• Journal of Chest Surgery
• /
• v.30 no.1
• /
• pp.83-87
• /
• 1997

Taussig-Bing anomaly is infrequently associated with interrupted aortic arch and size discrepancy of great arteries makes it difficult to undergo arch reconstruction and arterial switch operation. A 20-day old male infant was admitted with the diagnosis of Taussig-Bing anomaly with type B Interrupted aortic arch. Multi-organ failure, due to the diminution of ductal flow, was stabilized after 3 weeks of prostaglandin El and controlled ventilatory support. The surgical correction consisted of VSD closure, arterial swtich and extended aortic arch reconstruction. The marked disparity between the hypoplastic ascending aorta and the dilated main pulmonary artery was overcome by constructing distal neoaorta using both native ascending and descending aortic tissue. The patient was extubated on postoperative 2nd day Postoperative catheterization showed no left ventricular outflow obstruction, no intracardiac shunt, and no incompetence of neoaortic valve.

• Archives of Plastic Surgery
• /
• v.48 no.4
• /
• pp.378-383
• /
• 2021

Conjoined twins are rare, and each set of conjoined twins has a unique conjoined anatomy. It is necessary to perform separation to increase the chance of patient survival. Tissue expansion is an advanced technique for providing sufficient soft tissue and skin for wound closure. We report the successful application of rapid tissue expansion in 10-month-old xipho-omphalopagus conjoined twins in Vietnam. A tissue expander was placed on the anterior body between the sternum and umbilicus with a baseline of 70 mL sterile saline (0.9% NaCl). The first injection into the tissue expander began on the 6th day after expander insertion, and injections continued every 2 days with approximately 30-70 mL per injection according to the expansion of the skin. The expander reached 335 mL after six injections and within 10 days. In order to prepare for surgical separation, expansion was completed on the 15th day after insertion. The expanded skin area was estimated to be 180 cm², which was sufficient to cover both patients' skin deficiencies. The twins presented for surgical separation 6 days following the completion of tissue expansion. Both babies were discharged in good health 1 month after separation.

• Journal of Chest Surgery
• /
• v.24 no.11
• /
• pp.1133-1137
• /
• 1991

Congenital coronary arteriovenous fistula is relatively uncommon and often associated with additional congenital and acquired heart disease. If coronary arteriovenous fistula is suspected, the diagnosis can be made readily by cardiac catheterization and selective coronary arteriography. Surgical treatment is very satisfactory, with a low mortality and apparent good long term result. Recently, we experienced one case of congenital coronary arteriovenous fistula which was associated with aortic stenosis and regurgitation. The tortuous fistula tract was noted between the left anterior descending coronary artery and the main pulmonary artery. Under the cardiopulmonary bypass, aortic valve replacement[Carbomedics 23mm] and suture closure of the draining orifice of coronary arteriovenous fistula in the main pulmonary artery just above the pulmonary valve were performed, Postoperative hospital course was uneventful and the patient was discharged postoperative 9th day without any problems.

• Journal of Chest Surgery
• /
• v.28 no.9
• /
• pp.857-860
• /
• 1995

In a 53-year old male with post-infarction ventricular septal defect [VSD , owing to an acute exacerbation of pulmonary edema, respiratory failure developed, and the ventilatory support and intraaortic balloon counterpulsation [IABP were applied. At the following day, operation was performed with the aid of IABP. Under the cardioplumonary bypass, he underwent infarctectomy, trimming of VSD margin, patch closure of VSD and infarctectomy site. Left ventricular free wall rupture was detected during operation, which was confined with pericardial adhesion. Post-operative course was uneventful, and he could be discharged with minimal degree of dyspnea [NYHA class II .

• Journal of Chest Surgery
• /
• v.20 no.3
• /
• pp.635-641
• /
• 1987

Recently, direct atriopulmonary anastomosis was performed in 2 patients without using pericardium or prosthetic material. Case 1 A 13-year-old male patient whose diagnosis was tricuspid atresia [type lb] received direct atriopulmonary anastomosis successfully with good clinical and hemodynamic results. Nine months after operation, he has an increased exercise tolerance. Case 2 A 4-year-old female patient whose diagnosis was DORV with pulmonary atresia in A-V discordance had a formidable surgical challenge. A large-diameter direct atriopulmonary anastomosis was performed after the closure of the right atrioventricular valve. Her postoperative course has been even in 20th postoperative day.

• Journal of Chest Surgery
• /
• v.17 no.4
• /
• pp.780-785
• /
• 1984

We had studied 20 cases of VSD patients whose murmur was sustained after open heart surgery from 1977 to 1984. The postoperative cardiac catheterization was performed on post-op. 20th day. Their ages ranged from 5 to 25 years old. Among them, 4 patients had significant residual shunt which required reoperation. [1 patient; re-op, 3 patient; refused]. Sex ratio was 13:7 in male and female. Associated anomalies were PDA, ASD, Pulmonary stenosis, Mitral insufficiency. Except 1 case, all of them was Kirklin type II VSD. Postoperative complications were I RBBB, residual shunt, cardiac tamponade due to bleeding, wound infection. Preoperative pulmonary artery systolic pressure was highly related to residual shunt in our study. Postoperative LVEDV returned to normal range on the 3rd week.

• Korean Journal of Bronchoesophagology
• /
• v.18 no.1
• /
• pp.9-12
• /
• 2012

Boerhaave's syndrome is a very fatal condition occuring esophageal rupture during emesis and has the worst prognosis of the esophageal perforation. From May 2007 to March 2012 11 patients underwent surgical treatment for Boerhaave's syndrome at Inje University Sanggye Paik Hospital. There were 11 males whose mean age was 49.9 years ranging from 42 to 59. 2 cases of primary closure was performed and 9 cases of anastomosis using EEA (Esophago-Enteric Anastomisis) stapler. Mean operation time was 154.4 minutes and one patient who undergone primary repair died because of mediastinitis and sepsis on $35^{th}$ post-operative day. There was no leakage at other patients. Post-operative complication was one operative wound infection and one post-operative bleeding which was treated completely. Surgical treatment for Boerhaave's syndrome using EEA stapler is simple and effective technique but further studies with large number of cases should be carried out for better outcome.

• The Journal of the Korean dental association
• /
• v.13 no.7
• /
• pp.629-632
• /
• 1975

The clinical investigation and operation procedure were described on the gunshot wound which involved on soft, hard palate and nasal cavity. The patient, 19 years old, female, admitted in Han Yang Medical Center with clinical diagnosis of maxillofacial injuries on Nov. 1973. No Significant signs include of airway obstruction, Oro-nasal bleeding were revealed only exception of rupture and perforation on the soft, hard palate. For closure and reduction of destructed palatal wound, operation was done in out patient dental clinic under local anesthesia by means of Langenbeck method. And to control of post-operative inflammation and reactive swelling, administration of accurate antibiotics and physical therapy were performed for 5 days after operation. On the 10th day after administration, patient was discharged with satisfactory result of operation.

• Archives of Plastic Surgery
• /
• v.38 no.3
• /
• pp.329-332
• /
• 2011

Purpose: In developed countries, vesicovaginal fistula occur from various pelvic operations including total hysterectomy, leading to urinary leakage and incontinence. Although various methods have been proposed for adequate tissue coverage in fistula repair, the surgical treatment of is not simple and still controversial. We report a case of neobladder-vaginal fistula repair using modified Martius fat pad flap. Methods: A 62-year-old female patient underwent radical cystectomy with total abdominal hysterectomy and neobladder formation due to invasive bladder tumor 5 years ago. For 3 years following the operation, urine leakage was observed. Exploration demonstrated neobladder-vaginal fistula and primary repair including fistulectomy and direct closure was performed. Urinary incontinence relapsed 2 years after primary repair, and after demonstrating the recurrence of fistula on urography, repair of recurrent fistula was performed. After dissection of vagina and neobladder and closure of fistula by urologic surgeon, fibroadipose flap was elevated, rotated and advanced through the tunnel at vaginal sidewall, and interpositioned to the fistula site between neobladder and vagina. Results: There was no acute complication after the surgery and urethral catheter was extracted on the 8th day after the operation. During six month follow-up period after the operation, there is no clinical evidence of fistula recurrence. Conclusion: From our clinical experience and literature review, we think Martius fat pad flap is a useful technique in management of neobladder-vaginal fistula, for it provides enough vascularity, major epithelization surface and better lymphatic drainage, and also prevents overlapping of vesical, vaginal suture lines at the same time.

• Journal of Korean Society of Steel Construction
• /
• v.15 no.5 s.66
• /
• pp.475-487
• /
• 2003

This study developed an analysis model of estimating fatigue damage using the linear elastic fracture mechanics method. Stress history occurring to an element when a truck passed over a bridge was defined as block loading and crack closure theory explaining load interaction effect was applied. Stress range frequency analysis considering dead load stress and crack opening was done. Probability of stress range frequency distribution was applied and the probability distribution parameters were estimated. The Monte Carlo simulation of generating the probability various of distribution was performed. The probability distribution of failure block numbers was obtained. With this the fatigue reliability of an element not occurring in failure could be calculated. The failure block number divided by average daily truck traffic remains the life of a day. Fatigue reliability analysis model was carried out for the welding member of cross beam flange and vertical stiffener of steel box bridge using the proposed model. Consequently, a 3.8% difference was observed between the remaining life in the peak analysis method and in the proposed analysis model. The proposed analysis model considered crack closure phase and crack retard.