• Title/Summary/Keyword: 단단함

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경부기관절제 및 단단문합술

  • 김광문;홍원표;최홍식;조정일;최은창;김명상
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1995.04a
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    • pp.90.1-90
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    • 1995
  • 저자들은 최근 4년간 11례에서 기관절제 및 단단문합술을 사용하였기에 그 치료 결과를 살펴보고 치료적용의 범위를 넓혀보고자 한다. 대상은 후두-기관협착증 2례, 기관협착증 8례, 갑상선암 1례로 총 11례였으며 이중 3례에서 기관-식도누공이 동반되어 있었다. 술후 발거가 가능했던 경우는 8례였으며 발거가 불가능했던 경우는 술전에 이미 양측성대마비가 있던 경우 l례, 문합부위 아래에 새로운 협착 부위가 생겼던 1례, 기관 연골의 과도한 결손이 있었던 경우가 1례 있었다. 합병증으로 창상감염 1례, 육아조직 3례의 경우는 치료되었으며 양측성대마비가 있던 경우는 편측성대절제를 하여 관찰 중이다. 이상의 결과를 볼 때 기관절제 및 단단문합술이 실패한 경우는 2례로 술전 동반질환의 정확한 검사 및 절제부위의 국소화, 수술시 문합부위의 장력을 최소화하여 시행한다면 합병증은 비교적 받아들일만 하며 비교적 성공율도 기대할 만한 술식으로 여겨졌다.

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SLEEVE RESECTION AND END TO END ANASTOMOSIS WITH SUPRAHYOID RELEASE FOR THE CIRCUMFERENTIAL TRACHEAL STENOSIS (환상기관협착증에 대한 기관절제 및 단단문합술)

  • 이강대;이종담
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.25-25
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    • 1991
  • 최근 교통사고의 증가, 심폐술의 보편화 및 보조호흡을 필요로 하는 환자의 증가에 따라 경구적 혹은 기관절개술을 통해 기관내 삽관을 장기간 유치하는 경우가 많아져서 이에 따른 합병증으로 기관협착증의 빈도가 높아지게 되었다. 기관내 삽관후 기관협착증을 초래하는데에는 관의 외경, 삽관시 외상, 삽관유치기간, 기계적 보조호흡시 관의 이동, cuff 의 압력 등의 요인이 작용한다. 이러한 요인에 의해 기관내 삽관을 장기간 유치시 기관점막에 대한 지속적인 압박으로 점막하부의 압박괴사 및 혈관의 폐쇄로 인해 기관연골의 무혈성 괴사를 초래하여 환상의 기관협착이 병발하게 된다. 기관협착증에 대한 치료방법으로서는 여러 가지가 있으나 환상의 기관협착증인 경우는 협착부위의 절제 및 단단문합술을 시행하고 절제부위가 광범위한 경우는 release technique 을 이용하여 문합부위의 장력을 줄여주는 것이 효과적인 치료방법으로 알려져 있다. 저자들은 최근 기관내 삽관후에 병발한 환상기관협착증 3례(다발성 골절 1례, 기관지 천식 1례, 약물중독 1례)에 대해 기관절제 및 단단문합술을 경험하였기에 보고하고자 한다.

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기관 절제 및 단단문합술에 의한 기관 협착증의 치료

  • 서장수;이경항;김용대;송계원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1995.04a
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    • pp.90.2-90
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    • 1995
  • 기관 협착증은 기관 삽관, 기관절개술 혹은 외상 등에 의해 주로 발생하고 드물게 종양이나 염증성 질환에 의해 생길 수 있다. 치료의 원칙은 정상 발성기능을 가진 충분한 기관강을 유지하는데 있으며 여러 치료방법 중 기관절제 및 단단문합술은 다른 방법이 실패하였거나 협착정도가 심한 경우에 시행할 수 있고, 정상기관강을 유지함으로써 해부, 생리학적으로 가장 이상적인 수술방법으로 알려져 있다. 저자들은 1990년부터 1994년까지 경부기관 8례, 경부 및 흉부기관을 동반한 기관협착증 1례에서 기관 절제 및 단단문합술을 실시하였다. 전례에서 suprahyoid release를 시행하였으며, 술중 가능한한 회귀신경은 확인하지 않았으며 술후 2일째 기관발거를 실시하였다. 합병증으로 술후 1례에서 일측성대마비가 있었으며 문합부 육아조직 형성이 2례가 있었으나 전례에서 성공적인 기관발거가 가능하였다.

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A Simultaneous Fluid -Structure Modeling of the End-to-End Vascular Graft Anastomosis (인조혈관의 단단문합에 대한 유동과 구조의 동시해석)

  • 김영호
    • Journal of Biomedical Engineering Research
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    • v.20 no.5
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    • pp.593-599
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    • 1999
  • 수축절정기에 0.2mm, 0.4mm 두께의 소구경 인조혈관의 내경3.2mm의 동맥에 문합한 단단문합 주위의 유동과 구조해석을 동시에 수행하였다. 유동해석 결과 속도분포 및 벽단전률은 타 연구결과와 매우 유사하며 이론해와 매우 유사함을 보였다. 유동에 의해서 문합부 주위에 작용하는 응력은 문합부에 집중되며 이는 수십만 pa에 달했다. 또한 인조혈관과 동맥에 작용하는 원주방향의 응력을 이론해와 비교한 결과 서로 유사함을 보였으며 두께가 얇은 인조혈관을 사용하는 경우 문합부의 compliance mismatch 는 개선되나 반대로 응력은 더 많이 받음을 알 수 있었다. 본 연구를 통해서 유체에 의하여 혈관이 영향을 받는 심혈관계 현상을 연구하는데 있어서 이와 같은 유체-구조 상호작용을 고려하여 동시에 해결 하는 방법은 매우 유용할 것으로 생각된다.

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Changes in Texture and Sensory Properties of Low-Temperature and Long-Term Fermented Baechu Kimchi during the Fermentation (묵은 배추김치 제조과정에서의 텍스쳐 및 관능적 특성 변화)

  • Chung, Hee-Jong;Kim, Hyung-Ryang;Yoo, Maeng-Ja
    • Journal of the Korean Society of Food Culture
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    • v.20 no.4
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    • pp.426-432
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    • 2005
  • To develop a low-temperature and long-term fermented Baechu kimchi, kimchi was prepared according to a recipe of specific ratio with major and minor ingredients and adjusted its final salinity to 3.7%. Baechu kimchi fermented at $15{\pm}1^{\circ}C$ 24 hours and transferred them into in a refrigerator only for kimchi, and then continued to ferment at $-1{\pm}1^{\circ}C$ for 30 weeks to make a low-temperature and long-term fermented kimchi. The initial cutting force of 8.45kgf dropped gradually and reached to 5.19kgf after 30 weeks of fermentation. In compression force the gumminess, hardness and chewiness of Baechu kimchi showed a great decrease during the fermentation, but the springiness and adhesiveness increased in slight. Correlation coefficient between the chewiness and gumminess was the highest(r=0.879). In spite of sensory evaluation scores of the appearance and texture were the highest on 0 day of fermentation, the saltiness was evaluated the worst to eat. Scores for sourness and carbonated flavor were the best during 18 to 22 weeks of fermentation, and overall acceptability was the best after 14 weeks of fermentation. Very high correlation coefficients were revealed between the sourness and carbonated flavor(r=0.813) and between the sourness and off-flavor(r=0.805). According to these results we concluded that the best low-temperature and long-term fermented Baechu kimchi prepared with 3.7% salinity and fermented at $15{\pm}1^{\circ}C$ for 24 hours and then transferred into a kimchi refrigerator at $-1{\pm}1^{\circ}C$, and completed the fermentation for 18 weeks.

Anastomosis Site Stricture after Using Stapler Devices in a Total Gastrectomy (위전절제술에서 자동단단문합기 사용 후 문합부 협착에 대한 고찰)

  • Ku, Do-Hoon;Suh, Byoung-Jo;Han, Won-Sun;Yu, Hang-Jong;Kim, Jin-Pok
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.252-256
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    • 2004
  • Purpose: Anastomosis site stricture is a common complication after a total gastrectomy. End-to-end anastomosis (EEA) stapler devices are preferred to a hand-sewn esophagojejunostomy these days. However, stapling devices have been reported not to reduce the incidence of esophagojejunostomy site stricture considerably. Materials and Methods: From Sep. 1998 to Dec. 2000, at Korea Gastic Cancer Center, Seoul Paik Hospital, Inje University, we experienced 228 total gastrectomies in which EEA stapling devices had been used. We investigated the correlation of the stricture with the size of the EEA stapling device, the type of esophagojejunal reconstruction, reflux esophagitis, and duration of stricture development. Results: Among the 228 cases, as far as the patient's age was concerned, the 7th decade was the most common 64 cases, followed by the 5th decades. The Male-to-female ratio was 2.3:1. A loop esophagojejunostomy was used in 223 cases, and the Roux-en-Y method was used in 5 cases. The 32 patients with anastomosis site stricture were patients with loop esophagojejunal anastomosis. Anastomosis site stricture occurred in $14\%$ (32/228) of the total gastrectomy cases, in$15.9\%$ (11/69) of the total gastrectomies involving stapler devices with a 25-mm diameter, and in $13.2\%$ (21/159) of the total gastrectomies involving staper devices with a 28-mm diameter. There was no correlation between the incidence of stricture and EEA- stapling device size (P>0.05). Reflux esophagitis occurred in 56 of the 228 cases, with 7 of those 56 cases ($12.5\%$) and 25 of the remaining 172 cases ($14.5\%$) having strictures. There was no considerable difference in the stricture incidence rate according to the presence of reflux esophagitis (P>0.05). The onset of stricture development, occurred within 6 months in 16 cases, including 4 cases of reflux esophagitis, between 7 and 18 months in 14 cases, including 3 cases of reflux eshophagitis, and after 19 months in 2 cases. Conclusion: An esophagojejunostomy site stricture after a total gastrectomy was not correlated with the esophagojejunal reconstruction type, the size of the stapling device, or the presence of reflux esophagitis. General anastomosis technical factors (e.g., adequate blood supply, tension-free manner, adequate hemostasis) may be more important to prevent anastomosis site stricture after an esophagojejunostomy during a total gastrectomy.

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Sensory and Instrumental Texture Characteristics of Low Fat Ground Beef Manufactured with the Addition of Cooked Old Rice (취반 재고미를 청가하여 제조한 저지방 분쇄우육의 관능검사 및 물성학적 특성)

  • Whang, Key;Ha, Young-Duck;Kim, Hyuk-Il
    • Korean Journal of Food Science and Technology
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    • v.28 no.4
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    • pp.668-672
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    • 1996
  • Four low fat ground beef groups containing 10% fat plus 0, 5, 10 and 20% additional cooked old rice and a control ground beef containing 30% fat were prepared. Various sensory characteristics and instrumental textures were measured in order to determine the acceptability of low fat ground beef and to find out the most appropriate level of addition of cooked old rice as a fat replacer. Ground beef containg 10% fat had higher flavor and firmness scores than any other ground beef groups. Ground beef with 10% fat plus 5% cooked old rice had higher flavor, particle size, firmness and overall acceptability scores but lower juiciness and tenderness scores than ground beef with higher amount of cooked old rice (10 and 20%) and ground beef with 30% fat. Ground beef containing 10% fat plus 10 and 20% cooked old rice had higher juiciness, tenderness, particle size and overall acceptability scores but lower flavor and firmness scores than any other ground beef groups. Ground beef with 30% fat had higher flavor, juiciness, tenderness and firmness scores but lower particle size and overall acceptability scores. Conclusively, ground beef with the fat content reduced to 10% plus 5 or 10% additional cooked old rice as fat replacer still possessed the desirable sensory and instrumental texture properties.

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Surgical Treatment of Coarctation of the Aorta (대동맥축착증의 외과적치료)

  • 성시찬;방정희
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1069-1076
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    • 1997
  • There remains controversy regarding the appropriate surgical treatment for coarctation of the aorta because of relatively high rate of recoartation and high mortality in the cases associated with complex anomalies. We evaluated 31 consecutive patients who underwent surgical repair of coarctation of the aorta from May 1992 through June 1996. Nineteen patients(61.3%) were neonates and 26(83.9%) were under three months. Nine patients did not have major associated anom lies(Group I), 15 patients had ventricular septal defect(Group II), and 7 patients had major complex anomalies(Group III). 35.5% of the patients had arch hypoplasia. Surgical procedures performed were as follows: extended end-to-end anastomosis in 17 patients, combined resection-flap procedure in 7 patients, and subclavian flap aortoplasty in 7 patients. Residual coarctation occurred in 7(25%) of 28 patients; 2 after subclavian (lap aortoplasty(2/6, 33.3%), none after combillrd resection-flap procedure(0/7, 0%), and 5 after extended end-to-end anastomosis(5/15, 33.3%). Higher incidence of residual coarctation was noticed in the group with arch hypoplasia. The incidence of postoperative coarctation at a mean follow-up of 20.5 months in survivals was 12.0%(3/25); 2 cases after subclavian flap aortoplasty(2/6, 33.3%), none after combined resection-flap procedure(017, 0%), and one after endtoend anastomosis(1/12, 8.3%). The mortality rate related to coarctation repair was 9.7%(3 patients all in Group III). This study revealed that isolated coarctation of aorta and coarctation with ventricular septal di3fect(groups I & ll) can be repaired with low mortality, but repair of coarctation with complex anomaly had a high operative mortality Also the patients with arch hypoplasia had higher incidence of post-operative residual coarctation.

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Characteristics of Engineered Soils (Engineered Soils의 특성)

  • Lee, Jong-Sub;Lee, Chang-Ho;Lee, Woo-Jin;Santamarina, J. Caries
    • Journal of the Korean Geotechnical Society
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    • v.22 no.8
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    • pp.129-136
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    • 2006
  • Engineered mixtures, which consist of rigid sand particles and soft fine-grained rubber particles, are tested to characterize their small and large-strain responses. Engineered soils are prepared with different volumetric sand fraction, sf, to identify the transition from a rigid to a soft granular skeleton using wave propagation, $K_{o}-loading$, and triaxial testing. Deformation moduli at small, middle and large-strain do not change linearly with the volume fraction of rigid particles; instead, deformation moduli increase dramatically when the sand fraction exceeds a threshold value between sf=0.6 to 0.8 that marks the formation of a percolating network of stiff particles. The friction angle increases with the volume fraction of rigid particles. Conversely, the axial strain at peak strength increases with the content of soft particles, and no apparent peak strength is observed in specimens when sand fraction is less than 60%. The presence of soft particles alters the formation of force chains. While soft particles are not part of high-load carrying chains, they play the important role of preventing the buckling of stiff particle chains.

저온 브라인처리가 생선횟감용 어류 근육의 물리ㆍ화학적 변화에 미치는 영향 3. 어체크기에 빠른 변화

  • 이기봉;심길보;김태진;이근우;김건배;조영제
    • Proceedings of the Korean Society of Fisheries Technology Conference
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    • 2002.10a
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    • pp.114-115
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    • 2002
  • 식품의 맛은 인간이 갖고 있는 오감(五感)을 통하여 그 음식의 맛이 좋고 나쁨을 판단하게 되며, 이 오감은 식품의 종류에 따라서 작용하는 비중이 달라지게 된다. 생선회를 먹을 때는 오감중에서 씹을 때에 이발로 느끼는 촉감(씸힘성)이 가장 큰 영향을 미친다. 생선회는 육질이 단단할수록 씸힘성이 좋으므로 육질이 단단한 어종이 고급횟감으로 취급되고 있다. (중략)

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