• Title/Summary/Keyword: retraction

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The Diameter of Maximum Distended Urethra in Male Dogs (수컷 개에서 최대 확장된 요도의 직경)

  • Byeon, Ye-Eun;Lee, Sun-Tae;Kweon, Oh-Kyeong;Kim, Wan-Hee
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.331-335
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    • 2009
  • This paper was performed to investigate the propensity of the diameter of maximum distended urethra from urethra to os penis in mature male dogs of 25 male dogs of different breeds. The measured sites of urethras were divided into 7 regions, i.e. prostate, membrane, isthmus, perineum, scrotum, prescrotum and os penis. By using the inflated balloon catheter filled with contrast medium, the maximum diameter of the distended urethras of each region was recorded and compared among regions. The mean diameter of the lumen from the prostatic urethra to the os penis urethra was gradually narrowed except for the isthmus portion, with a sense of resistance for retraction being noted at the level of ischiatic arch in 22 dogs. Proposed results from this should be utilized as a predictor of a treatment plan for the removal of urethroliths using an urohydropropulsion.

Microscopic Excision of Neurilemmoma of the Extremities (사지에 발생한 신경초종의 미세수술적 치료)

  • Lee, Kwang-Suk;Woo, Kyung-Jo;Kim, Jong-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.88-93
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    • 1996
  • Neurilemmomas are the most common benign tumor of the peripheral nerve trunks, and arises from the cells in the sheath of Schwann. Neurilemmomas are well encapsulated and may be separated easily from surrounding tissue and lie completely within a larger nerve trunk, with bundles of neurofibrils spread out over the surface of the tumor. A careful dissection and retraction of the nerve bundles will allow the tumor to be enucleated from the parent nerve without any significant interference with the function of the nerve. Resection of the involved nerve is seldom necessary and should be avoided if at all possible. Our aim in microscopic excision of neurilemmoma of extremities is to reduce any disturbance of the intact neurofibrils of the parent nerve. Thirteen cases of neurilimmomas were treated by microscopic excision at the Department of Orthopaedic Surgery, Korea University Hospital between January 1990 and March 1995. The results was as follows ; 1. The average age at surgical intervention was 40.1 years. Cases in fourth and fifth decades predominated. 2. In their anatomical distribution, 8 cases were in the upper extremity and 5 cases in the lower extremity. 11 cases were on the flexor surface. 3. On the operative field, all the tumors were well encapsulated, however 1 case of 13 was adherent to the periosteum of fibula. 4. In all cases, the tumor were enucleated from the parent nerve without any injury to nerve under high-power magnification, preserving individual fascicles, and sensory and motor function.

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Posterior Microscopic Lesionectomy for Lumbar Disc Herniation with Tubular Retraction Using $METRx^{TM}$ System

  • Choi, Yu-Yeol;Yoon, Seung-Hwan;Ha, Yoon;Kim, Eun-Young;Park, Hyung-Chun;Park, Chong-Oon
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.406-411
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    • 2006
  • Objective : The authors have developed a procedure, termed posterior microscopic lesionectomy, that creates a minimal laminotomy site according to the location of the shifted disc using the $METRx^{TM}$ system in the lumbar spine. This study compared the usefulness and surgical outcomes of this procedure with those of traditional standard lumbar discectomy. Methods : From June 2003 to June 2004, Twenty-two patients with one-level radiculopathy due to lumbar disc herniation underwent posterior microscopic lesionectomy with the assistance of an operating microscope and the $METRx^{TM}$ tubular retractor. Surgical results of the new procedure were compared to those of 39 patients who underwent traditional lumbar discectomy from April 2003 to September 2004. All patients were evaluated for pain score, clinical assessment according to the VAS, and Roland-Morris scores pre-operatively and at 1, 3, 6, and 12 months post-operatively. Results : Mean blood loss, operation time, and admission date showed significant improvements for microscopic lesionectomy compared to traditional lumbar discectomy [P < 0.001]. Also, both measures of short-term functional improvement, the Visual Analogue Scale[VAS] and Roland-Morris[RM] scores, were statistically better for microscopic lesionectomy than for traditional discectomy [P < 0.001]. Conclusion : Posterior microscopic lesionectomy can be performed more safely and provide greater benefit than traditional discectomy. The procedure is associated with less post-operative pain, shorter hospital stays, and quicker rehabilitation.

Surgical Complications and Its Management in Intracranial Aneurysm (두개강내 뇌동맥류에서 수술적 합병증 및 치료)

  • Han, Jong Woo;Hwang, Soo Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1113-1120
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    • 2000
  • Objectives : Despite advance in the surgical treatment of the intracranial aneurysm, we have to be surgical complication. The aim of this report is to evaluate the complication and its management in intracranial aneurysm operation. Methods : We reviewed our exprience with interesting cases of surgical complication of intracranial aneurysm : 1) rebleeding, 2) intra-operative premature rupture, 3) missed aneurysm in angiography, 4) vasospasm. Results : The risk of rebleeding was not related to the patients' initial comdition, but all other intracranial complications occurred significantly more often in patients graded poor compared with patients in good clinical condition. Rebleeding before early surgery remains as major cause of unfavorable outcome. The causes of intraoperative premature ruptures were as follows : 1) dural opening and arachnoid opening(8.3%), 2) hematoma removal(12.5%), 3) brain retraction(16.7%) 4) aneurysm dissection(62.5%). The double suction technique and primary hemostasis using a small piece of cotton or temporary clip resulted in good outcome even in cases with premature rupture. The incidence of missed aneurysm in angiography occurred in 10%. The causes were as thrombosed aneurysm, vasospasm on feeder artery. The most common missed aneurysm is also the most common aneurysm(anterior communicating artery aneurysm). The repeated angiography were documented in missed aneurysm. Balloon angioplasty is superior topapaverine for treatment of proximal vessel vasospasm by viture of a more sustained effect on the vessel. Papaverine can be useful as an adjunct to ballon angioplasty and also for the treatment of distal vessels that are not accessible for ballon angioplasty. Conclusion : The minimization of the complications and active treatment can reduced the mortality and morbidity of ruptured aneurysm patients.

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Management Outcomes of Basilar Bifurcation Aneurysms (기저동맥 분지부 동맥류의 치료결과)

  • Ahn, Jae Sung;Kim, Jung Hoon;Kwon, Yang;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.918-922
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    • 2000
  • Objective : The authors analyzed the results of management outcomes for basilar bifurcation aneurysms treated with transcranial surgery and endovascular surgery. Methods : At the authors' institution between May 1989 and December 1998, 47 aneurysms with 45 patients were treated with transcranial surgery including surgical clipping/wrapping and endovascular surgery for basilar bifurcation aneurysms. The medical records and neuroimaging studies of the patients were reviewed retrospectively. Results : Of the 45 patients, 87 percent of the aneurysms were ruptured and 13% unruptured. Forty six percent of the patients had multiple aneurysms including basilar bifurcation aneurysm. Of the 39 patients with subarachnoid hemorrahge, 77% were in good neurological status(Hunt Hess grade I-III), 23% were in poor grade(H-H grade IV-V). Thirty two patients were treated with transcranial surgery and 15 patients were treated with endovascular surgery. Two patients who had treated with wrapping surgery later bled during follow-up period and treated with endovascular surgery. The management outcome of the transcranial surgery was : Glasgow outcome scale(GOS) I 66%, GOS II 12.5%, GOS III 6.3%, GOS IV 6.3% and GOS V(death) 9.4%. The major causes of morbidity related to transcranial surgery were perforator occlusion, vasospasm and retraction injury. The management outcome of the endovascular surgery was : GOS I 66.7%, GOS II 6.7%, and GOS V 26.7%. The major causes of mortality related to endovascular surgery were related to intraoperative aneurysmal bleeding. Conclusion : This report documents that more than 75% of patients undergoing treatment either transcranial or endovascular surgery can expect good clinical outcomes. Treatment modality in management of basilar bifurcation aneurysm must be carefully selected based on various considering factors.

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The Combined Effect of Autologous Fat Injection and Liposculpture for Gluteal Reshaping in Koreans (한국인에 있어 둔부몸매교정(Gluteal Reshaping)을 위한 자가지방주입술 및 지방흡입술의 효과)

  • Kim, Jee-Hoon;Hong, Jin-Joo
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.861-866
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    • 2011
  • Purpose: Together with the breast, buttocks are an important element of attractive body contour. To make a beautiful buttocks, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. The authors investigated characteristic features of buttocks in Koreans and report about the results of liposculpture and autologous fat injection for improving buttock's contour. Methods: We performed a retrospective study of 21 patients who would like to gluteal reshaping. We checked about buttock's ptosis, projection, depression, gluteal retraction and excessive fat accumulation around buttocks. Depending on it, we performed liposculpture and autologous fat injection. Under general anesthesia, we harvested fat from excessive fat accumulation areas around buttocks, and injected into buttocks medio-superiorly. Postoperatively, pillows were positioned on the bed not to press the buttocks which were injected with the fat. Results: Based on the shape of buttocks, A-shape is seen in 4 cases (19%), V-shape 3 cases (14%), squareshape 9 cases (43%), round-shape 5 cases (24%). Based on the Gonzalez's ptosis grading method, 1 degree ptosis is 1 case (4%), 2 degree ptosis is 6 cases (29%), 3 degree ptosis is 8 cases (38%), 4 degree ptosis is 6 cases (29%). There were no complications such as infection, hematoma, pain, dysparethesia. The subjective assessment of surgical results by patients was excellent. Conclusion: To make a beautiful buttock, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. Liposculpture and autologous fat grafting are very safe, useful and easy methods for improving buttock's contour.

Two-Stage Latissimus Dorsi Flap with Implant for Unilateral Breast Reconstruction: Getting the Size Right

  • Feng, Jiajun;Pardoe, Cleone I;Mota, Ashley Manuel;Chui, Christopher Hoe Kong;Tan, Bien-Keem
    • Archives of Plastic Surgery
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    • v.43 no.2
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    • pp.197-203
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    • 2016
  • Background The aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD) flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant. Methods We analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant. Results The average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry. Conclusions This approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.

Assessment of Dose Distribution using the MIRD Phantom at Uterine Cervix and Surrounding Organs in High Doserate Brachytheraphy (자궁주위 방사선 근접치료시 MIRD 팬텀을 이용한 주변장기의 피폭환경평가)

  • Lee, Yun-Jong;Nho, Young-Chang;Lee, Jai-Ki
    • Korean Journal of Environmental Biology
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    • v.24 no.4
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    • pp.387-391
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    • 2006
  • Computational and experimental dosimetry of Henschke applicator with respect to high dose rate brachytherapy using the MIRD phantom and a remote control afterloader were performed. A comparison of computational dosimetry was made between the simulated Monte Carlo dosimetry and GAMMADOT brachytherapy Planning system's dosimetry. Dose measurements was performed using ion chamber in a water phantom. Dose rates are calculated using Monte Carlo code MCNP4B and the GAMMADOT. Thecomputational models include the detailed geometry of Ir-192 source, tandem tube, and shielded ovoids for accurate estimation. And transit dose delivered during source extension to and retraction from a given dwell position was estimated by Monte Carlo simulations. Point doses at ICRU bladder/rectal pointswhich have been recommened by ICRU 38 was assessed. Calculated and measured dose distribution data agreed within 4% each other. The shielding effect of ovoids leads to 19% and 20% dose reduction at bladder surface and rectal points.

Fine Structural Investigations of Fertilization Envelopes and Acrosomal Reaction in Urechis unicinctus (Urechis unicinctus 수정막과 첨체반응에 대한 미세구조적 관찰)

  • Kwon, Hyuk-Jae;Shin, Kil-Sang;Kim, Wan-Jong
    • Applied Microscopy
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    • v.30 no.1
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    • pp.61-72
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    • 2000
  • Three fertilization envelopes (FE) have been observed after the artificial insemination of U. unicinctus oocytes. The substances of the first fertilization envelope, which is an effective barrier against excessive sperm, come mainly from the surface coat of the oocyte. The secretions of the cortical granules take part in formation of the 2nd fertilization envelope. Histologically, the 3rd fertilization envelope is not amorphous as seen under light microscope, but contains numerous panicles under electron microscope, which would be contributed to harden the envelope by 60 min after the fertilization. With the substantial similarity between the 1st fertilization envelope and the surface coat of the oocyte, and the coincidence of retraction of microvilli and the formation of the 1st fertilization envelope, it is suggested that the microvilli contain the sperm receptors in U. unicinctus. Some granular substances from the distal part of the acrosome diffuse on the surface coat of the oocyte while the acrosomal tubules penetrate into the surface coat. The acrosomal tubules arise from the proximal part of the acrosome and pass through the acrosomal lumen.

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An operational analysis and dynamic behavior for a landing gear system using ADAMS (ADAMS를 이용한 항공기 착륙장치 작동 동적거동 해석)

  • Choi, Sup;Kwon, Hyuk-Beom;Chung, Sang-Joon;Jung, Chang-Rae;Sung, Duck-Yong
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.31 no.6
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    • pp.110-117
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    • 2003
  • The operational characteristics of the landing gear retraction/extension depend on the complexity of design variables operational/environmental conditions. In order to meet the requirements of minimum stow area and performance, the integration of the landing gear system requires operational kinematic and dynamic analysis considering an effect of its related system. This study investigates operational dynamic behaviors of the T-50 landing gear system using ADAMS. Taking into account for various operational/environmental conditions, an analysis of dynamic behavior on the landing gear operational characteristics is performed with experience derived from a wide range of proprietary designs. Analytical results are presented for discussing the effects of temperature, aerodynamic and maneuver load on normal/emergency operation of the landing gears and doors. This analysis leads us to the conclusion that the proposed program is shown to be a better quantitative one that apply to a new development and troubleshooting of the landing gear system.