• Title/Summary/Keyword: Closure Day

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Experience with Enterostomy Closure in Very Low Birth Weight Infants (극소 저출생 체중아에서 조성한 장루의 복원 경험)

  • Shin, Hee-Chul;Moon, Suk-Bae;Lee, Seong-Cheol;Jung, Sung-Eun;Park, Kwi-Won
    • Advances in pediatric surgery
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    • v.15 no.1
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    • pp.18-26
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    • 2009
  • The survival of Very Low Birth Weight (VLBW) infants has been improved with the advancement of neonatal intensive care. However, the incidence of accompanying gastrointestinal complications such as necrotizing enterocolitis has also been increasing. In intestinal perforation of the newborn, enterostomy with or without intestinal resection is a common practice, but there is no clear indication when to close the enterostomy. To determine the proper timing of enterostomy closure, the medical records of 12 VLBW infants who underwent enterostomy due to intestinal perforation between Jan. 2004 and Jul. 2007 were reviewed retrospectively. Enterostomy was closed when patients were weaned from ventilator, incubator-out and gaining adequate body weight. Pre-operative distal loop contrast radiographs were obtained to confirm the distal passage and complete removal of the contrast media within 24-hours. Until patients reached oral intake, all patients received central-alimentation. The mean gestational age of patients was $26^{+2}$ wks ($24^{+1}{\sim}33^{+0}$ wks) and the mean birth weight was 827 g (490~1450 g). The mean age and the mean body weight at the time of enterostomy formation were 15days (6~38 days) and 888 g (590~1870 g). The mean body weight gain was 18 g/day (14~25 g/day) with enterostomy. Enterostomy closure was performed on the average of 90days (30~123 days) after enterostomy formation. The mean age and the mean body weight were 105 days (43~136 days) and 2487 g (2290~2970 g) at the time of enterostomy closure. The mean body weight gain was 22 g/day after enterostomy closure. Major complications were not observed. In conclusion, the growth in VLBW infants having enterostomy was possible while supporting nutrition with central-alimentation and the enterostomy can be closed safely when the patient's body weights is more than 2.3 kg.

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Spontaneous Closure of Delayed Esophageal Perforation: By temporary cervical fistulation with dual drainages (식도천공의 자연폐쇄치료[경부식도루 조성술과 이중배액법에 의한]:1예 보고)

  • Oh, Bong-Seok;Choi, Jong-Beom;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.77-82
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    • 1981
  • The esophageal perforation is the most rapidly fatal and most serious perforation of the gastrointestinal tract. The 53 year old male patient was admitted because of substernal and epigastric pain altar esophageal bougienage for the indigestion and the difficult swallowing before about 18 hours. On esophagogram, there was the extravasation of contrast media at the right side of the lower esophagus [retrocardiac segment]. The emergency thoractotomy, debridement and suture closure with drainage were performed. But after 7 days the esophageal leakage was complicated again with pus discharge, although primary repair was done. On the 13th hospital day, the temporary cervical esophageal fistulation with dual drainages was made under general anesthesia. On the 38th day after this procedure, the esophageal leakage was closed spontaneously. On the 63rd hospital day the cervical fistulation was repaired and ever since the esophageal passage was good without leakage or swallowing difficulty.

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Survival of a Neartotally Amputated Auricle by Simple Closure and Medical Leech (불완전 절단된 귀손상에서 단순봉합수술 및 거머리를 이용한 접합 치험례)

  • Ha, Ki Young;Kim, Boo Yeong;Kim, Han Joong;Kim, Tae Yeon
    • Archives of Craniofacial Surgery
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    • v.10 no.2
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    • pp.127-130
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    • 2009
  • Purpose: In an amputated auricle, a microvascular anastomosis is the best treatment of choice. But, the neartotally amputated auricle which is connected by very narrow tissue pedicle to the head, can survive by simple attachment without a microvascular anastomosis owing to the rich vascular network through the superficial temporal artery and posterior auricular artery. In cases of venous congestion resulting from a lack of vein anastomosis, medical leeches (Hirudo medicinalis) can solve the problem. We are reporting the case of a 6-year-old boy who had a neartotally amputated auricle with successful results by simple closure and medical leech treatment without a microvascular anastomosis. Methods: A 6-year-old male patient had an left auricular injury by an escalator accident. The left auricle was neartotally amputated from the temporal head with connection only by very narrow skin and subcutaneous pedicle (about 1 cm in width) at the helical root of upper and anterior part of auricle. Marginal bleeding from the avulsed auricle was noted and the arterial blood was supplied from a branch of upper auricular branch of the superficial temporal artery. The auricle was repaired by simple closure including cartilage and skin without any vascular anastomosis. After simple closure, the auricle showed good circulation with pink color. But on the 2nd day after the operation, there was a venous congestion with severe swelling, which resulted in a purplish colored auricle. The venous congestion disappeared after using medical leeches by the 5th day after the operation. Results: The repaired auricle showed aesthetically and functionally satisfactory result with normal development at the 9 months follow-up check after the operation. Conclusion: In cases of neartotally amputated auricles of children or crushing injury in which microsurgery is difficult, we can try simple closure with the use of medical leeches in treating a of venous congestion for a successful result.

Tracheoesophageal Fistula Due to Endotracheal Intubation: a case Report of Requiring Tracheal Reconstruction (기관상관후 발생한 기관식도루의 교정 1 례)

  • 신원선;곽영태
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.636-640
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    • 1997
  • The common cause of tracheoesophageal fistula(T-I fistula) after tracheal intubation is ulceration and necrosis of the posterior wall of trachea by compression pressure generated by cuff. We experienced a young woman sustaining a T-I fistula which was found on the 12th day of intubation for cardiopulmonary resuscitation. Because spontaneous closure of the fistula is far uncommon, operative closure should be aimed for and should be done as soon as diagnosis is conformed. We delayed ope ative closure because of poor general condition of the patient. In spite of delayed reconstruction, the tracheal reconstruction itself was successful, but the patient died of peritonitis induced sepsis on the postoperative 41th day.

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Surgical Closure of Patent Ductus Arteriosus in Premature Infant -A report of two cases - (미숙아에서 동맥관 개존증 수술 2례)

  • 김삼현;서필원
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.777-779
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    • 1996
  • Recently we operated on two cases of PDA in premature infant. In both cases, indomethacin therapy had failed to close the PDA. The extremely small baby(body weight 540gm) died 28hrs postoperatively by unexpe ted intrathoracic bleeding probably due to coagulopathy related to septic condition and thrombocytopenia. The clinical course of the second case(body weight 1395gm) was complicated by ileal perforation sec- ondary to necrotizing enterocolitis. The baby underwent segmental resection of ileum with ileostomy on the 8th hospital day. On the 34th hospital day surgical closure of the PDA was done and the ile'ostomy was repaired simultaneously. Ventilator weaning was possible on the postoperative 6th day. The baby discharged on the postoperative 33th day with the body weight of 2050gm.

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Ruptured Aneurysm of the Sinus of Valsalva - 8 cases report - (Valsalva 동맥류 파열;8례 보고)

  • Sun, H.;Ahn, B.H.;Oh, B.S.;Kim, S.H.;Lee, D.J.
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1482-1486
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    • 1992
  • Ruptured aneurysms of the sinus of Valsalva are relatively rare, and the incidence seems to be higher in oriental than in western countries. Eight patients underwent operative treatment at Chonnam University Hospital from June, 1986 to May, 1992. Six of the patients were male and two female. Age ranged from eight to fifty six years. Associated cardiac lesions were common including AR and VSD in four patients respectively. Diagnosis was made by 2D-Echo and cine-angiogram. In six patients aneurysms of the sinus of valsalva ruptured from the right coronary sinus to the right ventricle and in two from right coronary sinus to the right atrium Direct closure of aneurysmal rupture and patch closure of VSD in four cases, resection of the aneurysm and direct closure in one case, direct closure of the fistula and AVR in two cases, direct closure in one case were performed. One patient combined with VSD, pulmonary hypertention and bacterial endocarditis underwent operation, but he died of sudden cardiac arrest the day after the operation. Operative results were relatively good in the other patients.

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Evaluation of echocardiographic markers in dogs with patent ductus arteriosus after ductal closure

  • Park, Jong-In;Suh, Sang-IL;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.56 no.4
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    • pp.209-213
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    • 2016
  • This study evaluated several known echocardiographic markers related to the assessment of severity in dogs with patent ductus arteriosus (PDA) after the closure of ductus arteriosus (DA). Forty-two dogs with patent ductus arteriosus were enrolled in this study. Evaluated echocardiographic markers were left atrial to aortic root ratio, left ventricular end-diastolic dimension to aortic root ratio, indexed left ventricular end-diastolic and end-systolic dimensions, end-diastolic and end systolic volume index, pulmonic flow to systemic flow (Qp/Qs) ratio, velocities of pulmonary regurgitant and systolic jets, pulmonary flow profiles and the presence of mitral regurgitation. Those markers were evaluated before, 1 day, and 30 days after the closure of DA. Statistically significant changes in some echocardiographic markers (i.e., Qp/Qs) were observed. Although several studies in human and dogs have evaluated the clinical outcome of PDA occlusion using several echocardiographic markers, this study has firstly evaluated all echocardiographic markers known to be useful for assessing the clinical outcome of PDA occlusion in human, and has demonstrated that those markers including the Qp/Qs and pulmonary flow profiles were useful in evaluating of clinical outcome of PDA in dogs and the reduction of LA and LV preload after ductal closure could dramatically reduce after successful ductal occlusion of PDA in dogs.

Congenitally Corrected Transposition of the Great Arteries associated with Ventricular Septal Defect and Patent Ductus Arteriosus - One case report - (심실중격결손증 및 동맥관개존증을 동반한 선천성 교정형 대혈관전위증 1례 보고)

  • 장동철
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.786-792
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    • 1987
  • Congenitally corrected transposition of the great arteries is a congenital cardiac anomaly with ventriculoarterial discordant connection and atrioventricular discordant connection. This report describes a 17 year old male patient who had congenitally corrected transposition of the great arteries associated with ventricular septal defect and patent ductus arteriosus, underwent patch closure of the ventricular septal defect and suture closure of patent ductus arteriosus, and was discharged on 9th day after surgery with good condition.

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Opening and Closure Body Space Expressed in the Fashion Art

  • Huh Jung-Sun;Geum Key-Sook
    • International Journal of Costume and Fashion
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    • v.5 no.1
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    • pp.14-25
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    • 2005
  • The objective of this study is to understand bodily extension and identity in contemporary fashion art through the analysis of 'the fashion acting on the body' among the fashion theory excluding body and the conspicuous works on the opening and covering images as a fashion art as a body-space'. This study also investigated identity problems where there are poles apart in opening and closure their bodies and body-space in which its clothing types were distorted by being de-bodilization out of the traditional and ideological expression method in contemporary fashion art from a opening and closure point of view. Image of opening and closure among body-space in fashion art can be classified into opposing structure of opening and closure. Destroying the boundary between bodily opening and closure for a primary function of clothing and dismantling the role and boundary between body and clothing, opening body-space in appearance as a reemergence of body image or the border between inner and outer are being ambiguous because of transparent material. Being representative work of this study opening body-space was expressed as an opening space image using transparency. On the contrary, closure body-space was isolated from external environment and confined in the certain space, which could limit or restraint body- action. Excluding boundary of body and clothing on the whole or in part, boundary of work becomes body-space. However, these were appeared to be a work inducing unlimited curiosity and meaning from the audience. The interpretation of artistic and body-space in fashion art are indicating the role and function of the fashion art exceeding the suggestible dimensions in the every day life of fashion. The body-space of fashion art showing similar aspect of body art today could be understood that it is substituted into an metaphorical, critical space by seeing it as a symbol system connected with social space. Therefore, contemporary fashion art should be interpreted as an equivocal space looking at the body-space with open mind.

Two-Dimensional Elasto-Viscoplastic Finite Element Analysis Considering Shield Tunneling Construction Stages (실드터널 시공단계를 고려한 2차원 탄.점소성 유한요소해석)

  • 진치섭;노경배;한상중
    • Proceedings of the Computational Structural Engineering Institute Conference
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    • 1996.10a
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    • pp.89-94
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    • 1996
  • The use of shield is increasing day by day, because it's method is advantageous tunneling method to soft and collapsible ground. In case of analyzing shield tunnel by FEM, short term behavior of ground by initial heaving and tail void closure and long terms of it because of consolidation by changes of pore pressures in clay must be considered. In this paper, the shield tunneling construction stages was analyzed from 2 dimensional elasto - viscoplastic finite element program used Mohr - Coulomb yield criterion but not considered the changes of pore pressures. The object of investigation was N - 2 Tunnel. Since the good results of analysis compared to the measured behavior of ground for heaving, tail void closure and liner installation, this results can be applied to design and construction of shield tunneling for the subways, sewage lines etc.

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