• 제목/요약/키워드: Combined wedge

검색결과 47건 처리시간 0.064초

An Algorithm for Labia Minora Reduction Based on a Review of Anatomical, Configurational, and Individual Considerations

  • Maurits Lange;J. Joris Hage;Refaat B. Karim;Frederic Amant
    • Archives of Plastic Surgery
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    • 제50권1호
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    • pp.17-25
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    • 2023
  • A variety of reduction labiaplasty techniques have been introduced to date, but no single technique will offer the optimal solution for every patient. Rather, the technique should be chosen based on anatomical, configurational, and technical considerations, as well as on patients' personal preferences regarded maintenance of the labial rim, maintenance of labial sensitivity, and prevention of iatrogenic thickening of the labium. We reviewed, defined, and assessed labial configurational variety, neurovascular supply, reduction techniques, and patient's preferences as the considerations relevant to the choice of labiaplasty technique. Based on this review, an algorithm was constructed that leads to a choice of reduction technique through five decisions to be made regarding (1) resection or (partial) retention of the labial free rim, (2) the measure of required labial width reduction, (3) labial vascular status, (4) prevention of iatrogenic labial thickening, and (5) preservation of labial sensibility. The choice of techniques includes edge trimming, central spindle form de-epithelialization or full-thickness resection, and three modifications of the wedge resection or de-epithelialization technique. These three modifications comprised a modified anterior resection or de-epithelialization combined with posterior flap transposition, a custom flask resection or de-epithelialization, and a modified posterior wedge resection or de-epithelialization combined with anterior flap transposition. Use of the five decisional steps and the inclusion of modifications of all three conventional reduction techniques offer an improved algorithm for the choice of labioplasty technique.

재발성 자연기흉 101례에 관한 임상적 고찰 (Clinical Evaluation of Recurrent Spontaneous Pneumothorax - A review of 101 cases -)

  • 박종원
    • Journal of Chest Surgery
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    • 제24권5호
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    • pp.451-458
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    • 1991
  • We have observed 101 cases of recurrent spontaneous pneumothorax from Sep. 1979 to Dec. 1989 at the Department of Thoracic & Cardiovascular Surgery, College of Medicine, Inje University, Pusan Paik Hospital and the result obtained as follows. 1] Age range of patients was the first decade to seventh decade. Males outnumbered females by 6.7: l. One or two episodes of recurrent attack were noted in majority cases. 2] In distribution of the lesion sites, right side was 55 cases[55.4%], left 42 cases[41.9%], and bilateral 4 cases[3.0%]. 3] In clinical manifestations, abrupt onset of dyspnea was 78 cases[77.2%], chest pain 48 cases[47.5%], cough 9 cases[8.9%] and chest discomfort 8 cases[7.9%]. 4] Of 101 cases, 48 cases were associated with pulmonary tuberculosis and other cases were associated with subpleural bullae and blebs[26 cases], emphysema[7 cases], bronchiectasis[2 cases], lung cancer[1 case], and silicosis[1 case], 5] In 88 cases[87.2%] of patients, the magnitude of collapse was above 50% in plain chest film. 6] The interval of recurrence after last attack was frequently within 1 year. 7] In the management, closed thoracostomy with underwater-sealed drainage was applied in first recurrent 53 cases but 2nd recurrence was developed in 16 cases. In 52 cases, surgical management was applied. The pleurodesis with chemical agent[tetracycline] via chest tube was applied in 2 cases. Among 51 cases subjected to the open thoracotomy, pleural abrasion was performed in 3 cases, excision of bullae & blebs in 12 cases, wedge resection in 28 cases, lobectomy in 6 cases and wedge resection combined with lobectomy in 2 cases. In one case subjected to the median sternotomy, wedge resection on both lung apex was performed. 8] Postoperative complications were developed in 8 cases but not serious.

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A Case of Successful Surgical Repair for Pectus Arcuatum Using Chondrosternoplasty

  • Kim, Sang Yoon;Park, Samina;Kim, Eung Rae;Park, In Kyu;Kim, Young Tae;Kang, Chang Hyun
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.214-217
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    • 2016
  • Pectus arcuatum is a rare complex chest wall deformity. A 31-year-old female presented with a severely protruding upper sternum combined with a concave lower sternum. We planned a modified Ravitch-type operation. Through vertical mid-sternal incision, chondrectomies were performed from the second to fifth costal cartilages, saving the perichondrium. Horizontal osteotomy was performed in a wedge shape on the most protruding point, and followed by an additional partial osteotomy at the most concaved point. The harvested wedge-shape bone fragments were minced and re-implanted to the latter osteotomy site. The osteotomized sternum was fixed with multiple wirings. With chondrosternoplasty, a complex chest wall deformity can be corrected successfully.

실험 계획법을 이용한 고속 반활주선의 부가물 최적화 (A Study on the Appendages Optimization of a High Speed Semi-Planing Monohull using DOE)

  • 서관희;김현철
    • 대한조선학회논문집
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    • 제51권3호
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    • pp.184-192
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    • 2014
  • The resistance of a high speed monohull can be dramatically increased at the high speed range due to the severe stern trim, spray formation and hull bottom pressure irregularity etc. In order to avoid these demerits associated with this resistance increase, various appendages such as the stern wedge, vertical wedge, stern flap, spray strip etc. have been studied. Each of appendage can control the trim angle and/or improve the resistance performance. If these appendages are combined for finding the maximal resistance reduction, there are enormous combination selections. This paper presents the DOE(Design of experiment) using an orthogonal array in order to decrease the model tests finding the optimum appendage combination. And we evaluate that the method introduced in this paper makes the optimal combination of appendages efficient and time-saving by applying to high speed semi-planing monohull. Here, the maximum speed and the least fuel expense are adopted as the decision criteria.

Ewing's Sarcoma of the Stomach; Rare Case of Ewing's Sarcoma and Suggestion of New Treatment Strategy

  • Kim, Hyo-Sin;Kim, Sungsoo;Min, Young-Don;Kee, Keun-Hong;Hong, Ran
    • Journal of Gastric Cancer
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    • 제12권4호
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    • pp.258-261
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    • 2012
  • Ewing's sarcoma is a neoplasm of the undifferenciated small round cells, which generally affects the bone and deep soft tissues of children and adolescents. We present a case of gastric Ewing's sarcoma; a 35-year-old female who had no symptoms. While she was at a routine medical checkup, a protruding mass in her gastric antrum was incidentally found on esophagogastroduodenoscopy. Endoscopic ultrasonogram showed a submucosal mass on the same lesion and a laparosopic wedge resection was done. Pathologic gross findings showed a granular grape appearance tissue and histoloigc examination revealed a small round cell tumor with CD 99 immunoexpression positive. In general, a combined modality therapy for Ewing's sarcoma such as surgical resection with chemotherapy, is accepted as an effective method. However, this patient had no adjuvant chemotherapy after surgery and she has no recurrence for eleven months.

관절경 하 미세골절술 이후에도 통증이 지속되는 거골의 내측 골연골병변에 대하여 이차 관절경 수술과 함께 시행된 과상부절골술: 증례 보고 (Supramalleolar Osteotomy Combined with Redo Arthroscopy for a Patient with Persistent Pain after Primary Arthroscopic Microfracture for Medial Osteochondral Lesion of the Talus: A Case Report)

  • 송태훈;서진수;최준영
    • 대한족부족관절학회지
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    • 제27권2호
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    • pp.71-74
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    • 2023
  • A medial opening wedge supramalleolar osteotomy (SMO) introduced by Takakura et al. is a useful realignment procedure for patients with ankle joint arthritis and varus malalignment by shifting the weight-bearing axis laterally and redistributing the loads on the ankle joint. When pain persists after arthroscopic microfracture in patients with medial osteochondral lesion of the talus (OLT), redo arthroscopy, osteochondral autograft transplantation, autologous chondrocyte implantation, or matrix-induced chondrogenesis might be indicated. On the other hand, there is insufficient scientific evidence for realignment surgery through SMO, while the effect of realignment surgery has been studied consecutively for osteochondral lesions of the knee. Therefore, this paper reports a patient with medial OLT who underwent redo arthroscopy combined with SMO for persistent pain after primary arthroscopic microfracture.

A Numerical Analysis of Supersonic Intake Buzz in an Axisymmetric Ramjet Engine

  • Yeom, Hyo-Won;Sung, Hong-Gye;Yang, Vigor
    • International Journal of Aeronautical and Space Sciences
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    • 제16권2호
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    • pp.165-176
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    • 2015
  • A numerical analysis was conducted to investigate the inlet buzz and combustion oscillation in an axisymmetric ramjet engine with wedge-type flame holders. The physical model of concern includes the entire engine flow path, extending from the leading edge of the inlet center-body through the exhaust nozzle. The theoretical formulation is based on the Farve-averaged conservation equations of mass, momentum, energy, and species concentration, and accommodates finite-rate chemical kinetics and variable thermo-physical properties. Turbulence closure is achieved using a combined scheme comprising of a low-Reynolds number k-${\varepsilon}$ two-equation model and Sarkar's compressible turbulence model. Detailed flow phenomena such as inlet flow aerodynamics, flame evolution, and acoustic excitation as well as their interactions, are investigated. Mechanisms responsible for driving the inlet buzz are identified and quantified for the engine operating at subcritical conditions.

폐국균증의 외과적 치료 (Surgical Treatment of Pulmonary Aspergillosis)

  • 여승동
    • Journal of Chest Surgery
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    • 제25권6호
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    • pp.611-615
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    • 1992
  • Between July 1988 and August 1991, 8 cases of pulmonary resection for pulmonary asp-ergilloma had been performed in the department of thoracic surgery, Korea Cancer Center Hospital. The patients were consisted of 4 males and 4 females and were evenly distributed from fourth decade to sixth decade. Hemoptysis was the most common chief compla int. In chest roentgenogram, patch infiltration was noted in 4 cases[50%] and intracavi-tary fungus ball was noted in only 2 cases[25%]. A. fumigatus was identified pre-operatively in 2 cases by bronchoscopic washing and in 1 case by culture of pleural effusion, Eight pulmonary resections were done by 5 lobectomies, 1 segmentectomy, 1 wedge resection and 1 pneumonectomy, Postoperative pathologic findings showed that 6 cases [75%] were combined with bronchiectasis, 1 case with tuberculosis and 1 case with pneumonia. We experinced 1 case of postoperative pulmonary edema but there was no mortality case.

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Taxonomic Considerations on the Bast Fibres in the Genus Sida L. (Malvaceae) in Nigeria

  • Oladele, F.A.
    • Journal of Plant Biology
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    • 제29권2호
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    • pp.135-143
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    • 1986
  • The distributional pattern of the bast fibres strands or bundles in the stems of Sida species represented in Nigeria is studied. Three major patterns of arrangement are recognized, namely aggregation of fibre strands into units with wedge-shaped, or triangular, rectangular, rhomboidal, square and trapezoid outlines; serial arrangement of fibre strands into rings or circular, ovoid, semi-circular or crescentic rows; and intermediate pattern in which both fibre strands-aggregates and serial rows of strands patterns are combined. The first pattern is found in S. linifolia, S. urens and S. scabrida, the second in S. cordifolia, S. pilosa, S. ovata, S. rhombifolia and S. spinosa, and the third in S. garckeana, and S. acuta. A dichotomous key based on these features is presented. Dimensional characteristics of the bast fibre cells are also given.

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Outcome of Limited Resection for Lung Cancer

  • Cho, Jeong-Su;Jheon, Sang-Hoon;Park, Sung-Joon;Sung, Sook-Whan;Lee, Choon-Taek
    • Journal of Chest Surgery
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    • 제44권1호
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    • pp.51-57
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    • 2011
  • Background: Up to now, lobectomy, bilobectomy and pneumonectomy combined with extensive lymph node dissection have been regarded as the standard procedures for non-small cell lung cancer (NSCLC). In high-risk patients, however, limited resection (LR) has been attempted as a salvage procedure, and, recently, indication for LR has been extended to selected cases with early-stage NSCLC. Material and Methods: Among the 773 patients who underwent surgical procedures for NSCLC in Seoul National University Bundang Hospital from May 2003 to December 2008, 43 patients received LR. Medical records of these patients were retrospectively reviewed. Results: Mean age at operation was $66.0{\pm}12.4$ years, and there were 30 males. Twenty-five patients underwent conservative limited resection (CLR) and 18 underwent intentional limited resection (ILR). Indications for CLR were multiple primary lung cancer in 9 (9/25, 36%) and severe concomitant diseases in 5 (5/25, 20%). Of these, 6 patients underwent segmentectomy and 19 received wedge resection. During the follow-up period of $28.0{\pm}17.8$ months, 15 patient developed recurrent lung cancer. ILR was selectively performed in lesions almost purely composed of ground glass opacity (${\geq}$95%), or in small solid lesions (${\leq}$2 cm). Of these, 11 patients underwent segmentectomy and 7 underwent wedge resection. During the follow-up period of $31.7{\pm}11.6$ months, no patient developed recurrence. Conclusion: Intermediate-term outcome of LR for early-stage lung cancer is comparable to that of standard operation. For the delineation of the indications and appropriate surgical techniques for LR, prospective randomized multi-institutional study may be expedient.