• Title/Summary/Keyword: repair technique

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Locking horizontal mattress suture as the alternative closure method for scalp lacerations difficult to suture with staple (두피 봉합기로 봉합하기 어려운 두피 열상에 시행한 잠금 수평 매트리스 봉합법의 유용성 관찰 연구)

  • Sah, Seung Woo;Seol, Seunghwan;Lee, Woon Jeong;Woo, Seon Hee;Kim, Dae Hee;Lee, June Young;In, Sangkook;Kim, Bonggyeom
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.649-655
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    • 2018
  • Objective: This paper reports the possibility of using of a locking horizontal mattress suture technique in repairing lacerations that are difficult to suture with staples. Methods: Data were collected retrospectively over a 6-month period regarding the routine repair of scalp lacerations: those in areas injured by a high energy blunt mechanism, continued to bleed after pressure, nonlinear or damaged skin repaired with a locking horizontal mattress technique, and simple interrupted technique. The effects of the two techniques used to repair scalp lacerations on wound healing, complication rate, and patient satisfaction were examined. The categorical variables are expressed as the number and percent. A Mann-Whitney-Wilcoxon test was used for statistical analysis. A P-value less than 0.05 was considered significant. Results: Thirty-seven consecutive patients with scalp lacerations presented for care. Wound closure was accomplished with the locking horizontal mattress sutures in 40.5% (n=15) (median length, 5.0 cm; interquartile range [IQR], 4.0-7.0 cm). Simple interrupted sutures (median length, 4 cm; IQR, 3.0-5.0 cm) were used in 59.5% (n=22) (P=0.015). The frequency of additional bandage compression (P=0.008), frequency of exudative hemorrhage (P=0.018), and suture mark frequency at suture removal (P=0.047) were significantly lower in the locking horizontal mattress group. Conclusion: The locking horizontal mattress suture, which has the advantage of a horizontal mattress suture, may be one of the ways that can be used alternatively to treat scalp lacerations that difficult to suture with staples.

Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

  • Troy Li;Kenneth H. Levy;Akiro H. Duey;Akshar V. Patel;Christopher A. White;Carl M. Cirino;Alexis Williams;Kathryn Whitelaw;Dave Shukla;Bradford O. Parsons;Evan L. Flatow;Paul J. Cagle
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.245-251
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    • 2023
  • Background: For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair. Methods: This study retrospectively analyzed 169 shoulders that required primary anatomic total shoulder arthroplasty (aTSA). Shoulders were stratified by humeral stem fixation technique: cementation or press-fit. Data were collected pre- and postoperatively. Primary outcome measures included range of motion, patient reported outcomes, and radiographic measures. Results: One hundred thirty-eight cemented humeral stems and 31 press-fit stems were included. Significant improvements in range of motion were seen in all aTSA patients with no significant differences between final cemented and press-fit stems (forward elevation: P=0.12, external rotation: P=0.60, and internal rotation: P=0.77). Patient reported outcome metrics also exhibited sustained improvement through final follow-up. However, at final follow-up, the press-fit stem cohort had significantly better overall scores when compared to the cemented cohort (visual analog score: P=0.04, American Shoulder and Elbow Surgeon Score: P<0.01, Simple Shoulder Test score: P=0.03). Humeral radiolucency was noted in two cemented implants and one press-fit implant. No significant differences in implant survival were observed between the two cohorts (P=0.75). Conclusions: In this series, we found that irrespective of humeral fixation technique, aTSA significantly improves shoulder function. However, within this cohort, press-fit stems provided significantly better outcomes than cemented stems in terms of patient reported outcome scores. Level of evidence: III.

Repair of a Post-infarction Ventricular Septal Defect and Left Ventricular Pseudoaneurysm Rupture by the "Sandwich Technique" - A case report - ("Sandwich Technique"을 이용한 심근경색 후 발생한 심실 중격 결손과 가성 좌심실류 파열의 수술 - 1예 보고 -)

  • Kim, Hyung-Tae;Kim, Wook-Sung;Park, Pyo-Won;Lee, Young-Tak;Sung, Ki-Ick;Lee, Mi-Na
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.516-519
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    • 2009
  • Ventricular septal defect (VSD) complicating an acute myocardial infarction is rather uncommon. However, the outcomes after the development of a VSD are poor with an in-hospital mortality of more than 90% for the medically treated patients. To prevent the recurrence of VSD, many techniques have been reported on for the closure of a postinfarction VSD. In this. report, we present a case of a patient who had a postinfarction VSD due to Prinzmetai's variant angina, and the rupture of the pseudoaneurysm of the left ventricle was successfully treated by the "Sandwich technique".

Bioglue-Coated Teflon Sling Technique in Microvascular Decompression for Hemifacial Spasm Involving the Vertebral Artery

  • Lee, Seong Ho;Park, Jae Sung;Ahn, Young Hwan
    • Journal of Korean Neurosurgical Society
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    • v.59 no.5
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    • pp.505-511
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    • 2016
  • Objective : Microvascular decompression (MVD) for hemifacial spasm (HFS) involving the vertebral artery (VA) can be technically challenging. We investigated the therapeutic effects of a bioglue-coated Teflon sling technique on the VA during MVD in 42 cases. Methods : A bioglue-coated Teflon sling was crafted by the surgeon and applied to patients in whom neurovascular compression was caused by the VA. The radiologic data, intra-operative findings with detailed introduction of the procedure, and the clinical outcomes of each patient were reviewed and analyzed. Results : The 42 patients included in the analysis consisted of 22 females and 20 males, with an average follow-up duration of 76 months (range 24-132 months). Intraoperative investigation revealed that an artery other than the VA was responsible for the neurovascular compression in all cases : posterior inferior cerebellar artery (PICA) in 23 patients (54.7%) and anterior inferior cerebellar artery (AICA) in 11 patients (26.2%). All patients became symptom-free after MVD. Neither recurrence nor postoperative neurological deficit was noted during the 2-year follow-up, except in one patient who developed permanent deafness. Cerebrospinal fluid (CSF) leak occurred in three patients, and one required dural repair. Conclusion : Transposition of the VA using a bioglue-coated Teflon sling is a safe and effective surgical technique for HFS involving the VA. A future prospective study to compare clinical outcomes between groups with and without use of this novel technique is required.

Subclavian Portal Approach for Isolated Subscapularis Tendon Tear - Technical Note - (견갑하 건 단독 파열에 대한 쇄골하 삽입구를 이용한 봉합술 - 술기보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Kim, Se-Sik
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.221-225
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    • 2009
  • Purpose: For an isolated tear of the subscapularis tendon, the presented technique using a subclavian portal provides both a good angle for anchor placement and sufficient space for managing the upper portion of a subscapularis tendon tear. Materials and Methods: The conventional method needs 2 additional portals for traction, debriding the footprint and anchor fixation for repair. The presented technique requires only an anterior portal for suture management and a subclavian portal without cannula for suture anchoring and placement of suture hooks. Results: The two suture limbs of the anchor can be placed on the subscapularis tendon by the switching technique and these limbs are repaired sequentially. Conclusion: This technique is simple and reproducible and it can be applied to partial tears and minimally retracted subscapularis tears.

Anatomic reconstruction for acromioclavicular joint injuries: a pilot study of a cost-effective new technique

  • Pattu, Radhakrishnan;Chellamuthu, Girinivasan;Sellappan, Kumar;Kamalanathan, Chendrayan
    • Clinics in Shoulder and Elbow
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    • v.24 no.4
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    • pp.209-214
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    • 2021
  • Background: The treatment for acromioclavicular joint injuries (ACJI) ranges from a conservative approach to extensive surgical reconstruction, and the decision on how to manage these injuries depends on the grade of acromioclavicular (AC) joint separation, resources, and skill availability. After a thorough review of the literature, the researchers adopted a simple cost-effective technique of AC joint reconstruction for acute ACJI requiring surgery. Methods: This was a prospective single-center study conducted between April 2017 and April 2018. For patients with acute ACJI more than Rockwood grade 3, the researchers performed open coracoclavicular ligament reconstruction using synthetic sutures along with an Endobutton and a figure of 8 button plate. This was followed by AC ligament repair augmenting it with temporary percutaneous AC K-wires. Clinical outcomes were evaluated using the Constant Murley shoulder score. Results: Seventeen patients underwent surgery. The immediate postoperative radiograph showed an anatomical reduction of the AC joint dislocation in all patients. During follow-up, one patient developed subluxation but was asymptomatic. The mean follow-up period was 30 months (range, 24-35 months). The mean Constant score at 24 months was 95. No AC joint degeneration was noted in follow-up X-rays. The follow-up X-rays showed significant infra-clavicular calcification in 11 of the 17 patients, which was an evidence of a healed coracoclavicular ligament post-surgery. Conclusions: This study presents a simple cost-effective technique with a short learning curve for anatomic reconstruction of acute ACJI. The preliminary results have been very encouraging.

A Clustering Method Considering the Threshold of Energy Consumption Model in Wireless Sensor Networks (무선 센서 네트워크에서 에너지 소모 모델의 임계값을 고려한 클러스터링 기법)

  • Kim, Jin-Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.10
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    • pp.3950-3957
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    • 2010
  • Wireless sensor network is composed of sensor node with limited sources, and to maintain and repair is vexatious once made up. Accordingly it is important matter to maximize the network lifetime by minimizing the energy consumption in wireless sensor network, and utilizing the limited sources efficiently. In this paper, I propose a technique arranging the cluster number with efficiency in clustering method to optimize the energy consumption. The energy usage needed for wireless transmission varies in distance(threshold). This technique reduces the energy consumption considering the threshold when arranging the cluster number. I verify that the clustering method organized through the valid processes outperform the LEACH(Low-Energy Adaptive Clustering Hierarchy) in total energy consumption.

Effectiveness of seismic repairing stages with CFRPs on the seismic performance of damaged RC frames

  • Duran, Burak;Tunaboyu, Onur;Kaplan, Onur;Avsar, Ozgur
    • Structural Engineering and Mechanics
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    • v.67 no.3
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    • pp.233-244
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    • 2018
  • This study aims at evaluating the performance of repairing technique with CFRPs in recovering cyclic performance of damaged columns in flexure in terms of structural response parameters such as strength, dissipated energy, stiffness degradation. A 2/3 scaled substandard reinforced concrete frame was constructed to represent the substandard RC buildings especially in developing countries. These substandard buildings have several structural deficiencies such as strong beam-weak column phenomenon, improper reinforcement detailing and poor material properties. Flexural plastic hinges occurred at the columns ends after testing the substandard specimen under both constant axial load and reversed cyclic lateral loading. Afterwards, the damaged columns were externally wrapped with CFRP sheets both in transverse and longitudinal directions and then retested under the same loading protocol. In addition, ambient vibration measurements were taken from the undamaged, damaged and the repaired specimens at each structural repair steps to identify the effectiveness of each repairing step by monitoring the change in the natural frequencies of the tested specimen. The ambient vibration test results showed that the applied repairing technique with external CFRP wrapping was proved to recover stiffness of the pre-damaged specimen. Moreover, the lateral load capacity of the pre-damaged substandard RC frame was restored with externally bonded CFRP sheets.

Advanced Indentation Studies on the Effects of Hydrogen Attack on Tensile Property Degradation of Heat-Resistant Steel Heat-Affected Zones

  • Choi, Yeol;Jang, Jae-il;Lee, Yun-Hee;Kwon, Dongil;Kim, Jeong-Tae
    • Corrosion Science and Technology
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    • v.2 no.6
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    • pp.266-271
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    • 2003
  • Safety diagnosis of various structural components and facilities is indispensable for preventing catastrophic failure of material by time-dependent and environment accelerating degradation. Also, this diagnosis of operating components should be done periodically for safe maintenance and economical repair. However, conventional standard methods for mechanical properties have the problems of bulky specimen, destructive procedure and complex procedure of specimen sampling. So, a non-destructive and simple mechanical testing method using small specimen is needed. Therefore, an advanced indentation technique was developed as a potential method for non-destructive testing of in-field structures. This technique measures indentation load-depth curve during indentation and analyzes the mechanical properties related to deformation such as yield strength, tensile strength and work-hardening index. In this paper, we characterized the tensile properties including yield and tensile strengths of the V-modified Cr-Mo steels in petro-chemical and thermo-electrical plants. And also, the effects of hydrogen-assisted degradation of the V-modified Cr-Mo steels were analyzed in terms of work-hardening index and yield ratio.

Arthroscopic Capsular Repair without Relaying Sutures: 'Simple Sewing Technique'

  • Kim, Hyungsuk;Song, Hyun Seok;Kang, Seung Gu;Han, Sung Bin
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.146-148
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    • 2019
  • We report a simple technique for repairing capsular tear, using only a hook-like, cannulated instrument and braided sutures without relaying steps. A No. 2 braided suture is passed through the lumen of the instrument. Under direct arthroscopic view, the tip of the instrument is passed through the side of the capsule that has previously been separated with the probe. One end of the suture is retrieved with a grasper through a separate portal. The tip is moved back without withdrawing through the skin, and reinserted into the other side of the capsule. Holding the end retrieved earlier, the other end of the suture is retrieved with a suture retriever. After complete removal of the instrument, the suture is tied through a cannula using the standard knot tying techniques. The same procedures are repeated for other required knots.