• 제목/요약/키워드: One-stage operation

검색결과 516건 처리시간 0.026초

신생아기 일기식 방법으로 수술한 Hirschsprung병에 대한 고찰 (One-stage Repair of Neonatal Hirschsprung's Disease)

  • 임시연;정풍만
    • Advances in pediatric surgery
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    • 제13권1호
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    • pp.61-65
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    • 2007
  • Conventional treatment of Hirschsprung's disease consists of initial colostomy followed by pull-through operation. But, the treatment of Hirschsprung's disease has been changed along with the development of new surgical technique. Since 1995, endo-GIA has been available at our hospital and one stage Duhamel operation has been performed for neonatal Hirschsprung's disease. Between May 1995 and April 2006, 26 neonates have been treated with one stage pull-through operation by one pediatric surgeon at HanYang University Hospital. The sex ratio was 4.2:1 with male predominance. Clinical findings included abdominal distension (96.2 %), vomiting (50.0 %), delayed passage of meconium (46.2 %), constipation (23.1 %), and enterocolitis (15.4 %). Twenty two cases (84.6 %) were short-segment and 4 cases (15.4 %) were long-segment disease, of which 2 cases were total colon aganglionosis. One of the two patients with total colonic aganglionosis had double transition zones - distal ileum and hepatic flexure of the colon. The average age at operation was $14.56{\pm}8.77$ days and the average weight at operation was $3.26{\pm}0.66kg$. Primary Duhamel operations were performed in 25 patients and Soave-Boley operations was performed in one patient. The endo-GIA 35 (Ethicon, USA) was used from 1995 until 1997, and after that endo-GIA 60 (USSC, USA) was used. The average Duhamel operation time was $88.57{\pm}22.80$ minutes. Wound abscess (n = 2) and septum formation (n =1) occurred after Duhamel operation. Bowel function was normalized in 59 % within 3 months and in 95% within 1 year after operation. There was no mortality after one stage pull-through operation in neonate.

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유연 제조시스템에서 작업경로선택과 경제적인 설계에 관한 연구 (A Study on Parts Route Selection and Economic Design in Flexible Manufacturing System)

  • 장석화
    • 산업경영시스템학회지
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    • 제20권43호
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    • pp.249-263
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    • 1997
  • This paper addresses the parts route selection and economic design in flexible manufactuirng system (FMS). Parts are processed through several stage workstations according to operation sequences. The machine of each workstation can do multiple operation functions. And the operation stage of a part can be processed in several workstations, which are non-identical in functional performance. The objective of this paper is to determine the processing routes of parts, number of machine at each workstation, number of vehicle and makespan time. Two models are suggested. One is assumed that the operation stage of parts can be processed at the only one among several available workstations. Other is assumed that the operation stage of parts is allowed to be processed at several workstations. Parts are transported by automated guided vehicles (AGVs). The decision criteria is to minimize the sum of processing cost, travel cost, setup cost and overhead cost. The formulation of models is represented. A solution algorithm is suggested, and a numerical example is shown.

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식도암의 외괴적 조기관찰 성적 (Short-term Results of Surgical Treatment in Esophageal Carcinoma)

  • 오봉석
    • Journal of Chest Surgery
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    • 제25권4호
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    • pp.398-405
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    • 1992
  • Twenty nine adult patients underwent surgical esohpagectomy and one, bypass procedure for documented carcinoma of esophagus and cadiac portion of stomach at Chonnam National University Hospital from Jan 1986 to April 1991. There were several kinds of esophagectomies including through transhiatal, left thoracotomy only, laparotomy and thoracotomy, and laparotomy and right thoracotomy and cervical incision. Twenty five and squamous cell carcinoma and 5, adenocarcinoma. The tumor locations were the upper third in 3, middle third in 12, lower third in 10 and cardiac portion of stomach in 5. After operation, 8[27%] patients were classified in Stage IIa, 6[20%] patients in Stage IIb, 15 patients[50%] in Stage III and one patient in Stage IV. Major postoperative complications included anastomotic narrowing in 3, limited suture line leak in 2, wound infection in 2, hoarseness in 2, pseudomembraneous enterocolitis in 1 and herpes zoster in 1. There was no death within 30 days of operation. Ten months survival was 100% for patients with Stage lIa, 67% for patients with Stage IIb, 50% for patients with Stage III. Furthermore, 20 months survival was 75% in IIIa, 33% in IIb, and 40% in III. But there were no significant differences in survivals among the stage. The actuarial survival is 58% at one year and 41% at two years, The periods of average survival is 589 days after operation.

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재발성 비소세포암의 수술적 치료 (Surgical Treatment of Recurrent Lung Cancer)

  • 유원희;김문수;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • 제33권1호
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    • pp.68-72
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    • 2000
  • Background: The resection of recurrent non-small cell lung cancer can be performed very rarely. There has been many arguments for longterm result and therapeutic role in surgical management of recurrent non-small cell lung cancer(NSCLC). We analyze our result of surgical re-resection of recurrent NSCLC for 10 years retrospectively. Material and Method: In the period from 1987 to 1997, 702 patients who had been confirmed for NSCLC had undergone complete resection in Seoul National University Hospital. As December 1997, 22 of these patients have been operated on the diagnosis of recurrent lung cancer. In these patients one has revealed for benign nodule at postoperative pathologic pathologic was unresectable. and two had revealed other cell type on postoperative pathologic examination. Analysis about postoperative survival rate and the factors that influence postoperative survival rate - sex, age, pathologic stage, cell type, operation adjuvant therapy after first and second operation location of recurrence disease free survival-was 59.1$\pm$10.9 year. There were 14 men and 3 women. Four patients was received radiation therpy after first opration and two patients was received postoperative chemotherapy. At first operation 2 patients was stage Ia, 8 was stage Ib, 1 was stage IIa 6 was stage IIb. Eleven patients had squamous. cell carcinoma at postoperatrive pathologic examination five had adenocarcinoma and one had bronchioalveolar carcinoma. In second operation 8 patients were received limited resection. 9 were received lobectomy or pneumonectomy. One-year survival rate was 82.4% and five-year survival rate was 58.2% Non-adjuvant therapy group after initial operation was more survived than adjuvant therapy group statistically. Conclusion: operation was more survived than adjuvant therapy group statistically. Conclusion : Operation was feasible treatment modality for re-resectable non-small cell lung cancer. But we cannot rule out possibility of double primary lung cancer for them. Postoperative prognostic factor was adjuvant therapy or nor after first oepration but further study of large scale is needed for stastically more valuable result.

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흉선종의 외과적 치료 (Surgical Treatment for Thymoma)

  • 김동관;이두연
    • Journal of Chest Surgery
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    • 제24권1호
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    • pp.48-53
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    • 1991
  • This report documents the clinical k pathologic features of 33 patients treated for thymoma for 11 years & 6 months between September 1977 and February 1989. At the Thoracic & Cardiovascular Surgery, Yonsei University, College of Medicine of the group, 31 patients treated with surgery were examined for the result of operation & prognosis. Mean age was 50 years. Thirteen were female and twenty were male. Dyspnea on exertion and chest discomfort were common in the patients without myasthenia gravis. Fourteen patients[42.6%] had myasthenia gravis and one patient had autoimmune thyroid disease. Four patients[12.1%] presented without symptoms attributable to their thymoma. Histologic review disclosed 12[36.4%] epithelial thymoma, 10[30.3%] mixed lymphoepithelial, 9[27.3%] lymphocytic, 1[3.0%] spindle cell and 1[3.0%] unknown cell thymoma. They were classified according to Masaoka`s clinical staging criteria; by these criteria, 8 patients were stage I, 5 patients were stage II, 15 patients were stage III and 3 patients were stage IV. Total excision of mass was possible in 20 patients. Partial excision of mass in 4 patients and biopsy in 7 patients were carried out during the operation. There was only one operation mortality. Follow-up was possible in 26 patients and follow-up ranged from 4 months to 10.5 years[mean 28.9 months]. One-year survival rates were 77.8% and eight patients expired during follow-up period. Eleven[78.6%] patients with myasthenia gravis were improved after the operation. This observation suggests that the most significant factor determining the survival is whether or not total surgical excision had been performed.

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식도암의 임상적 고찰 (Clinical Analysis of Esophageal Cancer Patient)

  • 임창영
    • Journal of Chest Surgery
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    • 제21권5호
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    • pp.856-862
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    • 1988
  • The survival rate after resectional operation for carcinoma of the esophagus is still very low and many factors contribute to these poor results. We analyze the clinical results of 56 operated patients among 62 esophageal cancer patients between March, 1974 and July, 1988. Among the 62 patients, 52 patients were squamous cell carcinoma and 8 were adenocarcinoma, one was leiomyosarcoma and one was adenosquamous cell carcinoma. The classification of esophageal cancer was based on TNM classification of American Joint Committee on cancer". Among the operated patients, stage I was 5[9.6%], stage II was 13[25%], stage III was 26[50%], stage IV was 8[15.4%]. And its one year survival rate was 80%, 69%, 11.5%, 0% for each stages. The rate of resectability was 30.3% and resection of esophagus with esophagogastrostomy and extended lymph node dissection was performed on 17 patients without distant metastasis or adjacent organ invasion. Substernal esophago-colono-gastrostomy, Celestine tube insertion and feeding gastrostomy was performed on remained 39 patients. The analysis of postoperative survival duration revealed the superiority of esophagectomy with extended lymph node dissection over other palliative operation. [1 year survival rate: 79% versus 21%] We concluded that the survival rate of esophageal resection with lymph node dissection group was superior to nonresective palliative operation group. And transthoracic approach was superior to extrathoracic approach in involved lymph node dissection and esophageal resection in locally invaded cases.ases.

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수지 첨부 손상에서 피부이식을 동반하지 않은 무세포 진피조직의 사용 (Application of acellular dermal matrix without skin graft in fingertip injury)

  • 이동휘;강재경
    • Journal of Medicine and Life Science
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    • 제15권1호
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    • pp.23-26
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    • 2018
  • The most common surgical repair method for fingertip injuries are replantation, flap coverage, and skin graft. In fingertip injury cases, acellular dermal matrix (ADM) is generally used in a two-stage operation. In the present case, only ADM was used in a 67-year-old male patient with a right fifth fingertip injury. The patient was undergoing chemotherapy after surgery for colon cancer, preventing prolonged hospitalization. In addition, wound healing was likely to be problematic. As a typical surgical method might have been difficult to apply in such a patient, we performed a one-stage operation, using only ADM on the injured area. Postoperative followup for 3 months showed good wound healing. Accordingly, we report a successful treatment outcome using ADM alone for a fingertip injury.

Modified Ac-Dc Single-Stage Converters

  • Moschopoulos, Gerry;Liu, Yan;Bassan, Sondeep
    • Journal of Power Electronics
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    • 제7권1호
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    • pp.44-54
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    • 2007
  • Ac-dc power conversion can either be done with two separate converter stages or with a single converter stage. Two-stage ac-dc converters, however, can be costly and complex, while the performance of single-stage converters is compromised due to a reduced number of components. Several researchers have therefore proposed adding some sort of auxiliary circuit consisting of a second switch and some passive elements to single-stage converters to improve their performance. Although these modified single-stage converters may have two converters, they are not two-stage converters as they do not have two separate and independently controlled converters that are always operating to convert power from one form to another. In this paper, the operation of ac-dc single-stage converters is first reviewed and their strengths and weaknesses are noted. The operation of several modified single-stage converters, including one proposed by the authors, is then discussed, and the paper concludes by presenting experimental results that confirm the feasibility of the proposed converter.

방화문의 내화성능 향상을 위한 3단 문 결속기 연구개발 (Research and development of a three-stage door binder to improve the fire resistance of fire doors)

  • 임보혁;이주원;조동환;이해열
    • 한국건축시공학회:학술대회논문집
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    • 한국건축시공학회 2023년도 가을학술발표대회논문집
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    • pp.157-158
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    • 2023
  • Doors that are opened and closed when entering or exiting a general building are connected to the door frame and open and close. They are equipped with door locking devices of various structures, and are either locked to the door frame for the closing operation or released from the door frame for the opening and closing operation. Here, a single-stage door binding device having a door latch that is independently disposed at the center of one axis of the door is commonly used. On the other hand, if the size of the door is over a certain size or if the door is medium to large, the opening and closing operation may not be performed smoothly with only a single stage binder, or the closing state may not be achieved stably during the closing operation. In particular, in the case of the single-stage binding device provided in medium to large fire doors, the door is fixed to the door frame unstable, causing fatal errors in the fire prevention function of the fire door. Accordingly, in order to fundamentally solve these problems, we researched and developed a three-stage door binding machine that combines a top and bottom fastening structure with a single-stage fastening structure. This 3-stage door binder not only has the fire resistance performance of a fire door, but also has a T-shaped terminal in its fastening method, so if you eliminate the upper and lower fastening, it is a 1-stage binder like a regular product, but if you remove the door latch of the 1st-stage binder, it functions as an upper and lower 2-stage binder and forms a single mold. We researched and developed a three-stage door binder that can manufacture and produce three products at the same time, satisfying both product performance and price.

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Major Aorto-pulmonary Collateral Artery 를 동반한 폐동맥 형성부전 및 심실중격결손의 외과적 수술요법 (Unifocalization and Complete Repair of Pulmonary Atresia and Ventricular Septal Defect with Major Aortopulmonary Collateral Arteries)

  • 이정상
    • Journal of Chest Surgery
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    • 제23권6호
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    • pp.1191-1203
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    • 1990
  • Pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries [abbreviated as PA+VSD+MAPCA in the following] has limited the success of attempts at accurate diagnosis and complete surgical repair. From April 1986 to September 1990, 23 patients with PA+VSD+MAPCA among 96 patients of PA+VSD in Seoul National University Children’s Hospital were encountered. The group comprised 14 male and 9 female patients with ages ranging from 17 days to 177 months [mean 49.6 months]. We operated one stage total repair on good pulmonary artery sized two patients by R.E.V. [Reparation a l’etage ventriculaire] and Rastelli operation respectively. And the 11 patients who had independent MAPCAs and hypoplastic central pulmonary artery were dealt with unifocalization and modified Blalock-Taussig Shunt and followed by second stage repair in 3 patients later. We successfully had managed 7 patients whose MAPCAs could be ligated with modified Blalock-Taussig Shunt and followed by second stage repair in 3 patients with R.E.V or Rastelli operation. Recently, three obstruction after 11 unifocalization procedures made us to try palliative right ventricle-pulmonary artery conduit operation by Gore-Tex vascular graft interposition under cardiopulmonary bypass. And so we managed another 3 patients with these procedures for the purpose of pulmonary artery growth whose central pulmonary artery were severely hypoplastic. We experienced one death after second stage repair whose central pulmonary artery was created by 12mm Gore-Tex vascular graft and was unifocalized.

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