• Title/Summary/Keyword: Defect Repair

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A Case of Gastric Volvulus in a 3-year-old Female (3세 소아에서 발생한 Gastric Volvulus 1례)

  • Lee, Jin-Tae;Kim, Hwa-Jung;Kim, Hee-Sup;Tchah, Hann;Park, Ho-Jin;Kim, Han-Sun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.89-92
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    • 2000
  • Acute gastric volvulus is uncommon but surgically emergent. Normally, the stomach is held in position by four ligaments: gastrophrenic, gastrohepatic, gastrosplenic, and gastrocolic. In addition, relative fixation of the pylorus and esophagus provides further anchorage. A normal diaphragm also helps to prevent abnormal displacement of abdominal viscera and development of gastric volvulus. Volvulus may be organoaxial, mesenteroaxial, or a combination of both. Organoaxial volvulus is the rotation of the stomach around an axis extending from the hiatus of the diaphragm to the pylorus. Mesenteroaxial volvulus is the rotation of the stomach around an axis transecting the lesser and greater curvatures of the stomach. The symptoms of gastric volvulus depend on its type, the extent and degree of rotation and obstruction, and associated defects. Classic clinical features of acute gastric volvulus, as by Borchardt in 1904, include unproductive retching, acute, localized epigastric distention, and the inability to pass a NG tube. The presence and severity of these features depend on the degree of gastric obstruction of both the gastroesophageal junction and pyloric outlet. It may be suspected on plain abdominal radiographs and usually confirmed by upper gastrointestinal series. Acute volvulus requires immediate surgical repair, fixation to avoid recurrence, and correction of any underlying anatomic abnormality. Any associate defect should be repaired and the stomach must be fixed. The authors report a case of an 3-year-old girl who had a mesenterioaxial gastric volvulus.

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Comparison of wound healing effects between Oncorhynchus keta-derived polydeoxyribonucleotide (PDRN) and Oncorhynchus mykiss-derived PDRN

  • Lee, Jong Hun;Han, Jin Woo;Byun, Jin Hwan;Lee, Won Mi;Kim, Min Ho;Wu, Wen Hao
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.20-34
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    • 2018
  • Background: Polydeoxyribonucleotide (PDRN) influencing cellular growth and differentiation is recognized to promote wound healing by stimulating tissue repair. Although PDRN can be extracted from human placentas, PDRN medications have recently been extracted from the semen of trout (Oncorhynchus mykiss) and salmon (Oncorhynchus keta). The present study was designed to evaluate the wound healing effects of O. keta-derived PDRN for injection (Rejuvenex) and PDRN cream (Rejuvenex Cream) in comparison with those of O. mykiss-derived PDRN injection (Placentex). Methods: Full-thickness skin defects were made on the back of mice (n=60). The mice were divided into the following four groups according to the dressing used for the wounds: O. mykiss-derived PDRN injection group, O. keta-derived PDRN injection group, O. ketaderived PDRN cream group, and normal saline soaked dressing group (control group). We analyzed the gross findings, wound sizes, histological findings, immunohistochemistry and enzyme-linked immunosorbent assays for the groups immediately after the treatment, and again after 4, 7, and 10 days of treatment. Results: The wound healing effects were the greatest in the O. keta-derived PDRN injection and O. mykiss-derived PDRN injection groups, which showed similar scores, followed by the O. keta-derived cream and normal saline soaked dressing groups. Conclusion: The injection of PDRN extracted from O. keta was found to be as effective at healing full-thickness skin defects as the O. mykiss-derived PDRN injection, which is currently used in the clinic. Moreover, the O. keta-derived PDRN injection was also found to reduce the time required for wound healing.

The Effects of Graft of DFDB combined with Calcium Sulfate membrane on the Periodontal Wound Healing of Horizontal Dehiscence Defects in Dogs (성견 열개형 수평골 결손부에서 탈회냉동건조골과 Calcium Sulfate 차단막이 치주조직 치유에 미치는 영향)

  • Cho, Kyoo-Sung;Choi, Seong-Ho;Chai, Jung-Kiu;Moon, Ik-Sang;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.27 no.2
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    • pp.347-361
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    • 1997
  • The present study investigates the effects of DFDB graft combined with Calcium sulfate membrane on the periodontal wound healing in dehiscence defects of dogs. Following the initiation of general anesthesia by I.V. administration of 30mg/kg of pentobarbital, first premolar was extracted and full-thickness flap was elevated from the second to the fourth premolar. The portion of premolars coronal to the alveolar crest was removed and mesial and distal roots separated to produce single rooted teeth. Exposed root canals were sealed with Caviton and covered completely with flaps sutured. Following the healing period of 12 weeks, the surgical sites were uncovered and $4{\times}4mm$ dehiscence defects were surgically created. Those defects with DFDB graft combined with Calcium sulfate membrane following root planing, were designated as test sites and those with flap surgery-only were designated as controls. 1. No foreign-body reaction or inflammation were observed in either groups. Calcium sulfate was completely resorbed in the test sites. 2. Significantly greater amounts of new cementum was observed in test sites compared with the controls. Significant amounts of functionally orientated collagens were observed in the test sites. 3. New bone formation was observed in significantly greater amounts in test sites. The results suggest that combined graft of DFDB and calcium sulfate is extremely biocompatible with a potential for new bone and cementum formation, and functional alignment of periodontal ligaments.

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A Study on the Seller's Right to Cure in the Int'l Sale of Goods (국제물품매매계약(國際物品賣買契約)에서 하자보완권(瑕疵補完權)에 관한 고찰(考察))

  • Ha, Kang-Hun
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.12
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    • pp.253-276
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    • 1999
  • CISG articles 34 and 37 clearly allow the seller to cure any nonconformity in documents of sale or performance prior to the date for delivery if it does not cause the buyer unreasonable inconvenience or unreasonable expense. CISG article 48 allows a seller to cure the performance even after the date for delivery if it does not cause the buyer unreasonable delay, unreasonable inconvenience or unreasonable uncertainty of reimbursement by the seller of expenses advanced by the buyer. The wording any failure to perform is broad enough to include a delay. The seller's right to cure relates to all his obligations. The seller may remedy 'any failure to perform his obligations'. This language is broad enough to include a defect in documents. In some cases the fact that the seller is able and willing to remedy the non-conformity of the goods without inconvenience to the buyer, may mean that there would be no fundamental breach unless the seller failed to remedy the non-conformity within an appropriate time. It cannot generally be said what unreasonable inconvenience means. This can only be decided on a case-by-case basis. The seller must bear the costs involved in remedying a failure to perform. The curing of a failure to perform may have influence on the amount of the damage claimed. Insofar as the seller has the right to cure, the buyer is in that case obliged to accept the cure. If he refuses to do so, he can neither avoid the contract nor declare a reduction in price. This rule clearly shows the underlying concept of the CISG, to keep to the contract, if possible. Should the buyer requires delivery of substitute goods and the seller offers repair, it depends on the expense each case. The buyer must receive the request or notice by the seller. The relationship between the seller's right to cure and the buyer's right to avoid the contract is unclear. The buyer's right to avoid the contract should not nullify the seller's right to cure if the offer is reasonable. In addition, whether a breach is fundamental should be decided in the right of the seller's offer to cure.

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Experimental study on the effect of direct microcurrent to periodontal regeneration in class III furcation defects (3급 치근분지부 골결손에서 미세전류자극이 치주조직의 재생에 미치는 영향에 관한 실험적 연구)

  • Kim, Young-Jun;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.27 no.4
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    • pp.845-866
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    • 1997
  • Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggests that the application of electrical currents to periodontal defects could promote bone and cementum formation. The purpose of this study was to determine the effect of direct microcurrent to the periodontal regeneration of class III furcation defects in dogs. Class III furcation defects were surgically created on the third and the fourth premolars bilaterally in the mandibles of nine mongrel dogs. Experimental periodontitis were induced by placing small cotton pellets into the created defects for 3 weeks. The experimental sites were divided into three groups according to the treatment modalities: Group I-surgical debridement only; Group II-allogenic demineralized freeze dried bone grafting; Group III-allogenic demineralized freeze dried bone grafting and electrical stimulation. For fluorescence microscopic evaluation, calcein, oxytetracycline HCI and alizarin red were injected 2, 4 and 8 weeksfS days prior to sacrifice) after surgery. The animals were sacrificed in the 1st, 2nd, 4th and 8th week after periodontal surgery and the decalcified and undecalcified specimens were prepared for histological and histometrical examination. After the first and the second weeks, gingival recession was more severe in group I than groups II and III. After the fourth and the eighth weeks, there was no difference in the width of junctional epithelium and connective tissue attachment among the three groups, but the width of connective tissue attachment increased in group II at the eighth week, compared to the fourth week. The amount of bone repair in new attachment was significantly greater in group III, compared to groups I and II. New attachment formation was significantly greater in group III, compared to groups I and group II. These results suggest that electrical stimulation using microcurrent generator could be a useful tool for periodontal regenerative therapy in class III furcation defect.

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Critical Management Factors of Fluid-Applied Membrane Waterproofing Work for building basements (지하층 도막방수공사의 중점관리요인)

  • Kwon, Hae-Rim;Yu, Jung-Ho
    • Journal of the Korea Institute of Building Construction
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    • v.9 no.6
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    • pp.91-98
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    • 2009
  • One role of waterproofing work is to block external moisture and water. Defects in waterproofing work in building construction brings on huge repair costs for related construction work as well as for the waterproofing layer itself. However, we don't have a quantitative probabilistic management method for waterproofing work to successfully anticipate and prevent defects. From an analysis of the literature and prior research, defects in the waterproofing work in the underground parts of buildings occur frequently. We selected Fluid-Applied Membrane waterproofing work as representing waterproofing work in the underground parts of a building, and researched the general types and causes of defects. In this study, we developed the Relative-FMEA (Failure Mode and Effect Analysis) approach that merges the Matrix method and FMEA. From a survey of experts, we deduced the most important management factors for Fluid-Applied Membrane waterproofing work for the underground parts of buildings.

Management of Cerebrospinal Fluid Leak after Traumatic Cervical Spinal Cord Injury (경추 손상 후 뇌척수액 유출에 대한 관리)

  • Lee, Soo Eon;Chung, Chun Kee;Jahng, Tae-Ahn;Kim, Chi Heon
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.151-156
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    • 2013
  • Purpose: Traumatic cervical SCI is frequently accompanied by dural tear and the resulting cerebrospinal fluid (CSF) leak after surgery can be troublesome and delay rehabilitation with increasing morbidity. This study evaluated the incidence of intraoperative CSF leaks in patients with traumatic cervical spinal cord injury (SCI) who underwent anterior cervical surgery and described the reliable management of CSF leaks during the perioperative period. Methods: A retrospective study of medical records and radiological images was done on patients with CSF leaks after cervical spine trauma. Results: Seven patients(13.2%) were identified with CSF leaks during the intraoperative period. All patients were severely injured and showed structural abnormalities on the initial magnetic resonance image (MRI) of the cervical spine. Intraoperatively, no primary repair of dural tear was attempted because of a wide, rough defect size. Therefore, fibrin glue was applied to the operated site in all cases. Although a wound drainage was inserted, it was stopped within the first 24 hours after the operation. No lumbar drainage was performed. Postoperatively, the patients should kept their heads in an elevated position and early ambulation and rehabilitation were encouraged. None of the patients developed complications related to CSF leaks during admission. Conclusion: The incidence of CSF leaks after surgery for cervical spinal trauma is relatively higher than that of cervical spinal stenosis. Therefore, one should expect the possibility of a dural tear and have a simple and effective management protocol for CSF leaks in trauma cases established.

Thoracoscopic Aortic Valve Replacement assisted with AESOP (Automated Endoscope System for Optimal Positioning) 3000 (AESOP 3000을 이용한 흉강경적 대동맥 판막 치환술)

  • Shin Hong Ju;Kim Hee Jung;Choo Suk Jung;Song Hyun;Chung Cheol Hyun;Song Meong Gun;Lee Jae Won
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.507-509
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    • 2005
  • Open heart surgery via right thoracotomy can be accomplished in atrial septal defects, and mitral valve diseases. Recently, thoracoscopic atrial septal defect closure, mitral valve repair, Maze operation, and minimal invasive direct coronary artery bypass (MIDCAB) are accomplished with AESOP 3000. However, there is no report of thoracoscopic aortic valve replacement in Korea. We report a successful thoracospic aortic valve replacement assisted with AESOP 3000 in a 31-year-old female patient.

Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy

  • Park, Seong Hoon;Kim, Joo Hyun;Lee, Jun Won;Jeong, Hii Sun;Lee, Dong Jin;Kim, Byung Chun;Suh, In Suck
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.550-553
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    • 2017
  • Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury. We performed a jejunal free flap repair of the 8-cm defect in the esophagus. End-to-side microvascular anastomoses were created between the right external carotid artery and the jejunal branches of the superior mesenteric artery, and end-to-end anastomosis was performed between the external jugular vein and the jejunal vein. The right recurrent laryngeal nerve injury was repaired with a 4-cm nerve graft from the right ansa cervicalis. Esophagography at 1 year after surgery confirmed that there were no leaks or structures, endoscopy at 1 year confirmed the resolution of vocal cord paralysis, and there were no residual problems with swallowing or speech at a 5-year follow-up examination. RAT requires experienced surgeons with a thorough knowledge of anatomy, as well as adequate resources to quickly and competently address potentially severe complications such as esophageal rupture.

An Analysis on the Correlation between Crack Condition and Safety Grades in Masonry Buildings (조적조 건축물의 균열양태 및 등급판정과의 상관성에 관한 연구)

  • Kwon, Ki-Hyuk
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.9 no.3
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    • pp.101-110
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    • 2005
  • In Seoul, structural deterioration is severe in the private masonry buildings which have been built since 1906s. But most of these structures remain without any repair works. As a result, the rate of deterioration is getting faster and these dangerous structures may cause hazardous circumstances to the adjacent structures and neighborhood. The purpose of this study is to investigate the actual conditions of wall cracks among the defect types which occur in private masonry buildings and to analyze the correlation between safety grades and wall cracks for offering the fundamental data. Using these date we can establish basic criteria for safety grades of structures and improve the quality of masonry buildings. The result of this study indicate that there are high correlations between safety grades and the width of crack but much less so with the length. Furthermore, with regard to crack patterns, vertical cracks much more negatively effected the safety grades.