• Title/Summary/Keyword: Secondary Operations

Search Result 182, Processing Time 0.04 seconds

Three Dimensional Curvature Analysis of Femoral Shaft Bowing based on CT Images (CT 영상을 이용한 대퇴체부 휨의 3차원적 곡률 분석)

  • Lim, Ki Seon;Oh, Wang Kyun;Lee, Tae Soo
    • Journal of the Korean Society of Radiology
    • /
    • v.7 no.5
    • /
    • pp.313-320
    • /
    • 2013
  • For some patients with joint illnesses such as rheumarthritis or varus deformity, the total knee arthroplasty (TKA) procedures are performed. However, when inserting metal cutting guide for the procedures, due to the femoral shaft bowing, complications such as the cortex of the femoral shaft damages or secondary fractures can be caused. If the central coordinate value of the femoral shaft is known, the metal cutting guide could be inserted into the anatomical center, so such complications can be prevented. In this study, CT images of femoral shafts of 10 individuals in the experiment group who are in need of receiving the total knee arthroplasty procedures and those of 10 individuals in the control group without illness in the femoral shaft have been utilized to locate the 3-dimensional coordinate values. Then, Matlab was utilized to identify the central coordinate value in order to obtain a graph reflecting the anatomical shapes as well as to acquire the 3-dimensional radial curvature values by section. As a result, the average curvature range and standard deviation of femoral shafts of the experiment group was determined to be $758.15{\pm}206.3mm$ whereas the that of the control group was determined to be $1672.97{\pm}395.6mm$. The statistical significance of the measured results was verified through f-distribution analysis. Based on these results, it was verified that the level of curvature of the femoral shaft of the experiment group was higher. If the anatomical central points are located and analyzed using this methodology, it would be helpful in performing orthopedic operations such as the total knee arthroplasty.

A retrospective clinical study of isolated patent ductus arteriosus (동맥관 개존증의 임상적 고찰)

  • 곽영태
    • Journal of Chest Surgery
    • /
    • v.17 no.4
    • /
    • pp.593-606
    • /
    • 1984
  • With the ligation of patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease. Interruption of a ductus is one of the most satisfactory and curative operations in the field of surgery for congenital heart disease. 27 cases of isolated patent ductus arteriosus were operated from Jan. 1978 to July 1984 at the Department of Thoracic & Cardiovascular Surgery in Kyung-Hee University Hospital. Retrospective clinical analysis of these patients were: 1. Sex ratio, female: male, was 2:1. 2. Mean age at operation was 9.85\ulcorner.58 years. The youngest patient was a 23 month-old girl and the oldest one was a 24 year-old male. 3. More than half of the patients had less than 50 percentile of growth retardation. 4. Chief complaints of the patients were frequent URI [52%], dyspnea on exertion [33%], generalized weakness [22%], palpitation [7%], but 7 patients [26%] had no subjective symptoms. 5. Continuous machinery murmur could be heard at the 2nd or 3rd intercostal space on the left sternal border in 22 patients [81%]. The other S patients made systolic murmur with accentuation of the second heart sound and those were associated with pulmonary hypertension. 6. Radiologic findings of Chest P-A were cardiac enlargement in 15 patients [55%], enlargement of pulmonary conus and/or increasing density of pulmonary vascularity in 20 patients [74%]. 7. Electrocardiographic findings of the patients were within normal limit in 13 patients [48%], LVH in 4 patients [15%], biventricular hypertrophy in 3 patients [11%]. 8; echocardiogram was obtained from 11 patients. Ductus was directly visualized in 7 patients. Left atrial enlargement is the secondary change of left to right shunt, 10 patients had LA/Ao ratio more than 1.2. 9. Cardiac catheterization performed in 25 patients. The mean value of the results were:SO2[PA-RV]= 14.72\ulcorner6.01%, Qp/Qs=2.22\ulcorner.80, peak systolic pulmonary arterial pressure=48.28\ulcorner1.60 mmHg. 10. 26 patients were operated through the left posterolateral thoracotomy: closure of ductus by double ligation in 14 cases, triple ligation in 5 cases, and division with suture in 8 cases. One patient suffer from aneurysmal rupture of main pulmonary artery, endocarditis, hemopericardium was treated with cardiopulmonary bypass via median sternotomy and closure of ductus through the ruptured main pulmonary artery. 11.There was no death associated with the operation, but 3 cases were experienced with intraoperative rupture around the ductus resulting in massive bleeding. The other complications were transient hoarseness in one patient, atelectasis in left lower lobe in 3 patients, and postoperative systemic hypertension in 4 patients with unknown etiology. 12. Pulse pressure was reduced, 11.47+5.92 mmHg, postoperatively, as compare to preoperative status. 13. Intraoperative wedge lung biopsy from lingular segment for the evaluation of the pulmonary vascular disease was taken in S patients with severe pulmonary hypertension. The result was Heath-Edward grade I in one case, grade II in two cases, and grade III in two cases.

  • PDF

De Lege Ferenda for Improvement of the Management System for Sunken Vessels (침몰선박 관리체계의 개선을 위한 입법론적 연구)

  • Jeon, Yeong-Woo;Jeon, Hae-Dong;Hong, Sung-Hwa
    • Journal of the Korean Society of Marine Environment & Safety
    • /
    • v.23 no.5
    • /
    • pp.462-472
    • /
    • 2017
  • Sunken vessels on major fairways can cause many problems in terms of maritime safety and the marine environment. In order to prevent secondary marine pollution accidents caused by sunken vessels, information on sunken vessels has been collected, a risk assessment has been conducted, and the relevant vessels are being managed according to the results of each assessment. However, there is still a demand for improvements. The most important of the improvement plans is a paradigm shift. In other words, the management of sunken vessels needs to be transformed according to a new paradigm to manage all sunken vessels within three years from the time of sinking. Legislative improvements are also needed for the reporting system for sunken vessels, risk assessment tools, the implementation of risk mitigation measures, and criteria for the implementation cost of risk mitigation measures. In addition, close coordination between marine pollution response and sunken vessel management efforts is needed. As the division of duties between the Korea Coast Guard and the Ministry of Oceans and Fisheries is vague, collaboration between the two ministries is required. Close collaboration is also needed between the departments of navigation safety management and sunken vessel management. Therefore, it is necessary to more clearly establish the relationship between the two systems and create a synergy effect between the two administrative operations using the results of the risk assessment in the Marine Environment Management Act to determine the navigational risk posed by obstacles with regard to the Maritime Safety Act.

The Efficacy of Bioabsorbable Mesh in Craniofacial Trauma Surgery

  • Choi, Won Chul;Choi, Hyun Gon;Kim, Jee Nam;Lee, Myung Cheol;Shin, Dong Hyeok;Kim, Soon Heum;Kim, Cheol Keun;Jo, Dong In
    • Archives of Craniofacial Surgery
    • /
    • v.17 no.3
    • /
    • pp.135-139
    • /
    • 2016
  • Background: The ultimate goal of craniofacial reconstructive surgery is to achieve the most complete restoration of facial functions. A bioabsorbable fixation system which does not need secondary operation for implant removal has been developed in the last decade. The purpose of this study is to share the experience of authors and to demonstrate the efficacy of bioabsorbable mesh in a variety of craniofacial trauma operations. Methods: Between October 2008 and February 2015, bioabsorbable meshes were used to reconstruct various types of craniofacial bone fractures in 611 patients. Any displaced bone fragments were detached from the fracture site and fixed to the mesh. The resulting bone-mesh complex was designed and molded into an appropriate shape by the immersion in warm saline. The mesh was molded once again under simultaneous warm saline irrigation and suction. Results: In all patients, contour deformities were restored completely, and bone segments were fixed properly. The authors found that the bioabsorbable mesh provided rigid fixation without any evidence of integrity loss on postoperative computed tomography scans. Conclusion: Because bioabsorbable meshes are more flexible than bioabsorbable plates, they can be molded and could easily reconstruct the facial bone in three dimensions. Additionally, it is easy to attach bone fragments to the mesh. Bioabsorbable mesh and screws is effective and can be easily applied for fixation in various craniofacial trauma reconstructive scenarios.

A Case Study about Influence of Primary Mathematic Concepts on the Composition of Mathematic Concepts in 3rd grade Prodigies of Elementary Schools - Focusing on Addition and Multiplication of Fractions - (수학의 1차적 개념이 초등학교 3학년 영재아의 수학적 개념구성과정에 미치는 영향에 대한 사례연구 - 분수의 덧셈과 곱셈을 중심으로 -)

  • Kim, Hwa Soo
    • Journal of Gifted/Talented Education
    • /
    • v.24 no.1
    • /
    • pp.17-43
    • /
    • 2014
  • On the subjects of elementary 3rd grade three child prodigies who had learned the four fundamental arithmetic operations and primary concepts of fraction, this study conducted a qualitative case research to examine how they composed schema of addition and multiplication of fractions and transformed schema through recognition of precise concepts and linking of concepts with addition and multiplication of fractions as the contents. That is to say, this study investigates what schema and transformed schema child prodigies form through composition of primary mathematic concepts to succeed in relational understanding of addition and multiplication of fractions, how they use their own formed schema and transformed schema for themselves to approach solutions to problems with addition and multiplication of fractions, and how the subjects' concept formation and schema in their problem solving competence proceed to carry out transformations. As a result, we can tell that precise recognition of primary concepts, schema, and transformed schema work as crucial factors when addition of fractions is associated with multiplication of fractions, and then that the schema and transformed schema that result from the connection among primary mathematic concepts and the precise recognition of the primary concepts play more important roles than any other factors in creative problem solving with respect to addition and multiplication of fractions.

An Analysis of Core Competence and Core Element on the STEAM Program in the Research Report of School (학교연구보고서에 제시된 STEAM 프로그램의 핵심 역량 및 요소 분석)

  • Shin, Jin-Kyung;Choi, Dong-Kyu;Kim, Ji-Won;Heo, Gyun;Park, Jong-Un;Ju, Dong-Beom;Won, Hyo-Heon
    • Journal of Fisheries and Marine Sciences Education
    • /
    • v.25 no.4
    • /
    • pp.898-914
    • /
    • 2013
  • The fusion type human resources, it is a new human resources to scientific and technical information society of the future demands, and means to enjoy life with a creativity and expertise of fusion of various fields, to communicate in consideration of others. Fusion human resource education(STEAM), of "human resources to practice respect and compassion", "human resources equipped with communication skills", "human resources to pursue creativity and innovation" "human resources to understand the knowledge of the fusion to take advantage" in training I have presented to the area of core competence of the 4C 'Creativity"," Communication","Convergence', 'Caring'. In this study, the area of c ore competency for each element by elementary, middle, and high schools around the analysis of the target can be made by each school level to develop a practical program in the sense of basic research is to conduct. The findings are as follows: First, Area of Creativity, communication area, the contents fusion region, as well as care areas, to the detailed item capacity, the design of the class that contains the entire area should be performed. Second, Elementary and secondary school level analysis, design of the class containing the entire region up to capacity detail is required. High school was required study of school full of normal. Third, In general, for STEAM class environment and teaching model was developed by applying operations. Research and methods of teaching a wider variety of form was required. Later in this study is to develop programs and organize. and It intends to become the base to be able to interest and interest in science education by structured around the status of problems that can be found in the life of around themes STEAM.

A Clinical Study of Branchial Apparatus Anomalies (새성기형 50예의 임상적 고찰)

  • Gam Bong-Soo;Joo Jong-Soo;Kim Sang-Hyo;Paik Nak-Whan
    • Korean Journal of Head & Neck Oncology
    • /
    • v.8 no.1
    • /
    • pp.6-13
    • /
    • 1992
  • Branchial apparatus anomaly is rarely encountered congenital neck disease, it presents a palpable non-tender mass or fistulous opening existed at any site from external auditory canal or mandible angle to lower part of neck We have reviewed the records of 50 patients operated upon for branchial cleft anomaly, at Department of Surgery, Inje University Hospital, between 1981 and 1990, and the following results were obtained. I) In the classificiation of branchial cleft anomaly, first branchial fistula was 1 case, second branchial cyst 32 cases, second branchial sinus 11 cases, second branchial fistula 5 cases and third branchial fistula 1 case. 2) There were 20 men and 30 women in this series and male to female ratio was 2:3. 3) The age at first clinical presentation was 1st decade 15 cases, 2nd decade 10 cases, 3rd decade 17 cases, 4th decade 5 cases and 5th decade 3 cases. The peak age incidence was 3rd decade in overall, but the cyst was most common in 2nd decade, and majority of sinus or fistula was seen below 10 years old age. 4) The prevalent side of this anomaly was right side in 19 cases, left side in 29 cases and bilateral 2 cases, and so left side was more common than right. 5) The clinical presentation was characterized by the lesion along anterior border of sternocleido muscle, non-tender palpable mass were 28 cases, drainage sinus 18 cases, recurrent abscess and drainage 5 cases and intermittent ear discharge 1 case. 6) The mean size of cyst was about 4cm that containing turbid white-yellowish fluid but discharge from sinus or fistula was clear mucoid. 7) The culture of cyst fluid was no bacteria, but 2 cases showed staphyloccoci suggesting secondary infection. 8) The surgical procedure were complete excision of cyst 32 cases, sinus excision 11 cases, fistula excision 6 cases and I&D 1 case. And the recurrent 1 case was that fistula tract could not be identified due to severe scar from previous several operations.

  • PDF

Surgical Treatment of Anastomotic Pseudoaneurysm after the Aortic Replacement (대동맥치환술 후 문합부 가성동맥류 치험 2예)

  • Choi Pil-Jo;Kim Si-Ho;Bang Jung-Hee;Woo Jong-Su;Shin Tea-Bum;Cho Kwang-Jo
    • Journal of Chest Surgery
    • /
    • v.39 no.10 s.267
    • /
    • pp.786-790
    • /
    • 2006
  • An anastomotic pseudoaneurysm after the aortic replacement surgery is a rare complication which could be lethal when it ruptures. So it should be corrected whenever it is found after the aortic surgery. The authors performed three surgical corrections in 2 cases. The first case is type 8 chronic aortic dissection with abdominal aortic aneurysm. After an abdominal aortic replacement, the patient developed an anastomotic pseudoaneurysm. We treated him with a thoracoabdominal aortic replacement. The second case is ruputred throacoabdominal aortic aneurysm. After a thoracoabdominal aortic replacement, the patient developed an anastomotic pseudoaneurysm in the proximal anastomosis. We treated her with aortic arch replacement. But She developed another pseudoaneurysm in the aortic root anastomotic site. So we performed secondary operation to reinforce the anastomosis. They all recovered from the operations without any complication and are being followed up.

The Short Term Results of the Total Aortic Arch Replacement with Arch First Technique (궁부문합 선행법에 의한 대동맥 전궁치환술의 단기 임상 성적)

  • 우종수;김시호;방정희;이길수;최필조;조광조
    • Journal of Chest Surgery
    • /
    • v.37 no.11
    • /
    • pp.903-910
    • /
    • 2004
  • Background: The total aortic arch replacement is one of the most difficult operations with high mortality rate. But the arch first technique with subclavian arterial perfusion has been reported to be a safe methods for arch replacement. Material and Method: Between Feb 2003 and July 2004, 18 patients, 10 men and 8 women, underwent total aortic arch replacement with arch first technique. Their mean age was $59.3\pm12.9$ years. The patietns received 11 acute aortic dissections, 3 chronic aortic dissectiong aneurysms, and 4 ruptured aortic arch aneurysms. Result The mean admission period was $20.2\pm7.4$ days. There was one early mortality case which died of low cardiac output syndrome and another late mortality case which died of cerebral hemorrhage. The others were discharged without any sequelae and they were followed up for an average period of $180\pm156.3$ days. Conclusion: The total aortic arch replacement with arch first technique and subclavian arterial perfusion is a good method that will reduce the surgical mortality and the possibility of secondary late reoperation from the remnant distal aortic problems.

Treatment of Blepharoptosis by the Advancement Procedure of the Müller's Muscle-Levator Aponeurosis Composite Flap (뮐러근과 올림근널힘줄로 구성된 복합피판의 전진술에 의한 눈꺼풀처짐의 치료)

  • Baik, Bong Soo;Suhk, Jeong Hoon;Choi, Won Suk;Yang, Wan Suk
    • Archives of Plastic Surgery
    • /
    • v.36 no.2
    • /
    • pp.211-220
    • /
    • 2009
  • Purpose: Even in a small levator resection for blepharoptosis, 10 ~ 13 mm of $M{\ddot{u}}ller^{\prime}s$ muscle and levator aponeurosis is resected. To solve the problem, $M{\ddot{u}}ller^{\prime}s$ muscle was detached from the superior tarsal border and conjunctiva, and the muscle with overlying levator aponeurosis was advanced on the upper tarsus as a composite flap. The purpose of this study was to evaluate the effectiveness of the $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis complex advancement technique for the correction of blepharoptosis. Methods: Between 2003 and 2008, 107 patients(183 eyes) underwent the advancement procedure of the $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis composite flap for blepharoptosis. The advanced composite flap was fixed 3 mm below the superior tarsal border and 2 ~ 3 mm of distal flap stump was left after trimming up to 5 mm. The results of the operations were evaluated. Results: The mean age of the patients was 35.2 years and 83 patients(145 eyes) were followed up for a mean of 16.7 months. 128 eyes (88.3%) showed a normal level of upper eyelid margin (MRD1 4.1 ~ 5.0 mm) or less than 1 mm ptosis (MRD1 3.1 ~ 4.0 mm). 10 eyes(6.9%) showed 1 ~ 2 mm ptosis (MRD1 2.1 ~ 3.0 mm). 7 eyes(4.8%) showed more than 2 mm ptosis which required secondary correction. About 80% of the 183 eyes needed no trimming of the flap stump with 5 ~ 6 mm of composite flap advancement and 20% had about 3 mm of the flap stump trimmed with 8 ~ 9 mm of composite flap advancement(shortening of the levator complex). Conclusion: $M{\ddot{u}}ller^{\prime}s$ muscle - levator aponeurosis complex advancement technique offers several advantages: There is no, or minimal, sacrifice of the normally functioning $M{\ddot{u}}ller^{\prime}s$ muscle; it is more physiological; it is reproducible and it is predictable - with gratifying results for blepharoptosis.