• Journal of Chest Surgery
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• 제32권9호
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• pp.823-826
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• 1999

주대동맥폐동맥간 부행혈관, 심실중격결손과 폐동맥 형성부전이 동반된 6개월된 환아에서 Clamshell 절개 를 통한 일차 완전교정술을 시행하였다. 수술 후 특별한 합병증은 없었으며, 초음파 검사상 남아있는 심실중 격결손이나 의미있는 폐동맥 협착 소견을 보이지 않았다. 이러한 질환의 수술적 접근에 \ulcorner폐로 공급되는 혈 류의 형태에 따라 다양한 방법이 존재하는데, 최근 들어서는 일차 완전교정술에 대한 여러 형태의 수술방법 이 제시되고 있으며, 그 적용 또한 확대되고 있다. 본 증례의 경우 Clamshell 절개 방법을 적용함으로써 종격 동내 병변에 대한 접근이 용이하였으며, 수술 결과 및 합병증 등의 측면에서도 일차 완전교정술의 한 방법 으로 고려해 볼만하다고 여겨진다.

• Physical Therapy Rehabilitation Science
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• 제10권3호
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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.

• 자동차안전학회지
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• 제15권1호
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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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• 제57권2호
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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.

• 한국항해항만학회지
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• 제41권4호
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• pp.195-206
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• 2017

국내에 원위치 피복기술의 적용 사례가 전무한 가운데 본 연구에서는 부산 N항을 대상으로 피복 기술에 대한 시범 사업을 수행하였다. 오염 정화를 위하여 원통관과 클램쉘을 이용한 피복 공법이 적용되었다. 두 공법의 피복형상 변화, 퇴적물 오염도 변화, 공정 소요시간, 소요비용을 산정하고 비교하였다. 원통관 공법과 클램쉘 공법 모두 목표 두께인 50 cm를 평균적으로 만족하였다. 그러나 원통관 공법은 해저지형 변화에 민감하게 반응하지 못하는 단점을 가지고 있어 비균일한 피복형상을 나타내었다. 원통과 공법과 클램쉘 공법 적용 시 유기물 함량은 매우 감소하였지만, pH의 뚜렷한 변화는 없었다. Cd, Ni, Zn의 유기물 및 잔류 형태의 비율이 피복 후 증가하였다. 원통관 공법의 경우 클램쉘 공법에 비해 공정 소요시간이 약 4배 정도 더 소요되었다. 클램쉘 공법의 시공비용은 원통관 공법에 비해 약 40% 절감 되는 것으로 나타났다. 오염 퇴적물 정화 효율에 대한 평가를 위해서는 최소 2년 이상의 장기적인 모니터링이 진행되어야 한다.

• 한국지반공학회지:지반
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• 제29권5호
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• pp.19-26
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• 2013

• 대한물리의학회지
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• 제14권2호
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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.

• 한국항공우주학회지
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• 제36권4호
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• pp.375-383
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• 2008

완성무기 운반형 유도탄의 설계에는 고속비행 중 탑재물 투하에 적합한 안정성과 신뢰성 높은 기체분리 및 낙하산 전개 메커니즘이 요구된다. 이 전개 메커니즘은 다물체들 상호간의 역학적 운동 관계를 나타내는 것이므로 설계에서 모델링 & 시뮬레이션을 이용한 해석적 연구가 매우 중요한 역할을 할 수 있다. 본 논문에서는 크램쉘형 기체분리를 채택한 국내 대잠유도탄 설계에 적용된 기체분리 시뮬레이션 기법을 제시하고, 이를 이용한 주요 해석 결과를 가용한 비행시험 결과와 대비하여 보였다. 본 기법 연구의 초점은 효과적인 설계 적용의 필수적 요소인 계산의 신속성과 신뢰도 간의 적절한 조화에 주어졌다.

• Journal of Chest Surgery
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• 제33권8호
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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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• 제56권4호
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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.