• Title/Summary/Keyword: skeletonized

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A Tunnel Technique to Protect the Skeletonized Left Internal Thoracic Artery (골격화된 좌내흉동맥편을 보호하기 위한 이식편의 경로 만들기)

  • 최종범;한재오
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.690-692
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    • 1999
  • internal thoracic artery is used in myocardial revascularization because of many advantages. However, it may not be appropriate in the usual extrapleural or intrapleural route, because it can be easily displaced and injured due to the slender and weak characteristics. We introduce here, a simple technique of repositioning the skeletonized left internal thoracic artery in a stable and straight course by creating a tunnel between the left lateral pericardium and thymic tissue.

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Availability of the Skeletonized Gastroepiploic Artery as a Free Graft for Coronary Artery Bypass Grafting (관상동맥 우회로 조성술에 있어 유리 이식편으로 사용된 골격화 우위대망 동맥의 효용성)

  • Ryu Sang-Wan;Ahn Byong-Hee;Hong Seong-Beom;Song Sang-Yun;Jung In-Suk;Beom Min-Sun;Park Jung-Min;Lee Kyo-Sun;Ryu Sang-Woo;Yoon Ju-Sik;Kim Sang-Hyung
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.601-608
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    • 2005
  • Background: To maximize the histological advantage and minimize the physiological disadvantage, we have been using the skeletonized gastroepiploic artey (GEA) as a free graft for total arterial revascularization. The aims of the current study was to assess the efficacy of the skeletonized GEA as a composite or extended graft for total arterial revascularization. Material and Method: Between January 2000 and Feburary 2005, 133 patients (43 female, mean age=61.8 yrs) undergoing coronary artery bypass grafting (CABG) with a skeletonized GEA as free graft (22 extended, 107 composite and 4 others) were enrolled in this study. Coronary angiograms were performed in the immediate (median 44 days, n=86), early (median 366 days, n=56) and midterm (median 984 days, n=29) postoperative periods. Result: There were 3 ($2.2\%$) early and 4 ($3.3\%$) late cardiac-related deaths. The mean number of distal anastomoses per patient was 3.34 for total graft and 1.92 for GEA graft. The immediate, early, and midterm GEA patency were 157/159 ($98.7\%$), 106/142 ($94.6\%$), and 53/56 ($94.6\%$), respectively. During follow-up, four patients required percutaneous intracoronary intervention because of GEA and target coronary artery stenosis or competitive flow. Conclusion: These data demonstrate satisfactory clinical and angiographic results in the skeletonized GEA as free graft for total arterial revascularizatioh. Although we need a careful longer follow-up, the skeletonized GEA as a free graft will be a valuable option 'to be' for CABG.

Postprocessing Algorithm of Fingerprint Image Using Neural Network (신경망을 이용한 지문 영상의 후처리 알고리듬)

  • 이성구;박원우;김상희
    • Proceedings of the IEEK Conference
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    • 2003.11a
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    • pp.305-308
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    • 2003
  • The postprocessing of fingerprint image are widely used to eliminate the false minutiae that caused by skeletonization. This paper presents a new postprocessing algorithm of the skeletonized fingerprint image using SOFM. The proposed postprocessing method showed the good performance for eliminating the spurious minutiae.

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The Right Gastroepiploic Artery Graft for Coronary Artery Bypass Grafting: A 30-Year Experience

  • Suma, Hisayoshi
    • Journal of Chest Surgery
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    • v.49 no.4
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    • pp.225-231
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    • 2016
  • Throughout its 30-year history, the right gastroepiploic artery (GEA) has been useful for in situ grafts in coronary artery bypass grafting (CABG). The early graft patency rate is high, and the late patency rate has improved by using the skeletonized GEA graft and proper target selection, which involves having a target coronary artery with a tight >90% stenosis. Total arterial revascularization with the internal thoracic artery and GEA grafts is an option for achieving better outcomes from CABG procedures.

Neo- and Re- Vascularization in the Prefabricated Cutaneous Flap using Vascular Pedicle Implantation (혈관경 전위를 이용한 선조작 피부피판의 혈관화)

  • Lee, Byung-Il
    • Archives of Reconstructive Microsurgery
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    • v.11 no.2
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    • pp.125-134
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    • 2002
  • This study was designed to investigate the process of re- or neo-vascularization in the prefabricated cutaneous flap using a skeletonized arteriovenous pedicle implantation. Fourty-eight flaps were divided into six groups of eight flaps, including control group of the conventional epigastric flap. In experimental groups, skin flap was fabricated by subcutaneous implantation of a distally ligated saphenous arteriovenous pedicle in left abdomen. At 2, 4, 6, 8, and 10 weeks after, prefabricated flap was elevated as an island flap based on implanted pedicle and sutured back in place. Three days after flap repositioning, the area of flap viability was quantified, the pattern of flap vascularization was evaluated with microangiography, and the quantification of vessels was assessed histologically. There were statistically significant differences in flap viability between group 2, 3, 4, and the control (p<0.05), with increased survival area in order. But Group 5 and 6 showed higher flap viability as much as the control did. In the microangiographis study, numerous small meander vessels were newly developed in the vicinity of the implanted pedicle just only 2 weeks after pedicle implantation, but neovascularization around the tip of implanted pedicle, and its anastomosis with native vasculatures was more important for overall flap survival, which was usually developed at least 4 weeks after pedicle implantation. Histologically, vessels are evenly spread over all layers of the flap at 6 weeks after pedicle implantation. The quantification of vessels was correlated well with the improvement of flap viability (p<0.05). In conclusion, neo- and re-vascularization around the tip of implanted pedicle was an important factor for overall survival of the prefabricated flap. Therefore, skeletonized pure vascular pedicle transfer, even though it used alone without surrounding was sufficient to get higher flap viability. The optimal duration of pedicle implantation was8 weeks to obtain maximal survival.

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Application of portable digital radiography for dental investigations of ancient Egyptian mummies during archaeological excavations: Evaluation and discussion of the advantages and limitations of different approaches and projections

  • Seiler, Roger;Eppenberger, Patrick;Ruhli, Frank
    • Imaging Science in Dentistry
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    • v.48 no.3
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    • pp.167-176
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    • 2018
  • Purpose: In the age of X-ray computed tomography (CT) and digital volume tomography (DVT), with their outstanding post-processing capabilities, indications for planar radiography for the study of the dentition of ancient Egyptian mummies may easily be overlooked. In this article, the advantages and limitations of different approaches and projections are discussed for planar oral and maxillofacial radiography using portable digital X-ray equipment during archaeological excavations. Furthermore, recommendations are provided regarding projections and sample positioning in this context. Materials and Methods: A total of 55 specimens, including 19 skeletonized mandibles, 14 skeletonized skulls, 18 separate mummified heads, and 4 partially preserved mummies were imaged using portable digital X-ray equipment in the course of archaeological excavations led by the University of Basel in the Valley of the Kings between 2009 and 2012. Images were evaluated by 2 authors with regard to the visibility of diagnostically relevant dental structures using a 4-point grading system(Likert scale). Results: Overall, the visibility of diagnostically relevant dental structures was rated highest by both authors on X-ray images acquired using a dental detector. The tube-shift technique in the lateral projections of mandibular dentition achieved the second-best rating, and lateral projections achieved the third-best rating. Conclusion: Conventional planar digital X-ray imaging, due to its ubiquity, remains an excellent method-and often the only practicable one-for examining the skulls and teeth of ancient Egyptian mummies under field conditions. Radiographic images of excellent diagnostic quality can be obtained, if an appropriate methodology regarding the selected projections and sample placement is followed.

An Analysis of Cylindrical Tank of Elastic Foundation by Transfer Matrix and Stiffness Matrix (전달행렬과 강성행렬에 의한 탄성지반상의 원형탱크해석)

  • 남문희;하대환;이관희;장홍득
    • Computational Structural Engineering
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    • v.10 no.1
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    • pp.193-200
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    • 1997
  • Even though there are many analysis methods of circular tanks on elastic foundation, the finite element method is widely used for that purpose. But the finite element method requires a number of memory spaces, computation time to solve large stiffness equations. In this study many the simplified methods(Analogy of Beam on Elastic Foundation, Foundation Stiffness Matrix, Finite Element Method and Transfer Matrix Method) are applied to analyze a circular tank on elastic foundation. By the given analysis methods, BEF analogy and foundation matrix method, the circular tank was transformed into the skeletonized frame structure. The frame structure was divided into several finite elements. The stiffness matrix of a finite element is related with the transfer matrix of the element. Thus, the transfer matrix of each finite element utilized the transfer matrix method to simplify the analysis of the tank. There were no significant difference in the results of two methods, the finite element method and the transfer matrix method. The transfer method applied to a circular tank on elastic foundation resulted in four simultaneous equations to solve completely.

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Coronary Artery bypass Surgery Using Skeletonization Technique of Left Internal Mammary Aartery (관상동맥 우회술시 근막 및 정맥 등 주위조직이 없는 좌내흉동맥편의 이용)

  • Choe, Jong-Beom;Lee, Sang-Yun
    • Journal of Chest Surgery
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    • v.28 no.7
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    • pp.671-677
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    • 1995
  • Skeletonization of the internal mammary artery [IMA during myocardial revascularization procedures may provide some advantages, compared with the pedicle graft of the artery. In 17 patients undergoing IMA grafting by skeletonization technique, flow through the artery was measured on mean arterial pressure of 50-55 mmHg immediately after cardiopulmonary bypass started [first flow and just before its anastomosis to left anterior descending artery [second flow . In 16 patients except 1 patient whose graft was injured during mobilization, the first flow of IMA graft was 32.3 $\pm$ 7.4 ml/min and the second flow increased to 59.6$\pm$25.9 ml/min without any treatment and the site for anastomosis of the IMA graft was more than 1.0 cm above the bifurcation. On the basis of previous clinical studies, the flow of the skeletonized IMA was greater than that of the pedicle graft [59.6 $\pm$ 25.9 ml/min versus 37.7$\pm$ 14.1 ml/min, p < 0.05 . In comparison between the skeletonized IMA and the IMA graft intraluminally dilated with papaverine solution, there was no significant difference between two flows[59.6 $\pm$25.7 ml/min versus 74.7 $\pm$31.4 ml/min, not significant , but the former showed longer graft and anastomosis of more proximal portion of the graft to left anterior descending artery. In conclusion, the technique of internal mammary artery skeletonization has consistently produced a satifactory conduit for myocardial revascularization procedures. We have adopted IMA skeletonization not only because of the flow, diameter, and vessel length obtained but also because of limited perivascular tissue disruption that occurs during the dissection.

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Off-Pump Total Arterial Revascularization Using the Skeletonized Right Gastroepiploic Artery as a Third Arterial Conduit; Early and Midterm Results (제3동맥 도관으로서의 골격화된 우위대망동맥을 사용하여 시행한 심폐바이패스를 사용하지 않는 관상동맥 우회술;초기 및 중기 결과)

  • 이현주;최재성;김기봉
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.659-665
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    • 2003
  • The aim of this study was to evaluate the early and midterm results of off-pump total arterial revascularization using the skeletonized right gastroepiploic artery (RGEA) as a third arterial conduit. Material and Method: We prospectively analyzed 103 patients who underwent off-pump total arterial revascularization using bilateral internal thoracic arteries (ITAS) and RGEA. The RGEA was used as in situ graft in 88 patients, composite graft in 10 patients, and free graft in 5 patients. Postoperative coronary angiographies were performed before discharge in 100 patients, and at postoperative one year in 88 patients. Result: The RGEA showed a significantly higher free flow (130$\pm$95 ml/min) than that of right ITA(113$\pm$57 ml/min) or left ITA (107$\pm$55 ml/min), which was measured before anastomosis (p < 0.05). The total number of distal anastomoses was 3.8$\pm$0.7. The number of distal anastomoses per bilateral ITAs was 2.8$\pm$0.7 and the number of distal anastomosis per RGEA was 1.0. There were two morialities including one operative mortality. The late mortality was not related to cardiac events. Early postoperative morbidities were atrial fibrillation in 15 patients, bleeding reoperation in 4 patients, mediastinitis in 1 patients, perioperative myocardial infarction in 2 patient, and transient ARF in 3 patients. Postoperative coronary angiographies showed the early patency rate of 98.6% (272/276) for ITAs and 97.0% (97/100) for RGEA, respectively (p=ns), and the one-year patency rate of 95.9% (234/244) for ITAs and 88.6% (78/88) for RGEA, respectively (p=0.07). Flow competition between the RGEA and NCA (native coronary artery) was seen in 5 of the 100 patients (5.0%) immediate postoperatively and 7 of the 88 patients (8.0%) 1 year after surgery. Since July, 2000, we measured transit time flow intraoperatively and could reduce flow competition significantly Conclusion: The skeletonized RGEA demonstrated excellent early and midterm patency rates and could be used as a third arterial graft following the bilateral ITAs.