• Title/Summary/Keyword: repair technique

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Early Results of the Nuss Procedure (Nuss 술식의 조기 결과)

  • 박경택;김기봉;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.472-476
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    • 2001
  • Background: Minimally invasive surgery of pectus excavatum by Dr. Nuss is a new technique that allows the repair of this deformity without any cartilage resection or sternal osteotomy We describe the early experiences with Nuss procedure. Material and Method: From December 1999 to January 2001, twenty patients with pectus excavatum underwent repair by Nuss procedure There were 14 males and 6 females whose mean age was 10.1$\pm$7.7 years, ranging from 1 to 33 years. Most patients(N=19) were below 20 years, except 33 years old female patient(N=1). Result: The severity of depression was assessed by computed topography(CT). CT index was mean 4.9$\pm$5.7(ranged from 3.3 to 8). The average operating time was 85.8$\pm$23.7 minutes. The used metal bars were ranged in length from 8 inches to 16 inches(average 11.8$\pm$14.4 inches). Early postoperative complications were pneumothorax in three patients, paralytic ileus in one, and postoperative chest pain requiring analgesics in all patients. Epidural analgesia was used in one adult patient for control of postoperative pain. In our experiences, there were no serious complications posteoperatively. Conclusion: There were good early results with the Nuss procedure that we performed for repairing of pectus excavatum. However, we believe the procedure needs to be observed for the long term results for it to be broadly accepted.

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Casting and Soldering Techniques of the Bronze Buddhist Gong from the Sudasa Temple Site in Suhang-ri, Pyeongchang (평창 수다사지 청동금고 주조기법과 보수 방식)

  • Huh, Ilkwon;Ahn, Songyee;Yun, Eunyoung
    • Conservation Science in Museum
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    • v.15
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    • pp.4-25
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    • 2014
  • Chuncheon National Museum currently own a bronze Buddhist gong that was discovered in 1987 at the Sudasa Temple site of in Suhangri, Pyeongchang. Significantly, showing many casting defects and areas where was repaired, the Gong offered crucial information about the casting technique. To better understand the production technique, scientific analysis was conducted on various aspects of the gong, including its materials, moulds, chaplets, and defects. Composition analysis revealed that the gong was composed primarily of copper 71.6wt%, tin 18.2wt%, and lead 7.2wt%, along with about 1wt% of both arsenic and antimony. The lead content of the chaplets was higher than that of the gong, and the lead content was the highest in the solder, which was used to fill holes after casting. Surface analysis, based on the parting line, indicated that the gong was most likely produced with the sand casting process. Radiography and close examination of the surface disclosed various casting defects e.g., Cold Shut, Surface Folds, Misrun, and Blowholes Adjacent to Chaplets and their possible causes. The casting defects of a few holes were filled with soft solder.

PERIPHERAL NERVE REGENERATION USING A THREE-DIMENSIONALLY CULTURED SCHWANN CELL CONDUIT (삼차원 배양된 슈반세포 도관을 이용한 말초 신경 재생)

  • Kim, Soung-Min;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.1-16
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    • 2004
  • The use of artificial nerve conduit containing viable Schwann cells is one of the most promising strategies to repair the peripheral nerve injury. To fabricate an effective nerve conduit whose microstructure and internal environment are more favorable in the nerve regeneration than existing ones, a new three-dimensional Schwann cell culture technique using $Matrigel^{(R)}$. and dorsal root ganglion (DRG) was developed. Nerve conduit of three-dimensionally arranged Schwann cells was fabricated using direct seeding of freshly harvested DRG into a $Matrigel^{(R)}$ filled silicone tube (I.D. 1.98 mm, 14 mm length) and in vitro rafting culture for 2 weeks. The nerve regeneration efficacy of three-dimensionally cultured Schwann cell conduit (3D conduit group, n=6) was assessed using SD rat sciatic nerve defect of 10 mm, and compared with that of silicone conduit filled with $Matrigel^{(R)}$ and Schwann cells prepared from the conventional plain culture method (2D conduit group, n=6). After 12 weeks, sciatic function was evaluated with sciatic function index (SFI) and gait analysis, and histomorphology of nerve conduit and the innervated tissues of sciatic nerve were examined using image analyzer and electromicroscopic methods. The SFI and ankle stance angle (ASA) in the functional evaluation were $-60.1{\pm}13.9$, $37.9^{\circ}{\pm}5.4^{\circ}$ in 3D conduit group (n=5) and $-87.0{\pm}12.9$, $32.2^{\circ}{\pm}4.8^{\circ}$ in 2D conduit group (n=4), respectively. And the myelinated axon was $44.91%{\pm}0.13%$ in 3D conduit group and $13.05%{\pm}1.95%$ in 2D conduit group to the sham group. In the TEM study, 3D conduit group showed more abundant myelinated nerve fibers with well organized and thickened extracellular collagen than 2D conduit group, and gastrocnemius muscle and biceps femoris tendon in 3D conduit group were less atrophied and showed decreased fibrosis with less fatty infiltration than 2D conduit group. In conclusion, new three-dimensional Schwann cell culture technique was established, and nerve conduit fabricated using this technique showed much improved nerve regeneration capacity than the silicone tube filled with $Matrigel^{(R)}$ and Schwann cells prepared from the conventional plain culture method.

Application of Bicuspidalized Cryopreserved Allograft Valves for the RVOT Reconstruction in Complex Cardiac Anomalies (복잡 심장기형 환자에서 우심실 유출로 재건술시 이첨판화 냉동보전 동종이식편의 적용에 관한 연구)

  • 오삼세;지현근
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.270-274
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    • 1997
  • In recent years, the use of allograft conduits in repair of congenital cardiac disease is widely accepted. However, the supply of homograft. is currently limiting their increased clinical application, especially small cryopreserved homografts for use in neonates and inf'ants. We used a technique to surgically reduce the size of the more readily available large-diameter allografts, making them suitable for right ventricular outflow tract reconstruction in small infants and children. From December 1994 to March 1996, a total of 11 patients ranging in age from 10 months to 6 years (mean age, 27.3 months) and ranging in weight from 5.6 to 18.5 kg (mean 11.5 kg) underwent reconstruction of the right ventricular outflow tract using this surgical technique (pulmo ary atresia with ventricular septal defect, 9 cases ; tetralogy of Falloff, 2 cases). The diameter after downsizing ranged from 14 to 19 mm with a mean of 16.8 mm. There was one operative death due to rupture of the infected homograft. Evaluation of these patients between 2 and 15 months (mean 6.9 months) after homograft implantation reveals excellent clinical and echocardiographic results. There were no significant homograft insufficiency and RVOT obstructions. Although a longer follow-up is certainly required to evaluate the long term fate of the surgically modified bicuspid homografts, we believe that this technique may represent a valuable therapeutic alternative, at least in the short term, to the use of synthetic grafts when an appropriately sized homograft is not available.

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FLEXURE STRENGTH OF CAST-JOINED CONNECTOR WITH Ni-Cr-Be ALLOY (주조연결된 니켈-크롬-베릴리움 주조체의 굽힘강도에 관한 비교연구)

  • Jeong, Chang-Mo;Jeon, Young-Chan;Lim, Jang-Seop
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.6
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    • pp.858-866
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    • 1998
  • Soldering is the usual method used to correct an unstable fixed partial denture framework at patient's try-in; However, presoldering base metal alloys is technique-sensitve and results are unstable because it is difficult to maintain uniform heat distribution and to prevent oxidation of an alloy. A cast-joining technique has been developed by Weiss and Munyon for repair, correction and addition to base metal framework. This joining technique eliminates the problem with presoldering of non-precious frameworks. The object of this study was to 1) compare the relative flexure strength and the joining effectiveness of Ni-Cr-Be cast in two pieces and 'pre-soldered' versus in two pieces and 'cast-joined'. 2) determine the effect of increasing the number of retentive grooves on the face of the cast and 3) determine the effect of the relative matched position of groove patterns on flexure strength. The joining effectiveness can be expressed by the ratio of the mean flexure stress of soldered or cast-joined specimens to that of one-piece cast. Resin rods 3mm in diameter were used as pattern of specimens for one-piece casted, presoldered, and cast-joined groups. Cast-joined specimens had two different patterns of retentive grooves on the joined faces. Type A had cross-shaped grooves 1mm in depth. 0.6mm in width. Type B was the same except for the addition of one more retentive groove. In the experiment connecting cast-joined specimens, half of specimens with type A pattern had their patterns on the faces of paired casts matched with each other as mirror image. With the rest pairs, it was proceeded that one of paired casts turned 45 degrees so that the patterns crossed. Half of specimens with type B pattern also had the patterns matched as mirror image; However, here, one of paired casts turned 90 degrees with the other pairs. Retentive groove in this study lacked the intentional undercuts, in contrast with the suggestion of Weiss and Munyon. The specimens were subjected to four-point flexural loading in an Instron testing machine. The midspan flexural stress was calculated at the point of initial plastic strain as determined from a strip-chart recorder or at the point of failure if this occured at a lower stress level. Within the scope of this study, the following results were obtained. 1. The presoldered group showed flexural strength at least 2 times higher than the cast-joined groups. Its joining effectiveness was 82%. 2. In cast-joined groups, the flexural strength of joints with type B patterns exhibited 1.5 times that of joints with type A patterns. Joining effectivenesses were 38% for type B patterns, 25-26% for type A patterns. 3. The relative matched position of groove patterns did not have any significant effect on flexural strength of the cast-joined specimens with either type A patterns or type B patterns(p>.05).

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Surgical Treatment for Type 11 Distal Clavicle Fracture using Mersilene tape and K-wire (Mersilene tape와 K-강선을 이용한 제 II형 원위부 쇄골 골절의 수술적 치료)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Kang, Shin-Taek;Whang, Chan-Ha;Hong, Chang-Wha;Lee, Bum-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.123-128
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    • 2006
  • Purpose: Surgical reconstruction is usually indicated for type II distal clavicle fracture due to high rate of nonunion and delayed union. We report the clinical outcome of a surgical technique for type II distal clavicle fracture using Mersilen tape and K-wire. Materials and Methods: From 1999 through 2003, this technique has been used on 11 patients with type II distal clavicle fracture. The procedure consist of fracture reduction with a Mersilene tape, repair of torn coracoclavicular ligament, and K-wire fixation of the fracture fragment. All patients with at least 12 months of complete postoperative follow-up were included for functional and radiographic evaluation. We used simple X-ray and UCLA scoring system and constant scoring system for evaluation at last follow up in OPD. Results: Solid union of the fracture could be achieved at 11 weeks after operation in all patients. All patients could return to the same level of preinjury activity. Good and excellent results were obtained in all patients according to UCLA system. Conclusion: This technique was simple procedure and allowed for stable fixation with early mobilization and early return to work and sports.

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The Successful Application of Nuss Procedures with Modified Operative Technique (수술적 기법의 보완을 통한 성공적인 너스 술식의 적용(단일 기관 135명의 경험))

  • Kim Do-Mun;Shim Young-Mog;Kim Kwhan-Mien;Choi Yong-Soo;Kim Jhin-Gook
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.765-769
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    • 2006
  • Background: Nuss procedure is a minimally invasive technique for correcting the pectus excavatum. But there are some limitations of correcting the complex anomaly or grown-up patients. Material and Method: we retrospectively reviewed 135 consecutive patients who underwent repair of pectus excavatum by the Nuss procedure and its modifications between November 1999 and December 2004. We analyzed the computed tomography, age on operation, operative technique, and complications. Result: We operated 135 patients of pectus excavatum during 62 months. Total number of operations about Nuss procedure is 216, including bar removal procedure of 64 cases, redo Nuss procedures of 47 cases. We modified the point of bar insertion to the hinge point, made a shoulder in the bar to prevent a displacement. And then we changed the fixation material from Vicryl to steel wire. If the patients are old, we retract the sternum during bar rotation and fixation. Until 2002, the number of redo Nuss operations were 17, complications were 23. but, after modifications, the number of redo Nuss operation were 0, complications were 2. Conclusion: This result indicates that our modifications of Nuss operation is effective, and could decrease the number of redo Nuss operation and complications.

A New Technique of Angioplasty of the Left Pulmonary Artery Using an Autologous Main Pulmonary Artery Flap (활로 4징 환자에서 자가 주폐동맥 플랩을 이용한 새로운 좌폐동맥 성형술)

  • 이창하;전양빈;이택연;이석기;백만종;김수철;이영탁
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.255-260
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    • 2003
  • Background: Stenosis of the left pulmonary artery (LPA) after repair of tetralogy of Fallot (TOF) is troublesome. A new technique of LPA angioplasty using an autologous MPA flap was performed in patients with TOF Material and Method: From October 1998 to January 2001, 24 patients (median age; 10 months, range; 4 to 145 months) underwent total correction of TOF with LPA angioplasty using the autologous MPA flap. Five patients underwent pulmonary angioplasty without any patch over the MPA and LPA. The patches were required to enlarge only the MPA in 4 patients, and transannular RVOT widening was performed in 15. Result: There were no operative or late deaths. During follow-up (range: 6~42 months), reoperation for LPA stenosis was not required in any patients, but balloon angioplasty for branch pulmonary artery stenosis was performed in 3 patients. Echocardiography and CT angiography at the recent follow-up showed an obtuse angle between the MPA and LPA. Conclusion: Although further follow-up is needed, the angioplasty using the autologous MPA flap can be easily performed, avoiding patch-related complications, and allowing growth of the MPA flap. This angioplasty technique creates a more natural and obtuse angle between the MPA and LPA, which can minimize kinking of the LPA, especially in the patients who underwent transannular patch widening.

Deep learning algorithm of concrete spalling detection using focal loss and data augmentation (Focal loss와 데이터 증강 기법을 이용한 콘크리트 박락 탐지 심층 신경망 알고리즘)

  • Shim, Seungbo;Choi, Sang-Il;Kong, Suk-Min;Lee, Seong-Won
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.23 no.4
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    • pp.253-263
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    • 2021
  • Concrete structures are damaged by aging and external environmental factors. This type of damage is to appear in the form of cracks, to proceed in the form of spalling. Such concrete damage can act as the main cause of reducing the original design bearing capacity of the structure, and negatively affect the stability of the structure. If such damage continues, it may lead to a safety accident in the future, thus proper repair and reinforcement are required. To this end, an accurate and objective condition inspection of the structure must be performed, and for this inspection, a sensor technology capable of detecting damage area is required. For this reason, we propose a deep learning-based image processing algorithm that can detect spalling. To develop this, 298 spalling images were obtained, of which 253 images were used for training, and the remaining 45 images were used for testing. In addition, an improved loss function and data augmentation technique were applied to improve the detection performance. As a result, the detection performance of concrete spalling showed a mean intersection over union of 80.19%. In conclusion, we developed an algorithm to detect concrete spalling through a deep learning-based image processing technique, with an improved loss function and data augmentation technique. This technology is expected to be utilized for accurate inspection and diagnosis of structures in the future.

Deep-learning-based GPR Data Interpretation Technique for Detecting Cavities in Urban Roads (도심지 도로 지하공동 탐지를 위한 딥러닝 기반 GPR 자료 해석 기법)

  • Byunghoon, Choi;Sukjoon, Pyun;Woochang, Choi;Churl-hyun, Jo;Jinsung, Yoon
    • Geophysics and Geophysical Exploration
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    • v.25 no.4
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    • pp.189-200
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    • 2022
  • Ground subsidence on urban roads is a social issue that can lead to human and property damages. Therefore, it is crucial to detect underground cavities in advance and repair them. Underground cavity detection is mainly performed using ground penetrating radar (GPR) surveys. This process is time-consuming, as a massive amount of GPR data needs to be interpreted, and the results vary depending on the skills and subjectivity of experts. To address these problems, researchers have studied automation and quantification techniques for GPR data interpretation, and recent studies have focused on deep learning-based interpretation techniques. In this study, we described a hyperbolic event detection process based on deep learning for GPR data interpretation. To demonstrate this process, we implemented a series of algorithms introduced in the preexisting research step by step. First, a deep learning-based YOLOv3 object detection model was applied to automatically detect hyperbolic signals. Subsequently, only hyperbolic signals were extracted using the column-connection clustering (C3) algorithm. Finally, the horizontal locations of the underground cavities were determined using regression analysis. The hyperbolic event detection using the YOLOv3 object detection technique achieved 84% precision and a recall score of 92% based on AP50. The predicted horizontal locations of the four underground cavities were approximately 0.12 ~ 0.36 m away from their actual locations. Thus, we confirmed that the existing deep learning-based interpretation technique is reliable with regard to detecting the hyperbolic patterns indicating underground cavities.