• Title/Summary/Keyword: Incompetence

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Reconstructive Surgery for Mitral Incompetence Report of 10 Cases (승모판 폐쇄부전에 대한 판막성형술의 성적: 10례 보고)

  • O, Sang-Jun;Kim, Geun-Ho
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.62-68
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    • 1985
  • 10 patients with mitral regurgitation associated with various congenital cardiac anomalies were treated by reconstructive techniques in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the period of 2 years from 1982 to 1984. There were mitral valvular cleft in one case, chordae tendineae rupture associated with congenital multiple cardiac-anomalies [VSD, PDA, prolapse of aortic non-coronary cusp through VSD] in one case, elongated chordae tendineae after removal of left atrial myxoma in one case, and mitral annular dilatation associated with VSD in 3 cases, large PDA in 2 cases, aortic regurgitation [bicuspid valve] in one case, and unknown origin in one case. Owing to the various pathology above mentioned, reconstructive surgical approach to mitral incompetence is accordingly complicated and a combination of the following different procedures were properly used case by case, that is, suture of chordae tendineae, shortening of elongated chordae tendineae, closure of VSD, ligation of PDA, aortic valvuloplasty, mitral annuloplasty with mattress suture, etc. All patients were survived and they have been excellent postoperative results.

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Surgical Repair of Aortic Incompetence using Autologous Pericardium - A Case Report - (자가 심낭편을 이용한 대동맥판 폐쇄 부전의 수술적 교정;1례 보고)

  • 우석정
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1157-1160
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    • 1992
  • Aortic valve repair with the use of tailored autologous pericardial extension to the native cusp was performed in one patient with rheumatic aortic valve incompetence. The patient was a 10-year-old girl with Grade II aortic regurgitation and tiny postoperative recannalization of the patent ductus arteriosus. The left aortic coronary cusp appeared to be a little thickened and a cicatrical shortening of the distance between the free edge of the cusp and its annular attachment. A semilunar shaped patch of autologous pericardium, treated with glutaraldehyde solution[6 minutes in 0.6% solution] was sutured along the free edge of the left coronry cusp. Postoperative recovery was uneventful. Echocardiography 8 months later showed Grade I aortic regurgitation. She is now conducting as usual life.

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Interim palatal lift prosthesis as a constituent of multidisciplinary approach in the treatment of velopharyngeal incompetence

  • Raj, Neerja;Raj, Vineet;Aeran, Himanshu
    • The Journal of Advanced Prosthodontics
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    • v.4 no.4
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    • pp.243-247
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    • 2012
  • The velopharynx is a tridimensional muscular valve located between the oral and nasal cavities, consisting of the lateral and posterior pharyngeal walls and the soft palate, and controls the passage of air. Velopharyngeal insufficiency may take place when the velopharyngeal valve is unable to perform its own closing, due to a lack of tissue or lack of proper movement. Treatment options include surgical correction, prosthetic rehabilitation, and speech therapy; though optimal results often require a multidisciplinary approach for the restoration of both anatomical and physiological defect. We report a case of 56 year old male patient presenting with hypernasal speech pattern and velopharyngeal insufficiency secondary to cleft palate which had been surgically corrected 18 years ago. The patient was treated with a combination of speech therapy and palatal lift prosthesis employing interim prostheses in various phases before the insertion of definitive appliance. This phase-wise treatment plan helped to improve patient's compliance and final outcome.

Reconstruction of Velopharyngeal Function after Resection of Lateral and Superior Oropharyngeal Cancer (상외측 구인두암 절제술 후 구개인두기능의 재건)

  • Lee, Hyoung Gyo;Tark, Min Soong;Kim, Cheol Hann;Shin, Ho Sung;Kang, Sang Gue;Lee, Young Man
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.546-551
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    • 2006
  • Purpose: The reconstruction of oropharyngeal defect after cancer surgery is very difficult because of their complicated structure and the functional importance to prevent velopharyngeal incompetence. In this article we investigated affecting factors of velopharyngeal function after reconstruction and a fundamental rule of reconstruction for saving their functions such as swallowing, speeching and breathing. Methods: We classified 18 patients into three group under Kimata's grouping. Type I defect(6 patients) was healed by primary closure or secondary intention. In Type II or III defect, two operation methods were used - the folded flap(8 patients) and modified Gehanno method(4 patients), which include a lateral-posterior pharyngeal rotation-advancement flap. We evaluated wound dehiscence between the flap and the soft palate, speech intelligibility using Hirose's method, regurgitation during oral feeding, and hypernasality. Results: Most of type I or II defects patients recovered satisfactory velopharyngeal function. But, in patients with type III defects we found wound dehiscence, worse speech function, and common velopharyngeal incompetence. Conclusion: The large defect size and presence of wound dehiscence are major factors of postoperative velopharyngeal function. We conclude that folded flap or modified Gehanno method is a good reconstructive operation method for broad contact between the flap and defect site, preventing wound problem.

Effect of speech therapy of patient with Velopharyngeal incompetence using CPAP (CPAP를 활용한 비인강폐쇄부전 환자의 언어치료 효과)

  • Oh Yoo-Kyung;Lee Yong-keun;Park Rae-Yon;Kim In-Soo;Shin Hyo-Keun;Kim Hyun-Gi
    • Korean Journal of Cleft Lip And Palate
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    • v.8 no.1
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    • pp.39-44
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    • 2005
  • Velopharyngeal incompetence(VPI) is that soft palate and muscle of posterolateral pharyngeal wall can not close velopharyngeal port properly. Thing that prior to treatment for patient with VPI is to evaluation about nasopharyngeal closing function. This data is important for making a treatment plan and assesment of treatment effect to improve nasopharyngeal closing function. There are two ways of VPI assessment. The one is subjective method by auditory finding, the other is objective method by using equipment for language test. Using only subjective way is not adequate for evaluation of VPI because of low trust, so doing both two methods simultaneously help to make a diagnosis and assessment exactly. CPAP is effective method to treat hypernasality. This new treatment technique intensify oropharyngeal muscle for nasopharyngeal closing by direct resistance training. Becase conventional treatments have limitation, so many research about treatment effectiveness of CPAP are being studied. This study aims that we compare our result from Korean VPI patients with result about treatment effect in other advanced country, to make CPAP Treatment Questionares and to find ways that improve oropharyngeal closing function an[1 maximally increase language treatment effect.

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A Case Report of Postabortal Syndrome Patient (유산 후 산후풍 환자 1례에 대한 임상보고)

  • Kim, Se-Hwa;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Kyung-Sub;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.27 no.4
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    • pp.97-108
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    • 2014
  • Objectives: This study is to report the clinical effect of oriental medicine on a patient suffering from postabortal syndrome with somatic pain disorder, Qi deficiency and depression. Methods: The patient had a miscarriage by cervical incompetence in 24 weeks' gestation even though she had operated cervical cerclage in 20 weeks' gestation. The patient received herbal medication, acupuncture, moxibustion during 20 days of outpatient treatment. The clinical effects were evaluated through VAS (Visual Analogue Scale) and EPDS (Edinburgh Postnatal Depression Scale Test). Results: The clinical symptoms of somatic pain and Qi deficiency were reduced during the treatment. The EPDS score also decreased from 19 points (high risk level) to 8 points (low risk level). Conclusions: This case study showed that herbal medicine, acupuncture and moxibustion treatment appeared to effectively reduce postabortal syndrome. Since patients previously experienced cervical incompetence tend to have habitual abortion for next pregnancy, further long term observation and preventive treatment are needed in this case for next safe pregnancy and childbirth.

Design and Evaluation of Blending Algorithm for Rate Adaptive Pace: Simulation Study (심박수 적응형 심박 조율 알고리즘 설계 및 평가: 시뮬레이션 연구)

  • Myoung, Hyoun-Seok;Lee, Kyoung Joung
    • Journal of Biomedical Engineering Research
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    • v.40 no.1
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    • pp.32-37
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    • 2019
  • In this study, we designed a blending algorithm for rate adaptive pacing for cardiac pacemaker. Generally, rate adaptive pacing (RAP) is applied to patients whose heart rate does not rise during exercise for chronotropic incompetence (CI) patient. It is very important to develop an algorithm for RAP that can be properly applied to CI patients. In order to design an RAP algorithm we used dual sensors. Firstly, we designed a bio-signal measurement system based on the dual sensors, which are accelerometer and respiratory system. Secondly, we conducted treadmill test for the simulation experiment while using 3-lead ECG as reference. Finally, we designed a blending algorithm based on activation state of the dual sensors. The proposed blending algorithm was subdivided into three sections based on the accelerometer signal, which are rapidly increased section (W1), hardly changed section (W2), and decreased section (W3). Each weight is set aside for each section. To evaluate this algorithm, ten healthy adult males were participated. The correlation and Root Mean Square Error between the proposed algorithm and the reference were compared, and shown to be r=0.88 and 2.82 bpm, respectively. These results show that the proposed blending algorithm of dual sensors enables proper tracking of the heart rate during exercise. Also, it shows the possibility that the proposed blending algorithm can be applied to improve quality of life of the chronotropic incompetence patient.

Grading and Evaluation of Submucosal Cleft Palate (점막하구개열의 분류와 평가에 대한 고찰)

  • Kim, Hyun-Soo;Kim, Soung-Min;Oh, Jin-Sil;Seo, Mi-Hyun;Myoung, Hoon;Lee, Jong-Ho;Choi, Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.15 no.1
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    • pp.39-50
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    • 2012
  • A submucous cleft palate(SMCP) is characterized by a midline deficiency or lack with/without incorrect positioning of muscular tissues in the soft palate, and by a bony defect in the midline or the center of the hard palate. Velopharyngeal incompetence(VPI) related to this SMCP has been managed by various surgical and prosthetic techniques. Because the individual diagnosis and treatment of SMCP patients was not easy to the speech pathologist and to the maxillofacial reconstructive surgeons, and for the better understanding and for the ideal approaches to the SMCP patients, we reviewed several recent articles about grading system in the SMCP caused by VPI, and summarized in this review article.

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Corrected transposition of the great arteries associated with severe tricuspid insufficiency: one case report (삼첨판막 폐쇄부전을 동반한 선천성 교정형 대혈관전위증치험 1례 보)

  • Kim, Chi-Gyeong;Na, Beom-Hwan;Lee, Hong-Gyun
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.362-370
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    • 1984
  • The term corrected transposition of great arteries [hereafter referred to as corrected TGA] of the heart in which there is both a discordant atrio-ventricular relationship and transposition of the great vessels. Usually situs solitus is present, while the ventricles are inverted showing an l -loop. The great vessels are transposed and in the l-position so that the pulmonary artery arises from the right-sided morphological left ventricle and the anteriorly l- transposed aorta arises from the left-sided morphological right ventricle yielding an SLL pattern. In the majority of cases, associated lesions are common. The most frequent are ventricular septal defect, obstruction to the pulmonary outflow tract, tricuspid valve incompetence and atrio-ventricular conduction abnormalities. In the rare cases, no associated conditions are present and hemodynamic pathways are normal. In the report, we present one case of a 20 year-old male having corrected TGA associated with severe tricuspid valve incompetence, was corrected by tricuspid valve replacement, directly developed a supra-ventricular tachycardia but was controlled by calcium-entry blocker, verapamil, successfully.

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Study of Nasalance for Normal Korean Adults using Nasometer II (비음측정기를 사용한 정상 성인의 비음도에 관한 연구)

  • Kim, Seong-Il;Baik, Jin-Ah;Shin, Hyo-Keun;Kim, Oh-Hwan
    • Speech Sciences
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    • v.7 no.3
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    • pp.219-228
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    • 2000
  • Assessment of speech nasality provides important information for the treatment of velopharyngeal incompetence. Objective procedures may be used to assess velopharyngea1 function, in examples Nasometer, Aerodynamics, x-ray, Electromyography, Nasoendoscopy and Videofluoroscopy etc. The aim of this study was to obtain comprehensive nasalance data for Korean adults, aged 20 years and to investigate any gender differences within that age group using Nasometer II. The results were as follow: (1) The nasalance of the vowels(/a/, /i/, /e/, /o/, /u/, /ja/, /je/, /wi/) in the group of adults was higher in females than in males (p<0.05). (2) The nasalance of the plosives (/p/, /$p^h$/, /p'/, /t/, /$t^h$/, /t'/, /k/, /$k^h$/, /k'/) in the group of adults was higher in females than in males (p<0.05). (3) The nasalance of the affricatives (/c/, /$c^h$/, /c'/) in the group of adults was higher in females than in males (p<0.05). (4) The nasalance of the fricatives (/s/, /s'/, /$\int$/) in the group of adults was higher in female than in males (p<0.05). (5) There was no statistically significant effect for the nasalance of nasal consonants (/m/, /n/, /$a{\eta}$/).

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