• Title/Summary/Keyword: proximal method

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Fixation with Suture Material in Akin Osteotomy (봉합사 고정을 이용한 Akin 절골술)

  • Young, Ki-Won;Lee, Kyung-Tai;Kim, Jae-Young;Cha, Seung-Do;Kim, Eung-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.138-141
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    • 2004
  • Purpose: The purpose of this study was to document the results of fixation with ethibond suture in akin osteotomy and its advantages. Materials and Methods: From May 2001 to January 2004, Akin osteotomy was performed in 218 patients. We reviewed 110 patients (114 feet) who were possible radiographic evaluation more than 6 months after operation. 110 feet had hallux valgus and 4 feet had hallux valgus interphalangeus. 105 patients were female and 5 were male. The average age was 43.8 years old (18 to 68 years old). The average follow up was 9 months (6 to 23 months). After performing the Akin osteotomy at 7 mm from the proximal articular surface of the proximal phalanx, one hole is made on either side of the osteotomy site with a K-wire. The passer was passed through the both holes and the ethibond was passed. And then, the ethibond was tied tightly. 2 sutures in 66 feet and 1 suture in 48 feet were made. Radiographic bone union at 6 months follow up was regarded as success and loss of the reduction, nonunion was regarded as failed. Results: In the radiographic evaluation, bony union were made at 6 months follow up in all feet. There was no difference between 2 sutures and 1 suture, and the knots were removed in 3 feet because of skin irritation. Conclusion: The fixation of the osteotomy site using suture material was an effective method in Akin osteotomy. The advantage of this procedure was unnecessity of the material removal.

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Cytokine mRNA Expression in the Small Intestine of Weanling Pigs Fed Diets Supplemented with Specialized Protein or Peptide Sources

  • Zhao, J.;Harper, A.F.;Webb, K.E. Jr.;Kuehn, L.A.;Gilbert, E.;Xiao, X.;Wong, E.A.
    • Asian-Australasian Journal of Animal Sciences
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    • v.21 no.12
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    • pp.1800-1806
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    • 2008
  • Cytokines play a central role in the mucosal immune response and are involved in regulation of nutrient absorption, metabolism and animal growth. This study investigated the effect of diet manipulation with specialized protein or peptide sources on expression of cytokine (IL-1, IL-6, IL-10, and TNF-${\alpha}$) mRNA abundance in different intestinal regions and at different ages post-weaning in piglets. A total of 48 (17 days of age, $6.16{\pm}0.34kg\;BW$) weanling pigs were fed either a corn-soy/whey protein basal diet, the basal diet supplemented with spray-dried plasma protein (SDPP), or the basal diet supplemented with $Peptiva^{(R)}$, a hydrolyzed marine plant protein. A fourth treatment group was fed the SDPP diet, but the feed intake level was limited (SDPP-LF). Pigs were killed at 3 and 10 d, and intestinal cytokine mRNA was measured by real-time PCR using the relative quantification method. The SDPP-LF group exhibited an increased TNF-${\alpha}$ mRNA abundance compared with the ad libitum SDPP group (p<0.05). The TNF-${\alpha}$ and IL-10 mRNA abundance increased from the proximal to distal part of the intestine, and the mRNA abundance was greater (p<0.01) in the distal intestine as compared with the proximal and middle intestine. The cytokines IL-1-${\beta}$, IL-10 and TNF-${\alpha}$ mRNA abundance also increased from d3 to d10 postweaning (p<0.01). In summary, restricted feeding increased the TNF-${\alpha}$ mRNA abundance in the small intestine, however neither SDPP nor peptide supplementation affected cytokine mRNA expression. Abundance of mRNA for most cytokines examined in this study increased with age post-weaning, suggesting that during 10 d after weaning the mucosal immune system is still under development.

Effect of Electrode Placement on Procaine Iontophoresis (전극배치가 Procaine 이온도입에 미치는 영향)

  • Lee, Jae-Hyoung;Song, In-Young;Kook, Jee-Youn
    • Journal of Korean Physical Therapy Science
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    • v.4 no.2
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    • pp.399-403
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    • 1997
  • The purpose of this study was to determine the efficacy of electrode placement on procaine iontophoresis. Thirty-three healthy students with an age range of 19 to 34 years, were participated in this study. The subjects were randomly assigned into 3 groups. Each subjects received iontophoresis on the proximal 1/3 of volar surface of dominant forearm with soft cotton pad($3.5{\times}3.5cm$) soaked in 2 ml of 4% procaine hydrochloride (pH 5.1) at 4 mA for 10 minutes(total current 40 mA min) of anodal DC. In transversal electrode placement(TEP) group, dispersive electrode was placed on the proximal 1/3 of dorsal surface of the forearm. In longitudinal electrode placement (LEP) group and control group, dispersive electrode were placed on the distal 1/3 of volar surface of the forearm. After procaine iontophoresis, duration of anesthesia were evaluated at five minutes intervals on five random locations in the iontophoretically area using a 21-gauge sterile hypodermic needle pressed with 1 mm invagination until return the sharp pin-pricking pain sensation. The data were ana lysed with one-way ANOVA to determine signific~nt differences between groups. The results showed significantly differences in the local anesthetic duration between the 3 groups(p<0.001). The anesthetic durations of TEP group and LEP group were significantly longer when compared with control group(p<0.05). Anesthetic durations of TEP group and LEP group were not significantly difference, but anesthetic duration of LEP group tends to longer than TEP group. In view of these results, clinicians should consider the electrode placement method when performing the iontophoresis.

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Surgical Flow Alteration for the Treatment of Intracranial Aneurysms That Are Unclippable, Untrappable, and Uncoilable

  • Lee, Sung Ho;Ahn, Jae Sung;Kwun, Byung Duk;Park, Wonhyoung;Park, Jung Cheol;Roh, Sung Woo
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.518-527
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    • 2015
  • Objective : The treatment of complex intracranial aneurysms remains challenging. One approach is the application of surgical flow alteration to treat aneurysms that are neither clippable, trappable, or coilable. The efficacy and limitations of surgical flow alteration have not yet been established. Methods : Cases of complex aneurysms treated with surgical flow alteration (proximal occlusion with or without bypass, distal occlusion with or without bypass and bypass only) were included in this retrospective study. Results : Among a total of 16 cases, there were 7 giant aneurysms (${\geq}25mm$ diameter) and 9 large aneurysms (>10 mm diameter); 15 of 16 aneurysms were unruptured. There were 8 aneurysms located in the anterior circulation, while the other 8 were in the posterior circulation. Aneurysms were treated with proximal occlusion in 10 cases and distal occlusion in 5 cases; in 1 case, the aneurysm occluded spontaneously after bypass without parent artery occlusion. All but 2 cases underwent prior or concurrent bypass surgery. Complete obliteration of the aneurysm at the latest imaging follow-up was shown in 12 of 16 cases (75.0%). Bypass patency was confirmed in 13 of 15 cases (86.7%). Surgery-related morbidity developed in 3 cases (18.8%, Glasgow outcome scale of 4) and all were perforator infarctions. There were no mortalities. Conclusion : Surgical flow alteration resulted in a high rate of aneurysmal obliteration with acceptable morbidity. Although several limitations remained, it could represent an alternative method for treating complex aneurysms.

Removal of Submandibular Stones via Intraoral approach (구강내 접근을 이용한 악하선 타석의 제거)

  • Lee, Sung-Bu;Lee, Jong-Cheol;Choi, Seung-Ho;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Korean Journal of Bronchoesophagology
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    • v.14 no.1
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    • pp.23-28
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    • 2008
  • Background and Objectives : Traditionally, the excision of submandibular gland (SMG) has been commonly used for treatment of calculi in the proximal duct or gland parenchyma. Over the last 10 years several new minimally invasive techniques including lithotripsy, sialendoscope were introduced in the treatment of sialolithiasis. But these have some limitation on large, infected calculi. The aim of this study is to assess the intraoral treatment of submadibular stones. Subjects and Method : The records of one hundred and seventy-three patients who underwent intraoral removal of submadibular sialolithiasis between June 1, 1989 and July 31, 2006 were retrospectively reviewed. Results : Stone location was distal to the edge of the mylohyoid muscle in 127 patients and proximal to gland in 48 patients (mean size of sialoliths, 7.1mm [range 3.0-25mm]). The complete removal of stones was observed in 170 (97.1%) patients regardless of size and location. Recurrence of lithiasis was found in 8 patients (then treated with intraoral removal in 5 patientsand resection of SMG (submandibular glands) in 3 patients). Acalculous sialadenitis in 9 patients (5.1%) and cyst formation in 2 patients (1.1%) was found. But no evidence of postoperative complications including hemorrhage, fistula, damage to lingual nerve were found. Conclusion : The intraoral removal of submandibular stone is useful in preservation of submandiblar function and effective in palpable stones regardless of location, size.

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Surgical Treatment of the Fifth Metatarsal Base Fracture Using Multiple Kirschner Wires (다발성 Kirschner 강선을 이용한 제 5중족골 기저부 골절의 수술적 치료)

  • Kim, Jihyeung;Kim, Jang Woo;Lee, Jeong Ik;Kim, Sang Kil;Rhee, Seung Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.24-28
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    • 2014
  • Purpose: The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires (K-wires) for the fifth metatarsal base fracture. Materials and Methods: We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distance of fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visual analog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) mid-foot score at six months postoperatively. Results: In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bony union in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantly decreased after surgery. The average AOFAS score was 95 at six months postoperatively. Conclusion: Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a K-wire into the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.

Treatment of Intraoperative Thrombosis and Spasm in Free Tissue Transfers Using the Fogarty Catheter (포가티 카테터를 이용한 유리조직 전이술 시 수술 중 혈전 및 연축의 치료)

  • Lee, Seung Ryul;Yun, Young Mook;Oh, Sang-Ha
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.159-164
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    • 2008
  • Purpose: Microvascular free tissue transfer has become a reliable technique for the reconstruction of complex wounds. Occasionally, unexpected intraoperative thrombosis and/or spasm of recipient artery might be annoying problems even for the technically competent microvascular surgeons. If such problems are not treated properly, they will inevitably cause to flap failure. Methods: From January 2006 to February 2007, soft tissue reconstructions by free tissue transfers were performed on 21 patients having complex defects in the lower extremity. Although segmental revision and various pharmacologic agents were repeatedly applied, arterial occlusions were not managed in 6 cases. For removal of thrombi and release of spasm, Fogarty No. 2 or No. 3 catheters were inserted into the lumen to the proximal recipient artery. Its balloon was then inflated after passing through a resistant area. Next, the catheter was gently withdrawn backward. Results: After the Fogarty catheter was inserted two or three times, the pulsatile arterial flow was restored. When the catheter was inserted into the lumen, a feeling of resistance existed in a 5-10cm more proximal portion that could not be easily accessed from the vascular end. After the reestablishment of blood flow, successful anastomoses were achieved and immediate rethrombosis or spasm did not occur. No long-term sequelae associated with balloon trauma to the arterial wall were observed. Conclusion: The use of the Fogarty catheter can be an effective method in treating pedicle thrombosis and spasm. This is a very simple and rapid technique that offers microvascular surgeons another option to increase the success rate of microvascular anastomosis in free tissue transfers.

Iatrogenic Large Esophageal Perforation Caused by Sengstaken-Blackmore Tube (식도 정맥류 출현 환자에서 Sengataken-Blackmore관에 의한 의인성 거대 흉부식도 파열)

  • 윤영철;조광현;권영민;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.51-54
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    • 2003
  • This patient was an 53-year-old man who had undergone Sengstaken-Blackmore tube insertion for esophageal varix bleeding. Two days after Sengstaken-Blackmore tube insertion, he developed severe left hemothorax and was transferred to our hospital. The esophagoscopic findings revealed a large perforation lengthening 8-cm in the intrathoracic esophagus. A left thoracotomy was performed 33 days after the injury due to repeated varix bleedings and poor conditions. An 8-cm longitudinal perforation of the intrathoracic esophagus with gross suppurative empyema was found. Primary repair and esophageal exclusion was performed 2cm proximal and distal to the perforation, using rows of nonabsorbable staplers(TA stapler 60 $\times$ 4.8) and large bore thoracostomy tubes were placed for local drainage. Six days after intrathoracic esophageal exclusion, an esophagogram revealed a leakage at just above the proximal stapling site. A cervical esophageal exclusion was performed using the same method. One hundred thirty seven days after exclusion operation for the intra-thoracic esophageal perforation, the patient was able to eat per orally without any secondary esophageal reconstructive surgery.

The effects that massage has on a hypertensive's blood pressure (마사지 요법이 고혈압 환자의 혈압에 미치는 영향)

  • Kim, Jang-Woo;Sea, Hyun-Kyu;Park, Youn-Ki
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.9 no.2
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    • pp.47-58
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    • 2003
  • To closely examine the effects of the massage treatment as one method of curing hypertension by exploring the effects that one-time circulation-centered massage has on a hypertensive's blood pressure, this study selected as the subject ten among fifty-year-old essential hypertensives visiting N clinic, and measured and compared their blood pressures before and after I gave them massage. After stabilizing them, I measured their blood pressures. In their prone and supine postures, I gave them rubbing massage for twenty minutes from positions proximal to their hearts to ones distal from their hearts to help their artery circulation and circulation-centered stroking massage for ten minutes from positions distal from their hearts to ones proximal to their hearts to help their vein circulation. After the massage, I had them rest for five minutes and measured their blood pressures. Regarding each item analyzed, I calculated the mean and standard deviation before and after the massage. The difference before and after the massage was tested by corresponding t-test and the level of significance was made p<0.05. The findings are as follows. First, systolic pressure was $157.70{\pm}7.48$ before the massage and $143.00{\pm}9.39$, which is less than before the massage, after the massage, showing statistically significant difference (p<.05). Secondly, diastolic pressure was $97.80{\pm}6.56$before the massage and $95.20{\pm}5.18$, which is less than before the massage, after the massage, not showing statistically significant difference (p<.05).

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The Impact of Dynamic Geometry Software on High School Students' Problem Solving of the Conic Sections (동적기하가 원뿔곡선 문제 해결에 미치는 영향)

  • Hong, Seong-Kowan;Park, Cheol-Ho
    • The Mathematical Education
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    • v.46 no.3
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    • pp.331-349
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    • 2007
  • This study aims to improve the teaching and learning method on the conic sections. To do that the researcher analyzed the impact of dynamic geometry software on students' problem solving of the conic sections. Students often say, "I have solved this kind of problem and remember hearing the problem solving process of it before." But they often are not able to resolve the question. Previous studies suggest that one of the reasons can be students' tendency to approach the conic sections only using algebra or analytic geometry without the geometric principle. So the researcher conducted instructions based on the geometric and historico-genetic principle on the conic sections using dynamic geometry software. The instructions were intended to find out if the experimental, intuitional, mathematic problem solving is necessary for the deductive process of solving geometric problems. To achieve the purpose of this study, the researcher video taped the instruction process and converted it to digital using the computer. What students' had said and discussed with the teacher during the classes was checked and their behavior was analyzed. That analysis was based on Branford's perspective, which included three different stage of proof; experimental, intuitive, and mathematical. The researcher got the following conclusions from this study. Firstly, students preferred their own manipulation or reconstruction to deductive mathematical explanation or proving of the problem. And they showed tendency to consider it as the mathematical truth when the problem is dealt with by their own manipulation. Secondly, the manipulation environment of dynamic geometry software help students correct their mathematical misconception, which result from their cognitive obstacles, and get correct ones. Thirdly, by using dynamic geometry software the teacher could help reduce the 'zone of proximal development' of Vigotsky.

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