• 제목/요약/키워드: technical reconstruction

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TransFix 경골부 고정을 이용한 경 경골 두 다발 후방십자인대 재건술 - 수술 술기 - (Transtibial Double Bundle PCL Reconstruction using TransFix Tibial Fixation - Technical Note -)

  • 이용석;정영복;안진환;강번중;신윤창;공제관
    • 대한관절경학회지
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    • 제10권2호
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    • pp.203-208
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    • 2006
  • 목적: 후방십자인대의 경 경골 두 다발 재건술에 있어서 기존의 방법들은 공여 인대가 길어야 하는 문제 때문에 이식건의 선택이 제한적인 경우가 많으며 경골부에서 이중의 고정을 해야 하는 문제점 등이 있다. 이에 저자들은 두 다발 재건술을 실시하면서 경골부에서 초기에 단일 고정으로써 안정성을 얻고, 공여 인대 길이에 제한을 덜 받는 방법을 소개하고자 한다. 수술 술기: 진단적 관절경 검사를 실시 한 후 두 다발 재건술을 위한 이식건을 준비하고, 경골 터널 및 TransFix 고정을 위한 준비를 한다. 대퇴부에 2개의 터널을 만들고, 이식건을 전 내측 입구를 이용하여 경골부, 대퇴부 순으로 통과시킨 후 TransFix를 이용하여 경골부에 고정을 먼저 실시하고, 대퇴부의 2 다발을 각각의 고정 위치에서 고정을 실시한다. 결론: 경경골 터널을 이용한 두 다발 후방십자인대 재건술에서 TransFix를 이용한 경골부의 고정은 단일 고정으로써 강한 고정을 제공하면서 이식건의 길이에 제한을 받지 않고, 전 내측 입구로 이식건을 통과시킴으로써 이식건의 손상을 방지할 수 있는 좋은 방법이라고 생각한다.

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Reconstruction of Pharyngolaryngeal Defects with the Ileocolon Free Flap: A Comprehensive Review and How to Optimize Outcomes

  • Escandon, Joseph M.;Santamaria, Eric;Prieto, Peter A.;Duarte-Bateman, Daniela;Ciudad, Pedro;Pencek, Megan;Langstein, Howard N.;Chen, Hung-Chi;Manrique, Oscar J.
    • Archives of Plastic Surgery
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    • 제49권3호
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    • pp.378-396
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    • 2022
  • Several reconstructive methods have been reported to restore the continuity of the aerodigestive tract following resection of pharyngeal and hypopharyngeal cancers. However, high complication rates have been reported after voice prosthesis insertion. In this setting, the ileocolon free flap (ICFF) offers a tubularized flap for reconstruction of the hypopharynx while providing a natural phonation tube. Herein, we systematically reviewed the current evidence on the use of the ICFF for reconstruction of the aerodigestive tract. A systematic literature search was conducted across PubMed MEDLINE, Web of Science, ScienceDirect, Scopus, and Ovid MEDLINE(R). Data on the technical considerations and surgical and functional outcomes were extracted. Twenty-one studies were included. The mean age and follow-up were 54.65 years and 24.72 months, respectively. An isoperistaltic or antiperistaltic standard ICFF, patch flap, or chimeric seromuscular-ICFF can be used depending on the patients' needs. The seromuscular chimeric flap is useful to augment the closure of the distal anastomotic site. The maximum phonation time, frequency, and sound pressure level (dB) were higher with ileal segments of 7 to 15 cm. The incidence of postoperative leakage ranged from 0 to 13.3%, and the majority was occurring at the coloesophageal junction. The revision rate of the microanastomosis ranged from 0 to 16.6%. The ICFF provides a reliable and versatile alternative for reconstruction of middle-size defects of the aerodigestive tract. Its three-dimensional configuration and functional anatomy encourage early speech and deglutition without a prosthetic valve and minimal donor-site morbidity.

Analysis of a damaged industrial hall subjected to the effects of fire

  • Kmet, Stanislav;Tomko, Michal;Demjan, Ivo;Pesek, Ladislav;Priganc, Sergej
    • Structural Engineering and Mechanics
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    • 제58권5호
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    • pp.757-781
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    • 2016
  • The results of diagnostics and analysis of an industrial hall located on the premises of a thermal power plant severely damaged by fire are presented in the paper. The comprehensive failure-related diagnostics, non-destructive and destructive tests of steel and concrete materials, geodetic surveying of selected structural members, numerical modelling, static analysis and reliability assessment were focused on two basic goals: The determination of the current technical condition of the load bearing structure and the assessment of its post fire resistance as well as assessing the degree of damage and subsequent design of reconstruction measures and arrangements which would enable the safe and reliable use of the building. The current mechanical properties of the steel material obtained from the tests and measured geometric characteristics of the structural members with imperfections were employed in finite element models to study the post-fire behaviour of the structure. In order to compare the behaviour of the numerically modelled steel roof truss, subjected to the effects of fire, with the real post-fire response of the damaged structure theoretically obtained resistance, critical temperature and the time at which the structure no longer meets the required reliability criteria under its given loading are compared with real values. A very good agreement between the simulated results and real characteristics of the structure after the fire was observed.

Strengthening techniques for masonry structures of cultural heritage according to recent Croatian provisions

  • Hadzima-Nyarko, Marijana;Ademovic, Naida;Pavic, Gordana;Sipos, Tanja Kalman
    • Earthquakes and Structures
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    • 제15권5호
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    • pp.473-485
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    • 2018
  • The buildings of architectural and cultural heritage are mostly built with stone or brick wall elements, which are connected using limestone or limestone cement mortar, without a full knowledge of the mechanical properties of masonry structures. The compatibility of heritage masonry buildings with valid technical specifications and the rules for earthquake resistance implies the need for construction work such as repairs, strengthening or reconstruction. By strengthening the masonry buildings, ductility and bearing capacity are increased to a level, which, in the case of the earthquake design, allows for some damage to happen, however the structure retains sufficient usability and bearing capacity without the possibility of collapse. Comparison between traditional and modern techniques for seismic strengthening of masonry buildings is given according to their effects, benefits and disadvantages. Recent Croatian provisions provided for heritage buildings enabling deviation of technical specifications are discussed.

건축 공간적 가변성에 대응하는 설비 시스템에 관한 연구 (Research and study on facility system good enough to address the changing aspects of building space)

  • 이재용;윤해동;김석완
    • 대한설비공학회:학술대회논문집
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    • 대한설비공학회 2006년도 하계학술발표대회 논문집
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    • pp.554-559
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    • 2006
  • The currently common housing is obviously going to be under the reconstruction in just $20{\sim}30$ years, with the failure to satisfy the improvement of national income, diversification and advance of national demand. But, reckless and random reconstruction Induce the serious problem of environmental pollution involving the loss of national treasury and excess materials of constructions. In order to address such problem, the common housing of longevity, which can adequately cope with the changes of times and tastes of inhabiters, in the future, is arising as an alternative. Recently, the groundbreaking phase of common housing is also being considered as another alternative to resolve such problem. The common housing of longevity has an advantage to create a free and comfortable space in accordance with the tastes of inhabiters, as well as expanding the durability of building. But, the current facility system has an inability to deal with the sort of housing. Thus, the research paper is designed to make an analysis on problems of common housing in South Korea, which has made it difficult to handle a changing space, and based on the analysis, the paper is intended to make a review on the future-oriented facility service appropriate enough to deal with the changing aspects of space.

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Micro-computed tomography for assessing the internal and external voids of bulk-fill composite restorations: A technical report

  • Tosco, Vincenzo;Monterubbianesi, Riccardo;Furlani, Michele;Giuliani, Alessandra;Putignano, Angelo;Orsini, Giovanna
    • Imaging Science in Dentistry
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    • 제52권3호
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    • pp.303-308
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    • 2022
  • Purpose: This technical report aims to describe and detail the use of micro-computed tomography for a reliable evaluation of the bulk-fill composite/tooth interface. Materials and Methods: Bulk-fill composite restorations in tooth cavities were scanned using micro-computed tomography to obtain qualitatively and quantitatively valuable information. Two-dimensional information was processed using specific algorithms, and ultimately a 3-dimensional (3D) specimen reconstruction was generated. The 3D rendering allowed the visualization of voids inside bulk-fill composite materials and provided quantitative measurements. The 3D analysis software VG Studio MAX was used to perform image analysis and assess gap formation within the tooth-restoration interface. In particular, to evaluate internal adaptation, the Defect Analysis addon module of VG Studio Max was used. Results: The data, obtained with the processing software, highlighted the presence and the shape of gaps in different colours, representing the volume of porosity within a chromatic scale in which each colour quantitatively represents a well-defined volume. Conclusion: Micro-computed tomography makes it possible to obtain several quantitative parameters, providing fundamental information on defect shape and complexity. However, this technique has the limit of not discriminating materials without radiopacity and with low or no filler content, such as dental adhesives, and hence, they are difficult to visualise through software reconstruction.

Heart Transplantation in a Patient with Left Isomerism

  • Bang, Ji Hyun;Oh, You Na;Yoo, Jae Suk;Kim, Jae-Joong;Park, Chun Soo;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • 제48권4호
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    • pp.277-280
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    • 2015
  • We report the case of a 37-year-old man who suffered from biventricular failure due to left isomerism, inferior vena cava interruption with azygos vein continuation, bilateral superior vena cava, double outlet of right ventricle, complete atrioventricular septal defect, pulmonary stenosis, and isolated dextrocardia. Heart transplantation in patients with systemic venous anomalies often requires the correction and reconstruction of the upper & lower venous drainage. We present a case of heart transplantation in a patient with left isomerism, highlighting technical modifications to the procedure, including the unifocalization of the caval veins and reconstruction with patch augmentation.

Cycle-Consistent Generative Adversarial Network: Effect on Radiation Dose Reduction and Image Quality Improvement in Ultralow-Dose CT for Evaluation of Pulmonary Tuberculosis

  • Chenggong Yan;Jie Lin;Haixia Li;Jun Xu;Tianjing Zhang;Hao Chen;Henry C. Woodruff;Guangyao Wu;Siqi Zhang;Yikai Xu;Philippe Lambin
    • Korean Journal of Radiology
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    • 제22권6호
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    • pp.983-993
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    • 2021
  • Objective: To investigate the image quality of ultralow-dose CT (ULDCT) of the chest reconstructed using a cycle-consistent generative adversarial network (CycleGAN)-based deep learning method in the evaluation of pulmonary tuberculosis. Materials and Methods: Between June 2019 and November 2019, 103 patients (mean age, 40.8 ± 13.6 years; 61 men and 42 women) with pulmonary tuberculosis were prospectively enrolled to undergo standard-dose CT (120 kVp with automated exposure control), followed immediately by ULDCT (80 kVp and 10 mAs). The images of the two successive scans were used to train the CycleGAN framework for image-to-image translation. The denoising efficacy of the CycleGAN algorithm was compared with that of hybrid and model-based iterative reconstruction. Repeated-measures analysis of variance and Wilcoxon signed-rank test were performed to compare the objective measurements and the subjective image quality scores, respectively. Results: With the optimized CycleGAN denoising model, using the ULDCT images as input, the peak signal-to-noise ratio and structural similarity index improved by 2.0 dB and 0.21, respectively. The CycleGAN-generated denoised ULDCT images typically provided satisfactory image quality for optimal visibility of anatomic structures and pathological findings, with a lower level of image noise (mean ± standard deviation [SD], 19.5 ± 3.0 Hounsfield unit [HU]) than that of the hybrid (66.3 ± 10.5 HU, p < 0.001) and a similar noise level to model-based iterative reconstruction (19.6 ± 2.6 HU, p > 0.908). The CycleGAN-generated images showed the highest contrast-to-noise ratios for the pulmonary lesions, followed by the model-based and hybrid iterative reconstruction. The mean effective radiation dose of ULDCT was 0.12 mSv with a mean 93.9% reduction compared to standard-dose CT. Conclusion: The optimized CycleGAN technique may allow the synthesis of diagnostically acceptable images from ULDCT of the chest for the evaluation of pulmonary tuberculosis.

단지신근 근피판을 이용한 하지 원위부 연부조직 결손의 재건 (Reconstruction of Soft Tissue Defect on Distal Leg with Extensor Digitorum Brevis Myo-Cutaneous Flap)

  • 이상윤;정호윤;김종엽;양정덕;박재우;조병채
    • Archives of Plastic Surgery
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    • 제33권4호
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    • pp.474-479
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    • 2006
  • Purpose: To report of a series of successful reconstruction of soft tissue defect on distal leg with extensor digitorum brevis myo-cutaneous flap. Methods: Between April 2002 to December 2004, 7 patients with soft tissue defect on distal leg were operated with Extensor Digiotorum Brevis myocutaneous flap. 6 of these patients had osteomyelitis. Results: Extensor Digiotorum Brevis myocutaneous flap were used in 6 patients and reverse flow flap was used in one patient. Average follow up was 19 months. All flap were survived 100% without any complication and osteomyelitis were controled in all cases. Aesthetic and functional out come were excellent on both recipient and donor sites. Conclusion: The advantages of this flap are effectively control of local wound infection, constant and reliable anatomical structures, adequately thin flap. Technical easiness for raising flap and wide arch of rotation. Extensor Digitorum Brevis myo-cutaneous flap is one of ideal option for the reconstruction of distal leg and foot defects.

슬괵건을 이용한 전방십자인대 재건술시 횡고정 핀과 간섭나사를 이용한 대퇴터널 고정술 -수술 수기- (Cross-Pin and Interference Screw Femoral Fixation in Anterior Cruciate Ligament Reconstruction using Hamstring Tendon -Technical Note-)

  • 인용;박원종;박종범;홍승환
    • 대한관절경학회지
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    • 제6권1호
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    • pp.60-63
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    • 2002
  • 목적 : 네 겹의 슬괵건을 이용한 전방십자인대 재건술시 대퇴터널을 횡고정 핀과 흡수성 간섭나사로 함께 고정하는 수기를 소개하고자 한다. 수술 술기 : 반건양건과 박건을 채취하여 네 겹으로 준비하였다. 경골터널과 대퇴터널을 만드는데 대퇴터널의 깊이는 35 mm로 하였다. Rigidfix system의 가이드를 삽입하고 가이드의 위쪽 관에만 구멍을 내었다. 이식건을 통과시킨후 횡고정 핀 을 고정하였다. 이후 이식건을 경골쪽으로 당기면서 흡수성 간섭 나사로 고정하였다. 결론 : 슬괵건 전방십자인대 재건술시 횡고정 핀과 흡수성 간섭나사를 이용한 대퇴터널 고정은 강한 초기 고정과 이식건의 골통합을 촉진시킬 수 있는 좋은 방법으로 사료되어 소개하였다.

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