• Title/Summary/Keyword: proximal method

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Effect of Electromagnetic Navigated Ventriculoperitoneal Shunt Placement on Failure Rates

  • Jung, Nayoung;Kim, Dongwon
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.150-154
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    • 2013
  • Objective : To evaluate the effect of electromagnetic (EM) navigation system on ventriculoperitoneal (VP) shunt failure rate through comparing the result of standard shunt placement. Methods : All patients undergoing VP shunt from October 2007 to September 2010 were included in this retrospective study. The first group received shunt surgery using EM navigation. The second group had catheters inserted using manual method with anatomical landmark. The relationship between proximal catheter position and shunt revision rate was evaluated using postoperative computed tomography by a 3-point scale. 1) Grade I; optimal position free-floating in cerebrospinal fluid, 2) Grade II; touching choroid or ventricular wall, 3) Grade III; tip within parenchyma. Results : A total of 72 patients were participated, 27 with EM navigated shunts and 45 with standard shunts. Grade I was found in 25 patients from group 1 and 32 patients from group 2. Only 2 patients without use of navigation belonged to grade III. Proximal obstruction took place 7% in grade I, 15% in grade II and 100% in grade III. Shunt revision occurred in 11% of group 1 and 31% of group 2. Compared in terms of proximal catheter position, there was growing trend of revision rate according to increase of grade on each group. Although infection rate was similar between both groups, the result had no statistical meaning (p=0.905, chi-square test). Conclusion : The use of EM navigation in routine shunt surgery can eliminate poor shunt placement resulting in a dramatic reduction in failure rates.

A study of learning attitude and problem-solving abilities of middle school students in consideration of the Zone of Proximal Development at after school class (방과 후 수업에서 근접발달영역을 고려한 수업이 학습태도와 문제해결력에 미치는 영향 연구 - 중학교 1학년 함수를 중심으로 -)

  • Lee, Joong-Kwoen;Kang, Ka-Young
    • Journal of the Korean School Mathematics Society
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    • v.14 no.4
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    • pp.519-538
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    • 2011
  • The purpose of this study is to test whether the teaching method with the Zone of Proximal Development (ZPD) proposed by Vygotsky can be more effective at learning attitudes and problem-solving abilities in the middle school's after school class. This study find that there is meaningful difference between before and after learning attitudes and problem-solving abilities of control group students. This results accord closely with expected of after school as mentioned earlier.

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Reconstruction of Metaphyseal Defect of Large Long Tubular Bone with Double Barreled Fibular Graft (중첩한 비골 이식술을 이용한 대형 장골의 골 간단부 결손의 재건)

  • Chung, Duke-Whan;Park, Jun-Young
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.50-56
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    • 2005
  • There are limited treatment options in the reconstruction of the very large defect in the metaphyseal portion of distal femur and proximal tibia. Fibula is one of the most popular donor of the long bone reconstruction in reconstructive microsurgical field. It has many advantages such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter and long pedicle. There are limited donor site problems such as transient peroneal nerve dysfunction. In those situations with the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transferred. We performed 7 cases of "doule barrel" fibular transplantation on the metaphyseal portion of distal femur and proximal tibial large defects in which it is very difficult to fill the bony gap with conventional bone graft or callotasis methods. It takes averaged 8.3 months since that procedure to obtain bony union. After solid union of the transferred double barrelled fibular graft. There were no stress fracture in our series. So we can propose double barrel fibular graft is useful method in those cases with very large bone defect on the metaphysis of large long bone.

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Management of Proximal Iliac Artery Injury during Lumbar Discectomy with Stent Graft

  • Jin, Sung-Cheol;Park, Sang-Woo;Cho, Do-Sang
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.227-229
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    • 2012
  • Iatrogenic vascular injuries during lumbar disc surgery may occur rarely but they are serious complications, which can be fatal without appropriate management Prompt diagnosis and management of these complications are imperative to prevent a desperate outcome. A 72-year-Old female with proximal left common iliac artery iatrogenic injury during lumbar discectomy was successfully treated by percutaneous deployment of a stent graft in an emergency setting. Postprocedural angiogram demonstrated complete exclusion of the iliac artery laceration. The patient became hemodynamically stable. Two weeks later she complained of vascular claudication. Follow-up angiography revealed decreased arterial flow in the opposite common iliac artery. An additional kissing stent was inserted into the right common iliac artery and the symptoms of vascular claudication disappeared. Endovascular stenting offers a safe and effective method for the treatment of an iatrogenic arterial laceration, particularly in a critical condition. But, the contralateral iliac arterial flow should be kept intact in case of proximal iliac artery injury. Otherwise, additional treatments may be needed.

An immunohistochemical study of endocrine cells in the alimentary tract of the snake, Rhabdophis tigrinus tigrinus

  • Lee, Jae-hyun;Ku, Sae-kwang;Lee, Hyeung-sik
    • Korean Journal of Veterinary Research
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    • v.39 no.4
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    • pp.689-697
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    • 1999
  • The regional distribution and relative frequency of endocrine cells in the alimentary tract of the snake, Rhabdophis tigrinus tigrinus, were investigated by immunohistochemical method using 7 antisera. Chromogranin (Cg)-, glucagon-, somatostatin-, gastrin/cholecystokinin (Gas/CCK)-, serotonin-, bovine pancreatic polypeptide (BPP)-immunoreactive cells were identified in this study. Cg-immunoreactive cells were detected throughout the alimentary tract including the esophagus, with predominant frequency in the pylorus. Numerous immunoreactive cells were observed from the esophagus to the pylorus but a few cells were detected in the large intestine. Glucagon-immunoreactive cells were observed from the proximal portions to the distal portions of the small intestine. They were increased to the middle portions but thereafter decreased, and no cells were found in the terminal portions. Somatostatin-immunoreactive cells were restricted to the small intestine and these cells were decreased toward to distal portions of the small intestine. Gas/CCK-immunoreactive cells were detected in the pylorus and small intestine. They were most predominant in the pylorus and the proximal portions of the small intestine but thereafter decreased toward to the distal regions. Serotonin-immunoreactive cells were observed throughout the alimentary tract. They were most predominant in the pylorus and proximal portions of the small intestine but a few cells were observed in the large intestine. BPP-immunoreactive cells were restricted to the distal portions of the small intestine with rare frequency. No bombesin-immunoreactive cells were found in this study.

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Splinted and non-splinted implant-supported restorations : prosthetic considerations for restoring multiple adjacent teeth (Splinted or Non-splinted: 다수의 인접한 치아 결손부 수복을 위한 임플란트 보철)

  • Yoon, Hyung-In
    • The Journal of the Korean dental association
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    • v.54 no.3
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    • pp.198-205
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    • 2016
  • The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

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Operative Treatment with Locking Compression Plate (LCP) in Proximal Humerus Fracture (잠김 압박 금속판을 이용한 상완골 근위부 골절의 치료)

  • Ha, Sung-Sik;Kim, Jae-Young;Hong, Ki-Do;Sim, Jae-Chun;Kang, Jung-Ho;Park, Kwang-Hee
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.137-142
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    • 2008
  • Purpose: To evaluate the clinical and radiographic results of the treatment of a proximal humerus fracture with a locking compression plate(LCP). Materials and Methods: This study reviewed the results of 24 cases of a proximal humerus fracture treated with a LCP from January 2005 to April 2007, after a follow up of more than 12 months. There were 8 males and 16 females with a mean age of 68.9(33-90) years. The clinical results were evaluated using the Neer's evaluation criteria, and the radiographic results were evaluated using the bone union time and Paavoleinen method. Results: The mean time for bone union was 11.9 weeks. Using the Neer's functional evaluation, 21 cases of the 24 patients (87%) showed excellent or satisfactory results. Twenty two cases (91%) showed good results according to the Paavoleinen method. The complications encountered were metal failure (1 patient), AVN of the humeral head (1 patient) and joint stiffness (1 patient). Conclusion: The LCP demonstrated good results in the treatment of a proximal humerus fracture and has relatively fewer complications than other internal fixators.

A Promising Method for Tumor Localization during Total Laparoscopic Distal Gastrectomy: Preoperative Endoscopic Clipping based on Negative Biopsy and Selective Intraoperative Radiography Findings

  • Chung, Joo Weon;Seo, Kyung Won;Jung, Kyoungwon;Park, Moo In;Kim, Sung Eun;Park, Seun Ja;Lee, Sang Ho;Shin, Yeon Myung
    • Journal of Gastric Cancer
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    • v.17 no.3
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    • pp.220-227
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    • 2017
  • Purpose: Precise localization of tumors and creation of sufficient proximal resection margins are complicated processes during total laparoscopic distal gastrectomy (TLDG) for clinical T1/T2 gastric cancers. Various solutions to this problem have also yielded many disadvantages. In this study, we reviewed a preoperative endoscopic clipping method based on the results of negative biopsy and selective intraoperative radiography. Materials and Methods: A retrospective review of 345 consecutive patients who underwent TLDG and preoperative endoscopic clipping for tumor localization was conducted. During preoperative endoscopy, the endoscopists performed negative biopsies just 1-2 cm selectively above the tumor's upper limit. After confirming the biopsy results, endoscopic metal clips were applied just proximal to the negative biopsy site the day before surgery. Selective intraoperative tumor localization using portable abdominal radiography was performed only when we could not ensure a precise resection line. Results: Negative biopsy was performed in 244 patients. Larger tumor size (P=0.008) and more distally located tumors (P=0.052) were observed more frequently in the negative biopsy group than in the non-negative biopsy group. The non-negative biopsy group had significantly higher frequencies of differentiated tumor types than the negative biopsy group (P=0.003). Of the 244 patients who underwent negative biopsies, 6 had cancer cells in their biopsy specimens. We performed intraoperative radiography in 12 patients whose tumors had difficult-to-determine proximal margins. No tumors were found in the proximal resection margins of any patients. Conclusions: Our tumor localization method is a promising and accurate method for securing a sufficient resection margin during TLDG.

SQUARE QUADRATIC PROXIMAL METHOD FOR NONLINEAR COMPLIMENTARITY PROBLEMS

  • Bnouhachem, Abdellah;Ou-yassine, Ali
    • Communications of the Korean Mathematical Society
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    • v.34 no.2
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    • pp.671-684
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    • 2019
  • In this paper, we propose a new interior point method for solving nonlinear complementarity problems. In this method, we use a new profitable searching direction and instead of using the logarithmic quadratic term, we use a square root quadratic term. We prove the global convergence of the proposed method under the assumption that F is monotone. Some preliminary computational results are given to illustrate the efficiency of the proposed method.

Clinical and Histological Indicators of Proximal and Distal Gastric Cancer in Eight Provinces of Iran

  • Norouzinia, M.;Asadzadeh, H.;Shalmani, H. Mohaghegh;Al Dulaimi, D.;Zali, M.R.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5677-5679
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    • 2012
  • Background and Aim: Gastric cancer is the second most common cancer worldwide. In this study the clinical and histological features of gastric cancer in the cardia and distal stomach were evaluated. Method: Proximal and distal gastric cancer diagnosed and treated in eight provinces of Iran from 2010-2011 were reviewed in all collected cases. The age standardized incident rates were calculated and tumor location and histological type were recorded. Results: The age-standardized incidence rate for the eight centers was 40.6 per 100,000 populations per year with an upper and lower range of 22.1 and 102.4 per 100,000 population per year. Thirty four percent of the tumors were located in the cardia, 3% in fundus, and 63% in the distal stomach. In 7 provinces the prevalence of distal tumors was significantly greater than proximal tumors (p=0.006). A significant relationship was observed between diffuse form of gastric cancer and distal gastric tumors (p=0.007) and between poor tumor differentiation and distal gastric tumors (p<0.001). Conclusions: the result of this study shows that distal gastric cancer is more common than proximal gastric cancer in Iran.