• 제목/요약/키워드: Hand reconstruction

검색결과 286건 처리시간 0.03초

식도재건술후 문합부 합병증 (Anastomotic Complications after Esophageal Reconstruction)

  • 이철범;함시영;김혁;정원상;김영학;강정호;백홍규
    • 대한기관식도과학회지
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    • 제6권1호
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    • pp.62-71
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    • 2000
  • Background: For the purpose of reducing operating time and rate of anastomotic leakage, we have performed esophagovisceral anastomosis with an EEA stapler using the largest size possible. If any difficulty in the approach of the EEA stapler was encountered one-layer interrupted hand-sewn anastomosis. Because the rate of postoperative benign anastomotic stricture was higher than expected, a retrospective study was done on all patients who underwent esophageal reconstruction. Material and Method: Over a period of 3 years from January 1996 to December 1998, we performed esophageal reconstructions on 30 patients. Patients were divided into two groups ; EEA stapler group(Group Ⅰ) comprised of 21 patients and hand-sewn group(Group Ⅱ) comprised of 9 patients.Result:The hospital mortality was 6.67 %(2/30) and the anastomotic leakage rate was 3.33 %(1/30). Among the discharged patients, the rate of recurrent anastomotic tumor was 3.57 %(1/28) and the rate of benign anastomotic stricture stricture rate was 35 %(7/20) in Group Ⅰ and 12.5 %(1/8) in Group Ⅱ, which was not significant. Conclusion: Although nontumor benign stricture was significantly higher in Group Ⅱ than in Group Ⅰ(p=0.0492), the incidence of anastomotic complications did not differ between the two groups. The one-layer interrupted hand-sewn esophagovisceral anastomosis by maintaining a wide lumen and close approximation of mucosa to mucosal layers with evenly spaced sutures could be one of the preferred surgical method to reduce benign anastomotic strictures.

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Intra-Motion Compensation Using CSRS method in MRI

  • Ro, Y.M.;Yi, J.H.;Cho, Z.H.
    • 대한의용생체공학회:의공학회지
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    • 제15권4호
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    • pp.377-382
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    • 1994
  • In the conventional Fourier imaging method in MRI (Magnetic Resonance Imaging), intramotion such as pulsatile flow makes zipper-like artifact along the phase encoding direction. On the other hand, line-integral projection reconstruction (LPR) method has advantages such as imaging of short T2, object and reduction of the flow artifact by elimination of the flow-induced phase fluctuation. The LPR, however, necessarily requires time consuming filtering and back-projection processes, so that the reconstruction takes long time. To overcome the long reconstruction time of the LPR and to obtain the flow artifact reduction effect, we adopted phase corrected concentric square raster sampling (CSRS) method and improved its imaging performance. The CSRS is a fast reconstruction method which has the same properties with the LPR. In this paper, we proposed a new method of flow artifact reduction using the CSRS method. Through computer simulations and experiments, we verified that the proposed method can eliminate phase fluctuations, thereby reducing the flow artifact and re- markably shorten the reconstruction time which required long time in the LPR.

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양측 천외음부동맥 천공지 피판을 이용한 음경둘레 연조직 결손의 재건 (Reconstruction of a Circumferential Penile Shaft Defect Using Bilateral Superficial External Pudendal Artery Perforator Flaps)

  • 박종옥;신동혁;최현곤;김지남;이명철
    • Archives of Hand and Microsurgery
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    • 제23권4호
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    • pp.296-300
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    • 2018
  • 음경 둘레 연조직 결손은 다양한 공여부를 이용하여 재건할 수 있으며, 유리피판술 및 국소피판술을 응용할 수 있다. 유리피판술의 경우 성공적인 결과를 위해 수술 과정 및 술 후 관리에 기술적인 어려움이 있으며, 기존 국소피판술은 결손 부위의 크기나 모양에 제약이 따르게 된다. 이에 양측 천외음부동맥 천공지피판을 이용한 음경둘레 연조직 결손 재건의 성공적인 사례를 발표하고자 한다. 음경 둘레 연조직 결손은 음낭근막까지 관찰되었으며, 변연절제술 시행 이후 심부근막과 해면체는 보존하였다. 이후 양측 천외음부동맥 천공지 피판을 이용하여 음경 전체 둘레연조직 결손 부위를 재건하였다. 27개월의 추적 관찰 기간 동안 음경의 형태와 기능은 보존되었으며, 창상치유와 연관된 문제는 관찰되지 않았다.

트래커를 활용한 딥러닝 기반 실시간 전신 동작 복원 (Deep Learning-Based Motion Reconstruction Using Tracker Sensors)

  • 김현석;강경원;박강래;권태수
    • 한국컴퓨터그래픽스학회논문지
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    • 제29권5호
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    • pp.11-20
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    • 2023
  • 본 논문에서는 손 동작을 포함한 전신 동작 생성이 가능하고 동작 생성 딜레이를 조절할 수 있는 새로운 딥러닝 기반 동작 복원 기술을 제안한다. 제안된 방법은 범용적으로 사용되는 센서인 바이브 트래커와 딥러닝 기술의 융합을 통해 더욱 정교한 동작 복원을 가능하게함과 동시에 IK 솔버(Inverse Kinematics solver)를 활용하여 발 미끄러짐 현상을 효과적으로 완화한다. 본 논문은 학습된 오토인코더(AutoEncoder)를 사용하여 트래커 데이터에 적절한 캐릭터 동작의 실시간 복원이 가능하고, 동작 복원 딜레이를 조절할 수 있는 방법을 제안한다. 복원된 전신 동작에 적합한 손 동작을 생성하기 위해 FCN(Fully Connected Network)을 사용하여 손 동작을 생성하고, 오토인코더에서 복원된 전신 동작과 FCN 에서 생성된 손 동작을 합쳐 손 동작이 포함된 캐릭터의 전신 동작을 생성할 수 있다. 앞서 딥러닝 기반의 방법으로 생성된 동작에서 발 미끄러짐 현상을 완화시키기 위해 본 논문에서는 IK 솔버 를 활용한다. 캐릭터의 발에 위치한 트래커를 IK 솔버의 엔드이펙터(end-effector)로 설정하여 캐릭터의 발 움직임을 정확하게 제어하고 보정하는 기술을 제안함으로써, 생성된 동작의 전반적인 정확성을 향상시켜 고품질의 동작을 생성한다. 실험을 통해, 본 논문에서 제안한 딥러닝 기반 동작 복원에서 정확한 동작 생성과 사용자 입력에 따라 프레임 딜레이 조정이 가능함을 검증하였고, 생성된 전신 동작의 발미끄러짐 현상에 대해 IK 솔버가 적용되기 이전 전신 동작과 비교하여 보정에 대한 성능을 확인하였다.

전외측대퇴근막 유리피판술을 이용한 수부의 재건 (Reconstruction of hand using anterolateral thigh fascial free flap)

  • 김기완;김진수;이동철;기세휘;노시영;양재원
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.571-577
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    • 2009
  • Purpose: The Provision of thin and pliable tissue and the adequate coverage of tendon - gliding surface is necessary for a soft tissue defect of the hand with exposure of bone, tendon and muscle. This report will discuss our experience with anterolateral thigh fascial free flap for the reconstruction of the soft tissue defect of the hand. Methods: Between February 2004 and August 2008, seven patients with full - thickness soft tissue defects of the hand were reconstructed by means of a composite anterolateral thigh fascial free flap. There were soft tissue defects associated with trauma (n=5), scar contracture (n=1) and necrosis due to ischemia (n=1). Flaps were harvested from the anterolateral thigh as adipofascial flaps with only a small sheet of fascia and fatty tissue above it. The fascia and the skin of the donor site was closed directly and delayed split - thickness skin graft was performed. Result: All flaps survived completely. The size of the transferred flap ranged from $2{\times}4cm$ to $5{\times}8cm$. Thin flap coverage was possible without secondary debulking operations. It left minimal donor site morbidity with a linear scar. In one case, the thigh muscle herniation in the donor site was developed. Conclusion: The anterolateral thigh fascial free flap provided thin and pliable tissue which can establish a tendon - gliding mechanism, minimal bulk, minimal donor site morbidity. The disadvantages of this technique were the need for a skin graft and the muscle herniation of donor site.

Efficacy of Roux-en-Y Reconstruction Using Two Circular Staplers after Subtotal Gastrectomy: Results from a Pilot Study Comparing with Billroth-I Reconstruction

  • Kim, Tae-Gyun;Hur, Hoon;Ahn, Chang-Wook;Xuan, Yi;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • 제11권4호
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    • pp.219-224
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    • 2011
  • Purpose: The Roux en Y method has rarely been performed due to longer operation time and high risk of complication, despite several merits including prevention of bile reflux. We conducted a retrospective review of the result of Roux en Y reconstruction using two circular staplers after subtotal gastrectomy. Materials and Methods: From December 2008 to May 2009, a total of 26 patients underwent Roux en Y reconstruction using two circular staplers after subtotal gastrectomy, and seventy-two patients underwent Billroth-I reconstruction. Roux en Y anastomosis was performed using two circular staplers without hand sewing anastomosis. We compared clinicopathologic features and surgical outcomes between the two groups. All patients underwent gastrofiberscopy between six and twelve months after surgery to compare the bile reflux. Results: No significant differences in clinicopathologic findings were observed between the two groups, except for the rate of minimal invasive surgery (P=0.004) and cancer stage (P=0.002). No differences in the rate of morbidity (P=0.353) and admission duration (P=0.391) were observed between the two groups. Gastrofiberscopic findings showed a significant reduction of bile reflux in the remnant stomach in the Roux en Y group (P=0.019). Conclusions: When compared with Billroth-I reconstruction, Roux en Y reconstruction using the double stapler technique was found to reduce bile reflux in the remnant stomach without increasing postoperative morbidity. Based on these results, we planned to begin a randomized controlled clinical trial for comparison of Roux en Y reconstruction using this method with Billroth-I anastomosis.

A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer

  • Hur, Hoon;Ahn, Chang Wook;Byun, Cheul Su;Shin, Ho Jung;Kim, Young Bae;Son, Sang-Yong;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • 제17권3호
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    • pp.255-266
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    • 2017
  • Purpose: Although Roux-en-Y (R-Y) reconstruction after distal gastrectomy has several advantages, such as prevention of bile reflux into the remnant stomach, it is rarely used because of the technical difficulty. This prospective randomized clinical trial aimed to show the efficacy of a novel method of R-Y reconstruction involving the use of 2 circular staplers by comparing this novel method to Billroth-I (B-I) reconstruction. Materials and Methods: A total of 118 patients were randomly allocated into the R-Y (59 patients) and B-I reconstruction (59 patients) groups. R-Y anastomosis was performed using two circular staplers and no hand sewing. The primary end-point of this clinical trial was the reflux of bile into the remnant stomach evaluated using endoscopic and histological findings at 6 months after surgery. Results: No significant differences in clinicopathological findings were observed between the 2 groups. Although anastomosis time was significantly longer for the patients of the R-Y group (P<0.001), no difference was detected between the 2 groups in terms of the total surgery duration (P=0.112). Endoscopic findings showed a significant reduction of bile reflux in the remnant stomach in the R-Y group (P<0.001), and the histological findings showed that reflux gastritis was more significant in the B-I group than in the R-Y group (P=0.026). Conclusions: The results of this randomized controlled clinical trial showed that compared with B-I reconstruction, R-Y reconstruction using circular staplers is a safe and feasible procedure. This clinical trial study was registered at www.ClinicalTrials.gov (registration No. NCT01142271).

대퇴 근막이 포함된 전외측대퇴피판을 이용한 다양한 연부조직 결손의 재건 (Soft Tissue Reconstruction Using Anterolateral Thigh Flap with Fascia Lata Component)

  • 이신철;은석찬;백롱민
    • Archives of Plastic Surgery
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    • 제38권5호
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    • pp.655-662
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    • 2011
  • Purpose: The anterolateral thigh flap is versatile flap for soft-tissue reconstruction for defects located at various sites of the body. This useful flap offers a thick and vascular fascia lata component with large amounts that can be soft tissue coverage for different reconstructive purposes. We present our clinical experience with the use of vascular fascia lata, combined with anterolateral thigh flap for various reconstructive goals. Methods: From April 2008 to February 2011, we transferred anterolateral thigh flaps with fascia lata component to reconstruct soft-tissue defects for different purposes in 11 patients. The fascia lata component of the flap was used for tendon gliding surface in hand/forearm reconstruction in 4 patients, for reconstruction medial and lateral patellar synovial membrane and retinaculum in 2 patients, for reconstruction of plantar aponeurosis in the foot in 2 patients, for reconstruction of fascial and peritoneal defect in the abdominal wall in 2 patient, and for dural defect reconstruction in the scalp in the remaining one. Results: Complete loss of the flap was not seen in all cases. Partial flap necrosis occurred in 2 patients. These complications were treated successfully with minimal surgical debridement and dressing. Infection occurred in 1 patient. In this case, intravenous antibiotics treatment was effective. Conclusion: Anterolateral thigh flap has thick vascular fascia with large amounts. This fascial component of the flap is useful for different reconstructive aims, such as for tendon, ligament, aponeurosis defects, abdominal wall or dura reconstruction. It should be considerated as an important advantage of the flap, together with other well-known advantages.

RGB 이미지에서 트랜스포머 기반 고밀도 3D 재구성 (Transformer-based dense 3D reconstruction from RGB images)

  • 서가가;고서;문명운;조경은
    • 한국정보처리학회:학술대회논문집
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    • 한국정보처리학회 2022년도 추계학술발표대회
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    • pp.646-647
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    • 2022
  • Multiview stereo (MVS) 3D reconstruction of a scene from images is a fundamental computer vision problem that has been thoroughly researched in recent times. Traditionally, MVS approaches create dense correspondences by constructing regularizations and hand-crafted similarity metrics. Although these techniques have achieved excellent results in the best Lambertian conditions, traditional MVS algorithms still contain a lot of artifacts. Therefore, in this study, we suggest using a transformer network to accelerate the MVS reconstruction. The network is based on a transformer model and can extract dense features with 3D consistency and global context, which are necessary to provide accurate matching for MVS.

내족저변 격막 피판의 해부학적 고찰 및 임상적 적용 (An Anatomic Study and Clinical Application of Medial Plantar Septo-cutaneous Flap)

  • 윤을식;김정배;계민석;동은상;한승규;이병일;구상환;박승하;김우경
    • Archives of Reconstructive Microsurgery
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    • 제11권1호
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    • pp.53-62
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    • 2002
  • Several investigators have reported clinical experience of medial plantar septo-cutaneous flap for reconstruction for soft tissue defect of the hand and digits. Jayme and Hamilton first described the anatomy of superficial branch of medial division of the medial plantar artery used in this flap through cadavaric study in 1997. But, they had a few cases for this flap and there was no anatomic study in Korean. We experienced the reliability of medial plantar septo-cutaneous flap for reconstruction for soft tissue defect of hand and digits through an anatomic study (20 fresh specimens dissected) and clinical application (17 patients). An anatomic study revealed that there were differences in diameter and length of the vessels between Korean and Caucasian. The diameter of vessels in Korean is larger than Caucasian one in each area. Based on this anatomic knowledge, we could harvest this flap safely, and have performed reconstruction on 17 patients with soft tissue defects of hand and digits using a thin, flexible medial plantar septo-cutaneous flap similar to the volar aspect of the hand and digits in anatomical characteristics of the skin and subcutaneous tissue covering. The vessels used for this flap were superficial branches of medial division of the medial plantar artery and vena comitants, or the subcutaneous veins. The mean size of the flap was $2.82cm{\times}4.15cm$. All the flaps survived without significant complications. A medial plantar septo-cutaneous flap possesses several advantages : (1) It is very thin in comparison with other standard free flap; (2) it has two draining venous pathways; (3) it provides a good color and texture match for hand and finger; (4) a good recovery of protective sensation is achievable.

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