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Thoracoscopic Diaphragmatic Plication Using Three 5 mm Ports (흉강경하 횡경막 주름성형술: 작업창없이 3개의 포트를 이용한 수술법)

  • Kim, Do-Hyung;Kim, Kil-Dong;Hwang, Jung-Joo;Choi, Jin-Ho;Lee, Jun-Wan
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.513-517
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    • 2010
  • Background: Diaphragmatic plication through a thoracoscopic approach has been an effective modality to treat diaphragmatic enventration. However, the conventional technique for thoracoscopic plication has some disadvantages. We have developed an improved and simplified technique with utilizing the head up position, $CO_2$ insufflation and figure-of-eight sutures. Material and Method: Between October 2005 and September 2009, 9 patients with diaphragmatic paralysis underwent repair using our modified technique. The mean patient age was $38.5{\pm}53.0$ years (range: 2~76 years). Result: The mean operation time was $46.7{\pm}15.9$ min (range: 30~85 min). None of the patients died due to this procedure, but there was one case of prolonged air leakage, and a case of re-expansion pulmonary edema, which required 3 days of ventilator support after the procedure. The mean hospital stay was $6.22{\pm}2.04$ days (range: 4~11 days). The mean follow-up duration was $27.2{\pm}11.6$ months (range: 2~43 months). All the patients had their symptoms relieved and there was no recurrence of eventration except for one patient who developed more than 2 cm elevation of the diaphragm compared to the immediate post-operation status. Conclusion: With our technique, thoracoscopic diaphragmatic plication was feasible via using only three 5 mm ports and without a working window and the midterm results were favorable. Therefore, we advocate thoracoscopic diaphragmatic plication as a preferred technique to the conventional open plication technique.

Clinical Studies on Locally Invasive Thyroid Cancer (국소침범한 갑상선암의 임상적 고찰)

  • Kim Young-Min;Lee Chang-Yun;Yang Kyung-Hun;Rho Young-Soo;Park Young-Min;Lim Hyun-Jun
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.236-243
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    • 1998
  • Objectives: Local invasion of the thyroid cancer that is invasion of the upper aerodigestive tract, neurovascular structures of the neck and superior mediastinum, is infrequent and comprises of 1-16% of well-differentiated thyroid cancer. However the proximity of the thyroid gland to these structures provides the means for an invasive cancer to gain ready access into theses structures and when invasion occurs, it is the source of significant morbidity and mortality. So locally invasive thyroid cancer should be removed as much as possible, but still much debates have been exist whether the surgical method should be radical or conservative. This study was desinged to evaluate the clinical characteristics and the surgical treatment of the locally invasive thyroid cancer. Material and Methods: At the department of otorhinolaryngology of Hallym university, 10 patients diagnosed as locally invasive thyroid cancer among the 81 patients treated for thyroid cancer between 1991 to 1997 were retrospectively evaluated. Results: Of the 10 patients, 3 patients had histories of previous surgical treatment with or without radiation or radioactive iodine therapy. The site of invasion of thyroid cancer were trachea(7 cases), recurrent laryngeal nerve(5 cases), mediastinal node(5 cases), esophagus(3cases), larynx(3cases), carotid artery(3 cases), pharynx(l case), and other sites(4 cases). The operation techniques included 1 partial laryngectomy and 1 partial cricoid resection, 2 shavings and 3 window resections of the trachea, 1 sleeve resection of the trachea with end-to-end anastomosis and 1 cricotracheoplasty for tracheal invasion, 2 shavings and 1 partial esophagectomies for esophageal invasion, and 1 wall shaving and 2 partial resections with $Gortex^{\circledR}$ tube reconstruction for carotid artery invasion, and so on. Conclusions: These data and review of literature suggest that the surgical method should be perfomed on the basis of individual condition and complete removal of all gross tumor with preservation of vital structures whenever possible will offer a good result.

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The Research Status and Task of the Metalcrafts of Shoso-in Collection (정창원(正倉院) [쇼소인] 금속공예의 연구 현황과 과제)

  • Choi, Eungchon
    • Korean Journal of Heritage: History & Science
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    • v.51 no.3
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    • pp.32-53
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    • 2018
  • The $Sh{\bar{o}}s{\bar{o}}-in$(正倉院) is the detached storage building for Japanese treasures that belongs to $T{\bar{o}}dai-ji$ in Nara, Japan. The reason why $Sh{\bar{o}}s{\bar{o}}-in$ collections are drawing attention is that Japanese artifacts, sculptures, paintings, and other objects that were introduced through the Silk Road, such as Sasanian Persia and India, and those that were introduced from the Unified Silla and Tang China. In addition, hundreds of well-preserved documents of $Sh{\bar{o}}s{\bar{o}}-in$ collections play an important role as a historical reference material covering not only the social situation of the time but also the history of exchange of cultural diplomacy and the change of Buddhist doctrine. In particular, some of collections of $Sh{\bar{o}}s{\bar{o}}-in$ were made in China and may have been imported or received as gifts, but many of the artifacts made in Baekje and Unified Silla are becoming more and more important. This paper examined the research status of $Sh{\bar{o}}s{\bar{o}}-in$ metal crafts of Korean and foreign scholars, and examined the association with the relics of $Sh{\bar{o}}s{\bar{o}}-in$ through metal crafts excavated from the Korean Peninsula. The research on the future direction of $Sh{\bar{o}}s{\bar{o}}-in$ collections should be summarized as follows. 1. Systematization of state-level support and single window for the research of $Sh{\bar{o}}s{\bar{o}}-in$ collections 2. Accurate listing and database of $Sh{\bar{o}}s{\bar{o}}-in$ collections 3. The positive implementation of joint research with Japan and invitation of researchers related to $Sh{\bar{o}}s{\bar{o}}-in$ collections 4. The exchange exhibition between the Korean National Treasures and the $Sh{\bar{o}}s{\bar{o}}-in$ collections 5. Expansion of the research base through the publication and support of books related to $Sh{\bar{o}}s{\bar{o}}-in$ collections.

Next Generation Lightweight Structural Composite Materials for Future Mobility Review: Applicability of Self-Reinforced Composites (미래모빌리티를 위한 차세대 경량구조복합재료 검토: 자기강화복합재료의 적용 가능성)

  • Mi Na Kim;Ji-un Jang;Hyeseong Lee;Myung Jun Oh;Seong Yun Kim
    • Composites Research
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    • v.36 no.1
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    • pp.1-15
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    • 2023
  • Demand for energy consumption reduction is increasing according to the development expectations of future mobility. Lightweight structural materials are known as a method to reduce greenhouse gas emissions and improve energy efficiency. In particular, fiber reinforced polymer composite (FRP) is attracting attention as a material that can replace existing metal alloys due to its excellent mechanical properties and light weight. In this paper, industrial applications and research trends of carbon fiber reinforced composites (CFRP, carbon FRP) and self-reinforced composites (SRC) were reviewed based on the reinforcement, polymer matrix, and manufacturing process. In order to overcome the expensive process cost and long manufacturing time of the epoxy resin-based autoclave method, which is mainly used in the aircraft field, mass production of CFRP-applied electric vehicles has been reported using a high-pressure resin transfer molding process including fast-curing epoxy. In addition, thermoplastic resin-based CFRP and interface enhancement methods to solve the recycling issue of carbon fiber composites were reviewed in terms of materials and processes. To form a perfect matrix-reinforcement interface, which is known as the major factor inducing the excellent mechanical properties of FRP, studies on SRC impregnated with the same matrix in polymer fibers have been reported. The physical and mechanical properties of SRC based on various thermoplastic polymers were reviewed in terms of polymer orientation and composite structure. In addition, a copolymer matrix strategy for extending the processing window of highly drawn polypropylene fiber-based SRC was discussed. The application of CFRP and SRC as lightweight structural materials can provide potential options for improving the energy efficiency of future mobility.

Air Cavity Effects on the Absorbed Dose for 4-, 6- and 10-MV X-ray Beams : Larynx Model (4-, 6-, 10-MV X-선원에서 공기동이 흡수선량에 미치는 효과 : 후두모형)

  • Kim Chang-Seon;Yang Dae-Sik;Kim Chul-Yong;Choi Myung-Sun
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.393-402
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    • 1997
  • Purpose : When an x-ray beam of small field size is irradiated to target area containing an air cavity, such as larynx, the underdosing effect is observed in the region near the interfaces of air and soft tissue. With a larynx model, air cavity embedded in tissue-equivalent material, this study is intonded for examining Parameters, such as beam quality, field size, and cavity size, to affect the dose distribution near the air cavity. Materials and Methods : Three x-rar beams, 4-, 6- and 10-MV, were employed to Perform a measurement using a 2cm $(width){\times}L$ (length in cm, one side of x-ray field used 2cm (height) air cavity in the simulated larynx. A thin window parallel-plate chamber connected to an electrometer was used for a dosimetry system. A ratio of the dose at various distances from the cavity-tissue interface to the dose at the same points in a homogeneous Phantom (ebservedlexpected ratio, O/E) normalized buildup curves, and ratio of distal surface dose to dose at the maximum buildup depth were examined for various field sizes. Measurement for cavity size effect was performed by varying the height (Z) of the air cavity with the width kept constant for several field sizes. Results : No underdosing effect for 4-MV beam for fields larger than $5cm\times5cm$ was found For both 6- and 10-MV beams, the underdosing portion of the larynx at the distal surface was seen to occur for small fields, $4cm\times4cm\;and\;5cm\times5cm$. The underdosed tissue was increased in its volume with beam energy even for similar surface doses. The relative distal surface dose to maximum dose was changed to 0.99 from 0.95, 0.92, and 0.91 for 4-, 6-, and 10-MV, respectively, with increasing field size, $4cm\times4cm\;to\;8cm\times8cm$, For 6- and 10-MV beams, the dose at the surface of the cavity is measured less than the predicted by about two and three percent. respectively. but decrease was found for 4-MV beam for $5cm\times5cm$ field. For the $4cm\timesL\timesZ$ (height in cm). varying depth from 0.0 to 4.8cm, cavity, O/E> 1.0 was observed regardless of the cavity size for any field larger than about $8cm\times8cm$. Conclusion : The magnitude of underdosing depends on beam energy, field size. and cavity size for the larynx model. Based on the result of the study. caution must be used when a small field of a high quality x-ray beam is irradiated to regions including air cavities. and especially the region where the tumor extends to the surface. Low quality beam. such as. 4-MV x-ray, and larger fields can be used preferably to reduce the risk of underdosing, local failure. In the case of high quality beams such as 6- and 10-MV x-rays, however. an additional boost field is recommended to add for the compensation of the underdosing region when a typically used treatment field. $8cm\times8cm$, is employed.

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