and reduction mammoplasty is predominantly used. However, the average size of patients in our institution is 33A (300 ㎤), and so quite different approaches are selected in most cases. New techniques involving radiofrequency and fluorescence have been proposed as safe and easily accessible ways of reducing complications.