• 대한관절경학회지
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• 제2권1호
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• pp.45-50
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• 1998

Recently, a variety of arthroscopic techniques have been reported for the treatment of the displaced tibial eminence fracture. The purpose of this study was to describe details of arthroscopic technique using pull-out wire and to evaluate the results. Eleven patients with irreducible type II and type III tibial eminence fractures underwent the arthroscopic reduction and internal fixation using double strand pull-out wiring. The anterior cruciate ligament tibial drill guide was utilized for the reduction of fracture and passage of the guide pins. The tibial eminence fracture was firmly fixed with double strand 26-gauge pull-out wire(0.45mm diameter). Fracture union was achieved at 7.2 weeks (range, six to eight weeks) after operation. All cases were united at the last follow-up. Subjectively, nine patients had no pain and no restriction of daily activities. Two patients with combined injuries had limitation of knee motion(10 to 130 degrees, respectively) and one patient showed mild anterior laxity. Early rehabilitation was enabled without loss of reduction and breakage of pull-out wire. The arthroscopic reduction and internal fixation using pull-out wire showed good results including early rehabilitation, early fracture union, minimal morbidity, and no requirement of the second operation for hard ware removal.

• The Korean Journal of Pain
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• 제24권3호
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• pp.146-153
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• 2011

Background: Morphine has been commonly used for postoperative pain control. We measured plasma concentrations of morphine and compared the efficacy and safety of continuous epidural analgesia (CEA) using morphinebupivacaine with intravenous patient controlled analgesia (IV-PCA) with morphine for 48 hrs after the end of the operation. Methods: Nineteen patients undergoing Mile's operation were assigned to receive a morphine loading dose of 5 mg followed by IV-PCA with 0.1% morphine (IV-PCA group, n = 9) or a morphine loading dose of 2 mg and 0.125% bupivacaine 10 ml, followed by CEA with 0.004% morphine and 0.075% bupivacaine at a rate of 5 ml/hr (CEA group, n = 10). The plasma concentrations of morphine were measured and visual analog scales (VAS) for pain were recorded at 1, 6, 12, 24, and 48 hr postoperatively and the effects on respiration and any other side effects were noted. Results: The mean maximal and minimal levels of plasma morphine were $40.2{\pm}21.2\;ng/ml$ and $23.4{\pm}9.7\;ng/ml$ for the IV-PCA group and $11.8{\pm}3.5\;ng/ml$ and $8.2{\pm}1.9\;ng/ml$ for the CEA group, respectively. Resting and dynamic pain scores were significantly lower in the CEA group than in the IV-PCA group. There were no significant differences for the effects on respiration and for any side effects between the two groups. Conclusions: We evaluated plasma concentrations of morphine with CEA using morphine-bupivacaine and IV-PCA using morphine for the postoperative pain control. The CEA group had better postoperative analgesia than that of the IV-PCA group and the incidence of side effects were not significantly different between the two groups.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.87-94
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• 2000

Objective : Various surgical approaches have been implemented to fulfill the ideal goals of treatment for cervical spondylotic lesions. Conventional approaches are represented by anterior approach with or without fusion and posterior approach. The authors has applied newly developed anterior cervical microforaminotomy for these lesions on minimally invasive basis. Materials and Method : Twenty-one patients, with cervical HIVD, or stenosis, or both, underwent anterior cervical microforaminotomy between March, 1998 and April, 1999. Fifteen patients underwent unilateral decompression, and 6 bilateral decompression via unilateral foraminotomy. Operation of one level was performed in 16 patients, 2 levels in 4 patients, and 3 in 1 patient. The foraminotomy was accomplished by resecting the uncovertebral joint. Through this hole, compressed nerve root was decompressed by removing the spondylotic spur or disc fragment, and diagonal removing of posterior osteophyte from foraminotomy site to begining of contralateral nerve root made spinal cord decompression. Results : The outcome was excellent in 17 patients(81%) and good in 4 patients(19%) based on Odom's criteria. No complication was encounterd, and average post-operation hospital stay was 3.7 days. Conclusions : These results indicate that anterior cervical microforaminotomy provide adequate neural decompression, minimum postoperative discomfort and fast recovery.

• 한국임상수의학회지
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• 제16권2호
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• pp.339-351
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• 1999

Excess secretion of goblet cell stimulated by inhalation anesthetics have side effects during operation or postoperative care. Mucosubstances, which are almost secreted by goblet cells in the epithelium of the respiratory tract, are secreted by a direct irritation of inhalation anesthetics. This study was carried out to compare the differences of mucus secretion on lower respiratory tract stimulated by ethyl ether, halothane and isoflurane. Total of 24 rabbits were used as experimental animals. The trachea and the 1st bronchi were fixed in 10% neutral buffered formalin. After embedding in paraffin, the specimens were sectioned to a thickness of 6 ${\mu}{\textrm}{m}$, and PAS-H, Alcian blue pH 2.5 and Alcian blue pH 1.0 stains were performed for the observation of the composition and the quantity of the mucus. The results were as follows; Ethyl ether and isoflurane irritated the mucous membrane of the respiratory tract. Ethyl ether irritated more than isoflurane. Halothane irritated the mucous membrane, but its effect was minimal and had little influences during operation. In the specimens stained with PAS-H, Alcian blue pH 2.5 and Alcian blue pH 1.0, the mucosubstance lining the cilia and in the goblet cells of the trachea and 1st bronchi were the strongly PAS-H reactive mucosubstances, moderately Alcian blue pH 2.5 and Alcian blue pH 1.0. The PAS-H reactive mucosubstance were polysaccharides, neutral mucopolysaccharides, mucoproteins, glycoproteins and glycolipids. Trachea was easily affected than bronchi by inhalation anesthetics. Consequently, it is suggested that because halothane does not irritates respiratory mucosal secretion, its application may be efficient to the depressed respiratory system.

• 한국정보처리학회논문지
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• 제6권8호
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• pp.2196-2203
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• 1999

본 논문은 데이터패스 합성에서의 버스 스케줄링 문제와 레지스터의 최적화 방법을 다룬 것이다. 스케줄링은 DFG(Data Flow Graph)의 연산을 제어스텝(control step)에 할당하는 과정으로서, 주어진 조건을 만족하는 범위 내에서 비용함수(cost function)의 최소화에 목적을 둔다. 이를 위해 본 논문에서는, 연산자 배치를 위한 하드웨어 할당(hardware allocation) 과정에서의 설계비용을 최소화시키기 위해, 연산결과를 저장하는 레지스터(register)와 연산간의 이동 통로인 버스(bus)의 최적화 기법을 논하였다. 특히, 하드웨어 할당과정의 중요한 과제인 버스와 레지스터의 최소화 기법을 논하였으며, 레지스터의 최적화는 스케줄링이 완료된 후의 결과를 이용하였다. 실험대상으로는 벤치마크 모델인 5차 디지털 웨이브필터(5th-order digital wave filter)를 사용하였으며, 본 논문의 결과를 기존결과와 비교함으로써, 본 논문의 효용성을 입증하였다. 모든 실험결과는 구조형태의 선형정수계획법(ILP : Integer Linear Programming)을 이용함으로써, 모든 경우에 언제나 최적의 결과를 얻을 수 있도록 하였다.

• 한국산학기술학회논문지
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• 제11권1호
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• pp.67-72
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• 2010

본 논문에서는 기존의 궤도회로(Track Circuit)를 이용하는 FBS의 설비측면에서 단락감도 및 선로변 설비(지상설비)의 규모에 따른 유지보수의 증가 등의 문제점을 극복하고, 차량간 간격을 근접시키기 위한 열차제어 개념인 MBS의 구현에 따른 무인운전기술의 가능성을 검증하였다. MBS에 의한 열차 운전은 중앙국에서 열차의 위치를 실시간으로 알 수 있어 선행열차의 정보를 후속열차에 직접 전달할 수 있으므로 시격(Headway)단축이 가능해지고 그에 따라 수송수요 증대와 불필요한 가.감속을 방지할 수 있다. 이와 더불어 지상설비를 대폭적으로 감소시킬 수 있으며, 승객서비스 향상 및 승차감 향상 등의 이점을 제공한다.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.19-25
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• 2017

Background Numerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship. Methods We evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate. Results A 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits. Conclusions Our condylar repositioning method using a centric relation splint and miniplate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.200-204
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• 2009

Purpose: The epicanthal fold is a unique finding in the medial canthal area of many Asians. Various methods have been developed to eliminate this fold. However, excessive and prominent scarring in the medial canthal and nasal area and recurrence restricted application of epicanthoplasty. The authors performed a epicanthoplasty using Y-V advancement flap method in order to obliterate the epicanthal fold without making incisions in the nasal area and as a result, to avoid postoperative scarring. Methods: Sixty one patients underwent epicanthal fold correction using Y-V advancement flap method from July 1999 to February 2005. There were 4 males and 57 females with ages ranging from 9 to 60 years. The epicanthoplasty was performed combined with double eyelid operation, ptosis correction, augmentation rhinoplasty, nasal alar reduction, and nasal tip-plasty. Results: There were few complications in our studies, and most of the patients were satisfied with the results. Conclusion: Remarkable advantages of our Y-V advancement flap epicanthoplasty are as follows: 1) minimal postoperative scarring in the medial canthal area, 2) application of modified double eyelid operation, 3) wider opening of the medial palpebral fissure, 4 the correction of entropion or epiblepharon, 5) no recurrence.

• Journal of Chest Surgery
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• 제41권1호
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• pp.95-97
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• 2008

허혈성 좌심실벽 파열은 심근경색 후에 발생하는 치명적인 합병증 중의 하나인 심장파열의 한 유형으로 빠른 진단과 수술이 필요하다. 환자는 내원 15분 전 갑작스런 의식소실을 주소로 내원한 75세 여자로 당시 의식은 반 혼수상태로 얼굴과 상하지에 청색증 소견을 보였으며 응급실에서 시행한 심초음파 검사상 심낭에 약 $1.5{\sim}2\;cm$ 두께로 삼출소견이 관찰되었으며 심장박동 수가 35회/분까지 떨어져 심장마사지 시행하면서 응급수술을 시행하였다 우심실 전벽에 1 cm정도의 파열과 좌심실 벽에 괴사성 출혈반흔을 동반한 파열부위를 확인하고 체외순환 없이 사친스키 겸자를 이용해 출혈부위를 잡은 뒤 봉합하였다. 환자는 수술 후 28일째 약간의 호흡곤란은 있으나 일상생활 가능한 상태로 퇴원하였다.

• Archives of Reconstructive Microsurgery
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• 제13권1호
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• pp.1-6
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• 2004

Advances in microvascular techniques and refinements in microsurgical tissue transfers have enabled surgeons to combine different tissue components and reconstruction into a single-stage operation in extensive or composite defect following injury. Some problems and consideration for extensive or composite defects are form, shape, function, and dimension of the defect sites. Therefore combination of two or more flaps is required to reconstruct extensive or composite defect. This paper presents our clinical experience of four cases of combined free flaps with or without sequential microanastomosis in reconstruction of upper extremity based on peroneal flowthrough, thoracodorsal, and dorsalis pedis vascular system. Satisfactory results were obtained without flap loss and complications. The free flaps were combined in th following fashion; two cases by bridge fashion, one by chimeric microanastomosis and one by simple chimeric fashion. The median follow-up time on all patients was 21.7 months. Donor site morbidity was minimal. Extensive soft tissue or composite defects can be effectively covered by various combined flaps. Even though the risk for complication exists, the options of combination with or without sequential microanastomosis can add a functional or sensory dimension to reconstruction of complex wounds.