• Journal of Chest Surgery
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• 제46권6호
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• pp.439-443
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• 2013

Background: The surgically created arteriovenous fistula has recently been recommended as the best available angioaccess for hemodialysis. Therefore, in this study, we carried out a clinical analysis on surgical procedures in the ligation and division of a distal vein to achieve similar effects as those of vein end-to-arterial side after side-to-side anastomosis. Methods: We retrospectively reviewed the clinical data of 113 patients who came for an outpatient clinic follow-up to the department of internal medicine of our hospital; these patients were among the 125 patients who underwent radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) in our hospital in the period from January 2006 to December 2010. Results: The patency rate showed no statistical significance with respect to sex (p=0.775), age (p=0.775), hypertension (p=0.262), diabetes (p=0.929), and cardio-neurovascular disease (p=0.717). Patency rates were 96% for the first month, 93% for the first year, and 90% for the second year for the radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) performed on the wrist. Conclusion: The patency rates revealed favorable results and few postoperative complications as compared to those of previous reports. Therefore, radiocephalic fistula using side-to-side anastomosis with distal cephalic vein ligation is considered a recommendable surgical procedure in the distal part for the hemodialysis of CRF patients.

• 한국임상수의학회지
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• 제37권3호
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• pp.135-140
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• 2020

The purpose of this study was to determine the outcome of distal femoral osteotomy for distal femoral varus and medial patellar luxation (MPL) grade 4 in small-breed dogs. Radiographs and medical records were reviewed to collect data and plan the surgery in small-breed dogs with MPL grade 4. Computed tomography (CT) imaging was also performed in cases of severe bone deformities. Signalment, weight, medial patellar luxation and lameness grade, radiographic bone union, complications, pre- and postoperative femoral varus angle, passive range of motion, static weight bearing distribution and visual analogue scale scores were recorded. Thirteen corrective distal femoral osteotomies were performed with ancillary and additional procedures in 9 dogs; 4 dogs had staged bilateral procedures; and four stifles were suspected to have partial or complete rupture of the cranial cruciate ligament. One stifle underwent patellar groove replacement. The mean ± SD pre- and postoperative femoral varus angles were 109.15°± 3.71° and 96.30°± 2.97°, respectively. Significant improvements in passive range of motion, thigh circumference and visual analogue scale (VAS) scores were observed. There was no reluxation of the patella. This study suggests that distal femoral osteotomy with traditional and additional procedures provided satisfactory outcomes in patient healing and functional recovery in small-breed dogs with excessive femoral varus angles.

• 대한족부족관절학회지
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• 제10권1호
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• pp.56-59
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• 2006

Purpose: The purpose of this study is to find out the normal distal tibial articular surface angle in coronal plane in Koreans. This would be helpful as the basic data for ankle reconstruction after trauma or deformity correction. Materials and Methods: Weight bearing anteroposterior radiographs of 123 normal ankles were reviewed. A line parallel to the shaft of the tibia was made. Another line was drawn parallel to the articular surface of the distal tibia. The superolateral angle that subtended by these two lines was measured. Results: There were 72 males and 51 females. The mean age overall was 35.7 years old. The mean age for males was 31.9 ($28{\sim}36$) years old. The mean age for females was 41.1 ($37{\sim}45$) years old. The mean distal tibial articular surface angle was $90.8^{\circ}$. The mean distal tibial articular surface angle for males was $91.5^{\circ}$ and for females $89.9^{\circ}$. Conclusion: The mean distal tibial articular surface angle in coronal plane for Koreans is $90.8^{\circ}$. We can avoid the error of the varization at the ankle alignment when the correction was performed vertical or minimal valgus to tibia tuberosity axis in Korean people.

• Archives of Reconstructive Microsurgery
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• 제11권1호
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• pp.67-72
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• 2002

Purpose : Treatment of giant cell tumor of distal radius can be treated in several ways according to the agressiveness of the tumor. We treated 3 cases of widely involved giant cell tumor of distal radius with wide resection and proximal fibular graft and report the results with review of literatures. Material and Method : We have treated 3 cases of giant cell tumor of the distal radius since last 1990. Among 3 cases, two cases were grade III radiologically and treated by wide resection of distal radius and vascularized proximal fibular graft, and one case, grade II radiologically, treated by distal radial resection and non-vascularized proximal fibular graft. We followed up clinical results of above three cases 9 years, 12 years and 2 years. Result : In all three cases, tranplanted fibula graft showed solid union but grade III tumors recurred at 4 year and 6 year postoperatively. One of the case which recurred 4 year later was treated with secondary wide resection and wrist fusion with autogenous iliac bone graft, and didn't show any recurrent finding for these 5 years after re-operation. And another grade III, which recurred at 6th post-operative year, is under follow-up for 6 years after recur without 2nd operation. Grade II case didn't show any recurrent findings on 2 year follow-up. Conclusion : Grade III cases recurred at 4 year and 6 year follow-up. The cause of recurrence was thought to be invasion of remaining tumor cell in the soft tissue. To prevent recurrence, complete resection of primary tumor was necessary.

• 대한치과보철학회지
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• 제21권1호
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• pp.59-66
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• 1983

Distal extension partial dentures are supported by both the relatively rigid teeth and the resilient mucosa. So impression techniques of residual alveolar ridge in case of distal extension partial denture have particular importance in order to broad distribution of the masticatory force. McLean recognized the need for recording the tissues supporting distal extension partial denture base in functional form to equalize the resilient and non-resilient support, and this was called functional impression. Many investigators proposed various techniques of the functional impression for a distal extension partial denture, but only a little studies were performed about displacement of soft tissue under distal extension partial denture base. The purpose of this study is to investigate the amount of vertical displacement of the soft tissue under distal extension partial denture base by different functional impression techniques. Impression techniques used were Z.O.P. Impression, Selective Tissue Placement Impression, Functional Relining Impression. Measurement of the vertical displacement of soft tissue were made with Depth Gauge and Measuring Platform. A Anatomic Impression was used as a control. The results were tested statistically using 3 way ANOVA and Scheffe test. The followings were the results obtained from this study. 1. The greatest amount of soft tissue displacement was observed in the center of the retromolar pad. 2. No significant differences were found between the crest of alveolar ridge and the buccal shelf area. 3. The greatest soft tissue displacement was observed in Functional Relining Impression using Iowa wax, and the least displacement was observed in Selective Tissue Placement Impression using murcaptan rubber base. 4. No significant differences were found between finger pressure and biting pressure in Z.O.P. Impression, but greater displacement was observed by biting pressure than finger pressure in Functional Reling Impression.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.776-779
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• 2006

Purpose: Prior to closure of the epiphysis of the distal phalanx, fracture usually occurs through the growth plate, Salter-Harris type I or II, or through the juxtaepiphyseal region 1 to 2 mm distal to the growth plate. The terminal tendon of extensor inserts into the epiphysis only, while insertion site of the flexor digitorum profundus spans both the epiphysis and metaphysis. Because of the difference between these tendon insertions, this injury mimics a mallet deformity. But, this type of injury does not involve a tear or avulsion of the extensor, unlike mallet finger of adults. Seymour was the first to describe this type of injury in children and called after his name, Seymour's fracture. This fracture is prone to infection or remain the residual deformity unless adequate treatment. Methods: We report a case of Seymour's fracture. A 9-year-old boy presented a laceration of the nail matrix, with the nail lies degloved from the nail fold on the right middle finger gotten from an impact against a door. An X-ray examination showed the fracture line lying 1 mm distal to the growth plate. The injury was treated with debridement and the fracture was reduced by applying hyperextension force. Under the C-arm, a single 0.7 mm K-wire was used to immobilize the distal interphalangeal joint. Intravenous antibiotics were applied for 5 days after surgery. Results: The K-wire was removed in the 3rd week. No infection or significant deformity was found until follow-up of 12 months. Conclusions: Seymour's fracture may be at first classically mallet deformity by its appearance. But it is anatomically different and more problematic injury. If it isn't corrected at the time of injury, derangement of the extensor mechanism, and growth deformity of the distal phalanx may occur. The fracture site should be debrided, removed of any interposed soft tissue, and the patient should be given appropriate antibiotics. Reduction should be maintained by K-wire fixation. We experienced no infection or premature epiphyseal closure.

• Archives of Reconstructive Microsurgery
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• 제15권1호
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• pp.10-16
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• 2006

We retrospectively evaluated our results of replantations of distal digital amputations and analyzed the factors deterrent to the survival of replanted digits. From January 2004 to 2005 June, we performed 101 cases of replantations following complete amputations at or distal to interphalangeal joint level. The study included 98 patients with a mean age of 35.6 years (range 1 to 63 years). Amputation level correlated to zone I (distal to the lunula)in 47 cases and zone II (lunula to distal interphalangeal joint) in 54 cases according to Yamano's classification. According to the mechanism of amputation, 24 cases (22.9%) suffered from guillotine type injury, 27 cases (27.1 %) from avulsion type injury and 50 cases (50%) from crush type injury. In all cases, a single arterial anastomosis was performed. Venous anastomosis on either volar or dorsal side was performed in 12 cases of amputation in zone II. Salvage procedure for venous drainage was performed in 98 cases. The mean duration of salvage procedures was 5.9 days (ranging from 4 to 14 days). Successful replantation was achieved in 96 cases (95.1%), which included 93.7% cases in zone I amputations and 96.3% cases in zone II amputations. A single venous anastomosis was performed in 12 cases of amputation in zone II. All of them survived completely. Among the 5 cases that failed to survive, 3 cases were related with avulsion injury in zone I. Initial mechanism of injury determines the survival rate of amputated parts as it is directly related with the status of vessels and soft tissues. Meticulous precaution during the salvage procedure may affect the overall survival rate of distal digital replantations.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.723-728
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• 2008

Purpose: The disinsertion of the phalangeal tendon distal insertion has difficulties in ordinary tenorrhaphy operation for the anatomical features, and still has controversy between non-surgical and surgical management. The purpose of this study is to select treatment for the injury of the phalangeal tendon distal insertion, as we've had a good results from operation treatment with Pull-in suture technique. Methods: We reviewed the hospital records of 12 patients treated with Pull-in suture technique with disinsertion of the phalangeal extensor or flexor tendon distal insertion from June 2006 to June 2007. Eight patients were involved with the tendon disinsertion without bone fracture, and 4 patients were involved with the fracture of the phalangeal tendon distal insertion site. After removal of the K-wire in week 6, active physical exercises were commenced immediately. The mean follow-up period was 12.4 months. Results: All the patients who had tendon disinsertion with bone fracture had IIB, by Wehbe and Schneider's classification 2, and we evaluated the results comparing the same finger of the other hand according to Crawford's evaluation criteria 5. The nine excellent and three good results were obtained and there were no limitation of motor for the patient who had operation for the rupture of flexor tendon as well. There were no particular complications during the follow-up period. Conclusion: The most important thing for the disinsertion of the phalangeal tendon distal insertion is to maintain an accurate and durable reduction state keeping the tension of tendon. At this point, after removal of the K-wire, the Pull-in suture technique allows accurate realignment of the tendon-bone unit without any specific instrumentation under the more stable state. The Pull-in suture technique seems to be a strong alternative for the treatment of disinsertion of the phalangeal tendon distal insertion, with successful treatment outcome(rapid functional recovery and high patient satisfaction).

• 대한의용생체공학회:의공학회지
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• 제19권3호
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• pp.297-303
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• 1998

판막 후부의 공동부는 판막의 닫힘 거동과 판막 주위의 혈류 유동장을 변화시켜 인공 판막의 수력학적 성능에 영향을 미칠 수 있다. 계식 이엽 판막(SJMV), 폴리머 단엽 판막(MLPV), 폴리머 삼엽 판막(FTPV)을 판막 후부에 공동부가 있는 시험부와 공동부가 없는 직관형 시험부에 설치하여 모의 순환 장치에서 판막의 수력학적 성능을 평가하였다. 판막의 누수량은 공동부가 있는 시험부에서 약간 작았고, 수축기 평균 압력강하는 크게 나타났으나 통계적으로는 큰 차이가 없었다. 따라서 판막 후부의 공동부는 판막의 수력학적 성능에 큰 영향을 나타내지 않았다. 유량 파형의 해석 결과 판막 후부 공동부는 MLPV에서는 판막의 닫힘에 큰 영향을 주지 않았으나, SJMV에서는 판막의 닫힘이 일찍 시작하게 하였고 이 영향은 FTPV에서 더욱 크게 나타났다. FTPV는 공동부가 있는 시험부에서 역류 최대 유량이 감소하였으므로 판막 후두에 공동부는 판막의 급격한 닫힘에 의한 역류 제트의 발생을 감소시키리라 기대된다.

• 대한수의학회지
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• 제46권3호
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• pp.285-289
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• 2006

This study was performed to assess the growth plate closure time with aging in the Korean native goat. Radiographs of proximal and distal epiphysis of humerus, radius, ulna, femur and tibia were obtained at 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 13, 14, 17, 18, 20, 21, 30, 43 and 52 weeks after birth in 30 Korean native goats. The secondary ossification centers were scrutinized and assessed the maturity process on the basis of the criteria(stage 0 to 10). The secondary ossification centers of proximal and distal epiphysis of humerus, radius, femur and tibia and proximal ulna epiphysis appeared immediately after birth. While, that of distal ulna epiphysis appeared during the 1st to 2nd week of life. The fusion of distal humeral epiphysis occurred during the period from 8 to 12 months. The fusion of proximal radial epiphysis and distal tibial epiphysis were found at 1 year. The fusion of proximal and distal epiphysis of ulna and femur, proximal epiphysis of humerus and tibia and distal epiphysis of radius were found at 1 year or more than 1 year. As a result, growth plate closure was highly related to age in the Korean native goat and it is suggested that the estimation of animal's age might be useful by illustration of maturity process of the secondary ossification centers in the Korean native goat.