• Korean Journal of Mathematics
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• v.16 no.3
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• pp.363-367
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• 2008

In this paper, we define the S-distal flow and S-distal homomorphism which are motivated by the distal flow and the distal homomorphism respectively and obtain some results and that an Sdistal extension of an S-distal flow is S-distal.

• Journal of Korean Foot and Ankle Society
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• v.17 no.3
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• pp.174-181
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• 2013

Distal tibia fractures were mainly caused by high energy trauma and the lower legs were enveloped in poor soft tissue. Therefore, there are many open fractures and concomitant soft tissue injuries in distal tibia fractures. For the restoration of ankle function, the surgical treatment was performed in distal tibia fractures. However, it is difficult to treat the distal tibia fracture surgically. There are many complications in distal tibia fracture due to highly comminuted fracture and poor soft tissue condition. There are many surgical methods for distal tibia fractures, such as, external fixator, intramedulary nailling, open reduction & internal fixation, and minimally invasive plate osteosynthesis. We reviewed the surgical treatments of distal tibia fractures.

• Applied Microscopy
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• v.26 no.2
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• pp.177-195
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• 1996

Fine structure of the processes of intramembranous ossification and endochondral ossification at the tip of the distal phalanx of human fetuses was studied by electron microscopy. In 50 mm fetus, intramembranous ossification of the tip of cartilaginous phalanx was first noted. The osteoblasts of the perichondral zone of tip of cartilaginous phalanx started to lay down a thick membranous bony lamella. Most of the hypertrophied chondrocytes in the marginal parts of tip of the distal phalanx remained viable after being embeded in mineralized cartilaginous septa. The tuberosity of the distal phalanx was formed by membranous bony trabeculae on the exterior of the subperiosteal cap at 80 mm fetus. At this stage endochondral ossification was first observed in distal extremity of the distal phalanx. The maority of hypertrophied chondrocytes in the center of distal extremity appeared to be disintegrating. Resorption of calcified matrix was undertaken by perivascular cells and chondroclasts. From the periosteum, zone of calcification, vascular sprouts expanded within a recently opened lacunae, and the invading osteoblasts laid down osteoid and bone. After 120 mm fetus, endochondral and subperiosteal ossification proceeded in only one direction, just proximally. These findings demonstrate that intramembranous ossification, calcification, and endochondral ossification start at tip of the distal phalanx instead of at the center of the shaft, as was the case in other long bones.

• Journal of Gastric Cancer
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• v.13 no.1
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• pp.26-33
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• 2013

Purpose: The aims are to: (i) display the multidimensional learning curve of totally laparoscopic distal gastrectomy, and (ii) verify the feasibility of totally laparoscopic distal gastrectomy after learning curve completion by comparing it with laparoscopy-assisted distal gastrectomy. Materials and Methods: From January 2005 to June 2012, 247 patients who underwent laparoscopy-assisted distal gastrectomy (n=136) and totally laparoscopic distal gastrectomy (n=111) for early gastric cancer were enrolled. Their clinicopathological characteristics and early surgical outcomes were analyzed. Analysis of the totally laparoscopic distal gastrectomy learning curve was conducted using the moving average method and the cumulative sum method on 180 patients who underwent totally laparoscopic distal gastrectomy. Results: Our study indicated that experience with 40 and 20 totally laparoscopic distal gastrectomy cases, is required in order to achieve optimum proficiency by two surgeons. There were no remarkable differences in the clinicopathological characteristics between laparoscopy-assisted distal gastrectomy and totally laparoscopic distal gastrectomy groups. The two groups were comparable in terms of open conversion, combined resection, morbidities, reoperation rate, hospital stay and time to first flatus (P>0.05). However, totally laparoscopic distal gastrectomy had a significantly shorter mean operation time than laparoscopy-assisted distal gastrectomy (P<0.01). We also found that intra-abdominal abscess and overall complication rates were significantly higher before the learning curve than after the learning curve (P<0.05). Conclusions: Experience with 20~40 cases of totally laparoscopic distal gastrectomy is required to complete the learning curve. The use of totally laparoscopic distal gastrectomy after learning curve completion is a feasible and timesaving method compared to laparoscopy-assisted distal gastrectomy.

• Journal of Gastric Cancer
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• v.13 no.1
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• pp.44-50
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• 2013

Purpose: Laparoscopic gastrectomy has been adopted for the treatment of gastric cancer, and despite the technical difficulties, totally laparoscopic distal gastrectomy has been considered less invasive than laparoscopy-assisted distal gastrectomy. Although there have been many reports regarding the feasibility and safety of totally laparoscopic distal gastrectomy at large volume centers, few reports have been conducted at low-volume centers. The purpose of this study is to try to assess the feasibility and safety of totally laparoscopic distal gastrectomy at a low volume center through the analysis of short-term outcomes of totally laparoscopic distal gastrectomy compared with laparoscopy-assisted distal gastrectomy. Materials and Methods: The clinical data and short-term surgical outcomes of 35 patients who had undergone laparoscopy-assisted distal gastrectomy between April 2007 and March 2010, and 37 patients who underwent totally laparoscopic distal gastrectomy between April 2010 and August 2012 were retrospectively reviewed. Results: There was no significant difference in the demographic and clinical data. However the reconstruction method and extent of lymphadenectomy showed statistically significant differences. Operation time and estimated blood loss did not show significant differences. Surgical and medical complications did not show significant differences but postoperative courses including time-to-first oral intake and postoperative hospital stay were significantly increased. Conclusions: Our study shows that totally laparoscopic distal gastrectomy is technically feasible at a low volume center. Therefore, totally laparoscopic distal gastrectomy can be considered as one of the surgical treatment for early gastric cancer. However the possibility that totally laparoscopic distal gastrectomy may have less benefit should also be considered.

• Clinics in Shoulder and Elbow
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• v.24 no.2
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• pp.66-71
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• 2021

Background: Extra-articular distal humerus locking plates (EADHPs) are precontoured anatomical plates widely used to repair distal humeral extra-articular diaphyseal fractures. However, EADHPs frequently cause distal protrusion and resulting skin discomfort. The purpose of this study was to predict the occurrence of anatomic fit mismatch. We hypothesized that the smaller the humerus size, the greater the anatomic fit mismatch with EADHP. Methods: Twenty humeri were analyzed in this study. Humeral length and distal humeral width were used as parameters of humeral size. Plate protrusion was measured between the EADHP distal tip and the distal humerus. We set the level of unacceptable EADHP anatomic fit mismatch as ≥10 mm plate protrusion. Results: A significant negative linear correlation was also confirmed between humeral size and plate protrusion, with a coefficient of determination of 0.477 for humeral length and 0.814 for distal humeral width. The cutoff value of humeral length to avoid ≥10 mm plate protrusion was 293.6 mm (sensitivity, 88.9%; specificity, 81.8%) and for distal humeral width was 60.5 mm (sensitivity, 100%; specificity, 81.8%). Conclusions: Anatomic fit mismatch in distal humeral fractures after EADHP fixation has a negative linear correlation with humeral length and distal humeral width. For patients with a distal humeral width <60.5 mm, ≥10 mm plate protrusion will occur when an EADHP is used, and an alternative implant or approach should be considered.

• The Journal of Korean Academy of Prosthodontics
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• v.30 no.3
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• pp.379-400
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• 1992

The purpose of this study was to analyze the magnitude and distribution of stress using a photoelastic model from the mandibular distal extension removable partial dentures with the mesial or distal placement of the occlusal rest and the mesial or distal connection in the back-action clasp with the five various designs of the back-action clasp, that is, the mesial connection and the distal rest, the distal connection and mesial rest, the mesial connection and mesial rest, the distal connection and the mesial and distal rest, and the mesial connection, and the mesial and distal rest. A photoelastic model was made of the epoxy resin(PC-1) and the hardner(PLH-1) with the acrylic resin teeth used and was coated with the plastic cement-1 at the lingual surface of the model and then five kinds of the removable partial dentures on the photoelastic model were set. A unilateral vertical load of 12.5 kg was applied on the central fossa of the first molar with the use of specially designed loading device and the pattern and distribution of the stress of the photoelastic model under each condition was analyzed by the reflective circular polariscope. The following results were obtained. 1. In the back-action clasp with the mesial connection and mesial rest of the case 3, the effect of the stress distribution was the most favorable. 2. In the back-action clasp with the mesial and distal rest, of the case 4 and 5, the stress distribution was more greatly showed in the terminal abutment. 3. Generally, the stress distribution was more favarable in the mesial connection than in the distal connection. 4. In the back-action clasp with the mesial connection of the case 1, 3 and 5, the stress distribution was the most favorable in the mesial rest.

• Annals of Clinical Neurophysiology
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• v.3 no.1
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• pp.1-8
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• 2001

The distal myopathies(DM) are clinically defined as inherited or sporadic primary muscle disorders characterized by progressive muscular weakness and atrophy beginning in the hands or feet and pathologically by myopathic changes in skeletal muscles. The pathologic changes are somewhat similar to those seen in chronic muscular dystrophy, but necrotic and regenerative processes are less prominent and creatine kinase levels are either normal or only mildly elevated. The most representative diseases are dominantly inherited Welander distal myopathy and tibial muscular dystrophy, and the recessively inherited distal myopathy with rimmed vacuoles and distal muscular dystrophy(Miyoshi myopathy). At present, further study is necessary to determine why rimmed vacuoles are so common in the DM, and what role they play in the pathogenesis of muscle fiber atrophy and loss, predominantly in the distal portions of the extremities.

• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.222-230
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• 2023

Background: Distal biceps tendon repairs are commonly performed using open techniques. A minimally invasive distal biceps tendon repair technique using a speculum and hooded endoscope was developed to improve visualization, reduce soft-tissue dissection, and minimize complications. This paper describes the technique and reports the outcomes of 75 minimally invasive distal biceps tendon repairs. Methods: The operation reports and outcomes of 75 patients who underwent distal biceps tendon repair using this technique between 2011 and 2021 were retrospectively reviewed. Results: Median time to follow-up was 12 months (interquartile range [IQR], 6-56 months). Primary outcomes were function as measured by the Disabilities of Arm, Shoulder and Hand Score (DASH) questionnaire, and rate of complications. Median DASH score was 1.7 of 100 (IQR, 0-6.8). There were 2 of 75 (2.7%) re-ruptures of the distal tendon. There were no cases of vascular injury, proximal radius fracture, or posterior interosseous nerve, median, or ulnar nerve palsy. Conclusions: In this series, minimally invasive distal biceps repair was safe and effective with a low rate of major complications. Recovery of function, as indicated by low DASH scores, was satisfactory, and inconvenience during recovery was minimized. Level of evidence: IV.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.238-240
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• 2006

The incidence of distal anterior cerebral artery[ACA] aneurysm is relatively rare, and only a few cases of bilateral symmetrical distal ACA aneurysms which were adhered together have been reported. They are also called kissing aneurysms. We treated bilateral asymmetrical distal ACA kissing aneurysms in a 44-year-old woman. We successfully clipped the double aneurysmal sacs individually by interhemispheric approach in spite of intraoperative aneurysmal rupture. The patient was discharged without any neurological deficits two weeks after the operation.