• 제목/요약/키워드: Transection line

검색결과 9건 처리시간 0.023초

Setting the Stomach Transection Line Based on Anatomical Landmarks in Laparoscopic Distal Gastrectomy

  • Hosogi, Hisahiro;Kanaya, Seiichiro;Nomura, Hajime;Kinjo, Yousuke;Tsubono, Michihiko;Kii, Eiji
    • Journal of Gastric Cancer
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    • 제15권1호
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    • pp.53-57
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    • 2015
  • Laparoscopic distal gastrectomy has become widespread as a treatment for early gastric cancer in eastern Asia, but a standard method for setting the stomach transection line has not been established. Here we report a novel method of setting this line based on anatomical landmarks. At the start of the operation, two anatomical landmarks along the greater curvature of the stomach were marked with ink: the proximal landmark at the avascular area between the last branch of the short gastric artery and the first branch of the left gastroepiploic artery, and the distal landmark at the point of communication between the right and left gastroepiploic arteries. Just before specimen retrieval, the stomach was transected from the center of these two landmarks toward the lesser curvature. Then, about two-third of the stomach was reproducibly resected, and gastroduodenostomy was successfully performed in 26 consecutive cases. This novel method could be used as a standard technique for setting the transection line in laparoscopic distal gastrectomy.

위암 수술 시 절제연 암침윤의 임상적 의미 (Clinical Significance of Tumor Infiltration at the Resection Margin in Gastric Cancer Surgery)

  • 권성준
    • Journal of Gastric Cancer
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    • 제1권1호
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    • pp.24-31
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    • 2001
  • Purpose: Despite knowledge of the adverse effects of resection-line disease, surgeons continue to perform inadequate resections. This demonstrates the need for a more aggressive approach to assessment of resection margins at operation. Materials and Methods: Seven hundred fifteen gastric cancer patients who were operated on at our hospital from 1992 to 1998 were included in this analysis. Various clinicopathological factors, including resection-line involvement, were ascertained from the surgical and histopathological records. Results: Of the 715 evaluable patients, 27 patients ($3.8\%$) had involvement of one or both resection lines; in 10 patients the proximal resection line only, in 16 the distal resection line only, and 1 both resection lines were involved. Presence of resection-line involvement was significantly associated with T3 and T4 stage, N (+) stage, M (+) stage, type of operation (total gastrectomy), tumor location (entire stomach), size$\geq$11 cm), and gross type of tumor (Borrmann 4 type). When performing a distal subtotal gastrectomy, no involvement was found when the cranial and caudal distances between the lesion and the line of transection was equal to or greater than 2 cm and 3 cm, respectively, for early cancer and 7 cm and 3 cm, respectively, for advanced cancer. When performing a total gastrectomy for upper 1/3 or middle 1/3 gastric cancer, no involvement was found when the cranial distances between the lesion and the line of transection were equal to or greater than 3 cm and 4 cm, respectively, without distinction of the presence of serosal invasion. Conclusions: The difference in survival between positive and negative margin patients is limited to the group of patients with curative surgery. An important principle of treatment is that the entire tumor must be removed with a 3 cm distal margin and a 2- to 7 cm margin depending on the location and the depth of wall invasion of the tumor, to provide histologically negative margins.

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이동통신사의 콘텐츠 시장 진입에 따른 영향과 정책과제 (A Study on the Effects of Entry of Mobile Business Company to On-line Contents Market)

  • 김용환
    • 통상정보연구
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    • 제7권4호
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    • pp.287-303
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    • 2005
  • Mobile Business Companies open its music service and enters into the contents market. The entry of mobile business companies will be able to give diverse benefits to consumer. But, M&A between mobile business companies and contents companies may bring decreasing effect of number of creative industries. For the protection of small company producing cultural contents in contents market, fair transection competition order should be improved as soon as possible.

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좌측 주기관지 외상성 단절의 지연복원 -1례 보고- (Delayed Repair of Completely Transected Left Main Bronchus-A report of one case-)

  • 류한영;박이태;한승세
    • Journal of Chest Surgery
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    • 제23권3호
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    • pp.572-576
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    • 1990
  • A complete transection of left main bronchus was repaired by end to end anastomosis 5 months after the chest trauma in the Yeungnam University Hospital. The patient was a 36 years old male who had been injured bluntly by a heavy package on the left chest. The initial symptoms and signs were dyspnea, chest pain and subcutaneous emphysema on the left neck, but on admission at our hospital his chief complaint was only mild left chest discomfort. The preoperative chest X-ray findings 5 months after the trauma revealed total collapse of the left lung, deviation of trachea to the left, elevation of left diaphragm, abrupt discontinuation in the course of an air-filled left main bronchus and bronchoscopy showed that the left main bronchus was completely occluded, without any signs of inflammation, approximately 4 cm from the carina. The operation was performed through standard posterolateral thoracotomy incision at the fifth intercostal space. There was not any suppuration within the transected lung but plenty of white mucus which was removed by forceful suction. The transected bronchial edges were debrided and anastomosed primarily by end to end with interrupted nonabsorbable sutures. The suture line was reinforced with a pleural flap. The postoperative course was uneventful and pulmonary function following operation improved progressively and proved the delayed repair to have a reasonable decision.

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Modified high-submandibular appraoch for open reduction and internal fixation of condylar fracture: case series report

  • Lee, Sung-Jae;Chun, Young-Joon;Lee, Seung-Jun;Jun, Sang-Ho;Song, In-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권5호
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    • pp.267-276
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    • 2022
  • Objectives: Recently a modified high-submandibular approach (HSMA) has been introduced for treatment of condylar fracture. This approach involves an incision line close to the mandibular angle and transmasseteric transection, leading to a low incidence of facial palsy and allowing good visualization of the condyle area, especially the condylar neck and subcondyle positions. This study reports several cases managed with this modified HSMA technique for treating condylar fractures. Materials and Methods: Six cases of condylar fractures treated with modified HSMA technique were reviewed. Results: Three unilateral subcondylar fracture, 1 bilateral subcondylar fracture, 1 unilateral condylar neck fracture, 1 unlateral simultaneous condylar neck and subcondylar fracture cases were reviewed. All the cases were successfully treated without any major complication. Conclusion: Reduction, fixation, and osteosynthesis of condylar fractures via the modified HSMA technique enabled effective and stable treatment outcomes. Therefore, the described approach can be used especially for subcondylar and condylar neck fractures with minimal complications.

실험적으로 전십자 인대를 단열한 개에서 TPLO의 핵의학적 평가 (Scintigraphic Evaluation of Dogs with Experimentally Transected Cranial Cruciate Ligaments Treated Using Tibial Plateau Leveling Osteotomy)

  • 이재영;김중현;이원국;강성수;배춘식;최석화
    • 한국임상수의학회지
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    • 제22권1호
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    • pp.21-25
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    • 2005
  • This study was performed to assess therapeutic effect of the tibial plateau leveling osteotomy (TPLO) in dogs with experimentally transected cranial cruciate ligaments (CrCL). Nine healthy adult Beagle dogs were transected left CrCL under general anesthesia. The dogs were assigned to TPLO and non-TPLO control groups. The TPLO procedures for correcting the CrCL rupture in the left stifle of dogs were performed under sterile conditions. Before TPLO procedures, all dogs were screened by orthopedic and radiographic examinations. Dogs were lameness free for the previous three months, and when examined at the walk and trot on a hard surface, in a straight line and on a circle. Lateral and craniocaudal radiographs were done to confirm the soundness of the both knee joint in dogs and not detectable lesions were diagnosed. The dogs were intravenously injected with a 10 mci/kg of 99mTechnetium-methylene diphosphonate (99mTc-MDP) under general anesthesia. Scintigraphs were obtained using a large field of view gamma camera equipped a parallel-hole, low-energy about 3 hours after intravenous injection of 99mTc-MDP. Before CrCL transection and 4, 8, and 12 weeks after the procedures, scintigraphy were conducted. Bone uptake of the left stifle joint increased after the procedures in all dogs. When the bone uptake from the TPLO procedure was compared with that of the control, there was a significant difference (p < 0.05). At 12 weeks after the TPLO procedure, the dogs showed normal anatomical posture and gait. It is concluded that TPLO procedure was effective in reconstruct of the stifle joint in dogs with CrCL rupture.

Application of Near-Infrared Fluorescence Imaging with Indocyanine Green in Totally Laparoscopic Distal Gastrectomy

  • Liu, Maoxing;Xing, Jiadi;Xu, Kai;Yuan, Peng;Cui, Ming;Zhang, Chenghai;Yang, Hong;Yao, Zhendan;Zhang, Nan;Tan, Fei;Su, Xiangqian
    • Journal of Gastric Cancer
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    • 제20권3호
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    • pp.290-299
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    • 2020
  • Purpose: Recently, totally laparoscopic gastrectomy has been gradually accepted by surgeons worldwide for gastric cancer treatment. Complete dissection of the lymph nodes and the establishment of the surgical margin are the most important considerations for curative gastric cancer surgery. Previous studies have demonstrated that indocyanine green (ICG)-traced laparoscopic gastrectomy significantly improves the completeness of lymph node dissection. However, it remains difficult to identify the tumor location intraoperatively for gastric cancers that are staged ≤T3. Here, we investigated the feasibility of ICG fluorescence for lymph node mapping and tumor localization during totally laparoscopic distal gastrectomy. Materials and Methods: Preoperative and perioperative data from consecutive patients with gastric cancer who underwent a totally laparoscopic distal gastrectomy were collected and analyzed. The patients were categorized into the ICG (n=61) or the non-ICG (n=75) group based on whether preoperative endoscopic mucosal ICG injection was performed. Results: The ICG group had a shorter operation time and less intraoperative blood loss. Moreover, significantly more lymph nodes were harvested in the ICG group than the non-ICG group. No pathologically positive margin was found and there was no significant difference in either the proximal or distal surgical margins between the 2 groups. Conclusions: Near-infrared fluorescence imaging with ICG can be successfully used in totally laparoscopic distal gastrectomy, and it contributes to both the completeness of D2 lymph node dissection and confirmation of the gastric transection line. Well-designed prospective randomized studies are needed in the future to fully validate our findings.

동중국해 외대륙붕 저층수의 영양염 기원 (The origin of dissolved inorganic nutrients by Kuroshio Intermediate Water in the eastern continental shelf of the East China Sea)

  • 정창수;홍기훈;김석현;김영일;문덕수;박준건;박용철;이재학;이흥재
    • 한국해양환경ㆍ에너지학회지
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    • 제3권3호
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    • pp.13-23
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    • 2000
  • 1993년 12원과 1994년 8월 2회에 걸쳐 동중국해 동부해역 관측선 J (30° N)의 용존무기영양염들의 분포에 대해 조사하였다. 고온고염의 특성을 지닌 쿠로시오 표층수의 질산이온 및 규산농도는 각각 2μM 이하와 5μM 이하로 낮다. 반면에 수심이 증가할수록 질산이온 및 규산농도는 급격히 증가하여 쿠로시오 중층수에서는 각각 20~40, 45~100 μM 범위로 높았다. 대륙붕역 저층수와 쿠로시오 중퐁수의 수온과 용존무기영양염 관계는 용존무기영양염이 풍부한 쿠로시오 중층수가 대륙붕수로 관입되고 있음을 암시한다. 수온, 염분 및 규산 농도를 해수추적자로 이용하여 수괴득의 혼합을 분석한 결과, 대륙붕 저층수는 대륙붕단 바로 바깥쪽 수심 약 100~400 m의 쿠로시오 중층수와의 혼합수라는 것이 밝혀졌다. 이와같이 대륙붕단을 따라 대륙사면에서 대륙붕안으로 올라오는 높은 용존무기영양염 농도를 지닌 용승해수는 동중국해 대륙붕역의 식물플랑크톤 일차생산력을 증가시키는 중요한 영양염 공급원으로 사료된다.

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표준규격 교통신호제어기에서 TCP/IP 통신프로토콜 제정방안 연구 (A Study on Developing the TCP/IP Application Communication Protocol for the Standard Traffic Signal Controller)

  • 한원섭;현철승;이호원;주두환;이철기
    • 한국ITS학회 논문지
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    • 제8권5호
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    • pp.71-84
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    • 2009
  • 교통신호제어기의 표준규격에서 센터시스템과 지역제어기 간 통신방식은 전용선을 기준으로 한 모뎀방식의 시리얼통신으로 규정되어 있어, 지방도시에서 구축 운영되는 TCP/IP의 ITS 통신망에 내에 교통신호제어시스템에 대한 통신규격을 수용하지 못하고 있는 실정이다. 또, ITS 부문에서 데이터 교환을 위한 국내외 표준으로 이더넷 통신망을 기반으로 한DATEX-ASN 데이터 교환기술이 채택되고 있다. 따라서 본 연구는 교통신호제어시스템이 ITS 통신망 내에 구성이 가능하도록, TCP/IP 프로토콜을 기반으로 한 교통신호제어기 통신규격(안)을 개발을 목적으로 한다. 제어, 상태정보와 데이터 베이스 정보 등 표준규격 교통신호제어기의 23개 통신항목에 대한 통신규격(안)이 DATEX-ASN 통신처리 절차 및 구조 (KS ISO X 14827 Part1, 2, ISO/ DIS 15784 Part-3)를 적용하여 개발하였다. 실험을 위하여 통신항복별로 응용프로그램을 개발하였으며, 실험결과 통신항목 모두 인코딩 및 디코딩처리가 가능하였다.

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