• Title/Summary/Keyword: open cavity

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Simultaneous Surgery on Jejunum perforation with Pelvic Ring Fracture: A Case Report

  • Chung, HoeJeong;Bae, Keum-Seok;Kim, Seong-yup;Kim, Doosup
    • Journal of Trauma and Injury
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    • v.29 no.2
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    • pp.56-59
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    • 2016
  • Patients with pelvic bone fractures with gastrointestinal perforations are reported in 4.4% of the cases and in very rare cases jejunum (0.15) is involved. However, intestinal perforations are often undiagnosed on the first examination before peritonitis is evident. We are presenting a report where a patient with anteroposterior compression injury, who was expected to undergo an internal fixation procedure, did not show any jejunum perforations on abdominal CT or other physical exams but was found on abdominal CT 1 week after right before surgery, therefore excision and anastomosis surgery, pelvic open reduction and internal fixation was simultaneously done with favorable results. In our case, we present a 61 year old male patient with liver trauma, adhesion at the abdominal cavity, with a past history of gallbladder excision, but without abdominal pain, fever, or infection symptoms. Therefore, this was a case that was difficult to initially diagnose the patient with jejunum perforation and peritonitis. The diagnosis was further supported during laparotomy when peritonitis around the area of intestinal perforation was observed. Generally, it is understood that pelvic bone fracture surgery is not immediately done on patients with peritonitis. However, this kind of patient who had peritonitis with intestinal adhesion and other complications could undergo surgery immediately as infection or other related symptoms did not coexist and the patient was rather stable, and as a result the treatment was successful.

Surface Rendering in Abdominal Aortic Aneurysm by Deformable Model (복부대동맥의 3차원 표면모델링을 위한 가변형 능동모델의 적용)

  • Choi, Seok-Yoon;Kim, Chang-Soo
    • The Journal of the Korea Contents Association
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    • v.9 no.6
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    • pp.266-274
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    • 2009
  • An abdominal aortic aneurysm occurs most commonly in older individuals (between 65 and 75), and more in men and smokers. The most important complication of an abdominal aortic aneurysm is rupture, which is most often a fatal event. An abdominal aortic aneurysm weakens the walls of the blood vessel, leaving it vulnerable to bursting open, or rupturing, and spilling large amounts of blood into the abdominal cavity. surface modeling is very useful to surgery for quantitative analysis of abdominal aortic aneurysm. the 3D representation and surface modeling an abdominal aortic aneurysm structure taken from Multi Detector Computed Tomography. The construction of the 3D model is generally carried out by staking the contours obtained from 2D segmentation of each CT slice, so the quality of the 3D model strongly defends on the precision of segmentation process. In this work we present deformable model algorithm. deformable model is an energy-minimizing spline guided by external constraint force. External force which we call Gradient Vector Flow, is computed as a diffusion of a gradient vectors of gray level or binary edge map derived from the image. Finally, we have used snakes successfully for abdominal aortic aneurysm segmentation the performance of snake was visually and quantitatively validated by experts.

Limited eye movement caused by clumping of fibrin glue used in blowout fracture surgery: a care report

  • Shin, Jin Yong;Lee, Nae-Ho;Kim, Min-Seok;Roh, Si-Gyun;Chung, Yoon Kyu
    • Archives of Craniofacial Surgery
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    • v.23 no.5
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    • pp.228-231
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    • 2022
  • Fibrin glue is a topical agent widely used for hemostasis, wound healing, and surgical adhesion. Complications of fibrin glue itself are extremely rare because it is absorbed over time, but can occur as a result of inappropriate application. We report a case of a postoperative complication caused by inappropriate application of fibrin glue in blow-out fracture surgery. A 65-year-old male patient presented with periorbital swelling and an open wound on the right infraorbital area. Computed tomography showed a right orbital floor fracture. After reduction of the herniated tissue into the orbit, an implant was inserted and fibrin glue was applied to stabilize the implant. This procedure was performed without difficulty, but the patient complained of persistent diplopia and limited eyeball movement after surgery. An imaging study showed a mass-like lesion, which was not a hematoma, in the orbital cavity. In a second operation, the mass was identified as clotted fibrin glue that had not been applied properly. After removal, the patient's symptoms were relieved without further complications. Appropriate and careful application of fibrin glue is necessary to avoid unnecessary complications.

Penetration Model in Soil Considering J-hook Trajectory (토양 내 J-hook 궤적을 고려한 침투해석 모델 개발)

  • Sung, Seung-Hun;Ji, Hun
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.35 no.1
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    • pp.1-8
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    • 2022
  • This study proposes a penetration model in soil considering the wake separation and reattachment based on the integrated force law (IFL). Rigid body dynamics, the IFL, and semi-empirical resistance function about soil are utilized to formulate the motion of the hard projectile. The model can predict the trajectory in soil considering the spherical cavity expansion phenomenon under various oblique angles and angles of attack (AOA). The Mohr-Coulomb yield model is utilized as the resistance function of the soil. To confirm the feasibility of the proposed model, a comparative study is conducted with experimental results described in the open literature. From the comparative study, the penetration depth estimated from the proposed model had about 13.4% error compared to that of the experimental results. In general, the finite element method is widely used to predict the trajectory in soil for a projectile. However, it takes considerable time to construct the computational model for the projectile and perform the numerical simulation. The proposed model only needs to the dimension of the projectile and can predict the trajectory of the projectile in a few seconds.

Management Guidelines on the Large Old Trees as the Natural Monuments in Seoul, Incheon, and Gyeonggi Province through the Analysis of the Growing Environment (생육환경 분석을 통한 서울·인천·경기지역 천연기념물 노거수의 관리방안)

  • Lee, Seung Je
    • Korean Journal of Heritage: History & Science
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    • v.42 no.1
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    • pp.88-99
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    • 2009
  • This study was conducted to formulate management guidelines for Natural monumental old trees in Korea through survey of tree vigor and analysis of growing environments. A total of 20 old trees designated as natural monuments in Seoul, Incheon, and Gyeonggi Province were surveyed. The biological characteristics were surveyed with 4 items of species, ages and height of trees. The surrounding environments were surveyed with 2 items of location types and surroundings. The root conditions were surveyed with 2 items of denudation and molding depth. The health conditions were surveyed with 5 items of withering rate, cavity size, bark breakaway rate, damages by blight and insects, and growing tips. The soil conditions were surveyed with 6 items of PH, organic contents, valid phosphoric acid, transposal cations(K, Ca) and soil compaction. On the basis of outcomes of these research items, mutual relations among locations, growings and soil conditions of old trees were analyzed by carring out cross tabulation, correlation, and simple and multiple regression. Management guidelines were presented searching the factors effecting on the health of the monumental old trees. On the biological characteristics, the old trees designated as natural monuments were Pinus bungeana(4 trees), Juniperus chinensis(3 trees), Ginkgo biloba(3 trees), Poncirus trifoliata(2 trees). Actinidia arguta, Wisteria floribunda, Thuja orientalis, Quercus mongolica, Sophora japonica, Fraxinus rhynchophylla, Zelkova serrata, and Pinus densiflora. The tree height ranged from 4.2 to 39.2m, and root collar rounds ranged from 1.01 to 15.2m. On the surrounding environments, The location types ; Gardens(4), historical sites(5), residental sections(3) open agricultural fields(3), mountain hills(3), and near ocean beaches(1) and stream site(1). The surroundings ; 75% denudation of roots, molded more than 10cm except 4 trees(25%). On the health conditions, 1)Withering rate ; Ginkgo biloba(20%) in Yongmoon temple, (5%) in Saki-ri, kanwha-gun, and others had no withering rate. 2) Cavity size ; all subject had $5{\sim}100cm^3$ of cavity. 3) Bark breakaway rate ; Pinus bungeana in Soosong-dong, in the shrine of Confucius, in Samchung-dong, especially high rate of cavity(5~50%) in Seoul area and in Saki-ri, Kangwha-gun were high 45% brakeaway rate. 4) Damages by blight and insects was slight due to managements. 5Growing tips ; In cases of Juniperus chinensis in Changdeok palace and SunnogDang, seoul, growing tips were 1/2, presumably cause by air pollution, and in cases of Fraxinus rhynchophylla in Paju city and Pinus densiflora in BacksaDorip-ri, Icheon city, growing tips were fine, presumably because there were no moldings. On the Soil conditions, Soil pH ranged from 5.2 to 8.3, organic matter contents from 12% to 56%, phosphorus contents from 104 to 618ppm, soil compaction ranged from 7 to 28mm( among them, Denudation was severe with 21~28mm soil compactions in cases of Pinus bungeana in Soosong -dong, Thuja orientalis in Samchung -dong, Ginkgo biloba in the shrine of Confucius and in Yongmoon temple.) Results of cross tabulation, correlation, and regression analysis showed that molding depth was the most serious factor to deteriorate the tree vigor and cambium conductivity. In addition, soil acidity, organic matter contents, disease and insect damages and cambial detachment were also related to the tree vigor. Additional research of these relationships will be needed to conduct more detailed studies. Based on the relationships between the tree vigor and growing environments, it is considered that old trees should be managed to give them more growing spaces and less abuses. Also, molded soils should be removed and further soil-molding around the tree collar should be prohibited. For the construction of systematic management and removal of harmful factors, appropriative management according to spices, persistent monitering of damaged cases and construction of management system through the accumulation of data on the relationships of soil conditions are required.

Characterization of ATPase Activity of Chaperonin from the Hyperthermophilic Archaeon Pyrococcus horikoshii (초고열성 고세균 Pyrococcus horikoshii 유래 샤페로닌의 ATPase 활성 특성)

  • Choi, Seong Seok;Kim, Se Won;Seo, Yong Bae;Kim, Gun-Do;Lee, Hyeyoung;Kim, Yeon-Hee;Jeon, Sung-Jong;Nam, Soo-Wan
    • Microbiology and Biotechnology Letters
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    • v.47 no.4
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    • pp.574-580
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    • 2019
  • ATP drives the conformational change of the group II chaperonin from the open lid substrate-binding conformation to the closed lid conformation to encapsulate an unfolded protein in the central cavity. It is thought that the folding activity of group II chaperonin is strongly correlated with the ATP-dependent conformational change ability. In order to confirm the dependence of the reaction temperature and ATP concentration of PhCpn, the ATPase activities were measured under different reaction temperatures and ATP concentrations. The maximal ATPase activity of PhCpn was observed at 80℃ and 3 mM ATP concentration. As a result of ATPase activity according to the type of salt ions, the highest activity was observed at 300 mM LiCl among the univalent cations and 5 mM MgCl2 among the divalent cations, respectively. The values of Km and Vmax for ATP substrate were estimated as 2.17 mM and 833.3 μM/min, respectively. This results provide the enzymatic information of PhCpn when the prolonged and high activities of pharmaceutical and industrial proteins (or enzymes), by using chaperonin molecules, are required.

Study on the Development of Efficient Vitrification of Human Blastocysts (인간포배기 배아의 효과적인 유리화 동결법의 개발을 위한 연구)

  • Lee, Sang-Min;Lee, Ju-Hee;Lee, Sang-Won;Lee, Seoung-Min;Yoon, San-Hyun;Lim, Jin-Ho;Park, Huem-Dai;Lee, Seong-Goo
    • Clinical and Experimental Reproductive Medicine
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    • v.30 no.3
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    • pp.241-248
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    • 2003
  • Objective: The purpose of this study was to evaluate the survival rate of vitrified blastocyst according to the freezing vessels, equilibration time in cryoprotectant and artificial dehydration method. Methods: Human blastocysts were vitrified after loading onto the plastic straw, open-pulled straw (OPS), electron microscopy grid (EM grid) for 1.5 min or 3 min. They also were directly plunged into LN2 within 30sec. For artificial shrinkage of blastocysts, 36 gauge fine needle was pushed at the cellular junction of the trophectoderm into the blstocoele cavity until it shrank without damage of inner cell mass. Results: The survival rate of vitrified blastocysts on plastic straw, OPS, EM grid as freezing vessels were 26.7, 13.0 and 60.5%, respectively. The survival rate of EM grid was significantly higher than that of plastic straw and OPS (p<0.05). For 1.5 min equilibrium, the survival rates of early blastocyst (EB), middle blastocyst (MB) and late blastocyst (LB) were 64.4, 81.0, and 20.0% respectively. For 3 min equilibrium, the survival rates of EB, MB, and LB were 69.9, 50.0 and 57.5% respectively. The survival rates of EB and MB were significantly higher than that of LB in 1.5 min equilibrium group (p<0.05), however, the significance was not observed in 3 min equilibrium groups. In cytoplasmic shrinkage before vitrification, the survival rates of EB, MB and LB were 92.9, 100 and 75.9% respectively. The survival rate of MB was significantly higher than that of LB (p<0.05). The survival rates of vitrified blastocysts by artificial dehydration and slow-frozen blastocysts were not significantly different as 88.9 and 66.7%, respectively. Conclusion: This study showed that the vitrification of human blastocysts using EM grid and artificial dehydration is an effective method. Therefore, these methods would be an useful techniques for blastocyst cryopreservation.

Clinical Evaluation of Video-Assisted Thoracic Surgery (VATS) (비디오 흉강경 수술의 임상적 고찰)

  • 원경준;최덕영
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1133-1137
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    • 1996
  • From September 1994 to October 1995, we are reporting clinical results of 67 patients whom underwent video-assisted trio rabic surgery(VATS). 1. They were diagnosed as spontaneous pneumothorax In )5, diffuse interstitial lung disease in 9, empyema in 7, hemothorax in 5, malignant pleural effusion in 3, hyperhidrosis in 3, foreign body in chest cavity in 2, mesothelioma in 1, miliary tuberculosis in 1 and organizing pneumonia in 12. In pneumothorax, bullectomy in 33 and open bellectoiny in 2 due to pleural adhesion was done Hemostasis in 5, irrigation in 7, foreign body removal in 2, talcum powder insufrlation in 3, sympathectomy 3 as done. Thoracoscopic biopsy watt done In 12 3. For pneumothorax, operation was indicated as recurrent pneumothorax in 18, persistent air leak in 12, visible bullae In chest X-ray in 5. 4 Thoracoscopic biopsy was done in 12. They were interstitial pulmonary fibrosis in 9, miliary tuberculosis in 1, mesothelioma in 1, and organizing pneumonia in 1 .Among interstitial pulmonary fibrosis, usual interstitial pneumonia were 2 and diffuse interstitial pneumonia were 7. 5. Wo complication was found in 6) patients among 67 patients. The complication was found in 4 patients (2 persistent air leak, 2 contralateral lung atelectasis). We concluded that VATS was safe and beneficial in reducing postoperative complication and the role of thoracic surgery will increase markefdly.

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Diagnostic Accuracy, Sensitivity, Specificity and Positive Predictive Value of Fine Needle Aspiration Cytology (FNAC) in Intra Oral Tumors

  • Gillani, Munazza;Akhtar, Farhan;Ali, Zafar;Naz, Irum;Atique, Muhammad;Khadim, Muhammad Tahir
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3611-3615
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    • 2012
  • Objective: The objective of this study was to establish the diagnostic accuracy, specificity and sensitivity of fine needle aspiration cytology(FNAC) for intra-oral tumors, comparing with histopathology as the gold standard. Materials and methods: Forty cases of FNA cytology from intraoral tumors was performed in AFID along with the demographic data and clinical information and then diagnosed at AFIP, Rawalpindi. Then the cytology results obtained per FNAC were compared with the histopathological biopsy results of the same lesions. The following variables were recorded for each patient: Age, gender, site of biopsy, diagnosis. The data were entered and analyzed using Open-epi version 2.0. Diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Cohen Kappa was further applied to compare the agreement between the biopsy and FNAC diagnoses. A p-value of < 0.05 was considered as statistically significant. Results: Among the total patients included in the study there were 24 males and 16 females, with a ratio of 1.5:1. Age of the patients ranged from 24 to 80 years with a mean of 52 years. A total of six sites were aspirated from the oral cavity with maximum (11) aspirates taken from alveolar ridge. The results of FNAC revealed that there were 32 malignant and 8 benign aspirates. Confirmation through histopathological analysis came for 31/32 malignant cases while one was falsely given positive for malignancy on FNAC. Among a total of 40 cases, 31(77%) cases diagnosed were found to be malignant and remaining 9(23%) were benign. The FNAC results revealed 32 malignant and 8 benign lesions. Histopathology of the subsequent surgically excised specimen showed malignant lesions in 31(77%) and benign in 9(23%) patients. As a whole, it was found that the absolute sensitivity for introral FNAC was 100% and specificity 89% with positive predictive value of 97% and negative predictive value of 100%. Conclusion: Cytological diagnosis was almost corroborative with final histopathological diagnosis in all cases, with very few exceptions, exhibiting high diagnostic accuracy.

Robot-assisted Thymectomy with the 'da Vinci' Surgical System in a Patient with Myasthenia Gravis -A case report- (중증 근무력증 환자에서 da Vinci 로봇을 이용한 흉선절제술 -1예 보고-)

  • Yi, Jung-Hoon;Jeong, Sang-Seok;Woo, Jong-Soo;Cho, Gwang-Jo;Bang, Jung-Hee;Choi, Pill-Jo;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.557-561
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    • 2010
  • In the treatment of myasthenia gravis, thymectomy is generally accepted as the standard of therapy. For thymectomy, there have been various conventional open approaches including sternal splitting, but recently minimally invasive approaches have been increasingly applied. A 28-year-old man presenting with weakness of both hands and fatigability was diagnosed as having myasthenia gravis with thymic hyperplasia. He underwent a robot-assisted thymectomy with the 'da Vinci' surgical system. Through the right thoracic cavity, two thirds of the thymic gland was dissected, and the remainder was resected through the left; these procedures took, respectively, 1 hour and 30 minutes. The patient was discharged on the 8th postoperative day without complications. The minimally invasive approach with the 'da Vinci' surgical system is emerging as a popular choice and various advantages have been reported. Here we report the first successful case of robot-assisted thymectomy.