• Title/Summary/Keyword: 관혈적

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Repair of Large to Massive Rotator Cuff Tears in the Elderly Patients (65세 이상 고령 환자의 대형 및 광범위 회전근 개 파열에 대한 봉합술)

  • Jung, Hong Jun;Chun, Jae Myeung;Jeon, In-Ho;Kwon, Jun;Ha, Sang-Ho;Yang, Sung Wook;Lee, Ji-Ho
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.91-98
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    • 2012
  • Purpose: The objective of this study is to evaluate the functional outcome and identify prognosis of retear patients in patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear. Materials and Methods: From 1995 September to 2010 March, 147 patients aged 65years or over (40 male, 107 female, with an average age of 69.6) undergoing surgical repair for large to massive full thickness rotator cuff tear (large 67 cases, massive 80 cases). For functional evaluation, preoperative and postoperative 1 year range of motion and muscle power checked. For subjective evaluation, American shoulder and elbow surgeons score and Constant score were checked. For anatomical evaluation, 87 patients were checked shoulder MRI at the time of the postoperative 1 year. Results: ASES score improved from to 50.4 to 88.9, Constant score improved from 47.1 to 75.2. Supraspinatus power improved from 51.1% to 80.8%, external rotator muscle power improved from 64.5% to 83.1%. Forward elevation improved from 117.4 degrees to 153 degrees, external rotation improved from 23.6 degrees to 41.8 degrees. Follow up MRI showed re-tear in 23%, all re-tear patients were from massive tear except one patient. All re-tear patients showed improved clinical outcomes, but supraspinatus and external rotator muscle power were not improved. Conclusions: Patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear showed successful outcomes over 90 percent. Re-tear patients also showed successful clinical outcomes. In elderly patients with large to massive full thickness rotator cuff tear, aggressive surgical repair leads good clinical outcomes.

Limited Open Reduction and Internal Fixation of the Tibial Pilon Fractures (제한 절개를 통한 관혈적 정복 및 내고정술을 이용한 경골 Pilon 골절의 치료)

  • Kang, Chung-Nam;Kim, Jong-Oh;Kim, Dong-Wook;Koh, Young-Do;Ko, Sang-Hun;Yoo, Jae-Doo;Hwang, Jun-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.2
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    • pp.102-111
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    • 1997
  • The tibial Pilon fracture, which is defined as a comminuted intraarticular fracture of the distal tibia, is difficult to manage because high axial compression and rotational forces to the ankle joint result in impaction, severe comminution, metaphyseal disruption and soft tissue damage. There are variable methods of treatment such as manipulation and cast, calcaneal traction and cast, external fixation, pin and plaster, limited open reduction and external fixation, and open reduction and rigid internal fixation. Though most of authors reported better result after a surgical treatment. than that of conservative treatment, many complications such as posttraumatic arthritis and soft tissue problem still remain troublesome. We have reviewed 19 cases of the tibial Pilon fractures in 18 patients which were treated with limited open reduction and internal fixation from September 1993 to May 1996. The results were as follows: 1. The fractures were classified into five types according to the system of Ovadia and Beals, and the most frequent type was type 3 (53%). The most common cause of injury was traffic accident (47%). 2. All of the cases of type 1 and 2, in which the injury of the ankle joint was less severe, revealed good or excellent clinical results. But in type 4 and 5, because the injury is much severe and accurate reduction is difficult, the clinical results were unsatisfaetory. 3. The most frequent complication was posttraumatic osteoarthritis, and which developed in second frequent complication, was developed m the three cases of type 3 in which the radiographic results were less than fair, but there were no correlation with the clinical results. 4. We could markedly reduce the complications related to the soft tissue problem of Pilon fracture by treatment with limited open reduction and internal fixation, and consider that this is a good method of treatment of Pilon fracture when the injury is less severe and accurate reduction is possible.

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Analysis of Octyl-2-Cyanoacrylate as a Dressing Material after Pediatric Urological Procedures (소아비뇨기과 관혈적 수술 시 피부봉합제로 사용된 Octyl-2-Cyanoacrylate (Dermabond$^{TM}$)의 효용성)

  • Lee, Hahn-Ey;Min, Sun Ho;Kim, Kwang Myung
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.115-120
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    • 2012
  • Purpose: We aimed to evaluate the efficacy of Octyl-2-cyanoacrylate (Dermabond$^{TM}$) as a topical skin adhesive for pediatric urologic open surgery. Methods: From August 2010 to August 2011, we retrospectively evaluated pediatric patients who underwent urologic open surgery at our institution. A total of 128 pediatric patients with 210 incisions used Dermabond$^{TM}$ for skin closure. Results: We divided the 128 patients into 3 groups according to type of surgery. Group 1 underwent hydrocelectomy (55 cases, 41.3%), Group 2 underwent orchiopexy (43 cases, 32.3%), Group 3 underwent penoplasty (35 cases, 26.4%). One hundred and twenty eight patients who underwent 133 surgeries in total, with a total of 210 incisions visited our outpatient department postoperatively, and a total of 5 wound complications (2.3%) occurred, but were simple inflammations and no dehiscence was observed. When analyzed according to groups, no wound problems occurred in Group 1 (0/55, 0%), one occurred in Group 2 (1/43, 2.3%) and four cases occurred in Group 3 (4/35, 11.4%) respectively. When re-analyzed according to wound locations, one occurred in an inguinal wound (1/120, 0.83%), none occurred in scrotal wounds (0/55, 0%), and four occurred in penile wounds (4/35, 11.4%). In Group 3, the incidence of penile wounds was significantly increased compared to other groups (P=0.008). All 5 wound problems were inflammatory and healed at an average of 13.8 days (13-15 days) with antibiotic ointment application only. Conclusion: Dermabond$^{TM}$ is feasible and safe topical skin adhesive alternative to standard skin suture in pediatric urologic surgery. However, further research about its efficacy and safety could be valuable in the future.

A Noninvasive Estimation of Hypernasality using Linear Predictive Model (선형 예측 모델을 이용한 비관혈적 과비음성 추정)

  • 고영일;김덕원;나동균;최홍식
    • Journal of Biomedical Engineering Research
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    • v.20 no.6
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    • pp.591-599
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    • 1999
  • 연구개에 결함이 있는 사람의 발음은 부적절한 비음이 섞이게 되어 과비음성 비음이 되어 연구개를 복원해주는 시술을 하게 되는데, 과비음성 비음을 정량적으로 측정할 수있다면 시술 결과를 객관화 할 수 있게 된다. 현재 임상적으로 사용되고 있는 방법들은 관혈적이거나 고가의 장비를 필요로 한다. 본 논문에서는 비음의 특징인 스펙트럼에서 zero 의 존재와 비강에 의한 포만트의 존재 사실, 그리고 선형 예측 모델을 이용하여 마이크로폰과 사운드 카드가 장착된 PC로 구현할 수 있는 새로운 과비음성 비음 추정 알고리즘을 제안하였다. 음성 신호의 스펙트럼에 zero가 존재하는 경우, 낮은 차수(order)의 선형 예측 모델이 그 음성을 발음한 성도 시스템에 정확히 적용되지 않는다는 점을 이용하여, 같은 음성에 대한 높은 차수의 선형 예측 모델과의 차이를 이용해서 과비음성의 정량화를 시도했다. 본 논문에서는 제안된 알고리즘은 기존의 Teager Operator를 이용한 알고리즘에 비해서 Nasonmeter 의 측정결과와 더 높은 통계적 상관관계를 보여주었다.

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Interesting Foreign Bodies (흥미있는 이물례)

  • 박현수;이태정;김호성;조중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.10.3-10
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    • 1979
  • We have recently removed four interesting foreign bodies uneventfully. Case 1: Ten Won coin lodged over 8 months in the mediastinum of a 5 year old boy, which was removed surgically. Case 2: A balloon flute reed which made the sound of a flute when the child inhaled, in the right main bronchus of a 8 year old boy. Case 3 and 4: Two overlapped coins in the first isthmus of esophagus in both a 5 year old boy and a 5 year old girl.

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An interesting case of mediastinal foreign body (흥미 있는 종격동 이물 1례)

  • 이용화;이동수;옥흥남;이기주;이선철
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.8.4-8
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    • 1977
  • Coin is the most common foreign body in foreign bodies of food passage in ENT field. Most of the coin canbe removed with ease by means of endos copy but in rare cases operative measures are necessary. The authors have recently experienced a case of foreign body in mediastinum near bifurcation of trachea, between trachea and esophagus which was removed by lateral neck exploration under general anesthesia, and this is the report of this case along with literature survey.

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A Novel Pulse Pressure Amplification Index for Assessment of Artery (혈관기능평가를 위한 새로운 맥압증폭지수)

  • Lee, Chungkeun;Park, Sungha;Ha, Jong-Won
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2012.07a
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    • pp.227-228
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    • 2012
  • 맥압증폭은 대동맥과 말초기관과의 혈압기능 평가 및 심혈관 질환을 예측하는 주요 매개변수로 나이와 관련이 높다. 그러나, 기존의 맥압증폭을 구하기 위해서는 관혈적인 방법으로 대동맥압을 측정하거나 혹은 전달함수와 같은 복잡한 대동맥압 추정 알고리즘을 구현하여 측정하여야 한다. 그러나, 유헬스를 활용한 스마트케어 환경에서 복잡한 알고리즘은 오히려, 계산량을 높이고, 시스템가격을 높일 수 있으므로, 최대한 단순화된 알고리즘이 필요하다. 본 논문에서는 맥압증폭을 주파수영역의 에너지 관점으로 맥압증폭을 접근하였고, 대동맥압 추정없이 추정할 수 있는 새로운 지수를 제안한다.

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Comparative Study of Clinical Outcome of Three Surgical Techniques in the Achilles Tendon Rupture: Open Repair, Percutaneous Repair, and Minimal Incision Repair by Achillon (아킬레스건 파열의 세 가지 수술적 치료법의 임상 결과에 대한 비교: 관혈적 봉합술, 경피적 봉합술, 아킬론을 이용한 최소절개 봉합술)

  • Park, Won Seok;Lee, Myoung Jin;Kang, Jung Mo;Lee, Seung Yup
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.2
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    • pp.68-73
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    • 2018
  • Purpose: This study compared the clinical outcomes of open repair, percutaneous repair, and minimal incision repair by Achillon in ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with open repair (group 1), 8 patients with percutaneous repair (group 2), and 10 patients with minimal incision repair by Achillon (group 3) from February 2013 to March 2016 were analyzed retrospectively. The postoperative clinical evaluations were done by the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Arner-Linholm scale, mid-calf circumference difference, one-leg heel raise difference, visual analogue scale (VAS) for postoperative scarring, time to return to work, and complications. Results: No significant difference in the AOFAS ankle-hindfoot score, Arner-Linholm scale, and time to return to work was observed among three groups (p=0.968, 0.509, and 0.585). The mean differences in the mid-calf circumference in groups 1, 2, and 3 were 1.09, 0.73, and 0.58, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.002). In addition, the mean VAS scores for postoperative scarring in groups 1, 2, and 3 were 7.0, 9.1, and 9.1, respectively; groups 2 and 3 were significantly higher than group 1 (p=0.001). The mean differences in one-leg heel raising in groups 1, 2, and 3 were 2.03, 1.91, and 1.33, respectively; group 3 was significantly higher than groups 1 and 2 (p=0.010). The complications encountered were one case of deep infection in group 1 and one case of sural nerve hypoesthesia in group 2. Conclusion: Minimal incision repair by Achillon is recommended as an effective surgical treatment for Achilles tendon rupture because it minimizes the risk of complications, leads to an improved tendon strength and healing, and achieves cosmetic satisfaction.

Diagnosis of Meniscal Tear of the Knee Using Proton-weighted Fast Spin-Echo MR Imaging : Can be an Alternative to Conventional Spin-Echo Imaging\ulcorner (양지밀도강조 고속 스핀에코 자기공명영상을 이용한 슬관절 반월판 열상의 진단 : 고식적 스핀에코를 대체할 수 있는가\ulcorner)

  • 김기준;이재희;주종관;이성용
    • Investigative Magnetic Resonance Imaging
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    • v.3 no.1
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    • pp.73-77
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    • 1999
  • Purpose : The purpose of the study was to evaluate the sensitivity and specificity of proton-weighted fast spin-echo MR imaging in diagnosing the meniscal tear of knee as an reasonable substitute for conventional spin-echo imaging. Materials and Methods : 102 consecutive patients, proved by surgery, proved by surgery, were participated in this study. All of them were suspected internal derangement of knee, examined by fast spin-echo MR imaging including sagittal and coronal images on a 1.5T MR imager and underwent arthroscopic or open surgery of knee joint within 2 months. These images were reviewed retrospectively by three radiologists. The sensitivity and specificity of meniscal tear were calculated. Results : The sensitivity and specificity of meniscal tear using proton-weighted fast spin-echo MR imaging were 94%, 93% inmedialmeniscus and 92%, 88% in lateral meniscus. Conclusion : The sensitivity and specificity of meniscal tear using proton weighted fast-spin echo MR images were as high as those using conventional spin-echo images. The proton-weighted fast-spin echo MR imaging can be an alternative to conventional spin-echo MR imaging in diagnosing meniscal tear of the knee.

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Arthroscopic Reconstrucion in Megafrequency of Recurrent Anterior Shoulder Dislocations (관절경을 이용한 고 빈도 재발성 전방 견관절 탈구의 재건술)

  • Ko, Sang-Hun;You, Chong-Il;Cho, Sung-Do;Choi, Chang-Hyuk;Cheon, In-Ho;Woo, Jong-Keun;Kwag, Chang-Yul;Yun, Dong-Jin;Choe, Seong-Won
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.194-200
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    • 2005
  • Purpose: To evaluate the short-term follow up outcome and the effectiveness of arthroscopic vertical shift of anteroinferior capsulolabral complex, plication of AIGHLC (anterior band of inferior glenohumeral ligament complex) and thermal capulorraphy, posteroinferior suture plication, rotator interval closure as an adjuncts in recurrent instability of megafrequency with night time dislocation. Materials & Methods: From March 1998 to February 2004, we have had 18 shoulders out of 156. All of the cases have been night time dislocation above more one time. The age were average 29.4$(21{\sim}37)$ year old. The average follow up were 21.1 $(12{\sim}45)$months We checked Rowe score and ROM at pre-operation, post-operation 6 months,1 year & last follow up period. Results: Above good results were 16 cases(88.9%). The excellent were 6 cases, good were 10, fair 1, poor 1. Conclusions: In recurrent anterior shoulder dislocation in greater than 50 frequency, arthroscopic stabilization can be an alternative technique for selected patients against open inferior capsular shift. But more long ter n follow up and large materials will be needed in the future study.

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