• 제목/요약/키워드: One-stage operation

검색결과 516건 처리시간 0.033초

구강내 발생한 악성 흑색종 (MALIGNANT MELANOMA OF THE ORAL CAVITY;REPORT OF TWO CASES)

  • 양동규;정인교;김종렬;최갑림;박상준;문원룡
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권1호
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    • pp.135-141
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    • 1990
  • 저자등은 구강내 흑색병소를 가진 2명의 환자를 이학적 검사, 임상검사, 방사선 검사, 조직검사를 하여 악성흑색종(증례 I : Level IV, Stage II A, 증례 II : Level V, Stage II B)으로 진단하고 증례 I은 경부곽청술을 시행하지 않고 외과적 절제술만 시행하였는바, 술후 약 6주후에 악하임파결절이 증대되어 조직검사를 시행한 결과 전이성 악성흑색종으로 나와 DTIC를 이용한 전신적인 화학요법을 5회 시행하였다. 술후 22개월동안 관찰한 결과 재발은 없었다. 증례 II는 병소의 크기가 작았기 때문에 경부곽청술은 시행하지 않고 외과적 절제술만을 시행하였다. 8개월 동안 관찰한 결과 재발이나 전이는 발생하지 않았다.

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Analysis of a Harmonics Neutralized 48-Pulse STATCOM with GTO Based Voltage Source Converters

  • Singh, Bhim;Saha, Radheshyam
    • Journal of Electrical Engineering and Technology
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    • 제3권3호
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    • pp.391-400
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    • 2008
  • Multi-pulse topology of converters using elementary six-pulse GTO - VSC (gate turn off based voltage source converter) operated under fundamental frequency switching (FFS) control is widely adopted in high power rating static synchronous compensators (STATCOM). Practically, a 48-pulse ($6{\times}8$ pulse) configuration is used with the phase angle control algorithm employing proportional and integral (PI) control methodology. These kinds of controllers, for example the ${\pm}80MVAR$ compensator at Inuyama switching station, KEPCO, Japan, employs two stages of magnetics viz. intermediate transformers (as many as VSCs) and a main coupling transformer to minimize harmonics distortion in the line and to achieve a desired operational efficiency. The magnetic circuit needs altogether nine transformers of which eight are phase shifting transformers (PST) used in the intermediate stage, each rating equal to or more than one eighth of the compensator rating, and the other one is the main coupling transformer having a power rating equal to that of the compensator. In this paper, a two-level 48-pulse ${\pm}100MVAR$ STATCOM is proposed where eight, six-pulse GTO-VSC are employed and magnetics is simplified to single-stage using four transformers of which three are PSTs and the other is a normal transformer. Thus, it reduces the magnetics to half of the value needed in the commercially available compensator. By adopting the simple PI-controllers, the model is simulated in a MATLAB environment by SimPowerSystems toolbox for voltage regulation in the transmission system. The simulation results show that the THD levels in line voltage and current are well below the limiting values specified in the IEEE Std 519-1992 for harmonic control in electrical power systems. The controller performance is observed reasonably well during capacitive and inductive modes of operation.

외국인에서 발생한 심각한 이차 입술갈림코변형에 대한 한 단계 수술 (One Stage Correction of the Severe Secondary Cleft Lip Nasal Deformities in Foreigners)

  • 김석권;김주찬;박수성;이근철
    • 대한두개안면성형외과학회지
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    • 제12권2호
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    • pp.102-106
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    • 2011
  • Purpose: It is accepted universally that correction of the cleft lip nasal deformity requires multiple stages of surgery. Following primary lip repair in infancy or early childhood, secondary surgery to improve the deformity of the lip and nose is frequently necessary. A suitable surgical procedure to correct the accompanying deformity, such as cleft palate and alveolus, must be carried out at an appropriate age. In developing countries, it is common for patients with cleft lip nasal deformity to present severe secondary deformities in adolescence, because of poor follow-up and inappropriate surgery. Methods: The first patient was a 12 year old Mongolian boy. He presented prominent lip scar, short lip, wide columella, asymmetric nostril, palatal fistula, cleft alveolus, and velopharyngeal incompetence. He underwent cheilorhinoplasty, transpositional flap, alveoloplasty by iliac bone graft, and sphincter pharyngoplasty. On follow-up, a bilateral maxillary hypoplasia and a class III malocclusion developed. He underwent LeFort I osteotomy and maxillary advancement at the age of 16 years. The second patient was an 18 year old Eastern Russian girl. She presented with a deviated nose, right alar base depression, short lip, protrusion on vermilion, large palatal fistula, and severe VPI due to short palate. She underwent the combined procedure of cheilorhinoplasty, corrective rhinoplasty, tongue flap for palatal fistula, and superiorly based pharyngeal flap. And the tongue flap was detached at postoperative 3 weeks. Results: The overall results have been extremely pleasing and satisfactory to patients. There were no postoperative complications. Conclusion: We discovered the one stage operation for radical correction was sufficient procedure to provide excellent clinical outcomes in patients with severe cleft lip nose deformity.

시설원예 스마트팜의 인터랙션 구조 연구: 식물 생산 단계 중심으로 (A Study on the Interaction Structure of Smart Farm in Controlled Horticulture: Focusing on Plant Production Stage)

  • 이용진;반영환
    • 한국융합학회논문지
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    • 제12권6호
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    • pp.1-8
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    • 2021
  • 본 연구는 시설원예 스마트팜의 인터랙션 구조 연구를 목적으로 한다. 연구 방법으로는 스마트팜의 생산, 유통, 판매, 소비 단계 중 생산 단계에서 상호작용의 주체인 사람과 식물, 스마트팜 간의 관계를 파악하고, 식물의 생육 단계를 정의하여 인터랙션 요소를 분석하였다. 또한 현장방문 조사를 통해 상호작용 주체의 행동과 작동, 시간에 따라 일회성, 단기적, 장기적 상호작용으로 구분할 수 있었다. 그 결과, 1) 사람과 식물은 '일회성, 단기적', 2) 식물과 스마트팜은 '단기적', 3) 스마트팜과 사람은 '단기적, 장기적' 측면으로 상호작용 한다는 결론을 도출해 낼 수 있었다. 이에 본 연구는 시설원예 스마트팜 생산 단계에서 주체들 간의 관계와 상호작용 요소를 도출하고, 이를 구조화 하여 새로운 인터랙션 구조 모형을 제시하는데 의의가 있다.

급성기와 회복기 중풍 환자의 변증 유형의 상관관계 연구 (The Relationship of Differentiation of the Pattern Identification in Stroke Patients between Acute and Convalescence Stage)

  • 백종우;하유군;여현수;박종형;최유경;고호연;조기호;고성규;한창호;방옥선;전찬용
    • 대한중풍순환신경학회지
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    • 제9권1호
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    • pp.14-18
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    • 2008
  • Objectives : This study was done to investigate the relationship of differentiation of the patten identification in stroke patients between acute and convalescent stage. Methods : In the time of period Apr. 1st 2007 to Sep. 29th 2008, 903 patients with stroke admitted in the department of Internal Medicine of Kyungwon University Oriental Medical Hospital, Kyunghee University Oriental Medical Hospital, Dongguk University Oriental Medical Hospital were included. Patients were hospitalized within a month after the onset of stroke. Stroke patients were interviewed by doctors who studied standard operation procedures. A questionnaire was completed by a question-and-answer form between patients and doctors after explanation details to patients and the agreement of patients. Results : The frequency of fire-heat patten was the highest in acute stage of stroke and the one of deficiency of Yin group was the highest in convalescent stage of stroke. This result doesn't have statistical significance. (p<0.05) Conclusions : In this study, we found the relationship of differentiation of the patten identification in stroke patients between acute and convalescent stage. Further, we have concluded that this difference should be considered in the management for stroke patients.

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자궁경부암의 수술후 방사선치료 결과 (Therapeutic Results of Postoperative Radiation Therapy for Uterine Cervical Cancer)

  • 최두호;홍성언
    • Radiation Oncology Journal
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    • 제12권3호
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    • pp.369-376
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    • 1994
  • This is a retrospective analysis of 64 patients who was treated with postoperative radiation therapy after radical hysterectomy and bilateral pelvic lymphadenectomy (53 patients) or total abdominal hysterectomy(11 patients) for uterine cervix cancer between May 1980 and September 1991 at the Department of Radiation Oncology, Kyung Hee University Hospital. Most patients were FIGO IB (31 Patients) and IIA (25 patients), and median period of follow-up was 5.1 years. Of these patients,24 received adjuvant whole pelvis irradiation of 6000 cGy and 40 received 5000-5500 cGy whole pelvis irradiation and/or intracavitary radiation (7 Patients). The actuarial overall and relapse free 5 year survival rate were $71.0\%$, $68.3\%$ respectively. The survival rates by stage were $79.1\%$ in stage I, and $61.2\%$ in stage II. Treatment failure was noted in 18 of 64 patients ($28.1\%$), Iocoregional failure in 8 ($12.5\%$), distant metastasis in 8 ($12.5\%$), paraaortic node metastasis in 1 and one patient and concurrent locoregional and distant metastasis. The univariate analysis of prognostic factors affecting to overall survival rate represented lymph node status, the number and site of metastatic lymph node, parametrial invasion, the thichness of cervical wall invasion, and size of cancer mass. Histology, vessel invasion, endometrial extension, hemoglobin level. resection margin status, age, radiation dose were not significant prognostic factors. Complication relating to operation and postoperative radiation were variable according to radiation therapy method: 6000 cGy RT group 8/24($33.3\%$), 5000-5500 cGy+ICR 3/7 ($42.9\%$), 5000-5500 cGy external RT only group 3/33 ($9.1\%$). In conclusion, the results suggest that postoperative radiotherapy is necessary in high risk patients for locoregional control and improving survival rate, and higher dose does not improve results but only increases complication.

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농업용 전기차량의 전기식 동력인출장치용 전력변환시스템 (Power Conversion System for Electric Power Take-off of Agricultural Electric Vehicle)

  • 곽봉우;김종훈
    • 전기전자학회논문지
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    • 제23권3호
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    • pp.994-1002
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    • 2019
  • 본 논문은 농업용 전기차량의 전기식 동력인출장치용 전력변환시스템에 대해 제안한다. 대부분의 전기식 동력인출장치(Electric Power Take-Off : e-PTO)는 상용전원 $220V_{AC}$를 사용한다. 농업용 전기차량의 낮은 배터리 전압을 사용하여 높은 출력 전압을 공급하기 위한 DC-DC 컨버터와 DC-AC 인버터로 구성된 2단 구조를 갖는 양방향 전력변환시스템이 적합하다. 제안하는 전력변환시스템은 1단의 Dual Active Bridge(DAB)컨버터와 2단의 양방향 풀 브릿지 인버터로 구성된다. 또한, 초기 구동시 DC 버스단 커패시터 충전에 의해 발생되는 돌입 전류 저감을 위해 소프트 스타트 알고리즘을 제안한다. 3kW급 전력변환시스템 시제품 및 알고리즘을 구현하고 실험을 통해서 실용성을 입증하였다.

축구 선수에서 발생한 족관절 전방 충돌 증후군의 개방적 수술의 치료 결과 (Open Treatment of Anterior Impingement Syndrome of the Ankle in Elite Level Soccer Players)

  • 이경태;양기원;김재영;김응수;차승도
    • 대한족부족관절학회지
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    • 제8권1호
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    • pp.76-80
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    • 2004
  • Purpose: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. Materials and Methods: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. Results: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. Conclusion: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.

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이마 섬피판을 이용한 코재건술 (Forehead Island Flap For Nasal Reconstruction)

  • 이근철;권용석;정기환;한재정;박정민;김석권
    • Archives of Plastic Surgery
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    • 제32권2호
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    • pp.199-204
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    • 2005
  • The nose is the most prominent area of the face, therefore susceptible to trauma and skin cancer. When small sized defect is in nasal tip, it results in disturbance of the facial harmony even if replantation, composite graft, skin graft or median forehead flap has been used for the reconstruction. So it is needed that the best method reconstruction is performed according to the degree of defect or deformity. And at the same time the physiology and anatomy of nose were clarified and its aesthetic subunits were employed. How can we cover the about 3 cm sized nasal defect in nasal tip with cartilage exposure? At first, we can think forehead island flap is most appropriate. We performed 7 cases of the forehead island flap for reconstruction of the defect in nasal tip(4 cases: cancer, 3 cases: trauma) from March, 2001 to August, 2004. This result was satisfactory in the point of texture, color, donor scar, and there were no complication such as wound disruption, infection, flap atrophy, and hematoma. The advantages of forehead island flap are: 1) No injury of deep vessel and nerve, 2) control of shape and volume, 3) Short operation time, 4) primary closure of donor site, 5) one stage operation. Also, forehead island flap can cover the defect in nose where skin graft and local flap can not cover. But, operator always must take care for flap congestion and donor site scar. We thought forehead island flap is one of the best option of reconstruction of nasal tip defect.

Robot-Assisted Free Flap in Head and Neck Reconstruction

  • Song, Han Gyeol;Yun, In Sik;Lee, Won Jai;Lew, Dae Hyun;Rah, Dong Kyun
    • Archives of Plastic Surgery
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    • 제40권4호
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    • pp.353-358
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    • 2013
  • Background Robots have allowed head and neck surgeons to extirpate oropharyngeal tumors safely without the need for lip-split incision or mandibulotomy. Using robots in oropharyngeal reconstruction is new but essential for oropharyngeal defects that result from robotic tumor excision. We report our experience with robotic free-flap reconstruction of head and neck defects to exemplify the necessity for robotic reconstruction. Methods We investigated head and neck cancer patients who underwent ablation surgery and free-flap reconstruction by robot. Between July 1, 2011 and March 31, 2012, 5 cases were performed and patient demographics, location of tumor, pathologic stage, reconstruction methods, flap size, recipient vessel, necessary pedicle length, and operation time were investigated. Results Among five free-flap reconstructions, four were radial forearm free flaps and one was an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and one flap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flap insetting and microanastomosis were achieved using a specially manufactured robotic instrument. The total operation time was 1,041.0 minutes (range, 814 to 1,132 minutes), and complications including flap necrosis, hematoma, and wound dehiscence did not occur. Conclusions This study demonstrates the clinically applicable use of robots in oropharyngeal reconstruction, especially using a free flap. A robot can assist the operator in insetting the flap at a deep portion of the oropharynx without the need to perform a traditional mandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methods and is accepted as the most up-to-date method.