• 제목/요약/키워드: Defect case

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심실중격결손증의 임상적 고찰 (Open Heart Surgery for Ventricular Septal Defects - A Report of 29 Cases -)

  • 채헌;서경필;이영균
    • Journal of Chest Surgery
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    • 제8권1호
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    • pp.69-74
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    • 1975
  • Twenty-nine cases of ventricular septal defect operated in this department during the period from 1969 to May 1975 were presented. Out of 29 cases, there were 20 cases of type II defects, 8 cases of type I, and one case of type III, and the last case was multiple defect. The anomalies associated with ventricular septal defect were eight in all; three patent ductus arteriosus, one atrial septal defect, one tricuspid insufficiency and an aortic insufficiency. Over all mortality was 17%. The causes of death were complete heart block in a case, respiratory distress due to excessive administration of morphine in one, low cardiac output in two and perforation of the aortic annulus after repair of the ventricular septal defect associated with aortic insufficiency.

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Reconstruction of a temporal scalp defect without ipsilateral donor vessel possibilities using a local transposition flap and a latissimus dorsi free flap anastomosed to the contralateral side: a case report

  • Jung Kwon An;Seong Oh Park;Lan Sook Chang;Youn Hwan Kim;Kyunghyun Min
    • 대한두개안면성형외과학회지
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    • 제24권3호
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    • pp.129-132
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    • 2023
  • Scalp defects necessitate diverse approaches for successful reconstruction, taking into account factors such as defect size, surrounding tissue, and recipient vessel quality. This case report presents a challenging scenario involving a temporal scalp defect where ipsilateral recipient vessels were unavailable. The defect was effectively reconstructed utilizing a transposition flap and a latissimus dorsi free flap, which was anastomosed to the contralateral recipient vessels. Our report underscores the successful reconstruction of a scalp defect in the absence of ipsilateral recipient vessels, emphasizing the importance of employing appropriate surgical interventions without necessitating vessel grafts.

심내막상 결손증에 대한 임상고 (Clinical study of endocardial cushion defect: 37 cases report)

  • 조재일;서경필
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.657-665
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    • 1984
  • Thirty-seven patients had undergone repair of a endocardial cushion defect between 1977 and Aug. 1983 in Seoul National University Hospital. Twenty eight had a partial defect, one intermediate defect and eight complete endocardial cushion defect. Tricuspid cleft was found in 4 cases and mitral cleft was in all p-ECD. Seven patients were of type C anatomy in c-ECD. Four patients had associated major anomalies, including three TOF in c-ECD, one coarctation in p- ECD. In p-ECD patients, the septal defect was closed with patch in all cases and the atrioventricular valvular insufficiency was corrected with MVR in 4 cases, TVR in 1 case and simple interrupted sutures in remainders. In c-ECD patients the septal defect was closed with single patch except one case. The atrioventricular valve was repaired with simple interrupted sutures except one MVR and TVR case. The operative mortality was 14.2% in p-ECD, 44.4% in c-ECD, but recent 3 years [1980-1983] mortality was 8.7% in p-ECD, 20% in c-ECD. More than grade III systolic regurgitant murmur was oted postoperatively in 4 cases of c-ECD and 3 cases of p-ECD. The operative risk factors were preoperative NYHA classification, cyanosis, Rp/Rs, systolic pressure of main pulmonary artery and the degree of regurgitation of atrioventricular valves. The causes of death were low cardiac output syndromes, pulmonary complications and arrhythmias.

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복합재 연소관의 초음파 결함 분석 프로그램 개발 (Development of Ultrasonic Defect Analysis Program for a Composite Motor Case)

  • 김동륜;임수용;정상기;이경훈
    • 한국추진공학회지
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    • 제16권2호
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    • pp.65-72
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    • 2012
  • 초음파 결함 분석 프로그램은 초음파 반사법을 기반으로 초음파 신호처리 기법을 적용하여 개발되었고, FRP 층간분리 및 FRP/내열고무 미접착 결함을 정량적으로 측정할 수 있었다. 복합재 연소관에서 검출된 결함은 절단하여 전산화 단층촬영 및 영상 현미경으로 분석하였고, 결함 분석 프로그램의 결과와 일치하였다. 본 논문은 복합재 연소관의 초음파시험 데이터를 C-Scan 영상으로 변환하여 결함을 분석할 수 있는 프로그램 개발 과정을 기술하였다.

Reconstruction of a total defect of the lower eyelid with a temporoparietal fascial flap: a case report

  • Kim, Yun-Seob;Lee, Nae-Ho;Roh, Si-Gyun;Shin, Jin-Yong
    • 대한두개안면성형외과학회지
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    • 제23권1호
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    • pp.39-42
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    • 2022
  • The reconstruction of total lower eyelid defects is challenging to plastic surgeons due to the complicated anatomical structure of the eyelid. In addition, in the setting of cancer excision, the resection is deep, which requires some volume augmentation. However, in some cases, free tissue transfer is not applicable. We report a case of using a temporoparietal fascia flap (TPFF) for reconstructing a total lower eyelid defect. A large erythematous mass in an 83-year-old woman was diagnosed as squamous cell carcinoma by biopsy. After wide excision, the defect size was about 8×6 cm. The lower eyelid structures including the tarsus were removed. The TPFF including the superficial temporal artery was elevated and inset to the defect area. After the flap inset, a split-thickness skin graft with an acellular dermal matrix was performed on the fascial flap. There were no wound problems such as infection, dehiscence, or necrosis. After the patient's discharge, partial skin graft loss and ectropion occurred. The complications resolved spontaneously during the postoperative period. We report a case of reconstructing a lower eyelid defect using a TPFF. A TPFF can be applied to patients with large defects for whom free tissue transfer surgery is not appropriate as in this case.

공동주택 하자소송단계에서의 하자인정항목에 관한 연구 (A Study on the Newly Recognized Defect Factors in Defect Lawsuits of Apartment Housing)

  • 고영태;신윤석;이명도
    • 한국건축시공학회지
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    • 제20권6호
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    • pp.567-576
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    • 2020
  • 본 연구는 공동주택의 하자소송의 사례분석을 통해 하자소송단계에서 추가적으로 하자로 인정되는 하자 항목을 제안한다. 이 하자 항목은 하자소송에서 추가적인 비용의 증가, 일정 지연, 재감정 혹은 추가소송을 방지할 수 있을 것이다. 하자소송에서는 입주자 및 건설사에서 사전에 인지하지 못한 새로운 하자항목이 발생되며, 이를 새로운 하자인정항목으로 정의하였다. 이를 위해 본 연구에서는 국내의 15개의 하자소송의 사례분석을 실시하였다. 이를 통해 77개의 소송하자를 1차 선별하고 전문가 자문을 통해 최종적으로 23개의 소송하자를 도출하였다. 이후 하자의 요인을 분석하여 최종적으로 23개의 소송항목을 총 10개의 요인항목으로 정립하였으며, 사례연구를 통해 효용성을 분석하였다. 본 연구의 결과는 하자의 발생을 저감하고 분쟁을 최소화하는 데 기여할 수 있을 것이다.

심실중격결손의 Pulmonary Banding: 2 치험례 (Pulmonary Artery Banding for Ventricular Septal Defect: Report of 2 Cases)

  • 조범구
    • Journal of Chest Surgery
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    • 제5권1호
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    • pp.29-34
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    • 1972
  • Interventricular Septal Defect is probably the most common congenital cardiac lesion. Despite rapid technical advances and increasing surgical experience the risk of surgical intervention for correction of Ventricular Septal Defect in infants with pulmonary hypertension remains formidable. Since Sirak et al [1959] reported a succesful case of two stage approach to their surgical correction, it has led to a policy of primary palliation,followed by complete correction as a secondary procedure, after age 3 to 4 years. Most surgeon prefer to perform complete correction of Ventricular Septal Defect when body weight exceeds 30 Lbs. and before development of so-called Eisenmengers complex, for the good postoperative results. Authors report 2 cases of Ventricular Septal Defect with pulmonary hupertenslon, who was underwent pulmonary artery banding as a palliative procedure in the Department of Surgery,Severance Hospital Yonsei University. Case 1:4 year old male, initially a complete correction of Ventricular Septal Defect was attempted by the help of mild hypothermia and extracorporeal circulation. During the procedure of a construction of an extracorporeal by- pass, a sudden cardiac arrest developed. After resuscitation of the heart,pulmonary artery banding was performed as a palliation. On the first postoperative day the patient developed generalized tonic convulsion, cyanosis, vomiting and eventually shock. Patient discharged home after a full recovery. Case 2.: 9 month old female, the pulmonary artery constricted with Teflon patch successfully. After the patients first postoperative day several cyanotic spells developed followed by 3 cardiac arrests. This repeated until when she expired with respiratory failure.

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삼중방심 치험 1예 (Cor triatriatum(A case report))

  • 정경영
    • Journal of Chest Surgery
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    • 제16권3호
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    • pp.331-336
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    • 1983
  • Cor triatriatum is a rare congenital malformation of the heart, in which a septum stretches in a transverse or oblique plane through the left atrium, thus separating it into two compartments. The upper one connects with the pulmonary veins, and the lower one connects with the left ventricle. Due to the rarity of, and great difficulty in-diagnosing, cor trlatrlatum, data On the surgery of this disease are of necessity very limited and so accurate pre-operative diagnosis was very difficult to make. `We experienced a case of the cyanotic congenital heart disease which was diagnosed as a large atrlal septal defect with streaming venous blood from inferior vena cava to left atrium through atrial septal defect in August, 1982. We found that there were transverse septum in the left atrium through atrlal septal defect, the pulmonary venous drainage were located in the upper chamber of the left atrium, and the lower chamber was connected with the left atrial appendage, mitral valve and `left ventricle. But our case had not any opening in this transverse septum and the right atrium was connected with the upper chamber of the left atrium through the upper part of the atrlal septal defect, and was communicated with the lower chamber of the left atrium through the lower part of the atrlal septal defect. We excised the transverse septum and repair this atrial septal defect with Woven Dacron patch accompanying with the drainage of coronary sinus to right atrium. The post-operative course was not eventful and he was discharged with good result on the post-operative 8th day, and has been in good .condition up to now for longer than 10 months.

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승모판막 협착증의 외과적 요법 (Surgical Treatment of Mitral Stenosis)

  • 김용진
    • Journal of Chest Surgery
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    • 제10권2호
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    • pp.241-249
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    • 1977
  • Atrial septal defect is one of the most frequently encountered congenital heart disease. Up to December 31, 1976, 1682 cardiac patients received cardiac catheterization in the cardiac department of Yonsei university medical college. Out of the 1682 cardiac patients 723 cases had congenital heart disease and only 116 cases had congetial atrial septal defect. This amounted to 16.04% of all those with congenital heart disease. 58 cases of congenital atrial septal defect operated in the chest surgery department were presented. Of these 58 cases of atrial septal defect, 27 cases were male and 31 cases were female. Their ages ranged from 5 years to 54 years. The systolic pressure of the main pulmonary artery of 40 out of the 58 cases of atrial septal defect was below 40% of that of the systemic blood pressure: in 6 cases, the range of the systolic pressure of the main pulmonary artery was 50-90mmHg; in 12 cases, the range of the systolic pressure of the main pulmonary artery was 40-50mmHg. Average age of these was 30. 1 years. This study tends to show that Korean patients with atrial septal defect even though younger have a slight higher systolic pressure of the main pulmonary artery than Western patients have. The pulmonary blood is 1.5-2.5 times of systemic blood flow in 52 cases out of 58 cases of atrial septal defect.In only one of the 58 cases of atrial septal defect, the Rp was found to be as high as 45% of Rs. All other cases were below this level.51 cases had ostium secundum defect, 4 out of these cases had ostium secundum defect combined with mitral incompetence and 6 out of them had double ostium secundum defect. The remaining 7 cases had ostium primum defect. Their atrial defects were repaired under direct vision utilizing extracorporeal circulation, by hemodilution technic combined with moderate hypothermia. 44 cases [2nd atrial septal defect] were repaired by direct sutures while 14 cases, including the 7 cases ostium primum defects needed patches [1 pericardium and 13 teflon patch]. In 4 cases there were single defects while showed two defects. However the associated septal defect was so small that it could be closed by direct sutures. The size of the defect ranged between 6.0cm2and 10.0cm2 in 19 cases[33.7%]: the smallest being 0. 5cm2 and the largest 24cm2. The surgical mortality was 2 cases [3.4%]. These one case with ostium primum defect, could not be resuscitated on operation table. The cause of death in this case was myocardial failure and MI. The other, a case of ostium primum defect had a second operation on the first operative day due to massive bleeding from LV vent-line insertion site.The patient died on 26th post-operative day due to sepsis.

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