• Title/Summary/Keyword: Reconstruction

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Posterior Cruciate Ligament Augmentation Using an Autogenous Hamstring Tendon Graft and the Posterior-Posterior Triangulation Technique (만성 단독 후방십자인대 파열에서 자가 슬괵건과 후-후 삼각술기를 이용한 만성 후방십자인대 보강술)

  • Kim, Yeung Jin;Chae, Soo Uk;Choi, Byong San;Kim, Jong Yun;Lee, Hwang Yong;Han, Chang Wan;Han, Su Hyoun
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.24-30
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    • 2013
  • Purpose: To evaluate the outcome of arthroscopic posterior cruciate ligament (PCL) augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique with preservation of ligament remnant or elongated ligament. Materials and Methods: From January 2002 to December 2009, we performed PCL augmentation using an autogenous hamstring tendon graft and the posterior-posterior triangulation technique in 32 patients. The mean age was 35.2 years. Twenty two cases were male and 10 cases were female. Average follow-up period was 5 years and 5 months (range: 2-7.9). Subjective and objective parameters were utilized in analyses, such as the mean range of motion, post. drawer test, Lysholm knee score, Tegner activity score, International Knee Documentation Cominittee (IKDC) grade, and second look arthroscopic examination. Results: At last follow up posterior displacement by the Telos stress test decreased from $10.8{\pm}5.1\;mm$ to $2.8{\pm}3.7\;mm$ (p<0.05). The final Lysholm knee score improved from $60.4{\pm}5.8$ to $84.6{\pm}4.8$. Tegner activity score improved from 3.2 to 4.8. The final IKDC grade was A in 18, B in 11, C in 3. Postoperative Lysholm knee score, IKDC grades, Tegner activity scale, and posterior displacement demonstrated statistically significant improvement compared to the preoperative state (p<0.05). Conclusion: Arthroscopic PCL reconstruction using an autogenous hamstring tendon with preservation of ligament remnant showed a good clinical results and posterior stability.

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Time-lapse crosswell seismic tomography for monitoring injected $CO_2$ in an onshore aquifer, Nagaoka, Japan (일본 Nagaoka의 육상 대수층에 주입된 $CO_2$의 관찰을 위한 시간차 시추공간 탄성파 토모그래피)

  • Saito, Hideki;Nobuoka, Dai;Azuma, Hiroyuki;Xue, Ziqiu;Tanase, Daiji
    • Geophysics and Geophysical Exploration
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    • v.9 no.1
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    • pp.30-36
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    • 2006
  • Japan's first pilot-scale $CO_2$ sequestration experiment has been conducted in Nagaoka, where 10400 t of $CO_2$ have been injected in an onshore aquifer at a depth of about 1100 m. Among various measurements conducted at the site for monitoring the injected $CO_2$, we conducted time-lapse crosswell seismic tomography between two observation wells to determine the distribution of $CO_2$ in the aquifer by the change of P-wave velocities. This paper reports the results of the crosswell seismic tomography conducted at the site. The crosswell seismic tomography measurements were carried out three times; once before the injection as a baseline survey, and twice during the injection as monitoring surveys. The velocity tomograms resulting from the monitoring surveys were compared to the baseline survey tomogram, and velocity difference tomograms were generated. The velocity difference tomograms showed that velocity had decreased in a part of the aquifer around the injection well, where the injected $CO_2$ was supposed to be distributed. We also found that the area in which velocity had decreased was expanding in the formation up-dip direction, as increasing amounts of $CO_2$ were injected. The maximum velocity reductions observed were 3.0% after 3200 t of $CO_2$ had been injected, and 3.5% after injection of 6200 t of $CO_2$. Although seismic tomography could map the area of velocity decrease due to $CO_2$ injection, we observed some contradictions with the results of time-lapse sonic logging, and with the geological condition of the cap rock. To investigate these contradictions, we conducted numerical experiments simulating the test site. As a result, we found that part of the velocity distribution displayed in the tomograms was affected by artefacts or ghosts caused by the source-receiver geometry for the crosswell tomography in this particular site. The maximum velocity decrease obtained by tomography (3.5%) was much smaller than that observed by sonic logging (more than 20%). The numerical experiment results showed that only 5.5% velocity reduction might be observed, although the model was given a 20% velocity reduction zone. Judging from this result, the actual velocity reduction can be more than 3.5%, the value we obtained from the field data reconstruction. Further studies are needed to obtain more accurate velocity values that are comparable to those obtained by sonic logging.

Jejunal Pouch Interposition (JPI) after Distal Gastrectomy in Patients with Gastric Cancer (위암 환자에서 원위부 위절제 후 공장낭 간치술)

  • Jeon, Hae-Myung;Kim, Wook;Hur, Hoon;Lee, Joon-Hyun;Won, Jong-Man
    • Journal of Gastric Cancer
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    • v.4 no.4
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    • pp.242-251
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    • 2004
  • Purpose: Recently, because of the increasing numbers of early gastric cancer patients and improvements in their survivals, greater attention has been directed towards the quality of life and nutritional status of gastric cancer patients after surgery. However, conventional reconstructions, Billroth- I, -II (B-I and B-II) or Roux-en-Y, have proven to have certain limitations, such as a small reservoir, and a malabsorption for iron, fat, calcium, and carotene. To overcome these limitations, we used a jejunal pouch interposition(JPI) after a distal gastrectomy not only to substitute for the small reservoir but also to maintain a physiologic pathway for ingested foods. Materials and Methods: A total of 196 gastric cancer patients who underwent a distal gastrectomy between March 2001 and February 2004 were divided into 3 groups: JPI group (n=100), B-I group (n=29), and B-II group (n=67). We assessed the patient's nutritional status, gastric emptying time, and gastrofiberscopic findings. Results: The percents of body weight loss at 6 months, 1 year, and 2 years postoperatively in the JPI group ($5.14\%,\;3.01\%,\;2.37\%$) were significantly less than those of the conventional B-I ($8.41\%,\;6.69\%,\;5.90\%$) and B-II groups ($7.50\%,\;7.65\%,\;5.86\%$) (P=0.011, 0.000, 0.013). The laboratory findings showed no significant differences between the 3 groups, except for a higher total protein level in the JPI group after 6 months postoperatively. Especially, stage I and II cancers in the JPI group showed much higher total protein levels after 1 year postoperatively. The gastric emptying times in the $\^{99m}$Tc- semisolid scans at 6 months, 1 year, and 2 years postoperatively were 102.5, 83.1, and 58.1 minutes in the JPI group, 95.5, 92.0, and 58.5 minutes in the B-I group, and 53.9, 69.1, and 50.2 minutes in the B-II group, respectively. Also, the symptomatic gastric stasis detected with a gastrofiberscope during the early postoperative period (6 months) was gradually improved. Conclusion: From a nutritional aspect, a jejunal pouch interposition after a distal gastrectomy could be an alternative reconstruction method, especially in stage I and II gastric cancer patients, in spite of the longer operation time and the probable delayed gastric emptying.

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Measurement of the Mucosal Surface Distance in the Early Gastric Cancer Using CT Gastrography (조기 위암에서 CT Gastrography를 이용한 위점막 표면 거리 측정)

  • Choi, Hyang-Hee;Yu, Wan-Sik;Ryeom, Hun-Kyu;Lee, Jae-Hyuk;Choi, Jae-Jeong;Kim, Hee-Su;Cleary, Kevin;Mun, Seong-Ki;Chung, Ho-Young
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.161-166
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    • 2006
  • Purpose: Recently, the incidence of early gastric cancer (EGC) patients is rapidly increased in Korea. However, they're often not perceptible by surgical palpation or inspection. The aim of this study is 1) to develope a software that can locate the tumor and measure the mucosal distance from an anatomic landmark to the tumor using CT gastrography and 2) to compare the distance measured by the developed software with the distance measured by the pathologic findings. Materials and Methods: Between January 2004 and September 2005, sixty patients (male=45, female=15, mean 57.8 years old) estimated for EGC with preoperative CT scans and undergone gastrectomies in Kyungpook National University Hospital were enrolled in this study. Preoperative CT scans were performed after insufflations of room air via 5 Fr NG tube. The scans included the following parameters: (slice thickness/reconstruction interval: 0.625 mm, kVp: 120, mAs: 200). 3D volume rendering and measurement of the surface distance from the pylorus to the EGC were performed using the developed software. Results: The average difference between the lesion to pylorus distances measured from pathologic specimens and CT gastrography was $5.3{\pm}2.9\;mm(range,\;0{\sim}23\;mm)$. The lesion to pylorus distance measured from CT gastrography was well correlated with that measured from the pathologic specimens (r=0.9843, P<0.001). Conclusion: These results suggest that the surface distance from an anatomic landmark to the EGC can be measured accurately by CT gastrography. This technique could be used for preoperative localization of early gastric carcinomas to determine the optimal extent of surgical resection.

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Evaluation of Different Methods of Gastroenterostomy after Distal Gastrectomy for Gastric Carcinoma (위선암 환자의 원위부 위절제 후 위공장문합의 방법의 선택에 따른 임상 양상의 차이에 관한 고찰)

  • Choi, Eun-Hye;Lee, Jong-Myeong
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.215-222
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    • 2009
  • Purpose: Billroth II gastroenterostomy is a typical reconstruction method after distal gastrectomy for gastric carcinoma, but it has problems, especially frequent reflux esophagitis. Various methods have been tried to address this problem. Among them are Braun enteroenterostomy and Roux-en-Y gastroenterostomy, which are performed separately according to the size of the gastric remnant. The aim of our study was to determine whether these applications are compatible. Materials and Methods: Between September 2003 and April 2007, we performed Roux-en-Y gastroenterostomy operations (14 patients) when the size of the gastric remnant was <10%, Braun enteroenterostomy (17 patients) when the size was between 10 and 20%, and Billroth II gastroenterostomy (14 patients) when the size was between 20 and 40% after subtotal gastrectomy for gastric cancer by a single surgeon at our hospital. We analyzed the results of each treatment. We evaluated the symptoms and endoscopic findings using questionnaires and hospital records. To evaluate nutritional states, we reviewed albumin and hemoglobin levels and body weight changes. Results: All operations were performed safely mortality was 0% and postoperative complications were 8.9%. On endoscopy, reflux gastritis was observed to occur in 7.63%, 18.65% and 40.0%, respectively, of patients who had undergone Roux-en-Y, Braun and Billroth II operations (P=0.13). Reflux esophagitis was observed in 1 patient in the Roux-en-Y group and 1 patient in the Braun group. Endoscopic gastrostasis was observed in 2 patients in the Roux-en-Y group, one of which was thought to cause reflux esophagitis. Patients in the Roux-en-Y group and Braun groups ingested a lower volume of food than did those in the Billroth II group (respectively, 7.1%, 0.0% and 28.7%) and complained less of postprandial discomforts (respectively, 14.3%, 23.5% and 57.1%) and reflux symptoms (respectively 0.0%, 11.8% and 42.9%). Conclusion: The application of Braun enteroenterostomy and Roux-en-Y gastroenterostomy to the small gastric remnant may be effective for reducing reflux symptoms and abdominal discomfort after distal gastric resection. We recommend Roux-en-Y gastroenterostomy when the size of the gastric remnant is <10%, and Braun anastomosis in the others. It will need to be determined which reconstructive procedure is better for many different conditions.

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An Analytical Study of the Problems Involved in the Project to Rehabilitate the Illegal Field Burning Cultivators in Gangweon Do (강원도(江原道) 화전정리사업(火田整理事業)에 수반(隨伴)되는 문제점분석(問題點分析)에 관(關)한 연구(硏究))

  • Ho, Ul Yung
    • Journal of Korean Society of Forest Science
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    • v.28 no.1
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    • pp.50-66
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    • 1975
  • Since it is an undeniable fact that the so-called illegal field-burning cultivation is directly implicated in the causes of forest devastation, land erosion, and drought and flood, thus, barring the nation from a well-balanced economic growth, the policy to exterminate its practices must have the topmost priority. Eighty percent of Gangweon-do is mountain forests and naturally of all others this province has the largest area of illegally burned hill-side farminglands, stubbornly retarding the provincial development policy as well as directly causing tremendous forest damages. In 1965 a 7-year plan mapped out to rehabilitate these gypsy type field burning farmers only to be suspended in 1968 to give way to the mandatory project of clearing the isolated farmsteads set in deep mountain to circumvent the guerilla forces signaled by the so-called Samcheok-Uljin area infiltration. In the meantime, new hordes of roving farmers burned the forests, working a renewed havoc. To cope with this situation, the provincial government, taking the year 1973 as a planning year, launched another three year project (1974-76) and has been enforcing the rehabilitation project mobilizing the whole administrative power. Whether or not this project will succeed solely depends upon whether the forcedly rehabilitated roving farmers can really establish self-supporting homesteads. Among the various difficulties facing the newly established homesteaders are: (1) First of all, the homesteaders must be given money-earning jobs. (2) Financial supports or subsidies must be provided them with which to establish self-supporting homesteads. (3) Private enterprises as well as public organizations must offer them jobs with priority. (4) The rehabilitated rovers themselves must establish self-supporting homesteads before expecting the external assistance. (5) The rehabilitated rovers themselves must have the spirit of self-help, welcoming all levels and all kinds of jobs. (6) The rural revitalization movement must expand the self-help reconstruction projects to give them the opportunity to work. (7) All citizen in the province must receive and protect them with brethren love. (8) The evacuated burned-forests must be reforestrated with the principle of "best trees to the best lands". (9) The seedlings of species that the forest owners select must anyhow be secured and supplied (10) The organization and function of the village forestry association must be strengthened to take effective care of the reforestated burned-forests.

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A Case Study of ART Counseling on Maladjusted Children's Self-Respect and Social Ability Development (부적응 아동의 자아존중감 및 사회성 발달을 위한 미술상담 사례연구)

  • Hong, Mi-Young;Cho, Bung-Hwan
    • The Korean Journal of Elementary Counseling
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    • v.8 no.1
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    • pp.109-122
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    • 2009
  • The purpose of this study was to put an art counseling program in the elementary school maladjusted child and helped the school life adjustment of the maladjusted child's self-respect and social ability development. For this purpose, picked out 4 people children who are the lowest score in the child where the total score is below 100 points sorted 6 grades of Y elementary school in Daejeon. The art counseling program as a reconstruction of the prior study to meet an object of this study was provided to children in experimental group at the researcher's classroom after school for 12 session, two sessions per week. For analyze the study result. First, for quantitatively analysis of an maladjusted behavior compared pre and post test of conduct of school life adjustments test. Second, for confirm the change of self-respect and social ability development pre and post test and analyzed comparison. Third, recognizing trial state change of an maladjusted children put a KSD pre and post test and analyzed comparison with contents of a picture. Fourth, every session of the qualitative analysis which describes the conduct quality of each child led and the maladjusted child should have been visible what kind of change after the art counseling program execution criminal record, compared. The result of the study is the art counseling program decreased the maladjust conduct of the maladjusted child and is effective to self-respect and social ability development of the maladjusted child. And the art counseling program letting induces the change which is affirmative psychologically with the maladjusted child. As a result, the art counseling program to help the self-respect of the maladjusted child and social ability development, and it will be more effective in the school life adjustment for the maladjusted child.

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Evaluation of Image Noise and Radiation Dose Analysis In Brain CT Using ASIR(Adaptive Statistical Iterative Reconstruction) (ASIR를 이용한 두부 CT의 영상 잡음 평가 및 피폭선량 분석)

  • Jang, Hyon-Chol;Kim, Kyeong-Keun;Cho, Jae-Hwan;Seo, Jeong-Min;Lee, Haeng-Ki
    • Journal of the Korean Society of Radiology
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    • v.6 no.5
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    • pp.357-363
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    • 2012
  • The purpose of this study on head computed tomography scan corporate reorganization adaptive iteration algorithm using the statistical noise, and quality assessment, reduction of dose was evaluated. Head CT examinations do not apply ASIR group [A group], ASIR 50 applies a group [B group] were divided into examinations. B group of each 46.9 %, 48.2 %, 43.2 %, and 47.9 % the measured in the phantom research result of measurement of CT noise average were reduced more than A group in the central part (A) and peripheral unit (B, C, D). CT number was measured with the quantitive analytical method in the display-image quality evaluation and about noise was analyze. There was A group and difference which the image noise notes statistically between B. And A group was high so that the image noise could note than B group (31.87 HUs, 31.78 HUs, 26.6 HUs, 30.42 HU P<0.05). The score of the observer 1 of A group evaluated 73.17 on 74.2 at the result 80 half tone dot of evaluating by the qualitative evaluation method of the image by the bean curd clinical image evaluation table. And the score of the observer 1 of B group evaluated 71.77 on 72.47. There was no difference (P>0.05) noted statistically. And the inappropriate image was shown to the diagnosis. As to the exposure dose, by examination by applying ASIR 50 % there was no decline in quality of the image, 47.6 % could reduce the radiation dose. In conclusion, if ASIR is applied to the clinical part, it is considered with the dose written much more that examination is possible. And when examination, it is considered that it becomes the positive factor when the examiner determines.

Three Dimensional MRI and Software for Studying Normal Anatomical Structures of an Entire Body (온몸의 정상 해부구조물을 익히기 위한 3차원 자기공명영상 및 소프트웨어)

  • Lee, Yong-Sook;Park, Jin-Seo;Hwang, Sung-Bae;Cho, Jae-Hyun;Chung, Min-Suk
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.2
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    • pp.117-133
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    • 2005
  • For identifying the pathological findings in magnetic resonance images (MRIs), normal anatomical structures in MRIs should be identified in advance. For studying the anatomical structures in MRIs, a learning tool that includes the followings is necessary. First, MRIs of the entire body; second, horizontal, coronal, and sagittal MRIs; third, segmented images corresponding to the MRIs; fourth, three dimensional (3D) images of the anatomical structures in the MRIs; fifth, software incorporating the MRIs, segmented images, and 3D images. Such a learning tool, however, is hard to obtain. Therefore, in this research, such a learning tool which helps medical students and doctors study the normal anatomical structures in MRIs was made as follows. A healthy young Korean male adult with standard body shape was selected. Six hundred thirteen MRIs of the entire body were scanned (slice thickness 3 mm, interslice gap 0 mm, field of view 480 mm${\times}$480 mm, resolution 512${\times}$512, T1 weighted), and transferred to the personal computer. Sixty anatomical structures in the MRIs were segmented to make segmented images. Coronal, sagittal MRIs and coronal, sagittal segmented images were made. On the basis of the segmented images, forty-seven anatomical structures 3D images were made by manual surface reconstruction method. Software incorporating the MRIs, segmented images, and 3D images was composed. This learning tool that includes horizontal, coronal, sagittal MRIs of the entire body, corresponding segmented images, 3D images of the anatomical structures in the MRIs, and software is expected to help medical students and doctors study the normal anatomical structures in MRIs. This learning tool will be presented worldwide through Internet or CD titles.

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Accuracy Evaluation of CT-Based Attenuation Correction in SPECT with Different Energy of Radioisotopes (SPECT/CT에서 CT를 기반으로 한 Attenuation Correction의 정확도 평가)

  • Kim, Seung Jeong;Kim, Jae Il;Kim, Jung Soo;Kim, Tae Yeop;Kim, Soo Mee;Woo, Jae Ryong;Lee, Jae Sung;Kim, Yoo Kyeong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.25-29
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    • 2013
  • Purpose: In this study, we evaluated the accuracy of CT-based attenuation correction (AC) under the conventional CT protocol (140 kVp, on average 50-60 keV) by comparing the SPECT image qualities of different energy of radioisotopes, $^{201}Tl,\;^{99m}Tc$ and $^{131}I$. Materials and Methods: Using a cylindrical phantom, three different SPECT scans of $^{201}Tl$ (70 keV, 55.5 MBq), $^{99m}Tc$ (140 keV, 281.2 MBq) and $^{131}I$ (364 keV, 96.2 MBq) were performed. The CT image was obtained with 140 kVp and 2.5 mA in GE Hawkeye 4. The OSEM reconstruction algorithm was performed with 2 iterations and 10 subsets. The experiments were performed in the 4 different conditions; non-AC and non-scatter correction (SC), only AC, only SC, AC and SC in terms of uniformity and center to peripheral ratio (CPR). Results: The uniformity was calculated from the uniform whole region in the reconstructed images. For $^{201}Tl$ and $^{99m}Tc$, the uniformities were improved by about 10-20% AC was applied, but these were decreased by about 2% as SC was applied. The uniformity of $^{131}I$ was slightly increased as both AC and SC were applied. The CPR of the reconstructed image was close to one, when AC was applied for $^{201}Tl$ and $^{99m}Tc$ scans and $^{131}I$ was distant from 1 and that is only AC. Conclusion: The image uniformity improved by AC on low energy likely to $^{201}Tl$ and $^{99m}Tc$. However, image uniformity of high energy such as $^{131}I$ was improved, when both AC and SC was applied.

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