• 제목/요약/키워드: perforating

검색결과 79건 처리시간 0.022초

심하복벽동맥 천공지 유리피판에서 술전 MDCT의 유용성 (The Value of Preoperative Multidetector Computed Tomography for Deep Inferior Epigastric Artery Perforator Free Flap)

  • 허찬영;홍기용;윤창진;은석찬;백롱민;민경원
    • Archives of Plastic Surgery
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    • 제36권2호
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    • pp.140-146
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    • 2009
  • Purpose: Autologous breast reconstruction with abdominal tissue is one of the best options after mastectomy. In a free transverse rectus abdominis myocutaneous(TRAM) or deep inferior epigastric artery perforator(DIEP) flap, a preoperative evaluation of the precise location of perforating vessels and vascular run - off systems is required. The objective of this report is to demonstrate the usefulness of multidetector computed tomography(MDCT) in the preoperative planning of patients undergoing breast reconstruction with abdominal flap. Methods: From June 2006 to January 2008, 28 patients underwent MDCT evaluation before breast reconstruction. All subjects were females with an age range of 30 to 55 years. The CT scan was performed using a 64 - slice MDCT scanner(Brilliance 64; Philips Medical Systems, Best, Netherlands). Results: One perforator or two major perforators were marked on image in good relation with a hand - held Doppler examination and intraoperative findings. All vascular run - off systems were cleared before operation. Conclusion: Preoperative evaluation of perforator arteries with MDCT angiography is beneficial in patients undergoing breast reconstruction. This technique provides a noninvasive approach of the vascular anatomy of the entire anterior abdominal wall.

피하 근막 혈관경을 사용한 외측 과상부 피판술 (Subcutaneous Fascial Pedicled Lateral Supramalleolar Flap)

  • 이승환;정문상;백구현;이영호;공현식;이상기;김지영;박종현
    • Archives of Reconstructive Microsurgery
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    • 제16권2호
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    • pp.68-74
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    • 2007
  • Soft-tissue reconstruction of the foot and ankle has long been a challenge for reconstructive surgeons. Limitations in the available local tissue and donor-site morbidity restrict the options. In an effort to solve these difficult problems, the authors have begun to use a subcutaneous fascial pedicled lateral supramalleolar flap. This report presents the authors' experience with five patients treated with this flap. The patients’ ages ranged from 26 to 72 years; four of the patients were male and one was female. The cause of the soft-tissue defects involved acute trauma and malignant melanom. All flaps survived and provided satisfactory coverage of the defect. Compared with the classic lateral supramalleolar flap, when the perforating branch is interrupted in its course, it is possible to elevate this subcutaneous fascial pedicled flap. The distally based flap with a compound pedicle which is continuous with a vascular axis and a band of subcutaneous fascial pedicle has long pedicle. This procedure is valuable for remote defect of the foot. It is believed that this flap is versatile and effective and is a good addition to the available techniques used by reconstructive surgeons for coverage of the foot and ankle.

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Radiomorphometric analysis of edentulous posterior mandibular ridges in the first molar region: a cone-beam computed tomography study

  • Magat, Guldane
    • Journal of Periodontal and Implant Science
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    • 제50권1호
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    • pp.28-37
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    • 2020
  • Purpose: The aim of our study was to determine the prevalence and degree of lingual concavities in the first molar region of the mandible to reduce the risk of perforating the lingual cortical bone during dental implant insertion. Methods: A total of 163 suitable cross-sectional cone-beam computed tomography images of edentulous mandibular first molar regions were evaluated. The mandibular morphology was classified as a U-configuration (undercut), a P-configuration (parallel), or a C-configuration (convex), depending on the shape of the alveolar ridge. The characteristics of lingual concavities, including their depth, angle, vertical location, and additional parameters, were measured. Results: Lingual undercuts had a prevalence of 32.5% in the first molar region. The mean concavity angle was 63.34°±8.26°, and the mean linear concavity depth (LCD) was 3.03±0.99 mm. The mean vertical distances of point P from the alveolar crest (Vc) and from the inferior mandibular border were 9.39±3.39 and 16.25±2.44, respectively. Men displayed a larger vertical height from the alveolar crest to 2 mm coronal to the inferior alveolar nerve (Vcb) and a wider LCD than women (P<0.05). Negative correlations were found between age and buccolingual width at 2 mm apical to the alveolar crest, between age and Vcb, between age and Vc, and between age and LCD (P<0.05). Conclusions: The prevalence of lingual concavities was 32.5% in this study. Age and gender had statistically significant effects on the lingual morphology. The risk of lingual perforation was higher in young men than in the other groups analyzed.

적층구조, 프로브 급전방식, 정사각형 링형태 마이크로스트립 안테나 특성에 관한 연구 (Characteristics of Stacked Probe-Fed Sqare-Ring Microstrip Antenna)

  • 이정연;이중근;김성철
    • 한국전자파학회논문지
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    • 제12권1호
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    • pp.143-152
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    • 2001
  • 본 노문에서는 S밴드 (1.5 3.9 GHz)에서 주로 사용되어지는 마이크로스트립 패치 안테나에서 복사특성의 성능저하를 방지함과 동시에 소형화방법이 연구되었다. 연구는 마이크로스트립 단일 패치 안테나에서 패치의 중앙 부분을 제거함으로써 정사각형 링(Square-ring) 형태를 가지는 마이크로스트립 안테나의 형태에 관하여 수치적인 방법으로 수행되었다. 또한 링 구조를 가지는 정사각형 마이크로스트립 안테나를 연구함에 있어서 안테나 임피던스, 공진주파수, 대역폭 등을 제어하기 위한 부수적인 파라미터들이 연구되었다. 단일 정사각형 링 마이크로스트립안테나에 있어서 패치의 중앙부분이 제거됨에 따라 입력 임피던스가 증가되고, 공진주파수와 대역폭이 감소되는 현상이 관찰되었고, 안테나의 Directivity 에는 적게 영향을 미치는 것으로 나타났다. 또한 Moment Method 방식의 Zeland 사이의 IE3D 소프트웨어를 이용하여 안테나와 전송선로간의 임피던스 정합과 대역폭의 증가를 위해 다른 개체의 정사각형의 단일 패치와 링 형태의 패치가 각각 쌓아 올려지는 적층(stacked) 구조 형태로 설계, 최적치를 도출하여 단일 패치의 마이크로스트립 안테나보다 향상된 대역폭과 이득을 얻을 수 있음이 연구되었다. 또한 수치적인 시뮬레이션 결과와 실제의 측정을 수행한 결과를 서로 비교함으로써 잘 일치함을 증명하였다.

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경주 월성 해자 유적 출토 목제방패의 형태, 연대 및 수종분석을 통한 신라 방패의 기초적 연구 (A Fundamental Study of the Silla Shield through the Analysis of the Shape, Dating, and Species Identification of Wooden Shields Excavated from the Ruins of Wolseong Moat in Gyeongju)

  • NAM, Tae-Gwang;KIM, Hun-Suk
    • Journal of the Korean Wood Science and Technology
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    • 제49권2호
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    • pp.154-168
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    • 2021
  • 경주 월성의 본격적인 발굴조사로 다양한 종류의 목제유물이 출토되고 있다. 특히 월성의 주위를 둘러싸고 있는 해자에서 다량 출토되었다. 본 연구에서는 월성 해자에서 출토된 목제방패 2점의 수종분석, 방사성탄소연대측정, 그리고 형태분석을 통해 신라시대 방패에 대한 기초자료를 확보하고자 하였다. 연대측정 결과, 4세기 중반에서 5세기 초반에 벌채된 목재를 사용하여 제작되었음이 확인되었다. 수종분석 결과, 유물의 몸체는 소나무속 연송류로, 손잡이는 느티나무속 느티나무로 식별되었다. 출토 목제방패의 제작 순서는 판목으로 가공된 판에 얇은 선으로 구획을 표시한 후 이중동심원을 구획하고 작은 구멍을 투공한 것으로 확인되었다. 구획선 사이의 간격을 측정한 결과 약 6cm로 일정하고, 붉은 색과 검은 색으로 채색되어 있다. 형태 분석을 통해 유물의 너비는 각각 50cm, 36cm 이상으로 추정했다.

Evaluation of a new method, "non-injection resection using bipolar soft coagulation mode (NIRBS)", for colonic adenomatous lesions

  • Mitsuo Tokuhara;Masaaki Shimatani;Kazunari Tominaga;Hiroko Nakahira;Takuya Ohtsu;Katsuyasu Kouda;Makoto Naganuma
    • Clinical Endoscopy
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    • 제56권5호
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    • pp.623-632
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    • 2023
  • Background/Aims: Endoscopic resection of all colorectal adenomatous lesions with a low complication rate, simplicity, and negative residuals is challenging. Hence, we developed a new method called "non-injection resection using bipolar soft coagulation mode (NIRBS)" method, adapted for colorectal lesions. In addition, we evaluated the effectiveness of this method. Methods: We performed NIRBS throughout a 12-month period for all colorectal lesions which snare resection was acceptable without cancerous lesions infiltrating deeper than the submucosal layer. Results: A total of 746 resected lesions were included in the study, with a 4.5 mm mean size (range, 1-35 mm). The major pathological breakdowns were as follows: 64.3% (480/746) were adenomas, and 5.0% (37/746) were intraepithelial adenocarcinomas (Tis lesions). No residuals were observed in any of the 37 Tis lesions (mean size, 15.3 mm). Adverse events included bleeding (0.4%) but no perforation. Conclusions: NIRBS allowed the resection of multiple lesions with simplicity because of the non-injection and without perforating due to the minimal burn effect of the bipolar snare set in the soft coagulation mode. Therefore, NIRBS can be used to resect adenomatous lesions easily, including Tis lesions, from small to large lesions without leaving residuals.

장옹(腸癰)에 있어서 종양(腫瘍).농양(膿瘍).궤양(潰瘍)의 진단(診斷)과 치료(治療)에 관(關)한 고찰(考察) ('Studies on diagnosis and Treatment of tumor.abscess.ulcer in intestinal carbuncle')

  • 한규언;류봉하;박동원;류기원;장인규
    • 대한한방내과학회지
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    • 제11권1호
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    • pp.93-107
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    • 1990
  • Studies on diagnosis and treatment of tumor . abscess . ulcer in intestinal carbuncle were carried out. The result of studies were summerized as follows: 1. By Nai-Gyung carbuncle-tumor arose from disharmony between nutrient and defensive because of cold, abscess arose from fever victory between cold and fever, ulcer arose from decreasing function of Bi-Kam year. By latter literature Bi-Kam year could be interpreted that spleen stomach was invaded evil influence from unattainable vital force of the earth. 2. Sites of intestinal carbuncle were large intestine, small intestine, intestinal inside or outside between large and small intestine, Intestinal carbuncle was common name of a disease about large intestinal carbuncle, small intestinal carbuncle, pelvic intestinal carbuncle, shrink leg intestinal carbuncle etc.. Pain appeared Chunchu-Hyul in large intestinal carbuncle, and Gwanweon-Hyul in small intestinal carbuncle. 3. On abdominal diagnosis tumor had indistinct pain of Gwanweon Chunchu, edema and heary feeling in low abdomen, no excessive pain by hand press and intestinal boiling sound. In abscess pain descended from right side of low abdomen to huckle, and there was rejection against press, feeling about fever,water sound with flank movement. In ulcer hand approach was difficult since excessive pain diffuse to whole abdomen, and perforating ulcer sometimes caused a serious symptom of umbilical pus. 4. On fecal and urinary diagnosis in tumor urine was yellowish red pollakiuria like gonorrhoea and occasional constipation. In abscess uncomfortable rough pain short red early urine like gonorrhoea appeared during urination, and constipation with stinging pain appeared during defecation. In ulcer red rough pyuria appeared, and stinging and pain with puruloid blood appeared during defecation. 5. On treatment in tumor Daiwhang-Tang Daisenggi-Tang Dangui-Jun by dissipation method, calming down method, interior reliance maturation method, in abscess Mokdan-San Euiiin-Tang Jeokduiin-Tang by the method of water repelling pus discharge, acute breaking, in ulcer Takridanggui-Tang Paljin-Tang Bojungikki-Tang were each used by the method of interior reliance, virulence astriction, supplement vital force and blood, supplement spleen stomach. 6. On treatment patient may have to be careful of excessive moving and suprising anxiety. Abuse of acupuncture and moxibustion made patient worse, misuse of analgesics purgative intestinal irrigation etc. could provoke difficult diagnosis and perforation. So you must treat after exact diagnosis. 7. Prognosis of ease tumor ease abscess ease ulcer and ease astriction was good. If the intestinal carbuncle were not to promote to abscess and ulcer for a long time, its prognosis was bad and it could metastasize to cancer because of dark purple with hardness. So tumor abscess ulcer in intestinal carbuncle may be significant of precancerous lesion.

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외측 복사뼈 상부 근막-피부 섬피판을 이용한 발 및 발목관절 연부조직 결손의 재건 (Lateral Supramalleolar Fasciocutaneous Island Flap for Reconstruction of the Foot and Ankle Soft Tissue Defect)

  • 최재훈;김남균;최태현;이경석;김준식
    • Archives of Plastic Surgery
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    • 제33권6호
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    • pp.784-788
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    • 2006
  • Purpose: For the reconstruction of the ankle joint as well as the soft tissue defect in the distal lower leg, a free flap or a local flap has been used, and because of the condition of patients, if a complex microvascular surgery under general anesthesia could not be performed, it could be reconstructed by using the distally based lateral supramalleolar fascio-cutaneous island flap using the perforating branch of the peroneal artery in the ankle area. Methods: The study subjects were 4 male patients between 53 years and 73 years of age. 2 cases were tissue defect in the medial malleolus area due to systemic diseases such as gouty arthritis accompanied traffic accident, diabetes mellitus foot, atherosclerotic obliterans, etc., 1 case was the defect in the pretibia area, and 1 case was the defect underneath the lateral malleolus, which was reconstructed by the distally based lateral supramalleolar fascio-cutaneous island flap. The donor area was the skin harvested from the groin, and the full thickness skin graft was performed. The size of the flap varied from $4{\times}3cm$ to $9{\times}6cm$. As the flap border, the medial side was to the tibialis anterior tendon, the lateral side was to the fibula crest, and the proximal area was less than the fibula size. Results: The consequence is that, in total 4 cases, the congestion in the flap began from 12 hours after the surgery, and the progression of congestion was ceased on the 5th day after the surgery, and finally epidermal bulla and sloughing, partial necrosis was developed. After the end of necrosis, the defect area was reconstructed successfully by the second full thickness skin graft. Conclusions: Although the distally based lateral supramalleolar fascio-cutaneous island flap has the shortcoming of requiring the second skin graft, it has the advantages that it does not require a long complex microsurgery, the flap itself is thin, it is similar to the color of the skin in the recipient area, and it does not leave a big scar in the donor area. Therefore, it is thought that for the cases who could not undergo a long complex surgery due to systemic diseases or the cases of patients whose condition of the recipient area is not suitable for microsurgery, the lateral supramalleolar fascio-cutaneous island flap is very useful for the reconstruction of the distal lower leg and the ankle joint area.

제 IV 형 근관에서 System B Plugger tip의 깊이에 따른 근관 충전 효과 (THE EFFECT OF CANAL OBTURATION ACCORDING TO THE DEPTH OF THE SYSTEM B PLUGGER TIP IN THE TYPE IV CANAL)

  • 최희원;김수미;황호길
    • Restorative Dentistry and Endodontics
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    • 제33권6호
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    • pp.518-525
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    • 2008
  • 본 연구의 목적은 제 IV형 근관에서 Continuous Wave 가압법을 이용하여 충전할 때 System B Plugger tip의 깊이에 따른 근단부 밀폐효과를 평가하기 위함이다. 50개의 J형 만곡을 갖는 레진 블록에 부러진 F3 ProTaper 파일을 이용해 근관장에서 3mm 지점에 ledge를 형성한 후, F1 ProTaper Ni-Ti file을 이용해 레진 블록을 천공시켜 제 IV형 근관을 형성하고 System B Plugger tip의 깊이에 따라 3개의 실험군과 1개의 대조군으로 분류하였다. 제 IV형 근관의 거터퍼쳐와 실러의 길이는 확대경하에서 캘리퍼를 이용해 측정하였고 다음과 같은 결과를 얻었다. 1. 대조군의 설측 근관에서 거터퍼쳐와 실러 모두 관찰되지 않았다. 2. 3 mm군에서는 5 mm 또는 7 mm군에 비해 유의하게 많은 거터퍼쳐의 충전이 관찰되었다 (p<0.05). 3. 7 mm군에서는 유의하게 많은 빈 공간이 관찰되었다 (p<0.05).

복재정맥 부전에 대한 980-nm 다이오드 레이저를 이용한 치료와 전통적인 발거술 간의 비교: VCSS 점수와 재발에 의한 중기 임상 결과 (Comparison of Endovenous Treatment Using a 980 nm Diode Laser versus Conventional Stripping for Truncal Saphenous Vein Incompetence: Mid-term Results by VCSS Score and Recurrence)

  • 최재성;김응중;이정상
    • Journal of Chest Surgery
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    • 제43권4호
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    • pp.387-393
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    • 2010
  • 배경: 이번 연구의 목적은 정맥내 레이저 응고술(EVLT)과 발거술의 재발을 포함한 중기 임상 결과를 비교 평가하는 것이다. 대상 및 방법: 2007년 1월부터 2010년 2월까지 237명의 환자에서 대복재 및 소복재 정맥류 318개를 대상으로 980-nm 다이오드 레이저 또는 전통적인 발거술을 시행하였다. 첫 방문과 수술 후 1, 2, 6, 12, 18, 24, 36개월째 외래를 방문한 모든 환자를 대상으로 듀플렉스 초음파 검사와 Venous Clinical Severity Score (VCSS) 기록을 위한 임상검사 및 설문조사를 시행하였다. EVLT 및 정맥류 발거술의 두 치료군 간의 임상 결과를 비교하기 위해 수집된 모든 데이터를 이에 맞게 가공하여 분석하였다. 결과: 두 치료군 간에 관통정맥 부전의 수나 정맥 역류의 정도는 차이가 없었다. EVLT나 발거술로 대복재 및 소복재 정맥의 역류가 제거된 후 이 역류 제거 상태의 성공적인 유지율은 양 군간에 차이가 없었으며 12개월째 성공적인 유지율은 EVLT군이 $90.3{\pm}4.5%$, 발거술군이 $93.9{\pm}4.2%$였다. 전체적인 재발율은 EVLT군이 4.4%, 발거술군이 1.5%로 두 군간의 통계적인 차이는 없었다. VCSS 점수는 두 군 모두에서 수술 후 1주와 1개월, 2개월에 유의한 감소를 보였다. 결론: 대복재 및 소복재 정맥 부전의 제거에 대한 효율성이나 정맥 부전으로 인한 임상 경과의 수술 후 개선 능력 등에 있어 EVLT와 발거술은 비슷한 결과를 나타냈다.