• 제목/요약/키워드: Stanford A type

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대동맥-상대정맥루를 동반한 A형 대동맥 해리증 수술 치험 -1례보고- (Type A Aortic Dissection with Aortocaval Fistula -Report of 1 case-)

  • 김흥수;양승인;정성운;김종원;이형렬
    • Journal of Chest Surgery
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    • 제35권8호
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    • pp.599-604
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    • 2002
  • 급성 혹은 만성 대동맥 해리증은 파열을 일으킬 수 있는데 이는 사망의 주요 원인이 된다. 상행대동맥의 해리성 동맥류(Stanford A형 대동맥 해리증)는 극히 드물게 상대정맥으로 파열되어 대동백-상대정맥루를 형성할 수 있는데 대동백-하대정맥루는 복부 대동맥류 환자에서 이따금씩 보고되어 왔다. 최근 상대정맥증후군의 증상을 가진 67세 남자환자에서 CT, MR angiography, 동맥촬영 등 방사선학적 검사결과 Stanford A형 대동맥 해리증 및 대동맥-상대정맥루가 진단되었다. 해리된 동맥류는 절제 후 인조혈관으로 치환되었고 대동맥-상대정맥루는 초저온 순환정지 상태에서 교정되었다. 이에 대해 상세하게 기술하는 바이다.

Design Optimization of a Type-I Heterojunction Tunneling Field-Effect Transistor (I-HTFET) for High Performance Logic Technology

  • Cho, Seong-Jae;Sun, Min-Chul;Kim, Ga-Ram;Kamins, Theodore I.;Park, Byung-Gook;Harris, James S. Jr.
    • JSTS:Journal of Semiconductor Technology and Science
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    • 제11권3호
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    • pp.182-189
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    • 2011
  • In this work, a tunneling field-effect transistor (TFET) based on heterojunctions of compound and Group IV semiconductors is introduced and simulated. TFETs based on either silicon or compound semiconductors have been intensively researched due to their merits of robustness against short channel effects (SCEs) and excellent subthreshold swing (SS) characteristics. However, silicon TFETs have the drawback of low on-current and compound ones are difficult to integrate with silicon CMOS circuits. In order to combine the high tunneling efficiency of narrow bandgap material TFETs and the high mobility of III-V TFETs, a Type-I heterojunction tunneling field-effect transistor (I-HTFET) adopting $Ge-Al_xGa_{1-x}As-Ge$ system has been optimized by simulation in terms of aluminum (Al) composition. To maximize device performance, we considered a nanowire structure, and it was shown that high performance (HP) logic technology can be achieved by the proposed device. The optimum Al composition turned out to be around 20% (x=0.2).

Surgical Outcomes of Type A Aortic Dissection at a Small-Volume Medical Center: Analysis according to the Extent of Surgery

  • Lee, Chul Ho;Cho, Jun Woo;Jang, Jae Seok;Yoon, Tae Hong
    • Journal of Chest Surgery
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    • 제53권2호
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    • pp.58-63
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    • 2020
  • Background: Despite progress in treatment, Stanford type A aortic dissection is still a life-threatening disease. In this study, we analyzed surgical outcomes in patients with Stanford type A aortic dissection according to the extent of surgery at Daegu Catholic University Medical Center. Methods: We retrospectively analyzed 98 patients with Stanford type A aortic dissection who underwent surgery at our institution between January 2008 and June 2018. Of these patients, 82 underwent limited replacement (hemi-arch or ascending aortic replacement), while 16 patients underwent total arch replacement (TAR). We analyzed in-hospital mortality, postoperative complications, the overall 5-year survival rate, and the 5-year aortic event-free survival rate. Results: The median follow-up time was 48 months (range, 1-128 months), with a completion rate of 85.7% (n=84). The overall in-hospital mortality rate was 8.2%: 6.1% in the limited replacement group and 18.8% in the TAR group (p=0.120). The overall 5-year survival rate was 78.8% in the limited replacement group and 81.3% in the TAR group (p=0.78). The overall 5-year aortic event-free survival rate was 85.3% in the limited replacement group and 88.9% in the TAR group (p=0.46). Conclusion: The extent of surgery was not related to the rates of in-hospital mortality, complications, aortic events, or survival. Although this study was conducted at a small-volume center, the in-hospital mortality and 5-year survival rates were satisfactory.

대동맥벽내 혈종 환자에서의 폐동맥 외막주위 혈종: 증례 보고 (Pulmonary Artery Periadventitial Hematoma in a Patient with Aortic Intramural Hematoma: A Case Report)

  • 권훈;정연주;이지원;황민희;김진유;이남경;이지원
    • 대한영상의학회지
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    • 제85권3호
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    • pp.649-653
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    • 2024
  • 폐동맥 외막주위 혈종은 Stanford A형 대동맥벽내 혈종의 드문 합병증이다. 근위부 상행 대동맥과 폐동맥은 공통된 혈관외막을 공유하고 있기 때문에 대동맥벽내 혈종의 혈액은 폐동맥으로 확산될 수 있다. 저자들은 급성 흉통을 호소하는 66세 남성에게서 보인 Stanford A형 대동맥벽내 혈종과 연관된 폐동맥 외막주위 혈종의 증례를 보고하고자 한다.

저온 작동 박막 고체산화물 연료전지 (Fuel Cells for Intermediate Temperature Operations)

  • 심준형;차석원
    • 한국세라믹학회지
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    • 제43권12호
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    • pp.751-757
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    • 2006
  • Recently, a new type of solid oxide fuel cells has been developed employing extremely thin oxide electrolyte. These fuel cells are expected to operate at significantly reduced temperature compared to conventional solid oxide fuel cells. Accordingly, they may resolve the stability and material selection issues of high temperature fuel cells. Furthermore, they may eliminate the limitations of polymer membrane fuel cells whose operation temperature is under $100^{\circ}C$. In this paper, we review the electrolytes for intermediate temperature operation. Then, we discuss the current development of thin film solid oxide fuel cells that possibly operated at low temperatures.

만성 Stanford B형 대동맥 박리로 하행 대동맥 스텐트 도관 삽입술 후 발생한 제I형 Endoleak의 치료에 시행한 Hybrid 혈관내 술식 (Hybrid Endovascular Repair for Type I Endoleak after Stent Grafting of Chronic Stanford Type B Aortic Dissection)

  • 김관욱;조상호;심원흠;윤영남
    • Journal of Chest Surgery
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    • 제43권4호
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    • pp.428-432
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    • 2010
  • 67세 남자환자가 6개월 전부터 반복되는 배부 동통을 주소로 내원하였다. 환자는 11년 전 Stanford B형 대동맥 박리로 하행 대동맥 스텐트 도관 삽입술을 시행 받았다. 대동맥 컴퓨터 단층촬영에서 좌 쇄골하동맥 기시부에서 시작되어 복부 대동맥 분지 부위까지 진행된 대동맥 박리, 스텐트 도관 근위부의 제 1형 endoleak 및 하행 대동맥의 낭종성 확장을 관찰하였다. 체외 심폐 순환 하에 무명동맥, 좌 총경동맥, 좌 쇄골하동맥의 탈분지 및 재혈관화술을 시행하고, 수술 후 13일째 대동맥 궁에서 하행대동맥까지 스텐트 도관을 삽입하는 Hybrid 술식을 성공적으로 시행하였고, 수술 후 시행한 대동맥 컴퓨터 단층촬영에서 제 1형 endoleak의 완전한 소실을 보였으며 퇴원 후 8개월간 특이 합병증 없이 경과 관찰 중이다.

The utility of three-dimensional models in complex microsurgical reconstruction

  • Ogunleye, Adeyemi A.;Deptula, Peter L.;Inchauste, Suzie M.;Zelones, Justin T.;Walters, Shannon;Gifford, Kyle;LeCastillo, Chris;Napel, Sandy;Fleischmann, Dominik;Nguyen, Dung H.
    • Archives of Plastic Surgery
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    • 제47권5호
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    • pp.428-434
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    • 2020
  • Background Three-dimensional (3D) model printing improves visualization of anatomical structures in space compared to two-dimensional (2D) data and creates an exact model of the surgical site that can be used for reference during surgery. There is limited evidence on the effects of using 3D models in microsurgical reconstruction on improving clinical outcomes. Methods A retrospective review of patients undergoing reconstructive breast microsurgery procedures from 2017 to 2019 who received computed tomography angiography (CTA) scans only or with 3D models for preoperative surgical planning were performed. Preoperative decision-making to undergo a deep inferior epigastric perforator (DIEP) versus muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flap, as well as whether the decision changed during flap harvest and postoperative complications were tracked based on the preoperative imaging used. In addition, we describe three example cases showing direct application of 3D mold as an accurate model to guide intraoperative dissection in complex microsurgical reconstruction. Results Fifty-eight abdominal-based breast free-flaps performed using conventional CTA were compared with a matched cohort of 58 breast free-flaps performed with 3D model print. There was no flap loss in either group. There was a significant reduction in flap harvest time with use of 3D model (CTA vs. 3D, 117.7±14.2 minutes vs. 109.8±11.6 minutes; P=0.001). In addition, there was no change in preoperative decision on type of flap harvested in all cases in 3D print group (0%), compared with 24.1% change in conventional CTA group. Conclusions Use of 3D print model improves accuracy of preoperative planning and reduces flap harvest time with similar postoperative complications in complex microsurgical reconstruction.

Overexpression, Purification, and Characterization of the Herpes Simplex Virus-1 DNA Polymerase-UL42 Protein Complex

  • Song, Byeong-Doo;Lehman, I. Robert
    • BMB Reports
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    • 제31권6호
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    • pp.585-589
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    • 1998
  • The herpes simplex virus type-1 (HSV-1)-encoded DNA polymerase consists of two subunits, the products of the UL30 and UL42 genes. UL30 and UL42 were coexpressed in Sf9 cells infected with recombinant baculoviruses carrying the two genes. The UL30 and UL42 gene products remained tightly associated throughout the purification, which led to a near homogeneous heterodimer composed of the DNA polymerase and UL42 protein. The DNA polymerase-UL42 protein heterodimer, purified from the recombinant baculovirus-infected Sf9 cells, showed the same high degree of processivity of deoxynucleotide polymerization as the enzyme purified from the HSV-1 infected primate cells. Like the latter, it contained a 3'-5' exonuclease activity that specifically hydrolyzes an incorrectly matched nucleotide at the 3' terminus of a primer, thereby contributing to the fidelity of DNA replication.

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A형 대동맥 박리 수술 후 재발성 박리의 재수술 (Redo Opeations for Recurrent Dissection After Operation for Type A Aortic Dissection)

  • 홍유선;강정한;윤치순;이현성;박형동
    • Journal of Chest Surgery
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    • 제34권8호
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    • pp.604-610
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    • 2001
  • 배경: Stanford 제A형(type A) 대동맥 박리증은 상행대동맥이나 대동맥궁의 인조혈관 치환 수술 후에도 남은 대동맥의 가강이 확장되거나 파열의 가능성이 있기 때문에 철저한 추적관리가 필요하다. 연세대학교 세브란스병원에서는 1984년 6월부터 2000년 3월까지 Stanford 제A형의 대동맥박리 수술이 124예 있었다. 수술 후 가강의 확장이나 파열로 재수술한 6예에서 Marfan 증후군과의 관련성 등 원인을 조사하고 재수술의 방법과 결과, 재수술의 위험을 줄일 수 있는 방법 등을 알아보고자 한다. 대상 및 방법: 처음 대동맥 박리로 수술시급성인 경우가 4예 만성이 2예였으며 이중 3예가 Marfan 증후군이였다. 1예를 제외한 모든 환자에서 상행대동맥내에 내막파열이 있어 대동맥판막의 폐쇄부전의 정도에 따라 상행대동맥 인조혈관 치한수술(2례) 또는 Bentall 수술을 시행하였으며(3례) 1예는 여러 개의 가강과의 연결부위가 있는 만성 박리 환자로 Bentall 수술과 더불어 대동맥궁까지 인조혈관으로 치환을 하였다. 재수술은 평균 67.6개월(4개월-14년4개월) 후에 시행하였는데 1예는 만성 하행대동맥 박리 및 동맥류로 1예는 염증성 가성동맥류로 나머지 4예는 급성대동맥 박리로 재수술을 시행하였다. 수술은 하행흉부대동맥만을 치환한 경우가 1예, Hemiarch로 시행한 경우가 1예 그리고 나머지 4예는 원위부 상행대동맥에서 대동맥궁을 포함하여 근위부 또는 중간부위의 하행 흉부대동맥까지 인조혈관으로 치환하였다. 결과: 전체 124예 중 Marfan 증후군이 동반된 경우는 18예였다.

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The Changes in Range of Motion after a Lumbar Spinal Arthroplasty with Charite$^{TM}$ in the Human Cadaveric Spine under Physiologic Compressive Follower Preload: A Comparative Study between Load Control Protocol and Hybrid Protocol

  • Kim, Se-Hoon;Chang, Ung-Kyu;Chang, Jae-Chil;Chun, Kwon-Soo;Lim, T. Jesse;Kim, Daniel H.
    • Journal of Korean Neurosurgical Society
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    • 제46권2호
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    • pp.144-151
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    • 2009
  • Objective: To compare two testing protocols for evaluating range of motion (ROM) changes in the preloaded cadaveric spines implanted with a mobile core type Charite$^{TM}$ lumbar artificial disc. Methods: Using five human cadaveric lumbosacral spines (L2-S2), baseline ROMs were measured with a bending moment of 8 Nm for all motion modes (flexion/extension, lateral bending, and axial rotation) in intact spine. The ROM was tracked using a video-based motion-capturing system. After the Charite$^{TM}$ disc was implanted at the L4-L5 level, the measurement was repeated using two different methods: 1) loading up to 8 Nm with the compressive follower preload as in testing the intact spine (Load control protocol), 2) loading in displacement control until the total ROM of L2-S2 matches that when the intact spine was loaded under load control (Hybrid protocol). The comparison between the data of each protocol was performed. Results: The ROMs of the L4-L5 arthroplasty level were increased in all test modalities (p < 0.05 in bending and rotation) under both load and hybrid protocols. At the adjacent segments, the ROMs were increased in all modes except flexion under load control protocol. Under hybrid protocol, the adjacent segments demonstrated decreased ROMs in all modalities except extension at the inferior segment. Statistical significance between load and hybrid protocols was observed during bending and rotation at the operative and adjacent levels (p< 0.05). Conclusion: In hybrid protocol, the Charite$^{TM}$ disc provided a relatively better restoration of ROM, than in the load control protocol, reproducing clinical observations in terms of motion following surgery.