• Title/Summary/Keyword: distal extension

검색결과 126건 처리시간 0.063초

Arterial or venous free flaps for volar tissue defects of the proximal interphalangeal joint: A comparison of surgical outcomes

  • Choi, Min Suk;Roh, Si Young;Koh, Sung Hoon;Kim, Jin Soo;Lee, Dong Chul;Lee, Kyung Jin;Hong, Min Ki
    • Archives of Plastic Surgery
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    • 제47권5호
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    • pp.451-459
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    • 2020
  • Background For volar soft tissue defects of the proximal interphalangeal (PIP) joint, free flaps are technically challenging, but have more esthetic and functional advantages than local or distant flaps. In this study, we compared the long-term surgical outcomes of arterial (hypothenar, thenar, or second toe plantar) and venous free flaps for volar defects of the PIP joint. Methods This was a single-center retrospective review of free flap coverage of volar defects between the distal interphalangeal and metacarpophalangeal joint from July 2010 to August 2019. Patients with severe crush injuries (degloving, tendon or bone defects, or comminuted/intra-articular fractures), thumb injuries, multiple-joint and finger injuries, dorsal soft tissue defects, and defects >6 cm in length were excluded from the study, as were those lost to follow-up within 6 months. Thirteen patients received arterial (hypothenar, thenar, or second toe plantar) free flaps and 12 received venous free flaps. Patients' age, follow-up period, PIP joint active range of motion (ROM), extension lag, grip-strength ratio of the injured to the uninjured hand, and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score were compared between the groups. Results Arterial free flaps showed significantly higher PIP joint active ROM (P=0.043) and lower extension lag (P =0.035) than venous free flaps. The differences in flexion, grip strength, and QuickDASH scores were not statistically significant. Conclusions The surgical outcomes of arterial free flaps were superior to those of venous free flaps for volar defects of the PIP joint.

Radiographic Comparison of Cranial Tibial Wedge Osteotomy versus Tibial Plateau Leveling Osteotomy: A Cadaveric Study

  • Lee, Jiyoon;Kim, Dongwook;Oh, Hyejong;Lee, Sungin;Choi, Seok Hwa;Kim, Gonhyung
    • 한국임상수의학회지
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    • 제39권3호
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    • pp.93-99
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    • 2022
  • The present study was performed to compare cranial tibial wedge osteotomy (CTWO) and tibial plateau leveling osteotomy (TPLO) through radiographic evaluation. The experiment was conducted with five cadaver dogs [mean (± SD) weight, 32.9 ± 4.1 kg; mean (± SD) age, 6 ± 2 years; three males and two females] euthanized for reasons unrelated to this study. The cadaver dogs consisted of German Shepherd (n = 3), Belgian Malinois (n = 1), and mixed breed (n = 1). CTWO and TPLO were carried out by the standard surgical method. Radiographic evaluation was performed by comparing several factors, including the flexion and extension angles, the anatomical mechanical axis angle (AMA-angle), tibial length, patellar height measurement using the Labelle-Laurin method, mechanical medial proximal tibial angle (mMPTA), mechanical medial distal tibial angle (mMDTA), and frontal plane alignment (FPA). Both the CTWO and the TPLO groups showed significantly increased flexion angles after surgery. Only the CTWO group had significantly increased extension angle. Although both groups showed significant decreases in the AMA-angle, the mechanical axis moved cranially against the anatomical axis only in the CTWO group. The patellar height was significantly lowered in the CTWO group. No significant differences were found in mMPTA, mMDTA, or FPA. In conclusion, radiographic comparison revealed more changes in CTWO group than in TPLO group.

경저부 혈관손상의 임상적 고찰 (Clinical Study of Neck Base Injury)

  • 우종수
    • Journal of Chest Surgery
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    • 제11권4호
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    • pp.378-384
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    • 1978
  • Injuries to the major vessels in the thoracic inlet require early recognition and expedient operative approach. Delayed diagnosis difficulties encountered in the operative exposure of the region are the major factors limiting successful management. This report is a review of 13 patients with vascular injuries to the neck base who were managed at Busan National University Hospital from March 1975 to September 1978 about 3 years and 6 months. The important clinical problems are delineated with emphasis on the technical aspects of operative management. 1] Among 13 cases, 8 cases were male 5 cases were female. 2] Of 28 vascular injuries, subclavian axillary vascular injuries were 22 [78%]. Stab wound was the cause in 70% of these patients. 3] Without extension 7 cases[53.8%] were managed successfully with supraclavicular, and axillary incision. Posterolateral thoracotomy one of extending 4 cases, 2 cases were used right musculoskeletal flap for management of proximal part of the subclavian artery and innominate vessel, 2 cases were used left supraclavicular incision with anterolateral thoracotomy for management of left proximal subclavian artery. One Expired. 4] Repair of vascular injury was accomplished by lateral suture of debridement and end-to end anastomosis in 17[74%]. Autogenous vein was used one for interposition graft. Ligation was required 2 arterial, 6 venous injuries. Of 8 cases which were pulseless preoperatively, 5 cases were able to palpable distal pulse. 5] Post operative complications occurred 50%. Complication of vasular repair was rare. The majority was neurologic deficit (33.3%).

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생체모방형 건구동식 의수의 설계 (Design of Biomimetic Hand Prosthesis with Tendon-driven Five Fingers)

  • 정성윤;강성균;배주환;문인혁
    • 대한의용생체공학회:의공학회지
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    • 제30권3호
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    • pp.205-212
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    • 2009
  • This paper proposes a biomimetic hand prosthesis with tendon-driven five fingers. Each finger is composed of a distal-middle phalange, a proximal phalange and a metacarpal bone, which are connected to a link mechanism. The finger flexion is a resultant motion by pulling a wire to serve as a tendon, but the finger extension is performed by an elastic mechanism composed of a restoration spring. The designed hand prosthesis with tendon-driven five fingers has totally six degrees of freedom. But its weight is merely 400.73g. The hand can perform various hand functions such as the grasping and the hand postures. From experimental results, we show that the proposed hand prosthesis is useful to amputees as a prosthetic hand.

양성자치료용 보상체의 영상기반 정도 관리 기반 프로그램 개발 (Image Based Quality Assurance of Range Compensator for Proton Beam Therapy)

  • 김진성;윤명근;김동욱;임영경;곽정원;박소아;신동호;신정욱;이세병;박성용;조관호
    • 한국의학물리학회지:의학물리
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    • 제19권1호
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    • pp.35-41
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    • 2008
  • 양성자치료는 양성자의 물리적 특성으로 인해 인체 내의 특정범위에 모든 에너지를 전달하고 감쇠되어 타겟조직 뒤에 존재하는 정상조직에는 방사선이 조사되지 않는 큰 장점을 가진 치료법이다. 이 방법은 인체 내의 암 조직을 타겟으로 했을 때, 빔 방향에서의 타겟의 2차원적인 모양은 황동으로 제작된 블럭을 통해 정상조직에 들어가는 방사선을 차폐하고 마진을 주어서 GTV (eross Tumor Volume)에 90% 이상의 선량이 전달되도록 조절한다. 그리고, 양성자 빔의 날줄방향 (longitudinal)에서의 타겟의 3차원적인 모양을 고려하여 PMMA로 이루어진 보상체(compensator)를 밀링머신으로 조각하여 타겟에 방사선이 정확하게 분포되도록 한다. 이러한 보상체의 정확한 정도 관리를 위해 현재 사용되는 수동적인 방법을 보완하여 X선 영상으로 해당하는 보상체의 영상을 획득하여 이 영상을 기반으로 정도관리를 할 수 있는 방법을 제안하였고, 제안한 방법으로 보상체의 각각의 깎여진 평면의 모양과 두께를 정성적으로 비교 및 평가할 수 있었으며 두 영상의 차이가 80% 이상 맞는 것으로 확인되었다. 이를 바탕으로 영상을 이용한 정도관리 프로그램을 보완하여 추후 실제 양성자치료 정도관리에 사용될 예정이다.

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편측성으로 설계된 하악 유리단 국소의치에서 직접유지장치의 설계 변화에 따른 광탄성 응력 분석에 관한 연구 (A PHOTOELASTIC STRESS ANALYSIS IN MANDIBULAR DISTAL EXTENSION REMOVABLE PARTIAL DENTURE DESIGNED UNILATERALLY WITH DIFFERENT DIRECT RETAINERS)

  • 손홍석;계기성
    • 대한치과보철학회지
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    • 제30권1호
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    • pp.25-42
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    • 1992
  • The purpose of this study was to analyze the magnitude and distribution of stress using a photoelastic model from a unilateral distal extention removable partial dentures with five kinds of the direct retainers, that is, the bilaterally designed bar clasp of the cross-arch lingual bar and the unilaterally designed bar clasp, circumferential clasp, mini-Dalbo attachment, and telescope retainer. A photoelastic model for mandible was made of the epoxy resin(PL-1) and hardner (PLH-1) with the acrylic resin teeth used and was coated with plastic cement-1 at the lingual surface of the model, and then five kinds of removable partial dentures were set, A unilateral vertical load of about 16Kg was applied on the first molar and the stress pattern of the photoelastic model under each condition was analyzed by the reflective circular polariscope. The following results were obtained: 1. The conventional removable partial denture with the bilaterally cross arch lingual bar produced the most favorable stress distribution on the residual ridge and supporting structure of abutment teeth than the unilaterally designed removable partial dentures. 2. The unilaterally designed removable partial denture with the bar clasp produced the stress distribution on the residual ridge, except sligtly higher stress concentration on the supporting structure of the abutment teeth, similar to the conventional removable partial denture with the bilaterally designed cross arch lingual bar. 3. On the unilaterally designed removable partial dentures, the bar clasp produced greater stress distribution on the residual ridge and supporting structure of the abutment teeth than the circumferential clasp. 4. On the unilaterally designed removable partial dentures, the mimi-Dalbo attachment produced relatively higher stress concentration on the residual ridge, but produced lesser stress concentration on the supporting structure of the abutment teeth than the other direct retainers. 5. On the unilaterally designed removable partial dentures, the telescope retainer produced uniform stress distribution on the residual ridge, but produced higher stress concentration at the root apex of the terminal abutment tooth than the other direct retainers. 6. On the unilaterally designed removable partial dentures the circumferential clasp and telescope retainer produced slightly higher stress concentration on the residual ridge and supporting structure of the abutment teeth than the bar clasp and mini- Dalbo attachment.

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유리단 국소의치의 교합하중 적용시 이중금관, 어태치먼트 및 RPI clasp 유지장치에 따라 지대치와 의치상에 미치는 응력 비교 (Comparison of Stress of the Abutment Teeth and Denture Base in Distal Extension Removable Partial Dentures Retained Konus Crown, Precision Attachment and RPI Clasp with the Occlusal Load Application)

  • 전인식;김부섭;정인성
    • 대한치과기공학회지
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    • 제28권2호
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    • pp.331-346
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    • 2006
  • Free-end partial dentures, which are supported by teeth surrounded by dental root membranes and elastic mucous membrane tissues, may cause stress to the abutment teeth due to external force imposed on the denture base, increase the mobility of the abutment teeth, and bring about a change in the periodontal tissue. General retainers used in partial dentures are categorized into clasp, attachment, and Konus crown. Stress imposed on the abutment teeth and mobility of the denture base have relations with the lifetime of a crown and abutment teeth, and have direct relations with the chewing ability. Thus, a need arises to make a comparative analysis of stress of the three direct retainers on the abutment teeth and interpret the mobility of the denture base. This study designed three kinds of removable partial dentures (one kind of attachment partial denture, one kind of Konus crown partial denture, and one kind of clasp partial denture), and fabricated Dentiforms of bilateral partial dentures (Kennedy Class I) with lower left 1st premolar and lower right 1st and 2nd premolars being as the abutment teeth. A strain gauge was installed in the mesial and distal surface of the lowerr left 1st premolar (No. 34) of the fabricated dentiform and in the lower part of the denture base, and installed were a clasp partial denture, an attachment partial denture, and a Konus crown partial denture. Then, the vertical static load of 5kgf and 7.5kgf at the occlusion surface of the lower left No. 6 molar was generated for a total of 20 frequencies of load each using a push-full gauge, and thus a change in the output of the strain gauge was measured. With the respective application of Konus crown, attachment and RPI clasp in the free-end partial denture, surveyed was the distribution of stress imposed on the abutment teeth and the denture base according to the location of occlusion force load so as to come up with the following results. 1. Konus crown and attachment partial dentures generated much stress, and more stress on the abutment teeth than RPI clasp dentures did. Attachment dentures tended to further intensify stress on the abutment teeth than Konus crown dentures did. 2. Attachment dentures and Konus dentures imposed less stress on the denture base than RPI clasp dentures did. There was no stress difference between Attachment and Konus crown dentures. 3. Dentures that were designed with the application of retainers using sturdy linkage methods tended to be less mobile.

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Rhizoctonia solani에 의한 큰물개구리밥(Azolla japonica) 마름병 (Rhizoctonia Blight of Azolla japonica Caused by Rhizoctonia solani)

  • 이정한;차재율;노길한;한기수;배동원;권영상;임채신;정성우;권진혁;박정규;곽연식
    • 식물병연구
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    • 제17권3호
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    • pp.405-409
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    • 2011
  • 연 재배연못에서 발견된 큰물개구리밥에 R. solani AHL1에 의해 국지적으로 말라 고사하는 것을 관찰하였다. 병원균을 분리하여 형태적 특징을 조사한 결과 균사는 두께가 $5-6{\mu}m$이고 둔각분지를 하고 있었으며 핵형은 다핵형이었다. 배양적 특성으로 균사생육은 $25^{\circ}C$에서 가장 왕성하였으며 $30^{\circ}C$에서 가장 많은 균핵이 형성되었다. 온도에 따른 병원성과 발병정도를 조사한 결과 $20^{\circ}C$, $25^{\circ}C$$30^{\circ}C$에서 모두 병원성이 나타났으며 발병정도는 $30^{\circ}C$에서 가장 높게 나타났다. 병원균을 유전자 수준에서 동정하기 위해 ITS 영역을 Neighbor-Joining 방법을 이용하여 계통분류분석을 수행한 결과 R. solani로 동정되었다. 본 연구에서 분리된 R. solani AHL1은 벼잎집무늬마름병을 유발하는 병원균과 유사하여 벼에 대한 병 발생 여부는 추가적으로 연구가 필요하다. 현재 농업은 화학비료의 사용을 억제하는 추세로 녹비를 이용한 유기농업으로, 주요 녹비인 Azolla 안정적인 사용을 위하여 Azolla에 발생하는 병에 대한 연구가 더 이루어져야 된다고 사료된다.

상악동의 형태에 관한 방사선학적 연구 (A RADIOGRAPHIC STUDY ON THE MORPHOLOGY OF THE MAXILLARY SINUS)

  • 김봉영;김재덕
    • 치과방사선
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    • 제21권2호
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    • pp.297-306
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    • 1991
  • The purpose of this study is to improve the availabilities of radiographic technics as diagnostic methods to evaluate maxillary sinus in dental clinic. For the morphologic study of maxillary sinus, 20 dry maxillas were used and intraoral standard views, orthopantomograms, and skull P-A views were taken. For measuring the vertical image magnification rates, 5 sites in maxillary molar regions of 5 dry mandibles were selected radndomly and 25 wires of the determined sizes for selected portions were attached to the sites, after then, intraoral radiograms with bisecting technic and orthopantomograms were taken. The acquired results were as follows: 1. The anterior extension of the maxillary sinus on orthopantomogram was the distal side of the canine in 45.45% of subjects, the mesial side of the canine in 27.27%, the lateral incisor in 9.09%, the mesial side of the 1st premolar in 9.09%, and the mesial side of the 2nd pre-molar in 9.09%. 2. The positional relationship between the floor of maxillary sinus and the apex of alveolar socket revealed superimposed type in 58.3% of subjects, approached type in 33.3%, and separated type in 8.4%. 3. The morphology of inferior border of maxillary sinus was simple V or U shape in edentulous stage and V or wide U shape in alveolar socket stage. 4. The vertical image length on intraoral film taken by bisecting technic was magnified by 27.23% on the average and the length on orthopantomogram by 12.35%. 5. The inferior borders of maxillary sinus coinciding with each of the areas bearing the anterior and the posterior teeth on skull P-A view were determined.

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Subclavian artery 의 동맥류 -1예 수술 경험- (Surgical Treatment of Left Subclavian Aneurysm -A case report-)

  • 이성행;이성구;한승세;이길노;김송명
    • Journal of Chest Surgery
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    • 제9권2호
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    • pp.245-250
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    • 1976
  • 환자는 남자 33세이며 외상으로 인하여 좌측쇄골하동맥에 낭형의 가성동맥류가 발생했고 수술은 동맥류낭을 부분절제하고 Dacron 인조혈관을 이식하였다. 술후경과는 비교적 양호하였으며 관계된 문헌의 고찰과 함께 보고 하였다.

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