• Title/Summary/Keyword: End-to-end repair

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Clinical Study of Neck Base Injury (경저부 혈관손상의 임상적 고찰)

  • 우종수
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.378-384
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    • 1978
  • Injuries to the major vessels in the thoracic inlet require early recognition and expedient operative approach. Delayed diagnosis difficulties encountered in the operative exposure of the region are the major factors limiting successful management. This report is a review of 13 patients with vascular injuries to the neck base who were managed at Busan National University Hospital from March 1975 to September 1978 about 3 years and 6 months. The important clinical problems are delineated with emphasis on the technical aspects of operative management. 1] Among 13 cases, 8 cases were male 5 cases were female. 2] Of 28 vascular injuries, subclavian axillary vascular injuries were 22 [78%]. Stab wound was the cause in 70% of these patients. 3] Without extension 7 cases[53.8%] were managed successfully with supraclavicular, and axillary incision. Posterolateral thoracotomy one of extending 4 cases, 2 cases were used right musculoskeletal flap for management of proximal part of the subclavian artery and innominate vessel, 2 cases were used left supraclavicular incision with anterolateral thoracotomy for management of left proximal subclavian artery. One Expired. 4] Repair of vascular injury was accomplished by lateral suture of debridement and end-to end anastomosis in 17[74%]. Autogenous vein was used one for interposition graft. Ligation was required 2 arterial, 6 venous injuries. Of 8 cases which were pulseless preoperatively, 5 cases were able to palpable distal pulse. 5] Post operative complications occurred 50%. Complication of vasular repair was rare. The majority was neurologic deficit (33.3%).

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The Effects of Live Leech (Hirudo Medicinalis) Therapy on Diabetic Foot: a Clinical Case Report

  • Na, Hyun-Jong
    • The Journal of Korean Medicine
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    • v.24 no.4
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    • pp.136-138
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    • 2003
  • Purpose : A clinical case of diabetic foot-wound repair using Hirudo medicinalis therapy and its application is reported and discussed. Methods : The subject was a sixty-six-year-old woman diagnosed with a non-healing wound indicating the amputation of her right diabetic foot. Instead, Hirudo medicinalis therapy was performed twelve times over forty days, twice a week. The transition of wound closure was observed with the naked eye, and the plethysmogram was measured at the beginning and end of the treatment period. Results : The wound contracted with decreased exudate, collagen-like connective tissue sprouted, and then the wound gradually closed. The initial value (-0.08) of the dicrotic elastic index rose to -0.03. Conclusion : Hirudo medicinalis therapy had a positive effect on the wound repair, without a negative effect on the circulation, allowing the foot to be saved. It is necessary to investigate its wound repair mechanism for the further development of the Sahyul method.

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Seismic Response of Haunch Repaired Steel MRFs: A Case Study (헌치로 보강된 철골모멘트 골조의 지진 응답: 사례연구)

  • 이철호
    • Proceedings of the Earthquake Engineering Society of Korea Conference
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    • 1997.04a
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    • pp.173-181
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    • 1997
  • To investigate the effects of haunch repair on the system seismic performance of steel moment-resisting frames (steel MRFs), a case study was conducted for a 13-story frame damaged during the 1994 Northridge earthquake. It was assumed that only those locations with reported damage would be repaired with haunches. A new analytical modeling technique for the dual panel zone developed by the author was incorporated in the analysis. Both the inelastic static and dynamic analyses did not indicate detrimental side effects resulting from the repair. As a result of the increased strength in dual panel zones, yielding in these locations were eliminated and larger plastic rotation demand occurred in the beams next to the shallow end of the haunches. Nevertheless, the beam plastic rotation demand produced by the Sylmar record of 1994 Northridge earthquake was still limited to 1.7% radians. The repair resulted in a minor increase in earthquake energy input. In the original structure, the panel zones should dissipate about 80%(for the Oxnard record) and 70%(for the Sylmar record) of the absorbed energy, assuming no brittle failure of moment connections. After repair, the energy dissipated in the panel zones and beams were about equal.

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Evaluation of Occupant Protection of Van and Light Truck Vehicle (승합 및 경트럭의 탑승자 보호성능 평가)

  • Kim, Guan-Hee;Park, In-Song
    • Transactions of the Korean Society of Automotive Engineers
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    • v.20 no.3
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    • pp.13-19
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    • 2012
  • The fatalities rate for passenger vehicles, vans, and commercial vehicles is 1.23, 1.90 and 2.46 deaths per 10,000 registered vehicles, respectively. This shows that vans and commercial vehicles are vulnerable compare to passenger vehicles. To evaluate the crashworthiness of van and Light Truck Vehicle(LTV), we carried out frontal offset crash test at 64km/h, 40% overlap as per IIHS(Insurance Institute for Highway Safety). The test result show that LTV is very poor to protect occupant at frontal crash cause there is no safety system such as airbag and pretensioner and front end length(distance from front bumper to steering wheel) is short. One of the van rated as the lowest rating even it is equipped with airbag, cause its safety cage was collapsed during the test. This result shows that the structural integrity is very important in terms of occupant protection.

CRISPR as a strong gene editing tool

  • Shen, Shengfu;Loh, Tiing Jen;Shen, Hongling;Zheng, Xuexiu;Shen, Haihong
    • BMB Reports
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    • v.50 no.1
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    • pp.20-24
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    • 2017
  • Clustered regularly-interspaced short palindromic repeats (CRISPR) is a new and effective genetic editing tool. CRISPR was initially found in bacteria to protect it from virus invasions. In the first step, specific DNA strands of virus are identified by guide RNA that is composed of crRNA and tracrRNA. Then RNAse III is required for producing crRNA from pre-crRNA. In The second step, a crRNA:tracrRNA:Cas9 complex guides RNase III to cleave target DNA. After cleavage of DNA by CRISPR-Cas9, DNA can be fixed by Non-Homologous End Joining (NHEJ) and Homology Directed Repair (HDR). Whereas NHEJ is simple and random, HDR is much more complex and accurate. Gene editing by CRISPR is able to be applied to various biological field such as agriculture and treating genetic diseases in human.

Surgical Treatment of Coarctation of the Aorta (대동맥축착증의 외과적치료)

  • 성시찬;방정희
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1069-1076
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    • 1997
  • There remains controversy regarding the appropriate surgical treatment for coarctation of the aorta because of relatively high rate of recoartation and high mortality in the cases associated with complex anomalies. We evaluated 31 consecutive patients who underwent surgical repair of coarctation of the aorta from May 1992 through June 1996. Nineteen patients(61.3%) were neonates and 26(83.9%) were under three months. Nine patients did not have major associated anom lies(Group I), 15 patients had ventricular septal defect(Group II), and 7 patients had major complex anomalies(Group III). 35.5% of the patients had arch hypoplasia. Surgical procedures performed were as follows: extended end-to-end anastomosis in 17 patients, combined resection-flap procedure in 7 patients, and subclavian flap aortoplasty in 7 patients. Residual coarctation occurred in 7(25%) of 28 patients; 2 after subclavian (lap aortoplasty(2/6, 33.3%), none after combillrd resection-flap procedure(0/7, 0%), and 5 after extended end-to-end anastomosis(5/15, 33.3%). Higher incidence of residual coarctation was noticed in the group with arch hypoplasia. The incidence of postoperative coarctation at a mean follow-up of 20.5 months in survivals was 12.0%(3/25); 2 cases after subclavian flap aortoplasty(2/6, 33.3%), none after combined resection-flap procedure(017, 0%), and one after endtoend anastomosis(1/12, 8.3%). The mortality rate related to coarctation repair was 9.7%(3 patients all in Group III). This study revealed that isolated coarctation of aorta and coarctation with ventricular septal di3fect(groups I & ll) can be repaired with low mortality, but repair of coarctation with complex anomaly had a high operative mortality Also the patients with arch hypoplasia had higher incidence of post-operative residual coarctation.

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Surgical Treatment Outcomes of Acquired Benign Tracheoesophageal Fistula: A Literature Review

  • Kim, Sang Pil;Lee, Juhyun;Lee, Sung Kwang;Kim, Do Hyung
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.206-213
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    • 2021
  • Background: Tracheoesophageal fistula (TEFs) is a rare condition that requires complex surgical treatment. We analyzed the surgical outcomes of TEF reported in the literature and at Pusan National University Yangsan Hospital using standardized techniques. Methods: This retrospective study included 8 patients diagnosed with acquired benign TEF between March 2010 and December 2019. The surgical method was determined based on the size of the fistula observed within the endoscope. Results: TEF occurred in 7 patients (87.5%) after intubation or tracheostomy and in 1 patient (12.5%) after esophageal surgery due to conduit necrosis. For tracheal management, 5 and 2 patients underwent tracheal resection and end-to-end anastomosis and primary repair, respectively. The median length of resection was 2.5 cm (range, 1.3-3.4 cm). For esophageal management, 6 patients underwent primary repair and 1 patient underwent esophageal diversion. One patient underwent TEF division with a stapler. Interposition of a muscle flap was performed in 2 patients. TEF recurrence, esophageal stenosis, and dehiscence or granulation occurred in 1, 1, and 2 patients, respectively. A long-term tracheostomy tube or T-tube was used in 2 patients for >2 months. Conclusion: Although TEF surgery is complex and challenging, good results can be achieved if surgical standards are established and experience is accumulated.

Epidermal Growth Factor Receptor-Related DNA Repair and Radiation-Resistance Regulatory Mechanisms: A Mini-Review

  • Bai, Jing;Guo, Xiao-Guang;Bai, Xiao-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.4879-4881
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    • 2012
  • Epidermal growth factor receptor (EGFR) overexpression is associated with resistance to chemotherapy and radiotherapy. The EGFR modulates DNA repair after radiation-induced damage through an association with the catalytic subunit of DNA protein kinase. DNA double-strand breaks (DSBs) are the most lethal type of DNA damage induced by ionizing radiation, and non-homologous end joining is the predominant pathway for repair of radiation-induced DSBs. Some cell signaling pathways that respond to normal growth factors are abnormally activated in human cancer. These pathways also invoke the cell survival mechanisms that lead to resistance to radiation. The molecular connection between the EGFR and its control over DNA repair capacity appears to be mediated by one or more signaling pathways downstream of this receptor. The purpose of this mini-review was not only to highlight the relation of the EGFR signal as a regulatory mechanism to DNA repair and radiation resistance, but also to provide clues to improving existing radiation resistance through novel therapies based on the above-mentioned mechanism.

The road less traveled: strategies to enhance the frequency of homology-directed repair (HDR) for increased efficiency of CRISPR/Cas-mediated transgenesis

  • Devkota, Sushil
    • BMB Reports
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    • v.51 no.9
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    • pp.437-443
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    • 2018
  • Non-homologous end joining (NHEJ), and to a lesser extent, the error-free pathway known as homology-directed repair (HDR) are cellular mechanisms for recovery from double-strand DNA breaks (DSB) induced by RNA-guided programmable nuclease CRISPR/Cas. Since NHEJ is equivalent to using a duck tape to stick two pieces of metals together, the outcome of this repair mechanism is prone to error. Any out-of-frame mutations or premature stop codons resulting from NHEJ repair mechanism are extremely handy for loss-of-function studies. Substitution of a mutation on the genome with the correct exogenous repair DNA requires coordination via an error-free HDR, for targeted transgenesis. However, several practical limitations exist in harnessing the potential of HDR to replace a faulty mutation for therapeutic purposes in all cell types and more so in somatic cells. In germ cells after the DSB, copying occurs from the homologous chromosome, which increases the chances of incorporation of exogenous DNA with some degree of homology into the genome compared with somatic cells where copying from the identical sister chromatid is always preferred. This review summarizes several strategies that have been implemented to increase the frequency of HDR with a focus on somatic cells. It also highlights the limitations of this technology in gene therapy and suggests specific solutions to circumvent those barriers.

Staged Repair of Esophageal Atresia with Tracheoesophageal Fistula in a Very Low-birth-weight Infant - A case report- (극소저체중출생아에서 기관식도루를 동반한 식도폐쇄의 단계적 수술 - 1예 보고 -)

  • Sung, Si-Chan;Kim, Hyung-Tae;Ra, Yong-Joon;Byun, Shin-Yun;Kwon, Kyung-Ah;Jo, Yong-Hoon
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.820-823
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    • 2010
  • There are still some controversies in treatment strategy for the very low-birth-weight baby with esophageal atresia even though the result of primary repair has been improving. We report a successful end to end anastomosis with staged approach in one of twin weighing 1,270 g at birth.