• Journal of Chest Surgery
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• v.32 no.9
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• pp.823-826
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• 1999

A 6-month old girl who had pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals underwent one-stage complete repair with unifocalization through a bilateral thoracosternotomy(clamshell incision). There were no serious postoperative compli cations, and the postoperative echocardio-graphy showed no residual ventricular septal defect or significant pulmonary artery stenosis. In this condition, great surgical variability exists regarding the sources of pulmonary blood flow. Recent clinical work has focused on a one-stage complete repair. The potential advantages of the clamshell incision are apparent in terms of mediastinal approach, postoperative results, and safety.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.304-310
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• 2021

Objective: This study aimed to investigate effective cueing methods for selective muscle activation of gluteus medius muscles. Design: Cross sectional study design. Methods: Using the inclusion criteria for this study, 20 healthy adults, both males and females were selected for the measurement of muscle activation of gluteus maximus, gluteus medius, and tensor fascia latae muscles while performing clamshell exercise, basic movements in leg raise in side-lying, and 3 different cueing methods. Electromyogram was used to measure muscle activation, and both muscle activation and muscle ratio were compared during the basic movements and different cueing methods. Results: Gluteus medius activation was highest using "try not to make your body rotate" (cueing method 2) in both clamshell exercise and leg raise side-lying (F=5.533, p<0.05, F=7.771, p<0.05), and muscle ratio was highest in clamshell exercise using cueing method 2 (p<0.05) and "don't move your tensor fascia late" (cueing method 1) in leg raise side-lying (p<0.05). This study showed that cueing method 1 in leg raise side-lying and cueing method 2 in clamshell exercise were the most effective cueing methods for selective muscle activation of gluteus medius muscle. Conclusions: The results of this study may be used as basic information for future studies on muscle activation and muscle ratio for different cueing methods and different muscles in various exercises.

• Journal of Auto-vehicle Safety Association
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• v.15 no.1
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• pp.7-15
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• 2023

The purpose of this study is to predict the dynamic behavior of clamshell hood system on the harsh road driving condition, and secure the safety and durability performance of the system. The equation of motion of hood system is derived and the numerical analysis is implemented to obtain the lateral movement of the hood system. Also, the actual Belgian road test results are correlated to the predicted ones, and confirm the reliability of the system. Then, the parameter study is conducted to figure out the sensitive factors to affect the dynamic behavior, and the engineering design guide to make the system robust to confine the minimum friction force generated from hood latch and maximum hood weight is suggested from this research.

• Journal of Chest Surgery
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• v.57 no.2
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• pp.213-216
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• 2024

Bilateral transverse thoracosternotomy, or "clamshell" thoracotomy, can be complicated by dehiscence. A 65-year-old male underwent lung transplantation via clamshell thoracotomy, with subsequent sternal dehiscence on postoperative day 11. Upon repair, the previous sternal wires had pulled through, so a Sternal Talon connected to a Recon Talon was utilized to re-approximate the inferior sternum. On follow-up at 3 months, the patient recovered well. Use of the Sternal Talon provides an effective technique for repairing transverse sternal dehiscence.

• Journal of Navigation and Port Research
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• v.41 no.4
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• pp.195-206
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• 2017

In situ capping technology for marine sediment pollution control has never been applied in South Korea. In this study a pilot project for the capping was carried out in Busan N Harbor. Pipeline and clamshell capping technologies were implemented for the pollution control. Changes of capping shapes, sediment contamination, and the time and costs required for the two constructions were compared. Both the pipeline and clamshell technologies were found to satisfy the target thickness of 50 cm on average. However, the pipeline method did not operate sensitively in terms of change of the sea floor topography, resulting in an uneven shape and a thickness. Organic carbon and ignition loss quite decreased after the pipeline or the clamshell capping while pH showed no significant change. Organic and residual fraction of Cd, Ni, and Zn in the sediments appeared to decrease after all cappings. The pipeline method took a construction time four times as much as the clamshell method. The clamshell method was demonstrated to reduce the construction cost by about 40% compared with the pipeline method. However, a monitoring for all the parameters needs to be conducted at least two years in order to better evaluate an efficiency of the pollution control by these capping constructions.

• Geotechnical Engineering
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• v.29 no.5
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• pp.19-26
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• 2013

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.9-19
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• 2019

PURPOSE: This study compared the effects of three different clamshell exercises (CLAM) on the gluteus medius (GMED), quadratus lumborum (QL), anterior hip flexor (AHF), gluteus medius/quadratus lumborum ratio, and gluteus medius/anterior hip flexor ratio by studying the activities of participants with GMED weakness. METHODS: Eleven subjects with weak GMED participated in this study. Subjects performed CLAM under three different conditions (standard, and modified 1 and 2). Surface electromyography was then used to measure the muscle activity and one-way repeated-measures analysis of variance was used to assess the statistical significance of the measured variables. RESULTS: GMED and the QL muscle activities did not differ significantly between the standard CLAM and the modified CLAM with the 2 different foot positions (F=4.74, P=.02; F=4.57, P=.02, respectively). AHF activity was significantly different in the two different foot positions when compared to the standard CLAM (F=11.17, P=.00). However, there was no significant difference between the AHF activities for the two different foot positions (P=.09). Finally, GMED/QL and GMED/AHF ratios were not significantly different between the three different CLAM exercises (F=.63, P=.55; F=.82, P=.45, respectively). CONCLUSION: Modified CLAM can be recommended as a good method to minimize AHF activity while maintaining GMED activity in subjects with weak GMED.

• Journal of the Korean Society for Aeronautical & Space Sciences
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• v.36 no.4
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• pp.375-383
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• 2008

Design of a weapon-carrier type of missile requires to provide a highly reliable mechanism of airframe separation and air stabilizer deployment which enables the safe release of payload at high-speed flight conditions. This mechanism is characterized by a relative dynamic motion of multiple separated bodies, proceeding as swiftly as hundreds of milli-seconds, so that the use of modeling & simulation(M&S)techniques could play a crucial role in the design. This paper presents an M&S technique which has been developed for a design of anti-submarine missile employing a clamshell type of airframe separation, and shows some major results of simulation compared to available flight test results. Emphasis of the current study was laid on a proper balance between the quick calculation, which is essential for practical design application, and the credibility of the results.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.676-680
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• 2000

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.

• Journal of Chest Surgery
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• v.56 no.4
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• pp.282-285
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• 2023

Mature fetiform teratoma, or homunculus, is a term coined for a rare variant of teratoma with a prevalence of 0.01% of teratomas. There have been very few cases reported in the world, and its thoracic presentation is extremely unusual. We present the case of a 31-year-old female patient with a history of progressive chest pain in the left hemithorax, associated with dyspnea on moderate exertion and cough. Imaging studies revealed a large intrathoracic tumor visually compatible with a teratoma. Surgical resection by a clamshell approach was successful, and subsequent anatomopathological studies of the operative specimen concluded that the mass was a mature fetiform thoracic teratoma. The treatment of this entity is generally surgical and includes wide resection due to its large adhesive component to surrounding tissues. Thus, the cardiothoracic surgeon must know approaches that allow wide resection, making these cases true surgical challenges.