• Title/Summary/Keyword: 기형교정

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Clinical Observation of Congenital Urinary Tract Anomalies (소아 요로계 기형에 대한 임상적 고찰)

  • Chang Soo-Hee;Kim Sun-Jun;Lee Dae-Yeol
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.67-72
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    • 1997
  • Purpose : Congenital urinary tract anomaly is the most common anomaly in the childhood and progress to chronic renal failure and growth retardation. Therefore, early diagnosis arid treatment of urinary tract anomaly are important. Method : We reviewed medical records of 124 patients who had urinary tract anomalies on radiologic studies from Jan. 1986 to Dec. 1996. We analyzed demography and clinical characteristics of urinary tract anomalies. Results : 1) The age distributions were as follows ; 61 cases of 124 patients (49%) were under 1 year, 11 cases (8.8%) from 1 to 3 years, 20 cases (16%) from 4 to 6 years, 10 cases (8%) from 7 to 9 years, 9 cases (7.2%) from 10 to 12 years, 10 cases (8%) from 13 to 15 years, and 3 cases (2.4%) from 16 to 18 years. 2) Chief complaints in patients with urinary tract anomalies were fever, flank pain, prenatally diagnosed hydronephrosis, abdominal mass, dysuria and hematuria. 3) Of 124 patients, 68 cases(54.8%) were combined with urinary tract infection, and main causative organism was E.coli, and the most frequently associated anomaly was vesicoureteral reflux. 4) Most of the urinary tract anomalies were VUR, UPJ obstruction, congenital hydronephrosis and double ureter in order of sequence. 5) Whereas the frequency of simple urinary tract anomaly was 87.9%, that of complex anomaly was 12%. 6) Operative corrections were needed in 47 cases and 7 cases were progressed to renal insufficiency. Conclusion : We emphasize that early detection of urinary tract anomaly, appropriate treatment and regular follow-up are needed.

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Surgical Repair of Truncus Arteriosus in an Low-Birth Weight Premature Baby: Right Ventricular Outflow Reconstruction with Valveless Autologous Pericardial Conduit and the Result of 20-Month′s Follow-up (저체중조산아에서 동맥간의 교정 1예: 무판막 자가심낭도관의 이용과 20개월간의 추적결과)

  • 성시찬;양승인;이헝두;김시호;우종수;이영석
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.766-771
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    • 2003
  • It is known that low birth weight is a risk factor for poor outcome in cardiac surgery for many cardiac defects. Truncus arteriosus is a rare congenital anomaly that has an unfavorable natural course. We report a successful surgical correction of truncus arteriosus in an 13-day-old premature infant with body weight of 1.5 kg and gestational age of 32 weeks. We used autologous untreated pericardial conduit without valve in right ventricular outflow reconstruction. The patients remains in good condition with normal body weight (50 percentile) and wide right ventricular outflow tract 20 months after the operation.

Surgical Management of Coarctation of the Aorta with a Ventricular Septal Defect and Coexisting Partial Anomalous Pulmonary Venous Connection -A case report- (부분 폐정맥 환류 이상과 심실 중격 결손을 동반한 대동맥 축착증의 완전교정 -1예 보고-)

  • Kim Si-Ho;Lee Young-Seok;Woo Jong-Soo;Cho Kwang-Jo
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.479-481
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    • 2006
  • A newborn girl with a partial anomalous pulmonary venous connection, coarctation of the aorta, and ventricular and atrial septal defects underwent a complete repair successfully at 49 days of age. In this case, the left upper pulmonary vein was connected to the left innominate vein via an atypical vertical vein.

A CASE REPORT OF NEUROCRISTOPATHY THAT SHOWS OBLIQUE FACIAL CLEFT, MAXILLARY DUPLICATION AND OTHER FACIAL MALFORMATIONS (사선안면열, 상악돌기 중복 등 복합 기형을 유발한 신경능병변 환자의 치험례)

  • Ryu, Dong-Mok;Lee, Sang-Chull;Kim, Yeo-Gab;Lee, Baek-Soo;Choi, You-Sung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.4
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    • pp.407-413
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    • 1999
  • Maxillary duplication is a kind of proliferative neurocristopathy and considered to arise from bifurcation of neural crest elements soon after migration into mandibular arch. Sometimes this malformation is accompanied with oblique facial cleft. Usually this type of maxillofacial malformation requires multiple surgical intervention and the results are far from ideal. It became more troublesome if it had not been properly corrected on time, because secondary deformities could be developed from growth and development of abnormal tissues. This is a case of a 25-year-old-female patient who showed severe facial asymmetry thought to secondary deformity of maxillary duplication and masticatory disturbance due to multiple supernumerary teeth on posterior part right maxilla. We successully treated these deformities through four times of surgery of bone resection, orthodontic treatment, zygomatic and orbital reconstruction, orthognathic surgery and scar revision... ect. So we reported this rare case with review of literatures.

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One Stage Total Repair of the Aortic Arch Anomaly using the Regional Perfusion (대동맥궁 이상이 동반된 선천성 심장병에서 국소 순환을 이용한 일차 완전 교정)

  • Jang Woo-Sung;Lim Cheong;Lim Hong-Kook;Min Sun-Kyung;Kwak Jae-Kun;Chung Eui-Seuk;Kim Dong-Jin;Kim Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.434-439
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    • 2006
  • Background: Deep hypothermic circulatory arrest during repair of aortic arch anomalies may induce neurological complications or myocardial injury. So we surveyed if the regional cerebral and myocardial perfusion might eliminate those potential side effects. Material and Method: From March 2000 to December 2004, 62 neonates or infants with aortic arch anomaly underwent one stage biventricular repair using the regional perfusion technique by single surgeon. Preoperative diagnosis of the arch anomaly consisted of coarctation (n=46), interruption of the aorta (n=12), hypoplastic left heart syndrome (n=2) and truncus areteriosus (n=2). Combined anomalies were ventricular septal defect (n=51), TAPVR (n=1), PAPVR (n=1) and atrioventricular septal defect (n=2). Arterial cannula was inserted at the innominate artery. Result: The mean regional perfusion time of brain was $28{\pm}10min$. Operative mortality rates was 0 (0/62). Late death was 1 (1/62) during $11{\pm}7$ months of follow-up. Neurologic complications consisted of transient chorea in 1 case. There was no reoperation associated with arch anolamy. Pulmonary complication associated with arch repair occurred in f case which was managed by aortopexy. Conclusion: One-tage rch repair using the regional profusion is safe and effective in minimizing the neurologic and myocardial complications.

Early and Midterm Results of Arterial Switch Operation for Double-Outlet Right Ventricle with Subpulmonary VSD (폐동맥하 심실증격결손을 동반한 양대혈관 우심실기시중에서 동맥전환술의 중단기 결과)

  • 양승인;이형두;김시호;조광조;우종수;이영석;성시찬
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.313-321
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    • 2004
  • Excellent clinical results of the arterial switch operation and the limited availablity of the intraventricular rerouting has recently made an arterial switch operation to become the therapeutic method of choice for the repair of double-outlet right ventricle (DORV) with subpulmonary ventricular septal defect (VSD). The early and midterm outcomes of arterial switch operation for this anomaly were evaluated. Material and Method: Between August 1994 and July 2002, 13 patients underwent an arterial switch operation for the correction of double-outlet right ventricle with subpulmonary VSD at Dong-A university hospital.. The 50% rule was used to define DORV. Median age and mean body weight were 27 days (range, 3-120 days) and 3.8$\pm$0.7kg (range, 2.92-5.3kg) respectively. Aortic arch anomalies were associated in 6 cases (46.2%), which were all repaired through one-stage operation. The relationship of the great arteries were side-by-side in 8 cases (61.5%) and anteroposterior in 5 (38.5%). Coronary artery patterns were 1 LCx-2R in 6 cases, retropulmonary left coronary artery (LCA) in 6, and intramural LCA in 1 respectively. The enlargement of VSD was required in 1 patient and the patch enlargement of right ventricular outflow tract was performed in another one patient. The Lecompte maneuver was used in all but 3 patients with a side by side relationship of the great arteries. Result: Overall postoperative hospital mortality was 23.1 % (3/13). All operative deaths were occurred in the patients with aortic arch anomalies. There was one late death related to the postoperative complication of the central nerve system during the mean follow-up of 41.3$\pm$30.7 months. Pulmonary valvar stenosis (>30mmHg of pressure gradient) developed in 1 patient (10%) and left pulmonary artery stenosis in 2 (20%), among them, one required reoperation 52 months after repair. There was an asymptomatic patient with moderate aortic regurgitation. 5-year survival rate including operative deaths was 68.3%. Conclusion: Although the operative mortality is high in the patients with aortic arch anomaly, the arterial switch operation for DORV with supbpulmonary VSD can be performed with low operative mortality and low reoperation rate in the patients Without arch anomaly. The arterial switch operation can be considered a good option for this complex anomaly.

A Case of New Surgical Correction of Angular Limb Deformities Using One Screw Implant & Periosteal Transection in a Thoroughbred Foal (Thoroughbred 망아지에서 단일나사못 장착 및 골막박리를 이용한 지세교정술)

  • Yang, Jae-Hyuk;Lim, Yoon-Kyu
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.177-180
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    • 2012
  • Angular limb deformities (ALD) are common in foals. A 30-days-old Thoroughbred foal was presented for the evaluation of severe ALD of the both forelimbs. On radiographic examination, both distal radiuses were diagnosed as valgus angular limb deformities. But the degree of deviation of right forelimb was so severe that we tried to correct one after the other. We tried new surgical correction method combination of one screw implant on medial aspect for growth retardation and periosteal transection on lateral aspect of the right forelimb. 40 days later, successfully corrected and then removed the screw. After the right forelimb correction, the periosteal transection on left forelimb was performed. We did the inhalation anesthesia using isoflurane. There were no complications such as fibrosis over the screw heads, and overcorrection that produces an opposing deformity identified. These results suggest that combination of one screw implant and periosteal transection technique is able to be a safe and effective method to correct severe ALD in the foal.

Modified Starnes Operation for Neonatal Stenotic Ebstein Anomaly (신생아 폐쇄성 엡스타인 기형에 대한 변형 Starnes 술식)

  • Lee Seung Hyun;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.633-636
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    • 2005
  • Sixteen-day-old baby with severe Ebstein anomaly underwent emergency operation to relieve progressive hypoxia and congestive heart failure. Operative findings showed huge right atrium and atrialized right ventricle (aRV) with very small functional RV by distal displacemcent of tricuspid valve mechanism. We elected to perform modified Starness operation because biventricular repair was deemed unattainable. After pulmonary and tricuspid valves were primarily closed, aRV was obliterated with multiple sutures from RV apex to the base. Then a PTFE (Gore-Tex, USA) vascular graft was interposed between innominate artery and main pulmonary artery for systemic to pulmonary shunt. The patient was discharged uneventfully, and received bi-directional cavopulmonary shunt 6 months later.

Animal Experiments of Heart Transplantation for Complicated Congenital Heart Disease in Neonate (신생아의 복잡심장기형에서 심장이식을 위한 동물실험)

  • 박영환;윤치순;정원석;김명옥;조범구
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.504-509
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    • 1999
  • Background: Heart transplantation is considerated for a selected certain group of complicated congenital heart disease in neonates because corrective surgery is very difficult and has high mortality. Precise planning of transplantation is necessary to adequately fit the donor heart to the recipient. Material and Method: We have performed 4 neonatal pig heart transplantations to test the technical feasibility. Experiment 1: The transplantation was performed using the same technique as the adult heart transplantation. Experiment 2: The transplantation for hypoplastic left heart syndrome was simulated as we reconstructed the whole aortic arch with donor aorta. Experiment 3: The heart transplantation was done with radical pulmonary artery reconstruction. Experiment 4: The experiment was performed for a long term survival. Result: Preoperative planning was very important for adequate fitting. All animals could be weaned from cardiopulmonary bypass, however, two animals died due to bleeding at pulmonary artery and left atrium. Conclusion: We concluded that the neonatal heart transplantation can be applied in some complicated Further using animal model is mandatory.

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Minimally Invasive Simultaneous Treatment for Congenital Cystic Adenomatoid Malformation associated with Pectus Excavatum - A case report - (누두흉과 선천성 낭종성 선종양 기형의 최소 침습적인 동시수술 -1예 보고-)

  • Cho, Deog-Gon;Jo, Min-Seop;Kim, Kyung-Soo;Wang, Young-Pil;Cho, Kyu-Do
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.171-175
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    • 2006
  • Minimally invasive thoracic surgery has been one of the most important surgical advances recently. Congenital cystic adenomatoid malformation of the lung is a relatively rare anomaly and is clearly associated with various congenital anomalies such as pectus excavatum, cardiac and pulmonary vascular lesions. We have experienced a case that was treated with minimal invasive methods for congenital cystic adenomatoid malformation involving in the right lower lobe and pectus excavatum in a 5-year-old boy. We simultaneously performed thoracoscopic right lower lobectomy and Nuss procedure of pectus excavatum using a substernal steel bar. Therefore, a minimally invasive surgical treatment for this diseases is feasible and cosmetically excellent.