• Title/Summary/Keyword: 기형교정

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Surgical Repair of the Congenital Aneurysm of the Right Atrium (선천성 우심방 류의 수술치험 1례 보고)

  • 유양기;김정원;정성호;박정준;윤태진;서동만;김영휘;고재곤;박인숙
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.56-59
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    • 2002
  • The four most common types of congenital malformations involving the right atrium(RA) and the coronary sinus(CS) are congenital enlargement of the RA, single RA diverticulum, multiple diverticula of the RA, and aneurysm of the RA or CS. A previously healthy 6year-old child was presented with signs of upper respiratory tract infection. Chest X-ray and echocardiogram revealed a severely isolated right atrial enlargement. The abnormally dilated right atrim was widely resected under cardiopulmonary bypass. Pathology revealed multifocal myocardial loss associated with mild fibrotic changes of the endocardium and epicardium Our experience on this rare congenital disease is presented along with a review of the literature.

CONSERVING THE CENTRIC RELATION POSITION OF CONDYLAR HEAD WITH MINI-HOFFMANN SETS IN VERTICAL RAMUS OSTEOTOMY (하악골 수직골절단술시 MINI-HOFFMANN SETS을 이용한 하악 과두의 중심위의 보존)

  • Jeong, Inn-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.95-99
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    • 1991
  • Several authors have proposed techniques and devices by which the correct position of the proximal segment can be maintained both during fixation and postoperatively. Schendel, Epker, Lake, Worms, Ive and Poulton have been discussed the problem of condylar distration in mandibular orthognathic surgery. This study described have showed the some advantages forward repositioning of the condyle head in vertical ramus osteotomy which used with the Mini-Hoffmann sets in external skeletal pin fixation extraorally in 19 cases.

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Taussig-Bing Anomaly with Coarctation of Aorta (대동맥 축착을 동반한 Taussig-Bing 기형의 수술 치험 1예)

  • Kim, Hyuck;Lim, Hyoun-Soo;Kim, Young-Hak;Chung, Won-Sang;Kang, Jung-Ho;Lee, Chul-Beom;Jee, Heng-Ok;Kim, Nam-Su
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.189-193
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    • 2003
  • The patient was a 30-day-old female infant with symptoms of severe dyspnea and cyanosis, when she was admitted to the ER. The echocardiography revealed DORV with subpulmonary VSD, and the diagnosis of Taussig-Bing anomaly was made. Two days after admission, an urgent operation was performed. The operation consisted of intraventricular tunnel repair and arterial switch operation. She was discharged, and after checking her chest X-ray through OPD, there was no interval change of cardiomegaly. She was then re-admitted, and the angiography revealed coactation of aorta. We performed a resection and end-to-end anastomosis of aorta. She is currently in good condition 11 months postoperatively.

Extended Unroofing Procedure for Creation of a New Ostium for an Anomalous Right Coronary Artery Originating from the Left Coronary Sinus - A case report - (좌관상동맥동에서 이상 기시하는 유관상동맥 질환에서 새로운 개구부를 만드는 Extended Unroofing 수술 - 1예 보고 -)

  • Park, Jung-Sik;Lee, Hyang-Lim;Kim, Keun-Woo;Choi, Chang-Hyu;Lee, Jae-Ik;Jean, Yang-Bin;Park, Kook-Yang;Park, Chul-Hyun
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.102-105
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    • 2008
  • An anomalous origin of the coronary artery with subsequent coursing between the great vessels is a rare congenital heart defect that may cause myocardial ischemia and sudden death. Several surgical techniques have been described to address this defect. An extended unroofing procedure to create an alternative ostium for the right coronary artery was successfully carried out in a patient having an anomalous origin of the right coronary artery. The newly constructed orifice was widely patent 3 months later, without any episodes of myocardial ischemia or aortic regurgitation.

A CASE OF DERMIS-FAT AUTOTRANSPLANTATION FOR CORRECTION OF SOFT TISSUE DEFICIT IN HEMIFACIAL MICROSOMIA (반안면왜소증환자에 있어서 자가지방이식을 이용한 연부조직결손의 수복예)

  • Park, Young-Wook;Lee, Jin-Gew;Min, Byoung-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.82-87
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    • 1991
  • Hemifacial microsomia is a term used to describe a facial anomalies caused by the defect of anatomic structures originated from the first and the second branchial arches. The defect area encompasses some facial areas including mandible, facial muscles, masticatory muscles, cranial nerves, auricles, etc., and the degree of manifestations of the anomalies is extmely diverse. A 20-year-old man complaining of facial asymmetry and malocclusion visited our hospital. An orthognathic surgery was performed for the correction of hard tissue anomalies and then autogenous dermis-fat autotransplantation was done for the improvement of remaining soft tissue defect. The result was esthetically good and the case was presented here.

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Poland Syndrome -One Case Report- (폴란드 증후군 -1례 보고-)

  • Shin, Sung-Ho;Chon, Yang-Bin;Chon, Soon-Ho;Kang, Jung-Ho;Kim, Hyuk;Chung, Won-Sang;Kim, Young-Hak;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.915-918
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    • 1998
  • The chest wall deformity associated with Poland's syndrome is a very rare anomaly which consists of congenital unilateral absence of the sternal head of the pectoralis major muscle and various abnormalities of the upper extremity. Other clinical features associated with Poland's syndrome include deficiency or absence of the breast and nipple, deficiency of subcutaneous fat and axillary hair, and abnormalities of costal cartilages and anterior ends of ribs. The origin remains uncertain, but is considered not to be hereditary. Poland's syndrome may pose a serious psychologic and cosmetic problem, early recognition and surgical correction may prove beneficial. A 37 year old patient with Poland's syndrome was encountered and underwent satisfactory surgical correction.

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ORTHODONTIC AND PROSTHODONTIC TREATMENT IN CLEFT LIP AND PALATE PATIENT (순/구개열 환자에서의 교정-보철 치험례)

  • Chang, Weon-Suk;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.3
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    • pp.388-393
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    • 2000
  • Cleft lip and palate is one of the most common congenital defects in oro-maxillo-facial region. Because most patients undergo surgical repair in early life, the sagittal jaw relationships used to be deteriorated gradually from palate surgery up to adulthood. Also, the maxillary lateral incisor may be absent or atypical-shaped in the cleft site and may not erupt or erupt ectopically, so multidisciplinary dental cares are needed for cleft lip and palate patients. The effects of the cleft lip and alveolus seem to be limited to that part of the dentofacial complex that surrounds the cleft area. In the maxillary arch, the anterior part of the non cleft segment has a tendency to be rotated forward. On the other hand, the cleft segment has a tendency to rotated slightly medially ; hence, the tendency for canines to be edge-to-edge and sometimes in crossbite. Lip and alveolus surgery adequetely correct these problems, with little untoward effect on the skeletal maxillary-mandible relationships. In this report, the patient has a repaired lip and cleft alveolus on the left side with congenital missing on '62, '22, oronasal fistula, and skeletal class III malocclusion which is not affected by lip surgery. Dental treatments for this patient including orthodontic(space supervision, functional regulator in mixed dentition, fixed therapy in permanent dentition) and prosthodontic(removable obturator with key and keyway attachment and Konus crown) therapy were performed to improve the patient's functions and esthetics.

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One-stage Repair of Truncus Arteriosus with Interrupted Arch (대동맥궁 차단증를 동반한 동맥간의 일차 완전교정 - 1예 보고-)

  • 성시찬;박준호;이형두;김시호;우종수;이영석
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.759-765
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    • 2003
  • Truncus arteriosus with interrupted aortic arch is a very rare congenital cardiac anomaly that has an unfavorable natural course. We report a successful one-stage repair of truncus arteriosus with interrupted aortic arch through median sternotomy in a 25-day-old neonate weighing 3.1 kg. We reconstructed the aortic arch with direct side-to-end anastomosis between ascending and descending aortas. The right ventricular outflow reconstruction was performed with untreated autologous pericardial conduit without valve following Lecompte maneuver. The patient has been grown-up in good condition (25 ∼ 50 percentile of body weight) and shows the right ventricular outflow tract wide 1 year after the operation.

Evaluation of Prognostic Factors in Corrected Transposition of the Great Arteries at Mid-term Follow-up (수정 대혈관 전위 환자에서 예후에 영향을 주는 인자들에 대한 중기적 고찰)

  • Song, Young-Hwan;Kwon, Hyok-Joo;Kim, Gi-Beom;Kang, Soo-Jung;Bae, Eun-Jung;Noh, Chung-Il;Yun, Yong-Soo;Lee, Jeong-Ryul;Kim, Yong-Jin;Rho, Joon-Ryang
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.154-161
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    • 2003
  • Purpose : The prognosis of patients with corrected transposition of the great arteries(C-TGA) is variably affected by associated intracardiac defects, systemic right ventricular function, tricuspid valve competence, and conduction disturbances. This study aims to evaluate the importance of those factors at mid-term follow-up. Methods : Medical records of 94 patients(males 58, females 36; mean age at last follow-up, $12{\pm}9$ years; mean follow-up duration, $9{\pm}6.4$ years) diagnosed between January 1980 and May 2002 at Seoul National University Children's Hospital were studied retrospectively. Results : Among 94 patients, operations were performed in 72 patients(classic operations in 55; double switch operations in 17). Among prognostic factors including associated intracardiac anomalies(at least moderately severe tricuspid insufficiency(TI), ventricular septal defect, pulmonary stenosis and pulmonary atresia), intracardiac operation and complete atrioventricular block, TI was the only significant factor for death(P=0.001), and in turn, Ebstein anomaly and high grade atrioventricular block predicted TI. 20-year survival without TI was 77%, but only 35% with TI(P=0.0002); excluding perioperative death, the 20-year survival rates with and without TI were 48% and 87% respectively(P=0.008). There was no statistical difference in 20-year survival rate or association with TI between classic and double switch operation. Conclusion : TI was the major prognostic factor for C-TGA and was associated with Ebstein anomaly and high grade atrioventricular block at mid-term follow-up. Long-term follow-up is required to evaluate other factors, including double switch operations and associated intracardiac defects more exactly.

A Posteroanterior Cephalometric Study on Craniofacial Proportions of Koreans with Normal Occlusion (한국인 정상 교합자의 정모 두부 방사선 사진을 이용한 안모비율에 관한 연구)

  • Baik, Hyoung-Seon;Yu, Hyung Seog;Lee, Kie-Joo
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.643-659
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    • 1997
  • For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vortical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The Proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement ($Bj\ddot{o}rk$ Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.

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