• 제목/요약/키워드: One-stage operation

검색결과 516건 처리시간 0.03초

복잡 심기형에서의 동맥 전환술에 대한 연구 (Arterial Switch Operation in Complex Congenital Heart Diseaes (Application, procedure analysis,risk assessment,and results))

  • 김용진
    • Journal of Chest Surgery
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    • 제28권3호
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    • pp.237-246
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    • 1995
  • Between March 1989 and December 1994, one-stage repair was performed for correction of the intracardiac malformations associated with aortic coarctation in 34 patients or interrupted aortic arch in 8 patients via median sternotomy. There were 26 male and 16 female patients, and their body weight ranged from 1.8 to 8 kg [mean weight, 4.0 1.4 kg . The age at the operation ranged from 7 days to 18 months [mean age, 3.1 $\pm$ 3.8 months . The repair of aortic coarctation or interrupted aortic arch was performed using extended end-to-end anastomosis in most of the patients [86%, 36/42 , and six patients underwent ductal tissue excision and patch aortoplasty. Intracardiac defects were corrected concomitantly through the right atrium unless the anatomy dictated otherwise. Obstructive outlet septum was resected whenever necessary. There were seven early deaths [16.8 % , and three late deaths with a mean follow-up period of 25 months [range from 1 to 65 months . Three patients were reoperated upon residual subaortic stenosis, stenosis at the RPA origin, and subacute bacterial endocarditis respectively. None showed any significant residual or anastomotic stenosis postoperatively. One stage repair of the aortic coarctation and interrupted aortic arch associated with intracardiac defect leaves no native coarctation shelf tissue or residual hypoplasia in the repaired segment, has low incidence of recurrent or residual stenosis, minimizes reoperation and incisions, and manages arch hypoplasia easily. We concluded that surgical results of one-stage repair for the intracardiac malformation associated with aortic coarctation or interrupted aortic arch are reasonable.

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One Stage Posterior Minimal Laminectomy and Video-Assisted Thoracoscopic Surgery (VATS) for Removal of Thoracic Dumbbell Tumor

  • Nam, Kyoung Hyup;Ahn, Hyo Yeoung;Cho, Jeong Su;Kim, Yeoung Dae;Choi, Byung Kwan;Han, In Ho
    • Journal of Korean Neurosurgical Society
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    • 제60권2호
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    • pp.257-261
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    • 2017
  • Objective : This study was conducted to assess the surgical results of one-stage posterior minimal laminectomy and video-assisted thoracoscopic surgery (VATS) for the treatment of thoracic dumbbell tumor and to describe its precise technique. In addition, we investigated the technique's usefulness and limitations. Methods : Seven cases of thoracic dumbbell tumor (two men and five women, mean age, 43 years) were analyzed retrospectively. Pathological findings included schwannoma in four patients, neurofibroma in two patients, and hemangioma in one patient. The location of tumors varied from T2/3 to T12/L1. Dumbbell tumors were resected by one-stage operation using posterior laminectomy followed by VATS without instrumentation. Clinical data were reviewed. Results : The mean follow-up period was 25 months (range, 3-58 months), and the operative time ranged from 255 to 385 min (mean, 331 min), with estimated blood loss ranging from 110 to 930 mL (mean, 348 mL). The tumor was completely resected without instrumentation and postoperative instability in all cases. Postoperative complications included atelectasis and facial anhydrosis in one case each. Conclusion : One-stage posterior minimal laminectomy and VATS may be a safe and less invasive technique for removal of thoracic dumbbell tumor without instability. This method has the advantage of early ambulation and rapid recovery because it reduces blood loss and postoperative pain.

부정류 해석에 의한 금강하류부 홍수위결정 (Flood Stage Determination by Implicit Nymerical Technique)

  • 선우중호
    • 물과 미래
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    • 제16권2호
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    • pp.123-129
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    • 1983
  • One of the techniques to determine flood stages in natural channel is to find the solution of unsteady flow equations such as continuity and momentum equations. Since the exact analytic solution of these equations are not Known, the implicit numerical scheme is widely accepted tool for the approximate solution of equations. This technique is applied to the downstream of Daechung Dam in Geum River for the determination of flood stage for given frequency. However the flood stages are greatly affected by the method of reservoir Operation Method and Technical Operation Reservoir Method. Obviously, the Tech. ROM is found to be superior to Auto ROM.

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유리 피판술 후 기능적, 미용적 목적을 위한 2차 보완수술 (Secondary Adjuvant Operation after Free Flap for Functional and Aesthetic Purposes)

  • 안희창;양은진;김창연
    • Archives of Reconstructive Microsurgery
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    • 제19권2호
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    • pp.101-107
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    • 2010
  • Purpose: The free flap has been widely used as one stage reconstructive procedure the skin and soft tissue defect. The secondary adjuvant operations are often needed for better results as functional and aesthetic compartment. Therefore, we focus on the secondary adjuvant surgeries for better outcome after free flaps. Methods: One hundred ninety six consecutive patients underwent free flaps between January, 2002 and February 2009. The cases constituted ninety two male patients and one hundred four female patients. For the patients who got free flap operation, we investigated secondary adjuvant operations what type of procedures was applied according to the reconstructed sites. All clinical data were based on the patient's medical records. Results: Of one hundred ninety six patients in whom free flap was performed, a total of eighty two patients(41.8%) received the secondary adjuvant operation. Because of many patients got multiple secondary adjuvant operations, the number of the secondary adjuvant operation become one hundred fifty five cases. The most common used procedure is a liposuction, and the second one is a lipoinjection. Conclusion: As the secondary adjuvant operation like a liposuction, lipoinjection, etc., satisfaction for operative result was increased in the aspects of function and aesthetics. So the secondary adjuvant operation in free flap surgeries contributed in raising the patient's quality of life.

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A Process Planning System for Machining of Dies for Auto-Body Production-Operation Planning and NC Code Post-Processing

  • Dongmok Sheen;Lee, Chang-Ho;Noh, Sang-Do;Lee, Kiwoo
    • International Journal of Precision Engineering and Manufacturing
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    • 제2권3호
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    • pp.69-78
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    • 2001
  • This paper presents a process and operation planning system and an NC code post-processor for effective machining of press dies for production of cars. Based on the machining feature, major parts of press dies are categorized into 15 groups and a standard process plan is defined for each group. The standard process plan consists of a series of processes where a process is defined as a group of operations that can be done with one setup. Details such as cutting tools, cutting conditions, and tool paths are decided at the operation planning stage. At the final stage of process and operation planning, the NC code post-processor adjusts feedrates along the tool path to reduce machining time while maintaining the quality. The adjustment rule is selected based on the machining load estimated by virtual machining.

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pN2 이상인 조기위암 환자의 수술 전과 수술 중의 평가 (What is the Prognosis for Early Gastric Cancer with pN Stage 2 or 3 at the Time of Pre-operation and Operation)

  • 김찬영;이세열;양두현
    • Journal of Gastric Cancer
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    • 제6권2호
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    • pp.114-119
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    • 2006
  • 목적: pN2 이상의 조기 위암환자들은 수술 전, 중에 병기 진행의 예측이 가능하였는지 아니면 전혀 예측하지 못한 채 낮은 병기를 기대하다가 병리조직검사의 결과를 보고서야 알게 되는지를 알고자 하였다. 대상과 방법: 1990년부터 2003년까지 본 연구기관에서 위암으로 위 절제술을 받은 1,430명 중 조기위암 환자는 552명(38.6%)이었고 이들 중 pN2, pN3 환자 8명을 대상으로 수술 전의 임상적 병기 예측과 수술 중의 수술자가 예측한 병기 예측을 병리조직검사의 결과와 비교하고 환자의 경과를 알아보았다. 결과: pN2와 pN3인 조기위암 환자들은 모든 연령층에 분포하였고 남자가 7명으로 여자보다 많았다. 수술 전 전산화단층촬영의 평가에서 T1의 평가는 25% (2/8)로 대체로 과평가되었고 N2 이상 평가는 50% (4/8)이었다. cTNM병기 Ia의 예측환자는 한 명으로 나머지 환자는 진행된 병기로 예측하였다. 수술 중의 T1의 평가는 57.1%(4/7), N2 이상 평가는 66.7% (4/6)이었고 sTNM병기 Ia로 평가한 환자는 2명으로 나머지 환자들은 진행된 병기의 예측이 가능하였다. 5년 이상 장기생존 환자는 단 1명이었고 이들 8명의 중앙 생존기간은 15개월$(95%\;Cl:\;0{\sim}35.5)$이었다. 결론: pN2 이상의 조기위암 환자들은 수술 전이나 중에 진행된 병기로 예측이 어느 정도 가능하였다. 그러나 전혀 예측할 수 없었던 환자도 있어서 보다 정확히 예측할 수 있는 방법의 연구가 필요하겠다.

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개방성 동맥관 합병 심실중격결손증 -7례 보고- (Ventricular Septal Defect Associated With Patent Ductus Arteriosus -A Report Of 7 Cases-)

  • 이상호
    • Journal of Chest Surgery
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    • 제12권3호
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    • pp.233-239
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    • 1979
  • Ventricular septal defect associated with patent ductus arteriosus is well known cardiac anomaly that can be treated successfully by operation. This anomaly is found at low frequency. Seven cases of the combined malformation were operated on during the period from 1959 to 1978 in the Department of Thoracic Surgery, Seoul National University Hospital. Right heart catheterization and retrograde aortogram can diagnose the disease correctly. Staged operation in one case and one-stage operation in 5 patients were done. In all cases of the open heart surgery the closure of the ductus was done by transpulmonary suture of the PDA opening. Among 6 patients of the open heart surgery 2 operative death [33.3%] and one late death [total 50%] were noted. Four type II and one type I and one Type IV VSDs were found. In one case the anomaly was accompanied with aortic insufficiency by herniation of the right coronary cusp through Type I VSD.

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무인 반송시스템을 이용하는 유연 제조시스템에서 작업경로와 경제적 설계 (Parts Processing Route and Economic Design in Flexible Manufacturing Systems employing AGVs for Transport)

  • 장석화
    • 산업경영시스템학회지
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    • 제21권46호
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    • pp.19-32
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    • 1998
  • This paper addresses the processing route of parts and economic design in flexible manufacturing systems (FMSs) employing AGVs for Transport. Parts are processed through several workstations according to operation sequences. The machine of each workstation can do multiple operation functions. 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 route of parts, number of machines at each workstation, number of vehicles. The model is assumed that the operation stage of parts can be processed at the only one among several available workstations. Parts are transported by automated guided vehicle system(AGVS). The decision criteria is to minimize the sum of processing cost, travel cost, operating cost. A model formulation is represented. A solution algorithm is suggested by using mathematical programming and simulation technique, and a numerical example is shown.

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Anterior and Posterior Stabilization by One Stage Posterolateral Approach in the Unstable Fracture of Thoracolumbar and Lumbar Spine

  • Lee, Young-Min;Cho, Yang-Woon;Kim, Joon-Soo;Kim, Kyu-Hong;Lee, In-Chang;Bae, Sang-Do
    • Journal of Korean Neurosurgical Society
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    • 제40권1호
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    • pp.22-27
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    • 2006
  • Objective : The purpose of this study is to investigate the clinical results of anterior and posterior stabilization by one stage posterolateral approach for the unstable fracture of thoracolumbar and lumbar spine. Methods : By posterolateral approach with curved skin incision, unilateral facet and pedicle were removed. Through this route, corpectomy was performed, and then this space was replaced with mesh cage filled up with autologous bone graft. Both side pedicle screw fixation was followed to upper and lower levels. Results : Six of seven patients of this study showed neurological improvement. The other one patient showed no neurological change. One patient had postoperative infection, another patient had postoperative kyphosis. The other patient had epidural hematoma on operation site after surgery. And all patinets on this study made to have spinal stability except one patient happened postoperative kyphosis. Conclusion : In the unstable fracture of thoracolumbar and lumbar spine, one stage anterior and posterior stabilization and fusion by posterolateral approach seems to be an effective procedure, if we have more care and supplementation.

콜타르 오염토양의 슬러리상 생물반응기 처리를 위한 일단 및 이단 재순환식 공정의 효율성 (Effectiveness of One- and Dual-Stage Recycled-Water Systems in Slurry Bioreactor Treatment for Coal Tar-Contaminated Soil)

  • 남궁완;박진홍;이노섭;김정대;박준석
    • 한국환경보건학회지
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    • 제31권5호
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    • pp.423-430
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    • 2005
  • This research was performed to evaluate the effectiveness of one- and dual-stage recycled-water systems in slurry bioreactor treatment for coal tar-contaminated soil. Silty loam soil was used for this research. Coal tar and 14 target PAHs (Polycyclic Aromatic Hydrocarbons) concentration in the soil were determined with gas chromatography. There was no significant difference between removal efficiencies of one- and dual-stage recycled water systems in case of about 4,000 mg coar tar/kg. However, the dual-stage system increased significantly the removal efficiency in case of about 20,000 mg coar tar/kg and the first-order kinetic constant of the system was over 1.5 times higher than that of one-stage recycled water system. 3-Ring compounds in PAHs was removed completely within 30 days of operation. Coar tar was removed in over 96% through biodegradation and removed in about 4% by evaporation. High correlation coefficient($r^2=0.91$) was found between water solubility and removal efficiency of the cyclic compounds.