• Journal of Chest Surgery
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• v.41 no.5
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• pp.630-632
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• 2008

Minimally invasive cardiac surgery using AESOP (Automated Endoscope System for Optimal Positioning) offers certain advantages such as better a cosmetic outcome, a shortened post operative recovery time and a shorten hospital stay, and these advantages are not achieved by conventional cardiac surgery. We report here on our first robot-assisted (AESOP) left minithoracotomy surgery in a 26 year-old female with a subarteral ventricular septal defect, and this might have been treated by median sternotomy before the development of AESOP.

• Journal of Yeungnam Medical Science
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• v.9 no.2
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• pp.321-326
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• 1992

The study consisted of all patients over 35years old undergoing surgical repair of atrial septal defect for the period from June 1985, to August 1992. The following results were observed. 1. ASD was closed with patch in 11(73%) patients. 2. The relationship of pulmonary artery systolic pressure to Qp/Qs ratio was not significant. 3. Before operation 6 patients were in NYHA functional class II, 8 were in class III, After operation 8 patients were in class I, 6 were in class II. 4. Atrial fibrillation has persisted in 3 patients and returned regular rhythm in 1 patient after surgery. 5. There was no operative mortality and we had good surgical results regardless of patient's age.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.516-519
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• 2009

Ventricular septal defect (VSD) complicating an acute myocardial infarction is rather uncommon. However, the outcomes after the development of a VSD are poor with an in-hospital mortality of more than 90% for the medically treated patients. To prevent the recurrence of VSD, many techniques have been reported on for the closure of a postinfarction VSD. In this. report, we present a case of a patient who had a postinfarction VSD due to Prinzmetai's variant angina, and the rupture of the pseudoaneurysm of the left ventricle was successfully treated by the "Sandwich technique".

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.85-92
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• 2005

Reconstruction of defect in the anterior part of the maxilla to enable implant placement or prothesis is a complicated treatment due to the anatomical position and lack of soft tissues. Two cases are presented in which autogenous iliac PMCB(particulate marrow and cancellous bone) with titanium mesh were used for premaxilla reconstruction and alveolar bone repair of the anterior maxillas prior to denture and implants fixation respectively. Cancellous bone from the anterior iliac crest was compressed and placed against a titanium mesh fixed to the bone of palate in a patient with severe defect of the anterior maxilla. There were no problem in the healing, and the anterior maxillas of two patients had increased height and width during the initial healing and remodeling. The clinical reports describe the use of titanium mesh for reconstruction of premaxilla. Autogenous bone grafts were harvested from the iliac crest and were loaded on a titanium mesh that were left in the patient's maxilla for 6 months before they were removed respectively. The radiographic analysis demonstrated that a 10mm vertical ridge augmentation had been achieved. In guided bone regeneration, the quantity of bone regenerated under the barrier has been demonstrated to be directly related to the amount of the space under the membrane. This space can diminish as a result of membrane collapse. To avoid this problem which involved the use of a titanium mesh barrier to protect the regenerating tissues and to achieve a rigid fixation of the bone segments, were used in association with autologous bone in 2 cases. The aim of this study was to evaluate the capability of a configured titanium mesh to serve as a mechanical and biologic device for restoring a vertically defected premaxilla.

• Archives of Reconstructive Microsurgery
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• v.1 no.1
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• pp.24-30
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• 1992

Tendocutaneous free flap transfer has been usually used to treat troublesome wounds, which had extensive defect of skin and tendons, since Daniel and Taylor had reported successful free flap transfer in 1973. Among the numerous types of free flap, the dorsalis pedis flap, which could include superficial peroneal nerve, extensor tendon and second metatarsus, was widely used as composite free flap. The authors analysed 13 cases of tendocutaneous free flap transfer from dorsum of the foot which were operated at Korea University Hospital from March 1981 to August 1991. The results were as follows: 1. The average size of these flaps was $53.7cm^2$(mazimum $82cm^2$, minimum $30cm^2)$, the average number and length of tendons were 2.9(maximum, 5, minimum 1), and 9.2cm (maximum 17cm, minimum 5cm). 2. The survival rate of flaps was 100%, and functional results by Dargan's criteria were 4 in excellent, 4 good, 3 fair and 2 poor. 3. The delayed healing on donor site could prevented by the meticulous skin graft and repair of extensor retinaculum. 4. The cases of electrical burn were more worse than the traumatic cases in functional results.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.619-625
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• 2012

Background After skin tumor excision on the face, extremities, or trunk, the choice of treatment for a skin defect is highly variable. Many surgeons prefer to use a local flap rather than a skin graft or free flap for small- or moderately-sized circular defects. We have used unilateral or bilateral V-Y advancement flaps, especially on the face. Here we evaluated the functional and aesthetic results of this technique. Methods All of the patients were pathologically diagnosed with squamous cell carcinoma (SCC), basal cell carcinoma (BCC), or malignant melanoma or premalignant lesion (Bowen's disease). Thirty-two patients underwent V-Y advancement flap repair (11 unilateral and 21 bilateral) from January 2007 to June 2011. We analyzed the patients' age and satisfaction, and location and size of defect. The patients were followed up for 6 months or more. Results There were 22 women and 10 men. The ages ranged from 47 to 93 years with a mean age of 66 years. The causes were SCC in 15 cases, BCC in 13 cases, malignant melanoma in 1 case, Bowen's disease in 2 cases, and another cause in 1 case. The tumor locations were the face in 28 patients, and the scalp, upper limb, and flank each in one patient. All of the flaps survived and the aesthetic results were good. Postoperative recovery was usually rapid, and no complication or tumor recurrence was observed. Conclusions The V-Y advancement flap is often used not only for facial circular defects but also for defects of the trunk and extremities. Its advantages are less scarring and superior aesthetic results as compared with other local flap methods, because of less scarification of adjacent tissue and because it is an easy surgical technique.

• Journal of Chest Surgery
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• v.24 no.1
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• pp.15-25
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• 1991

From February 1988 to December 1990, 42 patients underwent so called REV operation for pulmonary stenosis or atresia with or without anomalies of ventriculoarterial connection and truncus arteriosus. The principles of operative technique are mobilization of pulmonary arterial tree beyond the pericardial reflection, transection of pulmonary trunk between the pulmonary ventricle and pulmonary artery, suture of distal pulmonary arterial stump to the upper margin of Pulmonary ventriculotomy site with absorbable suture, and anterior patch with 0.625% glutaraldehyde fixed autologous pericardium with monocusp inside it. Age at operation ranged 3-156months [mean 41.8 month] with twelve of whom infants. Operative indications were pulmonary atresia, with ventricular septal defect[16], and pulmonary stenosis with double outlet right ventricle[8], with ventricular septal defect[16], with double outlet right ventricle[8], with complete transposition of the great arteries[8], with corrected transposition of the great arteries[6], with Fallot`s tetralogy[3], and truncus arteriosus[1]. There were six hospital deaths[14%] and no late death. Twenty-four of 36 survivals were followed up more than 12 months with good clinical results. Postoperative angiocardiogram was performed in fifteen patients. Hemodynamically, two patents had residual pressure gradients along the pulmonary outflow tract, one patient showed severe pulmonary regurgitation; morphologically, there were six significant stenosis of left pulmonary arterial tree, two of whom showed significant pressure gradients. Our present experience with REV operation suggests that this technique make it possible to perform anatomic repair in a wide variety of congenital anomalies of abnormal ventriculoarterial connection associated with pulmonary outflow tract obstruction without using the prosthetic material, even in infants, with relatively low mortality and morbidity.

• Journal of Chest Surgery
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• v.53 no.1
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• pp.16-21
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• 2020

Background: Patients undergoing cardiac surgery require postoperative chest drainage. However, the drain is difficult to keep in place in children with congenital heart disease. Since 2015, at Kyungpook National University Hospital, the chest tube is removed on postoperative day 1 in patients who have undergone simple congenital cardiac surgery (i.e., closure of an atrial or ventricular septal defect). In this study, we evaluated the relationship between the duration of drain placement and the likelihood of pericardial effusion after congenital cardiac surgery. Methods: The medical records of patients who underwent closure of an atrial or ventricular septal defect at our hospital between January 2014 and December 2016 were reviewed. In total, 162 patients who received follow-up echocardiography and had information available on postoperative pericardial effusion after the repair procedure were enrolled. Results: Echocardiography was performed at a median of 5 days (range, 4 to 6 days) postoperatively before discharge from the hospital. Pericardial effusion occurred in 21 patients (13.0%), of whom only 3 (1.9%) had moderate or greater pericardial effusion, regardless of the drain duration. All patients improved during outpatient follow-up without invasive management. No patient had severe complications because of pericardial effusion. The duration of drain placement did not affect the incidence of postoperative pericardial effusion (p=0.069). Operative survival was 100%. Conclusion: Based on our study, we recommend removing the drain as soon as its role is complete, generally on postoperative day 1, because early removal does not increase the incidence of pericardial effusion in patients undergoing simple congenital cardiac surgery.

• Journal of Chest Surgery
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• v.15 no.4
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• pp.432-439
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• 1982

Congenital posterolateral diaphragmatic hernia [Bochdalek hernia] is the result of a congenital diaphragmatic defect in the posterior costal part of the diaphragm in the region of the tenth and eleventh ribs. There is usually free communication between the thoracic and abdominal cavities. The defect is most commonly found on the left [90%], but may occurs on the right, where the liver often prevents detection. The male to female ratio is 2:1. Owing to the negative intrathoracic pressure, herniation of abdominal contents through the defects occurs, with resultant collapse of the lung. Shifting of mediastinum to the opposite side and compression of the opposite lung occurs. Most often these hernias are manifestated by acute respiratory distress in the newborn. A second, but less well recognized, group of patient with Bochdalek hernia survive beyond the neonatal period, usually present at a later time with "failure of thrive, intermittent vomiting, or progressive respiratory difficulty. " The diagnosis can often be made on clinical ground from the presence of respiratory distress, absence of breath sounds on the chest presence of bowel sounds over the chest . Roentgenogram of the chest confirm the diagnosis. Obstruction and strangulation have been reported but are rare. Treatment consists of early reliable identification of these congenital diaphragmatic hernia with high risk and surgical repairment. and postoperative pharmacological management with extracorporeal membranous oxygenation [=ECMO] support in the period of intensive care. On the surgical approach, for defects on left side, an abdominal incision is preferred, because of the high incidence of malrotation and obstructing duodenal bands. In the neonate, the operative mortality may be appreciable, but, later repair almost always is successful. During the period from 1972 to 1982, 4 cases of congenital Bochdalek hernia were experienced at the Kyung-Hee University Hospital.

• Archives of Reconstructive Microsurgery
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• v.8 no.2
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• pp.97-107
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• 1999

The osteogenic capacity of the vascularized periosteum autograft has been extensively demonstrated by experimental works. The objective of this study was to characterize the behavior of experimental model of vascularized periosteal flap(VPF) by observing sequential stages of osteogenesis after simulated VPF in rabbits. In experimental group, segmental resection of bone including the periosteum was performed in 22 radii of 22 New Zealand white rabbits preserving the periosteal circulation of median artery to the periosteum. In order to simulate the transplantation of VPF, the vascular pedicle consisting of median artery and veins was dissected from adjacent soft tissue and the periosteum was longitudinally incised to remove the bone followed by repair of the periosteum. From the first to sixteenth week after the simulated VPF, the changes in VPFs were observed by radiological, light microscopical, scanning electron microscopical methods and the activity of osteocalcin was measured by immunohistochemical method. In control group, the bone tissue and periosteum were completely removed from the mid-shaft of radius and the findings were observed by radiological and light microscopical methods. From the results of this study, it is demonstrated that the experimental model of VPF is vigorously and uniformly osteogenic. Therefore it is thought that VPF can be used as a measure to treat bone defect of shaft of long bone.