• Title/Summary/Keyword: proximal method

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Subjective and Functional Results after a Proximal Gastrectomy: Prospective Study for Comparison of Reconstruction Procedures (근위부 위절제술 후 재건 술식에 따른 경과 관찰)

  • Kim, Ji-Hoon;Yook, Jeong-Hwan;Kim, Byung-Sik;Oh, Sung-Tae
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.1-5
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    • 2006
  • Purpose: A proximal gastrectomy is performed for gastric cancer in the upper part of the stomach to preserve the function of the stomach after surgery. An esophagogastrostomy is one of the common reconstruction methods for a proximal gastrectomy, but this method results in a high incidence of reflux esophagitis. This study was undertaken to compare subjective and functional results between esophagogastrostomy and jejunal interposition reconstructions. Materials and Methods: From June 1998 to December 2002, proximal gastrectomies were performed in 33 patients with tumors in the upper third of the stomach; 8 had reconstruction using jejunal interposition between the esophagus and the remnant stomach (JI group) while 25 had reconstruction using esophagogastrostomy (EG group). The postroperative courses of the patients were reviewed in terms of symptoms, weight changes, and endoscopic findings. Results: The mean age of the patients was 59 years; 26 were men and 7 were women. There were no significant differences in general complications, operating times, or histologic features between the two groups. Fifty-two percent (52%) of the EG group complained of dysphagia, and 16% them experienced heartburn and acid belching. Twelve percent (12%) of the JI group complained of dysphagia, but heartburn and acid belching did not occur. Incidences of reflux esphagitis (36%) and balloon dilatation for anastomotic stricture (16%) were more common in the EG group than in the JI group (0% and 12%). Conclusion: To prevent or minimize complications, such as reflux esophagitis and postoperative symptoms, a proximal gastrectomy with a jejunal interposition is an alternative method as an organ-preserving surgical strategy to improve quality of life for patients. (J Korean Gastric Cancer Assoc 2006;6:1-5)

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A FAST NUMERICAL METHOD FOR SOLVING A REGULARIZED PROBLEM ASSOCIATED WITH OBSTACLE PROBLEMS

  • Yuan, Daming;Li, Xi;Lei, Chengfeng
    • Journal of the Korean Mathematical Society
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    • v.49 no.5
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    • pp.893-905
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    • 2012
  • Kirsi Majava and Xue-Cheng Tai [12] proposed a modified level set method for solving a free boundary problem associated with unilateral obstacle problems. The proximal bundle method and gradient method were applied to solve the nonsmooth minimization problems and the regularized problem, respectively. In this paper, we extend this approach to solve the bilateral obstacle problems and employ Rung-Kutta method to solve the initial value problem derived from the regularized problem. Numerical experiments are presented to verify the efficiency of the methods.

Clinical Experience of Tapering Enteroplasty Using GIA Stapler in Jejunoileal Atresias (소장 무공증 환아에서 GIA stapler를 이용한 Tapering Enteroplasty 임상경험)

  • Song, Young-Tack
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.27-32
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    • 1995
  • Jejunal and ileal atresias are the most common cause of congenital intestinal obstruction and accounts for about 1/3 of all cases of intestinal obstruction in newborns. Despite the relative frequency of this anomaly, its survival rate was less than 10% up to 1950, more recently the survival rate has risen rapidly to 90% with the introduction of modern surgical techniques and the use of total parenteral nutrition. In 1969 Thomas described a tapering jejunoplasty to manage the discrepancy in the size of the proximal dilated lumen & contracted distal lumen, and to preserve absorptive surface when the dilated jejunum involved a long length, and Grosfeld et al.(1979) facilitated this method by using GIA staplers. Author have also used GIA stapler to resect the antimesenteric portion of the dilated proximal bowel in 8 cases of jejunoileal atresias with good results. The following results were obtained ; 1. There we 3 jejunal atresias & 5 ileal atresias, and male to female sex ratio was 5 : 3. 2. The type of atresia was as follows ; type IIIa was 3 cases, type IIIb was 4 cases, type IIIb+IV was 1 case. 3. In non-complication cases(5 cases), the mean hospital day was 16 days, and oral feeding was feasible from 6.2 days after operation. 4. The complications(anastomotic leakage, pneumonia) were frequently occurred in type IIIb cases and in low birth weight cases(75%). 5. Mortality rate was 25% including DAMA(discharge against medical advice) discharge case.

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Finite element analysis of stress distribution on supporting bone of posterior implant partial dentures by loading location (유한요소 분석을 이용한 하중 위치에 따른 구치부 임플란트 국소의치 지지골의 응력 분포 연구)

  • Son, Sung-Sik;Kim, Young-Jick;Lee, Myung-Kon
    • Journal of Technologic Dentistry
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    • v.29 no.1
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    • pp.93-101
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    • 2007
  • The purpose of this study is to evaluate the effect of three different oblique mechanical loading to occlusal surfaces of posterior implant partial dentures on the stress distributions in surrounding bone, using 3-dimensional finite element method. A 3-dimensional finite element model of a posterior implant partial dentures composed of three unit implants, simplified 3 gold alloy crown and supporting bone was developed according to the design of AVANA self tapping implant for this study. Three kinds of surface distributed oblique loads(300 N) are applied to following occlusal surfaces in the three crowns; 1) All occlusal surfaces in the three crown(load of 300 N was shared to three crown), 2) Occlusal surface of centered crown (load of 300 N was applied to a centered crown), 3) Occlusal surface of proximal crown(load of 300 N was applied to a distal proximal crown). In the results, 141 MPa of maximum von Mises stress was calculated at third loading condition and 98 MPa of minimum von Mises stress was calculated at first loading condition. From the results, location and type of occlusive loading conditions are important for the safety of supporting bone.

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The Distal Filling Effects on Hip Jont Function in Cementless Total Hip Replacement (인공 고관절 대치술에서 무시멘트형 스템의 원위부 압박이 고관철 성능에 미치는 영향)

  • 채수원;박상석;박재원
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.24 no.11
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    • pp.2777-2785
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    • 2000
  • In cementless total hip replacement(THR), an initial stability of the femoral component is important to long term fixation of femoral stem. The intial stability has close relationship with the relative displacement of prosthessis and sponge bone at the proximal of femur. After implantation of the proshesis, the surrounding bone is partially shielded from load carrying and starts to resorb. Stress shielding is the cause of the loss of proximal bone. Assessing stress distribution of femur is important to predict stress shielding. The initial stability and the stress shielding were investigated for two loading conditions approximating a single leg stance and a stair climbing. Three types of stems were studied by the finite element method to analyze the biomechanical effects of distal filling of cementless femoral stems. Three types of stems empolyed are a distal filling stem, a distal flexible stem, and a distal tapered stem.

Bending Mechanism Analysis and Bending Coupler Optimal Design for Laparoscopic Surgical Instrument (복강경수술기구의 벤딩메커니즘 해석 및 벤딩커플러 최적설계)

  • Hwang, Dal Yeon;Moon, Dae Hoan;Choi, Seung Wook;Won, Jong Seok
    • Journal of the Korean Society for Precision Engineering
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    • v.30 no.4
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    • pp.434-441
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    • 2013
  • Bending motion has been used in the surgical instruments with bending structures and tendon mechanisms. A simplified bending angle amplification ratio between the proximal and distal bending joint was derived in this article. The bending structure of disk and rib in the proximal joint was analyzed based on finite element method with an emphasis on the circumferential uniformity of bending stiffness. Regarding the distal joint, optimal design and sensitivity analysis was done with four design variables of outer and inner diameter, rib height and rib width while maximizing the deformation under the stress distribution below the yield stress. Outer diameter and rib width are most critical to maximum deformation as the outer diameter and inner diameters are so to maximum equivalent stress.

Biomechanical characteristics of the distal filling effects in cementless femoral stem (무시멘트형 대퇴스템에서 원위부 압박 정도에 따른 생체역학적 특성)

  • Park, Sang-eok;Park, Jae-Won;Chae, Soo-Won
    • Proceedings of the KSME Conference
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    • 2000.04a
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    • pp.387-392
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    • 2000
  • In cementless total hip replacement(THR), an initial stability of the femoral component is important to long term fixation of femoral stem. The initial stability has close relationship with the relative displacement of prosthesis and spongy bone at the proximal of femur. After implantation of the prosthesis. the surrounding bone is partially shielded from load carrying and starts to resort. Stress shielding is the cause of the loss of proximal bone. Assessing stress distribution of femur is important to predict stress shielding. The initial stability and the stress shielding were investigated for two loading conditions approximating a single leg stance and a stair climbing. Three types of stems were studied by the finite element method to analyze the biomechanical effects of distal filling of cementless femoral stems, Three types of stems employed are a distal filling stem, a distal flexible stem, and a distal tapered stem.

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Effect of Various Levels of Dietary Fat on Cell Proliferation of Rat Colon (식이지방의 양적 변화가 대장 상피세포 증식에 미치는 영향)

  • 이중희
    • Journal of Nutrition and Health
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    • v.32 no.4
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    • pp.394-400
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    • 1999
  • Since it has generally been considered that high-hat diets promote carcinogenesis, fat intake of less than 30% of total calories has been recommended to reduce the risk of cancer. Specific dietary guidelines for fat intake to reduce the risk of colon cancer have not yet been established. In order to determine the level of dietary fat needed the risk of colon cancer, rats were fed one of four experimental fat diets, very low(7% of total calories from corn oil, VLC), low(15% LC), medium (30%, MC), and high fat(45%, HC). Cell proliferation as an intermediate biomarker of color carcinogenesis was measured by the in vivo incorporation of bromodeoxyuridine into DNA. Fecal lipid excretion was measured by gravimetric method. As fat levels in the diet increased, fecal lipid concentrations also increased (VLC

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Reconstruction of Injured or Inadquate Left Internal Thoracic Artery in Cornonary Artery bypass Graft (관상동맥우회술시 부적절한 좌내흉동맥의 변형 활용에 대한 경험)

  • 이영탁
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.897-902
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    • 1999
  • Use of the left internal thoracic artery(ITA) to bypass the left anterior descending(LAD) coronary artery has become the standard of care based on its superior graft patency, reduced cardiac events, and enhanced survival. But rarely we encountered with injury to the artery during harvesting which leads to loss of the merits of surgery. We reconstructed inadequate ITAa with other arterial conduits so proximal stump to be a blood source if possible. Maternal and method: Between January 1996 and March 1999, 12 patients received bypass with the reconstructed left internal thoracic artery grafts to left anterior descending artery because of an injury(n=8), short or small(n=4). Right or left ITA was used to LAD as a free graft(n=2). And the other 10 left ITAs were extended with radial artery(n=6), right ITA(n=3), saphenous vein(n=1). Composite "T" graft was made with other arterial conduits in these extended graft(n=5). Result: There was only one morbidity of minor would problem, and no mortality. The patency of extended graft to LAD was complete in 5 patients who received angiography during the period of 2wks to 2 years postoperative, but one of side branch of "T" graft occluded. All of these patients were well. Conclusion: Reconstructive extension with the use of other arterial conduit for the injured proximal ITA is warranted in any patients with acceptable results. acceptable results.

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Spontaneous Release of Glycosylphosphatidylinositol (GPI)-anchored Renal Dipeptidase from Porcine Renal Proximal Tubules

  • Park, Sung-Wook;Kang, Bok-Yun;Yoon, Hyun-Joong;Park, Eun-Mi;Choi, Kyong;Lee, Hwang-Hee Blaise;Hooper, Nigel M.;Park, Haeng-Soon
    • Archives of Pharmacal Research
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    • v.25 no.1
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    • pp.80-85
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    • 2002
  • The incubation of porcine renal proximal tubules (PTs) resulted in the release of the Glycosylphosphatidylinositol (GPI)-anchored renal dipeptidase (RDPase, EC 3. 4. 13. 19) from the membrane after a lag period of approximately 6 hours. This spontaneous release of RDPase from the membrane was inhibited by antibiotics. When the incubation supernatant was added back to fresh PTs, both the antibiotic inhibition of RDPase release and the lag period disappeared. The released RDPase reacted with an anti-cross reacting determinant antibody indicating the presence of the Ins (1, 2-cyc)P. These results suggest that bacteria in the PTs, when incubated, grow find Secrete a phosphatidylinmsitol-specific phospholipase C (PIPLC). This enzyme then hydrolyses the GPI-anchored RDPase and is transferable. RDPase was purified following its release from the membrane by this simple and inexpensive method which may also be applied to other GPI-anchored proteins.