• Proceedings of the KACD Conference
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• 2006.05a
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• pp.241-241
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• 2006

• Journal of Chest Surgery
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• v.31 no.9
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• pp.899-902
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• 1998

Recent advances in understanding the anatomy of complete atrioventricular septal defect have led to alternative methods of repairing these defects. Here we report two cases of complete atrioventricular septal defect repair by direct closure of the ventricular element of the defect. Follow-up for average of 3 months suggests that, when direct closure can be performed, the results can be comparable with those of the standard technique. Our initial success with this approach is encouraging; however, longer follow-up and more experiences are required to establish whether it will be broadly applicable.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.3
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• pp.163-168
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• 2023

An oroantral fistula (OAF) or oroantral communication (OAC) is an opening between the oral cavity and the maxillary sinus. If left untreated, these openings may cause chronic maxillary sinusitis. Although small defects (diameter <5 mm) may close spontaneously, larger communications require surgical intervention. Various studies have been conducted on OAC closure using a platelet-rich fibrin (PRF) membrane; most of these prior studies have involved simple direct application of PRF clots. This study introduces a new "double-barrier technique" using PRF for closure of an OAF involving sinus mucosal lifting and closure. The PRF material is inserted into the prepared maxillary sinus space, and the buccal advancement flap covers the oral side. This technique was successfully used to treat two patients with chronic OAF in the posterior maxillary region after implant removal or tooth extraction. The use of a PRF membrane in a double-barrier technique may have advantages in soft-tissue healing and could enable easy closure of chronic OAF with minimal trauma.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.2
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• pp.163-168
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• 2017

Anterior diastemas are common esthetic problems. One of the challenges in clinical esthetic dentistry is closing anterior diastemas without creating "black triangles" between the teeth. The success of a restorative treatment in anterior teeth depends on the esthetic integration between soft tissues and hard tissues. This report describes the successfully accomplished diastema closure case by producing the emergence profile with natural contours at the gingival-tooth interface and then generating of gingival recontouring process.

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

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.867-870
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• 2011

Purpose: The authors would like to introduce two patients who presented with velopharyngeal inadequacy. We emphasize the importance of nasaopharyngeal endoscopy in evaluating the velopharyngeal function and the usefulness of biofeedback trial therapy. Methods: Two patients visited our clinic due to velopharyngeal inadequacy. Both of the patients showed hypernasality, nasal emission and compensatory articulation such as glottal stop. During oral examination and nasopharyngeal endoscopy both showed no evidence of structural deformities. One inconsistently showed a small gap during articulation. The other showed a rather large gap during compensatory articulation. Both received a simultaneous biofeedback trial therapy using the nasopharyngeal endoscope. Results: Both patients were successfully diagnosed and treated at once using biofeedback trial therapy with nasopharyngeal endoscopy. By giving direct visual feedback to the patient, they were both able to achieve complete velopharyngeal closure during production of 2~3 nonsence syllables and hypernasality was not detected in both of them. Conclusion: The authors were able to help patients with velopharyngeal inadequacy to have velopharyngeal closure through biofeedback trial therapy. The accurate evaluation of velopharyngeal function and the possibility of closure prevented unnecessary operations.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.1045-1049
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• 1996

Post-intubation tracheoesophageal fistula is rare, and its management causes a serious problems to surgeons. We have experienced 4 cases in 3 patients. Simple ditcision and closure of the fistulas were done by trans-cervical approach after weaning of ventilator. The tracheal defect was closed by simple suture, and the esophageal defect was closed in two layers before a viable muscle flap was interposed between the two suture lines in order to prevent recurrence. There was one delayed tracheal stenosls and one recurrent fistula, and these complications were also managed success ully.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.953-961
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• 1990

Congenitally corrected transposition of the great arteries is a rare congenital heart anomaly, in isolation, has no hemodynamic consequences. It is usually associated with one or more of a variety of intracardiac lesions, ventricular septal defect, valvular or subvalvular pulmonary stenosis, and deformity of the systemic atrioventricular valve with insufficiency. This report describes a successful two stage operation for congenitally corrected transposition, [SLL] type, with ventricular septal defect, pulmonary atresia, persistent ductus arteriosus, and atrial septal defect. A 9 years old patient underwent modified Blalock-Taussig operation because of severe pulmonary hypoplasia. 2 years later a corrective operation, direct closure of ASD and PDA, VSD closure with Dacron patch, Enlargement of left pulmonary artery with pericardial patch and Relief of ROTO with Rastelli procedure could be successfully performed without complication.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1250-1253
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• 1992

A patient with intravascular hemolysis due to residual shunt and right ventricular outflow track obstruction after total correction of TOF was presented. The patient was 29 years old female. She underwented VSD closure with dacron patch, infundibulectomy, pulmonic valvotomy and direct closure of PFO. 8 months after the operation, severe intravascular hemolysis and hemolytic anemia appeared. Conservative therapies were not effective, her general condition and laboratory finding got worse gradually. She underwent reoperation, the shunt was closed and right ventricular outflow tract obstruction was corrected by pulmonary valvotomy, infudibulectomy and transannular patch. After operation, hemolysis disappeared dramatically. Severe hemolysis may induce renal failure and necessitate transfusion frequently. If hemolytic anemia is not corrected by conservative treatment, early reoperation is required.

• Journal of Preventive Medicine and Public Health
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• v.29 no.4 s.55
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• pp.831-842
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• 1996

Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.