• 제목/요약/키워드: Plication

검색결과 114건 처리시간 0.026초

흉강경을 이용한 횡격막 거상증 치험 1례 (Videothoracoscopic Repair of Diaphragmatic Eventration -A Case Report-)

  • 정윤섭;염욱
    • Journal of Chest Surgery
    • /
    • 제32권3호
    • /
    • pp.330-332
    • /
    • 1999
  • 좌측 횡격막 거상증을 가진 40세 여자 환자에게 흉강경을 이용하여 횡격막 주름성형술을 시행하였다. 술후 흉부 X선 사진에서 좌측 횡격막의 하강과 좌측폐의 팽창을 확인할 수 있었다. 횡격막 거상증 환자에게 흉강경을 이용하여 수술하면 최소 침습적 수술이 갖는 여러 장점을 환자에게 제공할 수 있다.

  • PDF

자율 주행 헬리콥터 시스템의 지능 힘제어 응용 (Intelligent Force Control Ap plication of an Autonomous Helicopter System)

  • 엄일용;정슬
    • 대한임베디드공학회논문지
    • /
    • 제6권5호
    • /
    • pp.303-309
    • /
    • 2011
  • In this paper, an intelligent force control technique is applied to an autonomous helicopter. Although most research on the autonomous helicopter system is about navigation and control, force control of an autonomous helicopter system is quite new and not presented yet. After controlling the position of the helicopter by the LQR method, force control is applied. The adaptive impedance force control algorithm is introduced and tested to regulate the desired force under unknown location and stiffness of the environment. To compensate for uncertainty from outer disturbance, a neural network is added to form an intelligent force control framework. Simulation studies show that the proposed force control algorithm works well.

Correction of pixie ear: infraauricular skin redraping method

  • Kim, Jun Hyeok;Yang, Young Bin;Oh, Deuk Young
    • 대한두개안면성형외과학회지
    • /
    • 제23권4호
    • /
    • pp.187-189
    • /
    • 2022
  • Patients with pixie ear have an attached, tapering, and low-set earlobe. Traditional methods usually describe excision of the caudal portion of the lobule and reattachment in a more superior position. The present report suggests a simplified skin redraping method for correction of pixie ear. The procedure provides easy method to design and perform, which only requires elevation and trimming of the skin. Other ancillary procedures, such as flap design, anchoring, plication, and subdermal fixation, are not required. This method produces satisfactory results. Postoperative scar is invisible because the incision is on the retroauricular region, and the corrected earlobe has a more natural appearance than the repositioned earlobe. Moreover, skin redraping avoids tension, which contributes to minimization of the postoperative scar.

선천성 이엽성 대동맥판막질환에 대한 판막성형술의 중기 성적 (Mid-term Results of the Congenital Bicuspid Aortic Valve Repair)

  • 조광리;곽재건;안혁
    • Journal of Chest Surgery
    • /
    • 제37권10호
    • /
    • pp.833-838
    • /
    • 2004
  • 배경: 선천성 이엽성 대동맥판막질환에 대한 성형술은 술 후 조기 성적에서는 매우 우수하다고 알려져 있으나 중기 및 장기 성적에 대해서는 논란이 되고 있는 실정이다. 대상 및 방법: 판막 성형술의 중기 성적을 알아보기 위해 1994년부터 2003년까지 선천성 이엽성 대동맥판막질환으로 판막성형술을 시행받은 22명의 환자들의 임상기록 및 심초음파 검사들을 후향적으로 분석하였다. 결과: 남자가 17명, 여자가 5명이었으며 평균 연령은 41$\pm$14세였다. 이엽성 판막의 폐쇄부전이 대부분(91%=20/22)의 환자에서 주 병변이었다. 수술 방법들로는 붙어 있는 공통 판막엽의 해리(release)가 19예(86%)에서 시행되었으며, 이탈된 판막엽에 대한 수술로는 채기 절제 및 일차봉합술이 11예(50%), 판엽줄임술(plication) 후 심막으로 보강한 것이 6예(27%), 판막엽만 줄인 3예(14%)가 있었다. 두꺼워진 판막엽을 깎은 것이(slicing) 12예(55%)에서 사용되었으며, 교련부위의 성형술은 8예(36%), 교련부위절개술이 6예(27%)에서 시행되어 평균 환자당 2.8개의 술식이 사용되었다. 수술 사망은 없었으며 모든 환자를 술 후 평균 38$\pm$17개월간 추적 관찰하였다. 추적기간 중 1명의 환자가 술 후 2개월에 성형술 봉합의 풀림에 의한 급성 대동맥판막 폐쇄부전으로 대동맥 판막 치환술을 받았다. 환자들의 기능적 상태는 (NYHA functional class)는 술 전 평균 1.9$\pm$0.6에서 술 후 1.2$\pm$0.5로 의미있게 개선되었으며(p<0.01), 심초음파 검사상 좌심실의 수축기말/이완기말 용적도 각각 45$\pm$9 mm, 67$\pm$10 mm에서 37$\pm$10 mm, 56$\pm$10 mm로 의미있게 줄어들었다(p<0.05). 대동맥 판막의 폐쇄부전 정도는 술 전 3.1$\pm$1.2에서 심폐기 이탈 직후에 0.9$\pm$0.7로 의미있게 줄었으나 추적 관찰 중 1.8$\pm$1.1로 증가하는 양상을 보였다. 중등도 이상의 폐쇄부전이 없이 생존할 확률은 술 후 1년에 89.7%, 3년에 89.7%, 4년에 39.9%로 나타나 중기 이후에 판막기능의 악화가 빨라지는 경향을 보였다. 결론: 선천성 이엽성 대동맥판막질환 성형술의 중기 성적은 임상적으로는 초기의 우수한 상태를 유지하였으나, 성형된 대동맥 판막의 장기적 내구성은 장담할 수 없었다.

병원 전산시스템 활용에 영향을 주는 컴퓨터불안과 제변수간의 관계 (A Correlation of the Computer Anxiety and the Variables Affecting the Application of a Hospital Computer System)

  • 김용순;박지원
    • 대한간호학회지
    • /
    • 제25권4호
    • /
    • pp.617-632
    • /
    • 1995
  • Nowadays, most big hospitals have a computer system to manage their administration. For maxi mum effectiveness in managing the computer system, an analysis of the variables affecting its implementation is necessary from the beginning. This study was done to analyze the variables influencing the operation of a hospital information system (HIS). The theoretical base for this study considered the combined effects of user expectations of computerization, and computer-anxiety. The relationship between variables in the theoretical base were analyzed and the individual characteristics influencing each variable were also analyzed. This study was done in two steps. First, 344 nurses were given an initial questionnaire developed to evaluate the reliability of the items. Based on the results, a second revised questionnaire was administered to 88 nurses who had been working in the areas where HIS was applied. The results of the first and second steps of the study are as follows 1. The initial study was done with nurses who were trained on the computer system briefly before HIS was implemented. The individual characteristics influencing computer anxiety and expectation regarding computer system usage in that initial study included, length of career, type of degree or certification, previous experiences with a computer, training on a computer, desire for computer training, and level of acceptance of a computerized work environment. But in the second study with nurses working in areas of the hospital where HIS was introduced, the work site was the only influencing characteristics. There-fore, in applying a computer system, overcoming work-environment barriers will be more import-ant than any individual characteristics. 2. The computer anxiety of the nurses in both groups, before and after the computer system ap-plication, was below the average level but the expectation of the effects of computerization was above average. The nurses using the computer program showed an above average level of satis-faction with the computer system itself, and with its effect on their efficiency. Therefore, the ability of nurses operating HIS will be positively. predictive. 3. For the variables included in the theoretical framework of the study, all of the correlational coefficients were statistically significant in the analysis of variation correlation. Therefore, the theoretical base of the study, "expectation in con junction with computer anxiety" can be considered an model which can be evaluated. Accord-ing to our analysis, the higher the level of nurses' motivation to use the computer system and the lower the anxiety about computer usage, the higher the possibility of computer system acceptance by nurses. The results of this study showed that in applying a computer system in the hospital, the main characteristic influencing acceptance was where the individual worked rather than personal characteristics such as length of career, type of degree or certification, and previous experiences with a computer. Therefore, it is suggested that the first step in uncovering and eliminating hindrance factors in ap-plication of a computer system should be an analysis of working conditions in relation to the functional content of the computer system. The suitability of the theoretical model based on the hypothesis ap-plied in this study should be further tested.

  • PDF

관절경을 이용한 고 빈도 재발성 전방 견관절 탈구의 재건술 (Arthroscopic Reconstrucion in Megafrequency of Recurrent Anterior Shoulder Dislocations)

  • 고상훈;유총일;조성도;최창혁;전인호;우종근;곽창렬;윤동진;최승원
    • 대한관절경학회지
    • /
    • 제9권2호
    • /
    • pp.194-200
    • /
    • 2005
  • 목적: 수면중 탈구가 동반된 고 빈도를 보이는 재발성 견관절 전방 불안정성의 제한된 증례에서 관절경 술식을 이용한 하 견갑 상완 인대 전대의 축화 성형술과 전하 관절 낭-관절 순 복합체의 상방 전위와 더불어 보조적으로 시행된 후 하방 봉합 축화술, 열선 수축술, 회전간 폐쇄술의 단기 추시 결과와 효용성을 알아보고자 하였다. 재료 및 방법: 1998년 3월부터 2004년 2월까지 수면중 탈구가 동반된 고민도 재발성 탈구를 보인 드문 증례에 대하여 18예의 증례를 분석하였다. 평균 나이는 29.4$(21{\sim}37)$세 였으며, 평균 추시 기간은 22.1$(12{\sim}45)$개월이었다. 술전과 술후 6개월, 1년, 마지막 추시에서 운동 범위와 Rowe점수를 측정하였다. 결과: 우수 6예, 우량 10예로 우량 이상이 88.9%(16예)였으며 보통이 1예, 불량이 1예였다. 결론: 수면중 탈구를 동반한 고 빈도 탈구를 보이는 재발성 전방 견관절 불안정성에서 관절경 하 재건술은 좋은 결과를 보여 관혈적 술식의 대체 방법이 될 수 있지만, 더 많은 증례에 대한 장기 추시가 필요할 것으로 사료된다.

  • PDF

Effect of Aminoglycoside Antibiotics on in-Vitro Morphogenesis from Cultured Cells of Chrysanthemum and Tobacco

  • Teixeira da Silva, Jaime A.;Fukai, Seiichi
    • Journal of Plant Biotechnology
    • /
    • 제6권1호
    • /
    • pp.25-37
    • /
    • 2004
  • Successful genetic transformation of plants requires non-chimeric selection of transformed tissues and their subsequent regeneration. With rare exceptions, most transformation protocols still rely heavily on antibiotics for selecting transgenic cells that contain an antibiotic-degrading selectable marker gene. Here, the morphogenic capacity of in-vitro explants of chrysanthemnum and tobacco stems and leaves (control and transgenic) changed with the addition of aminoglycoside antibiotics (AAs), In a test of 6 AAs, phytotoxicity occurred at concentrations of 10 to 25 and 50 to 100$\mu\textrm{g}$ $mL^{-1}$ in chrysanthemum and tobacco explants, respectively. Light conditions as well as explant source and size also had significant effects. The use of transverse thin cell layers (tTCLs), in conjunction with high initial AA selection levels, supported the greatest regeneration of transgenic material (adventitious shoots or callus) and the lowest number of escapes. Flow-cytometric analyses revealed no endodu-plication in chrysanthemum, even at high AA levels. However, this phenomenon was observed in tobacco calli(8C or more), even at low AA concentrations (i.e., 5 to 10 $\mu\textrm{g}$ mL$^{-1}$ ).

승모판협착 및 폐쇄부전증이 동반된 다발성 양측 관상동정맥루 1례 치험 (Multiple Bilateral Coronary Arteriovenous Fistulas Associated with Mitral Stenoinsufficiency - One Case Report -)

  • 강창희
    • Journal of Chest Surgery
    • /
    • 제21권5호
    • /
    • pp.877-881
    • /
    • 1988
  • A coronary arteriovenous fistula represents an abnormal communication from a coronary artery that may enter any cardiac chamber, a pulmonary artery, the coronary sinus, the superior vena cava or the pulmonary vein. We had a successful experience with 46 year-old male who complained exertional dyspnea[NYHA classification II] and anginal pain since 5 years ago. In intensive study of cardiac catheterization and coronary cineangiography, multiple bilateral coronary arteriovenous fistulas and mitral stenoinsufficiency with left atrial thrombi were recognized. The coronary arterio-venous fistula of left coronary artery was revealed large tortuous aberrant vessels that were connected between just distal portion of first diagonal branch of left anterior descending artery and main pulmonary artery. Other fistula was small tortuous vessel which was originated from left atrial branch of left circumflex artery, was drained into left atrium. The fistula of right coronary artery was communicated conal branch of right coronary artery to main pulmonary artery. But there was no 0y step-up in the right cardiac catheterization. The operative procedure were suture-ligation of draining orifice of coronary arteriovenous fistula in main pulmonary artery, mitral valve replacement[Ionescu-Shiley 25mm] with removal of left atrial thrombi and plication of left atrium under the extracorporeal circulation. The postoperative course was uneventful without any complication and discharged without problem at 17th postoperative days.

  • PDF

횡경막성 내장탈출증: 1례 보고 (A Case of Eventration of the Diaphragm)

  • 박광훈;최인환
    • Journal of Chest Surgery
    • /
    • 제6권2호
    • /
    • pp.243-248
    • /
    • 1973
  • Eventration of the diaphragm is, by definition, abnormally high or elevated position of diaphragm as a result of paralysis, aplasia or atrophy of varing degrees of muscle fibers, and the cause of which may be congenital or acquired. The unbroken continuity of the diaphragm differentiates it from diaphragmatic hernia. The clinical manifestations of the condition, if present, are usually due to the interference of the ventilatory function of the lung and digesive dysfunction due to gastrointestinal distorsion. Treatment consists of surgical repair of the relaxed diaphragm to it`s normal position. A ease of left sided eventuration of the diaphragm, 31 year old officer, was found by chance after traffic accident with chief complaints of hemoptysis and multiple superficial contusions. Routine chest roentgenogram and barium study of the colon revealed moderately elevated left hemidiaphragm with displacement of the splenic flexure of the colon into the left chest. Past history revealed frequent attack of upper respiratory infection and some abnormal condition on his left chest announced by screen cheek of chest X-ray at the time of entrance for his army service 3 years before. Plication of the relaxed diaphragm through left thoracotomy was done and result was excellent as seen on Fig. 5. Cause of eventration of the left hemidiaphragm was due to paralysis of the left phrenic nerve which was tested during thoracotomy.

  • PDF

심방중격류의 수술적 교정 (Atrial Septal Aneurysm)

  • 이승진;이석열;장인성;정윤섭;염욱
    • Journal of Chest Surgery
    • /
    • 제32권11호
    • /
    • pp.1046-1048
    • /
    • 1999
  • A life-long anticoagulation for the prevention of ischemic cerebral events by thromboemboli has been conventionally introduced for the treatment of an atrial septal aneurysm. However, due to the recent decrease of the risks in the open heart surgery, the alternative therapeutic modality has been introduced for the prevention of complications of the anticoagulation. A 41-year old female with dizziness was admitted to our hospital. She was diagnosed a shaving atrial fibrillation and a cerebellar infarction, and an atrial septal aneurysm was detected by transesophagel echocardiography that was not detected by the transthoracic echocardiography. Surgery was approached to the right submammarial anterolateral thoracotomy. The atrial septal aneurysm was obliterated by a purse-string suture and plication. Surgial results were excellent with normal sinus rhythms and esthetically satisfying appearance.

  • PDF