• 제목/요약/키워드: Defect Repair

검색결과 592건 처리시간 0.021초

성인에서 선천성 심장기형의 수술성적 -725 치험례 보고- (Operative result congenital cardiac disease in adult - A reort of 725 surgical cases-)

  • 이정렬;서경필
    • Journal of Chest Surgery
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    • 제19권1호
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    • pp.116-121
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    • 1986
  • Patients over 15 years of age who have undergone a surgical correction of a congenital cardiac malformation during period of January 1958 through January 1986 have been reviewed. During this period there were 3957 congenital cardiac lesions consisting of 2712 acyanotic and 1245 cyanotic cases. Among them, a total of 725 adults [18.3%] with a variety of congenital heart lesions, 548 acyanotic group and 177 cyanotic group were operated on. 372 patients were male and 252 patients were female. There were 280 patients under 20 years of age, 206 between 20-24 years, 102 between 25-29 years, 48 between 30-34 and 89 over 35 years. The most common defects were atrial septal defect which accounted for 207 cases [28.6%] and other common anomalies were VSD [140 cases, 19.3%], TOF [136 cases, 18.6%], PDA [120 cases, 16.6%] and PS [33 cases, 4.6%] in order of incidence. Overall operative mortality for this series was 3.6% [1.8% of a cyanotic group and 9.0% of cyanotic group] compared with 2.8% of total cases of congenital heart disease [acyanotic group 1.1% and cyanotic group 6.5%]. This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.

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발살바동 동맥류 파열의 외과적 치료 - 10례 보고 - (Surgical Treatment of Ruptured Sinus of Valsalva Aneurysm)

  • 김우찬;윤정섭;김치경;조규도;왕영필;곽문섭
    • Journal of Chest Surgery
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    • 제29권11호
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    • pp.1207-1211
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    • 1996
  • 본 가톨릭대학교 의과대학 흉부외과학 교실에선 최근 10년간 10예의 발살바동 동맥류 파열환자를 경험하였다. 8명은 선천성이었으며 2명은 세균성 심내막염에 의한 후천성이었다. 동반된 심질환으로는 대동맥판막폐쇄부전증 4예, 심방중격결손증 2예, 심실중격결손증 1례, 승모판막폐쇄부전증 1례 그리고 삼첨판막폐쇄부전증 1례가 있었다. 전례에서 동맥류가 우관상동에서 발생하였으며, 8명의 환자에서 우심실으로 2명의 환자에서 우심방으로 파열하였다. 저자들은 대동맥절개와 동맥류가 파열된 심방 또는 심실절개를 통한 수술을 선호하였으며, 8명의 환자에서 Dacron 첩포를 사용하여 봉합하였고 2명의 환자에서는 단순봉합하였다. 전 환자에서 양호한 결과를 보였으며, 술후 사망예는 없었다.

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Aortic Periannular Abscess Invading into the Central Fibrous Body, Mitral Valve, and Tricuspid Valve

  • Oh, Hyun Kong;Kim, Nan Yeol;Kang, Min-Woong;Kang, Shin Kwang;Yu, Jae Hyeon;Lim, Seung Pyung;Choi, Jae Sung;Na, Myung Hoon
    • Journal of Chest Surgery
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    • 제47권3호
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    • pp.283-286
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    • 2014
  • A 61-year-old man was diagnosed with aortic stenoinsufficiency with periannular abscess, which involved the aortic root of noncoronary sinus (NCS) that invaded down to the central fibrous body, whole membranous septum, mitral valve (MV), and tricuspid valve (TV). The open complete debridement was executed from the aortic annulus at NCS down to the central fibrous body and annulus of the MV and the TV, followed by the left ventricular outflow tract reconstruction with implantation of a mechanical aortic valve by using a leaflet of the half-folded elliptical bovine pericardial patch. Another leaflet of this patch was used for the repair of the right atrial wall with a defect and the TV.

Coexistence of Radiation-induced Meningiomas and Shunt Related Pneumocephalus in a Patient with Successfully Treated Medulloblastoma

  • Kim, Young-Hoon;Kim, Chae-Yong
    • Journal of Korean Neurosurgical Society
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    • 제41권6호
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    • pp.403-407
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    • 2007
  • The authors encountered a case of simultaneous radiation-induced multiple meningiomas and ventriculoperitoneal [VP] shunt-related pneumocephalus. A 35-year-old man, who had undergone surgery for medulloblastoma 21 years previously and subsequently received high dose craniospinal irradiation with adjuvant chemotherapy and later underwent a VP shunt because of hydrocephalus, presented with a severe headache and weakness of both lower extremities. Computed tomography showed an air pocket lesion in the left temporal lobe and a large amount of pneumocephalus with a bony defect of the left tegmen tympani. In addition, a 3 cm sized well enhancing mass was noted in the in the right middle cranial fossa and additional small enhancing nodule in the left frontal pole. He was treated by left temporal craniotomy and repair of the bony and dural defects of the left tegmentum tympanum through extradural and intradural approaches, respectively. Afterwards, he underwent right temporal craniotomy and gross total removal of a rapidly growing right middle fossa mass and a left frontal mass. The histological examination was consistent with atypical meningioma, WHO grade II. In conclusion, physicians have to consider the serious long term complications of high dose radiation therapy and VP shunt placement and need to perform the neuroradiologic follow-up after such treatments for several decades.

Resolution of Protein-Losing Enteropathy after Congenital Heart Disease Repair by Selective Lymphatic Embolization

  • Kylat, Ranjit I;Witte, Marlys H;Barber, Brent J;Dori, Yoav;Ghishan, Fayez K
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권6호
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    • pp.594-600
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    • 2019
  • With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, postdouble switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ${\leq}0.9g/dL$) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.

압력용기 클래드 보수용 전해니켈도금 인자 관계 연구 (Variables of Electrolytic Nickel Plating for RPV Cladding Repair)

  • 김민수;황성식;김동진;이동복
    • Corrosion Science and Technology
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    • 제18권4호
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    • pp.148-153
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    • 2019
  • Pure nickel with a thickness of 1 mm was plated on type 304 stainless steels and low alloy steels (JIS G3131 SPHC) by electrolytic plating method in a circulating plating bath. Plating performance, mechanical properties, and surface characteristics were evaluated in terms of pretreatment process, anode material, pH, current density, and flow rate of the plating solution. Addition of hydrochloric acid during pre-treatment process improved the adhesion performance of plating. To improve plating efficiency, it is desirable to use S-nickel rather than electrolytic nickel. The use of S-nickel was also confirmed to be desirable for maintaining the pH and concentration of the plated solution. The defect of the plating using S-nickel anode produced pit on the surface. However, it is believed that proper control can be obtained by increasing the flow rate. Internal stress and hardness values of electrolytic nickel plating according to current density need to be carried out with further studies.

Incarcerated Hiatal Hernia with Perforation after Laparoscopic Total Gastrectomy with Roux-en-Y Reconstruction: a Case Report

  • Wang, Nai-Yu;Tsai, Chung-Yu;Liu, Yuan-Yuarn;Chen, I-Shu;Ho, Kai-Hung
    • Journal of Gastric Cancer
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    • 제19권1호
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    • pp.132-137
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    • 2019
  • The occurrence of hiatal hernia after total gastrectomy with Roux-en-Y reconstruction is rare. We report the case of a 76-year-old man who presented with dyspnea, vomiting, and fever around 8 days after total gastrectomy with Roux-en-Y reconstruction. Abdominal computed tomography revealed a hiatal hernia containing part of the small intestine in the left thoracic cavity. Emergent reduction and repair of the hiatal hernia were performed later. Operative findings revealed that the Roux limb was incarcerated in the left pleural cavity. Esophagojejunostomy leakage, perforation of the small intestine with transient ischemic change, and pyothorax were also found. Thus, feeding jejunostomy, thoracoscopic decortication, and diversion T-tube esophagostomy were performed. Considering that the main cause of hiatal hernia is blunt dissection with division of the phrenoesophageal membrane, approximating the crus with 1 or 2 figure-8 sutures, according to the size of the defect, to prevent the incidence of hiatal hernia after total gastrectomy may be performed.

Hair Growth Promoting Effect of Radish Crude Saponin Extract on Athymic Nude Mice

  • Kim, Hyun-Kyoung
    • International journal of advanced smart convergence
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    • 제8권1호
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    • pp.184-195
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    • 2019
  • This study investigates the hair restoration efficacy of selected radish saponin extracts on nude mice. Nude mice genetically predisposed to pattern balding were used in this study. Our study revealed the underlying mechanism of stimulating hair growth in athymic nude mice by repair the nu/nu follicular keratin differentiation defect. Thus, the topical application of radish saponin may represent a novel strategy for the management and therapy of certain forms of alopecia. The term of hair density of PEE treated nude mice were significantly increase as compared with of control nude mice. Histological observation of skin sample showed no hair follicle or only distorted hair follicles were observed in the control samples, in contrast, by the PEE treatment groups showed a fully formed and increased the number of hair follicles up to three times higher than that of control group in terms of the number of hair follicles in nude mouse skin.PEE treated mice the number of BrdU-labeled keratinocytes per anagen follicle increased significantly, especially in the follicular bulbs and outer root sheath compared with the control mice. Moreover, PEE-treated nude mice also exhibited a significant increase in the number of BrdU-labeled epidermal keratinocyte proliferation.

Fatigue evaluation and CFRP strengthening of diaphragm cutouts in orthotropic steel decks

  • Ke, Lu;Li, Chuanxi;He, Jun;Lu, Yongjun;Jiao, Yang;Liu, Yongming
    • Steel and Composite Structures
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    • 제39권4호
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    • pp.453-469
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    • 2021
  • The cracking at the transverse diaphragm cutout is one of the most severe fatigue failures threatening orthotropic steel decks (OSDs), whose mechanisms and crack treatment techniques have not been fully studied. In this paper, full-scale experiments were first performed to investigate the fatigue performance of polished cutouts involving the effect of an artificial geometrical defect. Following this, comparative experimental testing for defective cutouts strengthened with carbon fiber-reinforced polymer (CFRP) was carried out. Numerical finite element analysis was also performed to verify and explain the experimental observations. Results show that the combinative effect of the wheel load and thermal residual stress constitutes the external driving force for the fatigue cracking of the cutout. Initial geometrical defects are confirmed as a critical factor affecting the fatigue cracking. The principal stress 6 mm away from the free edge of the cutout can be adopted as the nominal stress of the cutout during fatigue evaluation, and the fatigue resistance of polished cutouts is higher than Grade A in AASHTO specification. The bonded CFRP system is highly effective in extending the fatigue life of the defective cutouts. The present study provides some new insights into the fatigue evaluation and repair of OSDs.

Free Flap Salvage in the Ischemic Foot: A Case Report

  • Seo, Dongkyung;Dannnoura, Yutaka;Ishii, Riku;Tada, Keisuke;Kawashima, Kunihiro;Yoshida, Tetsunori;Horiuchi, Katsumi
    • Archives of Plastic Surgery
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    • 제49권5호
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    • pp.696-700
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    • 2022
  • We performed distal bypass and free flap transfer in a single-stage operation to repair an extensive soft tissue defect in an ischemic foot of an 84-year-old woman. The nutrient artery of the free flap was anastomosed to the bypass graft in an end-to-side manner. Subsequently, the bypass graft became occluded on several occasions. Although intravascular and surgical interventions were performed each time, the bypass graft eventually became completely occluded. However, despite late occlusion of the nutrient artery, the free flap has remained viable and the patient is ambulatory. The time required for a transplanted free flap to become completely viable without a nutrient artery is likely longer for an ischemic foot compared with a healthy foot. However, the exact period of time required is not known. A period of month was required in our patient. We report this case to help clarify the process by which a free flap becomes viable when applied to an ischemic foot.