• Title/Summary/Keyword: Heart defects

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Treatment of Articular Cartilage Defects of The Knee with Microfracture (미세 천공술을 이용한 슬관절 관절 연골 손상의 치료)

  • Shin, Sung-Il;Song, Kyoung-Won;Lee, Jin-Young;Lee, Seung-Yong;Kim, Gab-Lae;Hyun, Yoon-Suk;Seo, Eun-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.205-210
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    • 2008
  • Purpose: To evaluate the clinical results after microfracture surgery for full-thickness chondral lesion of the knee. Materials and Methods: Thrity-seven patients, who had underwent microfracture surgery for full-thickness chondral lesion of the knee between January 1999 and December 2005, were reviewed. Their mean age at the time of operation was 31 years (range, 21~38 years) and mean follow up period was 2.7 years. All patients were reviewd every 6 months after operation. Clinical outcomes were evaluated by activity of daily living (ADL), Tegner activity scale, International Knee Documentation Committee (IKDC) knee examination form, Lysholm score and satisfaction of treatment. Results: ADL and Tegner activity score improved in 83% of patients during first 18 months, but decreased during next 6months. IKDC score improved from 58 points at operation time to 86 points after 12 months, but decreased to 79 points and 68 points at 18 and 24 months after operation, respectively. Also, Lysholm score improved from 61 points at operation time to 89 points after 12 months, to 92 points after 18 months, but 73 points after 24 months. At the last follow-up, 22 patients were excellent or good in satisfaction of treatment, whereas 12 patients were fair, 3 patients were poor. Conclusion: Microfracture surgery for full-thickness chondral lesion of the knee has a good functional improvement for first 12 months after operation, but its effectiveness has decreased over time.

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Primary Surgical Closure of Large Ventricular Septal Defects in Small Infants (조기 영아기 심실 중격 결손의 개심술)

  • 최종범;양현웅
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.486-492
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    • 1997
  • We r viewed a policy of primary surgical closure of large ventricular septal defects in small infants. Sixty-three infants met criteria for inclusion in the study, and were divided into two groups based on age: group 1 infants aged less than 5 months(n = 31), and group 2 infants aged 5 months or more(n = 32). Both groups had similar variation in ventricular septal defect location(paramembranous versus muscular), and showed no significant difference in left to right shunt and in ratio of systemic and pulmonary vascualr resistance. Three early deaths(9.7%) occurred in group 1, but no death(0%) in group 2. The causes of death were preoperative cardiac arrest and cerebral injury followed by postoperative respiratory insufficiency in two patients, and preoperative tracheomalacia followed by laryngeal edema and respiratory arrest in one Two patients in group 1 showed postoperative low cardiac output syndrome(6.5% in group 1 versus 0% in group 2). There was no late death during the follow-up per od in both groups. No surviving patients had postoperative patch leakage, or required a second operation. These results indicate that primary surgical closure of large ventricular septal defects, if logical perioperative care is accompanied, can be saefly performed in small infants aged less than 5 months with low postoperative mortality or morbidity rates.

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Reverse Superficial Sural Artery Flap for the Reconstruction of Soft Tissue Defect Accompanied by Fracture of the Lower Extremity (하지 골절과 동반된 연부조직 결손 재건을 위한 역행성 비복동맥 피판술)

  • Han, Soo-Hong;Hong, In-Tae;Choi, SeongJu;Kim, Minwook
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.253-260
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    • 2020
  • Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

Deep Sedation for Palate Alginate Impression Procedure in a Post-Fontan Procedure Patient with Mental Retardation (Fontan 수술을 받은 정신지체 소아에서 인상채득을 위해 시행한 깊은 진정)

  • Lee, Jung-Man;Seo, Kwang-Suk;Kim, Hyun-Jeong;Shin, Soon-Young;Shin, Teo-Jeon
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.1
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    • pp.45-50
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    • 2012
  • The Fontan operation is a heart operation used to treat complex congenital heart defects like tricuspid atresia, hypoplastic left heart syndrome, pulmonary atresia and single ventricle. A single ventricle is dedicated to pumping oxygenated blood to the systemic circulation and the entire systemic venous return reaches the pulmonary arterial system without the direct influence of a pumping chamber. In the patient with Fontan operation, it is important to achieve adequate pulmonary blood flow and cardiac output in anesthetic management. In this case, a 10-year-old boy (19.6 kg, 114 cm) with cleft palate, cerebral palsy and severe mental retardation, who underwent a Fontan operation when he was 4 years old, was presented for deep sedation. Because he was suffering from eating disorder with cleft palate, the orthodontist and the plastic surgeon planned to insert intraoral orthodontic device before cleft palate repair. But it was impossible to open his mouth for alginate impression procedure. After careful pre-anesthesia evaluation we planned to administer deep sedation with propofol infusion. After Intravenous catheter insertion, we started propofol intravenous infusion with the formula of a loading dose of 1.0 mg/kg followed by an infusion rate of 6.0 mg/kg/hr with syringe pump. His blood pressure was remained around 80/40 mmHg after loss of consciousness, but he could not maintain his airway patent. So we lowered the infusion rate to 3.0 mg/kg/hr, immediately. The oxygen saturation was maintained above 95% with nasal oxygen supply, and blood pressure was maintained around 100-80/60-40 mmHg. After the sedation of 110 minutes with propofol (the infusion rate to 3.0-5.0 mg/kg/hr), he fully regained consciousness, and was discharged without complication after 1 hour observation. In case of post-Fontan patient, intravenous deep sedation with propofol was safe and effective method of behavioral management during dental treatment.

Case Report of Partial Endocardial Cushion Defect with Mild Pulmonary Hypertension in Old Age (경증의 폐동맥 고혈압을 동반한 고령에서의 심내막상 결손 환자 치험 1예)

  • Kim Woo-Shik;An Jae-Bum;Song Chang-Min;Kim Mi-Jung;Jung Sung-Chol;Shin Yong-Chul;Kim Byung-Yul;Kim In-Sub
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.633-636
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    • 2006
  • The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

Recent incidence of congenital heart disease in neonatal care unit of secondary medical center: a single center study

  • Cho, Seon-Young;Oh, Jin-Hee;Lee, Jung-Hyun;Lee, Jae-Young;Lee, Soon-Ju;Han, Ji-Whan;Koh, Dae-Kyun;Oh, Chang-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.7
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    • pp.232-237
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    • 2012
  • Purpose: With feasibility in the diagnoses of congenital heart disease (CHD) in the antenatal period, we suspect changes have occurred in its incidence. No data have been reported about the current incidence of simple forms of CHD in Korea. We have attempted to assess the recent incidence and characteristics of CHD in the neonatal care unit of a secondary referral medical center. Methods: Medical records of 497 neonatal care unit patients who underwent echocardiography in the past 5 years were reviewed. Preterm infants with patent ductus arteriosus and other transient, minimal lesions were excluded from this study. Results: Although the number of inpatients remained stable, the incidence of simple forms of CHD showed a gradual decrease over the 5-year study period; a markedly low incidence of complex forms was seen as well. CHD was observed in 3.7% full-term and 6.8% pre-term infants. CHD was observed in 152 infants weighing >2,500 g (3.5% of corresponding birth weight infants); 65 weighing 1,000 to 2,500 g (9.3%); and 6 weighing <1,000 g (8.0%). The incidence of CHD was higher in the pre-term group and the low birth weight group than in each corresponding subgroup (P<0.001); however, the incidence of complex CHD in full-term neonates was high. The number of patients with extracardiac structural anomalies has also shown a gradual decrease every year for the past 5 years. Conclusion: Findings from our study suggest that the recent incidence and disease pattern of CHD might have changed for both complex and simple forms of CHD in Korea.

Influence of Surimi-like Material (SLM) from Pig Heart on Quality of Frankfurter Sausage (돼지 심장으로부터 획득한 수리미유사물이 프랑크푸르트 소시지의 품질에 미치는 영향)

  • 문성실;강근호;양한술;박구부;주선태
    • Journal of Animal Science and Technology
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    • v.48 no.3
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    • pp.435-442
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    • 2006
  • Effects of surimi-like material (SLM) from pig heart on the quality of frankfurter sausage were investigated. The sausages were made by substituted addition of SLM at 5 and 10% levels in raw meats. Contents of moisture and fat in batter were not changed by addition of SLM, respectively, whereas protein content was significantly (P<0.05) decreased with SLM level increased. Although pH of frankfurter sausage was significantly (P<0.05) increased with SLM addition, percentage of cook yield was significantly (P<0.05) decreased. As increasing of addition levels of SLM, hardness and chewiness were decreased, but springiness was significantly (P<0.05) increased. Also, panel rated sausages of 10% SLM as having a higher tenderness and acceptability compared with control. These results suggested that a tender frankfurter sausage without any defects of flavor might be made with substitution of SLM from pig heart.

Effect of Myofibrillar Protein Extracted from Pig Hearts on Quality Characteristics of Emulsion Type Sausages (돼지심장에서 획득한 근원섬유 단백질 추출물이 유화형 소시지의 품질특성에 미치는 영향)

  • 강근호;오성현;양한술;김진성;주선태;박구부
    • Food Science of Animal Resources
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    • v.23 no.2
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    • pp.122-127
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    • 2003
  • A surimi like material was made from fresh pig hearts and used to manufacture emulsion-type sausages for the improvement of quality characteristics. The heart muscles were diced and frozen at -60$^{\circ}C$ until processed. Then, the frozen diced heart muscles were thawed, chopped, filtered, and washed to extract myofibrillar proteins. The residue was centrifuged to take a surimi-like material. Emulsion-type sausages were made different levels of surimi-like material(5∼15%) and compared to the control. Cooking loss(CL, %) and water-holding capacity (WHC, %) were measured on raw meat batter, whereas shear force, hardness, color and panel test were measured after cooking. The addition of the surimi-like material up to 15% level in the sausage formulation reduced CL and increased WHC, as compared to the control. Shear force and hardness values of the control had the highest value, however sausages containing 15% surimi-like material had the lowest value(p<0.05). Increased surimi-like material became darker in color. Although no differences in panel scores of flavor and off-flavor were observed, panellists prefer to select sausages having 15% surimi-like material(p<0.05). These results indicated that a surimi-like material, which was a myofibrillar protein extracted from pig hearts, could be used to manufacture emulsion-type sausage up to 15% to improve cooking yield and textural characteristics without color and flavor defects.

Outcomes of the Warden Procedure for Anomalous Pulmonary Venous Return to the Superior Vena Cava: A 17-Year Experience

  • Lim, Su Chan;Kwak, Jae Gun;Cho, Sungkyu;Min, Jooncheol;Lee, Sangjun;Kwon, Hye Won;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.206-213
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    • 2022
  • Background: Surgical repair of partial anomalous pulmonary venous return (PAPVR) to the superior vena cava (SVC) using the Warden procedure has favorable outcomes. However, there remain some concerns after the Warden procedure, such as sinoatrial nodal dysfunction and systemic or pulmonary venous stenosis. We investigated the outcomes of the Warden procedure for repair of PAPVR to the SVC. Methods: This retrospective study included 22 consecutive patients who underwent the Warden procedure for PAPVR between 2002 and 2018. The median age and body weight at operation were 27.5 months (interquartile range [IQR], 5.0-56.8 months) and 13.2 kg (IQR, 6.5-16.0 kg), respectively. The median follow-up duration was 6.2 years (IQR, 3.5-11.6 years). Results: There were no cases of early or late mortality. No patients had postoperative heart rhythm problems, except 1 patient who showed transient sinoatrial nodal dysfunction in the immediate postoperative period. Procedure-related complications requiring reintervention occurred in 5 patients, including 3 of 4 SVC stenosis cases and 2 pulmonary venous stenosis cases during follow-up. The rate of freedom from reintervention related to the Warden procedure was 75.9% at 10 years. Conclusion: In cases requiring extension or creation of an atrial septal defect to achieve a sufficient venous pathway, or interposition of an entire circumferential conduit between the SVC and right atrium due to the shortness of the SVC in the Warden procedure, stenotic complications of the venous pathway occurred. Careful observation of changes in the pressure gradient or anatomical stenosis is required in such patients.

Successful Repair of Critical Tricuspid Regurgitation Secondary to a Ruptured Papillary Muscle in a Neonate

  • Min, Jooncheol;Kim, Eung Re;Yang, Chan Kyu;Kim, Woong-Han;Jang, Woo Sung;Cho, Sungkyu
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.398-401
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    • 2014
  • Severe tricuspid regurgitation resulting from a flail leaflet is a rare cause of neonatal cyanosis. We report a neonate with profound cyanosis and severe tricuspid regurgitation caused by a rupture of the papillary muscle supporting the anterior leaflet, without other structural heart defects. Ductal patency could not be established. The repair of the tricuspid valve was performed after initial stabilization by using extracorporeal membrane oxygenation.