• Journal of Chest Surgery
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• v.5 no.1
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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.

• Journal of The Korea Institute of Healthcare Architecture
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• v.21 no.1
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• pp.27-36
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• 2015

Purpose : Ministry of Health & Welfare started to 'Comprehensive care ward' project for patient hospitalization in order to help the economic and medical By providing comprehensive care services through professional nursing staff since 2013. Many physical environments changes are expected by providing comprehensive care services. The purpose of this study is to investigate the comprehensive care services and identify the problems of the corresponding physical environment usage. Methods : Data were collected through research, field surveys, and expert interviews to analyze and investigate the physical environment of the 'Comprehensive care ward'. Results : Physical environments changes in accordance with the comprehensive care services provided in 'Comprehensive care ward' are being only partially achieved. It have to considered not only ward environmental improvement for nursing services provided directly to the patient, but Including nurses warehousing space, work space. Implications : Comprehensive care ward project is scheduled to be operational even some wards throughout the hospital since 2018. This study is basic research for architectural planning of the future ward with comprehensive care services in public hospital.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.1
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• pp.23-26
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• 2004

Caustic ingestion can produce a progressive and fatal injuries to esophagus, stomach and other organs. Reported exposure to acetic acid results injuries to gastrointestinal tract, hemolysis and disseminated intravascular coagulation is general, but causing hepatic necrosis by direct injuries are rare. A 47-year-old man visited our emergency medical center complaining odynophagia and abdominal pain after ingesting glacial acetic acid ($99\%$) with suicidal ideation. At the time of arrival, the patient complained mild abdominal pain but a few hours later the patient complained severe abdominal pain with markedly elevated liver enzymes. The Abdominal Computerized Tomography showed diffuse gastric wall edema and density of wedge shaped hypodense area in right hepatic dome showing focal hepatic necrosis without significant inflammation. This seems likely to be a direct effect of the noxious agent on hepatocyte involving the portal circulation.

• Journal of Korean Foot and Ankle Society
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• v.18 no.4
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• pp.222-226
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• 2014

Four patients with soft tissue defects around the ankle joint were covered with peroneal artery perforator-based propeller flaps. Using color Doppler sonography, the flap was designed by considering the location of the perforator and soft tissue defects. The procedure was then performed by rotating the flap by $180^{\circ}$. Additional skin graft was required in a patient due to partial necrosis, and delayed wound repair was performed in another patient with poor blood circulation at the distal part of the flap. The remaining patients did not have any complications and results were considered excellent. Good outcomes were eventually obtained for all patients.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.670-673
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• 2009

Purpose: Epidural abscesses and subdural empyemas after craniotomy are uncommon, potentially lethal, complications of neurosurgery. Patients with these complications may be difficult to manage and dural reconstruction in these patients are challenging. Methods: A 28 - year - old female patient showed recurrent intracranial infection after craniotomy for evacuation of a arachnoid cyst and subdural hematoma. Despite prolonged systemic antibiotic administration and a debridement of the subdural space, infection persisted, as evidenced by persistent fever, an elevated WBC count, CSF leakage, low CSF glucose level, and purulent wound discharge. The authors removed the previously applied lyophilized dura and transferred free omental flap to reconstruct the dura, obliterate the cyst and cover the cerebral hemisphere in the craniotomy defect. Microvascular anastomosis was between gastroepiploic and superficial temporal vessels. Results: The postoperative course was uneventful and flap survival was excellent. The infection - resistant omental tissue allowed sufficient blood circulation and dead space control. The patient was discharged 1 month after surgery and wound discharge or recurrence was absent during 13 months of follow up periods. Conclusion: The use of vascularized free omentum proved useful in cases of intractable cranial wound infection and cerebrospinal fluid leakages.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.58-60
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• 2019

Herein, we report a case of lung transplantation in a patient with profound preoperative hypercapnia, focusing on the cardiopulmonary bypass strategy used for brain perfusion during the operation. We applied the pH-stat method for acid-base regulation, and thereby achieved the desired outcome without any neurologic deficit.

• Journal of radiological science and technology
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• v.42 no.4
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• pp.265-270
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• 2019

Mammography is the most useful test for the early diagnosis of breast cancer. The MammoPad can be used for the purpose of reducing the pain felt by the patient due to the pressure of the breast. MammoPad cushion the pressure between the breasts and the equipment and reduce the patient's discomfort. A new material pad was fabricated to solve the problem of the H-pad which is currently in circulation. Quantitative evaluation of SNR and CNR and qualitative evaluation of imitation lesion using ACR Phantom were performed. In the quantitative evaluation, SNR and CNR of Non pad and Filter pad were not statistically significant.(p>0.05) In the qualitative evaluation, Fiber and Imitation lesion of H-pad and Filter pad were statistically significant(p<0.05), and all values of Calcification and Mass were not statistically significant. (p>0.05) In addition, Fiber, calcification, mass, and imitation lesion were not statistically significant in both Non pad and Filter pad.(p>0.05) Through this study, it was confirmed that the newly created Filter pad minimizes image quality degradation and can replace existing products.

• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.2
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• pp.27-35
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• 2019

Purpose: This study is to address the spacial composition of a standard ward and bedroom size for sake of infection control and efficient medical service. Methods: Spacial composition of a standard ward has been proposed by comparative analysis of 5 big hospitals' wards. Bedroom sizes have been explored on the ground of Health care facility regulations from Korea, USA, Australia and Canada. Of course, Literature and field survey have been conducted in order to draw out various bedroom sizes. Results: 16 basic and some other additional spaces have been proposed for the composition of hospital standard ward. Area of Single bedroom is $11.6m^2$, and that of multi-beded room is $7.4m^2$. Bed to bed Clearance is 1.5m, spacing between bedsize and hard wall is 0.9m in 1~2 beded room, 0.75m in 4-beded room. Space clearance between Foot side of bed and curtain is proposed as 0.3m and additional 0.9m is necessary for the circulation. Implications: The result of this study can be applied to the new cons.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.699-702
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• 2021

Extensive bone loss associated with severe vascular injury remains a challenge for lower extremity reconstruction. The fibular free flap has been utilized for many decades to reconstruct long-segment tibial defects. We present an unusual scenario of unilateral weight-bearing, wherein we salvaged the sole lower extremity by transfer of the fractured ipsilateral fibula and a bipedicled skin flap. A 38-year-old man sustained a severe crush injury in the right leg with loss of circulation. His left lower leg had a soft tissue defect measuring 20×15 cm with an exposed comminuted fracture and a 17-cm tibial defect, along with a segmental fracture of the fibula. Subsequently, we reconstructed the tibial defect by transferring a 17-cm-long section of the ipsilateral fibula. We covered the soft tissue defect with a bipedicled skin flap. The patient eventually began to ambulate independently after surgery.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.864-870
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• 1990

This study was undertaken to evaluate current technique of extracorporeal circulation by analyzing the results in 73 cases. We performed standard cardiopulmonary bypass using Polystan roller pump, bubble[Polystan] and membrane[Cobe] oxygenator. There were 42 males and 31 females. We studied the changes of hemoglobin. hemodynamics, speed of cooling and warming, methods of cannulation and ACT. Arterial cannula was inserted on ascending aorta except for 7 cases of femoral cannulation. Preoperative hemoglobin was 13.2 gm% and this value dropped to 7.5 gm% during perfusion. Blood pressure of 113 mmHg in systolic dropped 57mmHg in 10 minutes of perfusion and became 98 mmHg at the end of perfusion. Initial drop of blood pressure was marked in pediatric patient. Mean cooling time was 19.4 min[0.54 Q /min] and warming time was 34 minutes[0.25 Q /min]. During perfusion, ACT was maintained above 600 sec and 44 patient did not need additional Heparin.