• Archives of Plastic Surgery
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• 제33권1호
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• pp.61-66
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• 2006

The purpose of this study is to introduce the method of palate repair that combines minimal hard palate dissection and radical retropositiong of levator musculature, which was presented by Sommerlad. As this method presents, additional use of the operating microscope enables atraumatic and radical dissection, and it might provide more improved speech function to the patients. A total of 17 patients with cleft palate underwent Sommerlad's method from December 2003 to August 2004. The mean follow-up period was 4.5 months. The use of a microscope provided high quality variable magnification and good illumination at the operating field. Repair was carried out through incisions at the margins of cleft with mucoperiosteal flap elevation. Muscles were rearranged and repaired properly. It was unable to evaluate the improvement of speech because the patients were too young to learn meaningful speech. Average operating time including anesthetic induction time, V-tube insertion and recovery from anesthesia was 2 hours 45 minutes which was not quite different from conventional method's operating time. Oronasal fistula developed in 2 patients of them. One of them was healed spontaneously. As meticulous and radical muscle dissection was possible with Sommerlad's method, we could minimize the trauma to the muscular and neurovascluar structure. In addition, we expect better faculty of speech as a result of this method although longer follow-up time was unavailable.

• Journal of Chest Surgery
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• 제27권12호
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• pp.989-994
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• 1994

Between January 1986 and August 1993, 11 patients underwent surgical repair of ventricular septal defect [VSD] complicated with myocardial infarction. The ages of patients were ranged from 22 years to 83 years with a mean of 64 years. There were 8 male and 3 female patients. The preoperative cineangiograms of all patients were reviewed to measure both ventricular function and to evaluate coronary artery disease. The mean time interval between occurance of VSD and operation was 13 days. The operations were performed as soon as possible if there were hemodynamic derangement. Postmyocardial infarction VSD were repaired simultaneuously with coronary artery bypass graft in 3 patients, repaired with left ventricular aneurysmectomy in 6 patients, with left ventricular thrombectomy in 1 patient and with mitral valve chordae repair in 1 patient. There was no early death [within 30 days]. There were 6 postoperative complications; one with perioperative myocardial infarction, two with recurred VSD on postoperative 1 and 6 days respectively, two with lower leg embolism associated with intraaortic balloon pump insertion, one with wound infection. Of the complicated patients, 1 patient with lower leg embolism performed left above ankle amputation. Among two patients with recurred ventricular septal defect, one patient is doing well without problem. On follow up echocardiogram, the residual VSD was occluded completely. However another patient was with recurred VSD died 3 months after the operation because of congestive heart failure. Of the long term survivors, all patients are in NEW YORK Heart Association functional Class I or II. Although number of patients were small, our results of surgical closure of postmyocardial infarction VSD were favored to the others. Moreover, seven patients with preoperative cardiogenic shock among 11 were performed early operation after diagnosis of ventricular septal rupture. All of the patients were survived and doing well during the follow up period. Therefore early diagnosis with aggressive preoperative care with intraaortic balloon pumping and early operation seems to be very important for prevention of deterioration of vital organ.

• 한국항공우주학회지
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• 제41권12호
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• pp.959-966
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• 2013

이 논문에서는 설계정보가 없는 노후 항공기를 사용한 P-3CK 해상초계기 사업을 바탕으로, 끝단거리 부족 결함 수리를 위한 패스너 홀 구조특성 연구를 수행하였다. 이를 위해 끝단거리 결함이 많이 발생했던 낫셀 론저론 부분을 선택하고, 1.5, 1.8, 2.0배 끝단거리에 대한 정적 해석을 수행하여 보수적인 응력을 구하였다. 이 응력을 바탕으로 TWIST의 표준하중 스펙트럼을 적용하여 비행하중을 생성하고, 이 비행하중을 이용하여 균열성장 피로해석을 수행하였다. 이 결과를 통하여 P-3CK 사업 중 수리된 패스너 홀의 유효성을 평가하고 정비주기 및 기준을 설정하였다.

• Archives of Plastic Surgery
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• 제47권2호
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• pp.187-193
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• 2020

Upper limb nerve damage is a common condition, and evidence suggests that functional recovery may be limited following peripheral nerve repair in cases of delayed reconstruction or reconstruction of long nerve defects. A 26-year-old man presented with traumatic injury from a wide, blunt wound of the right forearm caused by broken glass, with soft tissue loss, complete transection of the radial and ulnar arteries, and a large median nerve gap. The patient underwent debridement and subsequent surgery with a microsurgical free radial fasciocutaneous flap to provide a direct blood supply to the hand; the cephalic vein within the flap was employed as a venous vascularized chamber to wrap the sural nerve graft and to repair the wide gap (14 cm) in the median nerve. During the postoperative period, the patient followed an intensive rehabilitation program and was monitored for functional performance over 5 years of follow-up. Our assessment demonstrated skin tropism and sufficient muscle power to act against strong resistance (M5) in the muscles previously affected by paralysis, as well as a good localization of stimuli in the median nerve region and an imperfect recovery of two-point discrimination (S3+). We propose a novel and efficient procedure to repair >10-cm peripheral nerve gap injuries related to upper limb trauma.

• Journal of Chest Surgery
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• 제48권1호
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• pp.7-12
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• 2015

Background: Mitral regurgitation is one of the leading causes of cardiovascular morbidity in pediatric patients with Marfan syndrome. The purpose of this study was to contribute to determining the appropriate surgical strategy for these patients. Methods: From January 1992 to May 2013, six patients with Marfan syndrome underwent surgery for mitral regurgitation in infancy or early childhood. Results: The median age at the time of surgery was 47 months (range, 3 to 140 months) and the median follow-up period was 3.6 years (range, 1.3 to 15.5 years). Mitral valve repair was performed in two patients and four patients underwent mitral valve replacement with a mechanical prosthesis. There was one reoperation requiring valve replacement for aggravated mitral regurgitation two months after repair. The four patients who underwent mitral valve replacement did not experience any complications related to the prosthetic valve. One late death occurred due to progressive emphysema and tricuspid regurgitation. Conclusion: Although repair can be an option for some patients, it may not be durable in infantile-onset Marfan syndrome patients who require surgical management during infancy or childhood. Mitral valve replacement is a feasible treatment option for these patients.

• Journal of Chest Surgery
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• 제49권1호
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• pp.15-21
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• 2016

Background: We aimed to evaluate the incidence, predictive factors, and impact of acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR). Methods: A total of 53 patients who underwent 57 TEVAR operations between 2008 and 2015 were reviewed for the incidence of AKI as defined by the RIFLE (risk, injury, failure, loss, and end-stage kidney disease risk) consensus criteria. The estimated glomerular filtration rate was determined in the perioperative period. Comorbidities and postoperative outcomes were retrospectively reviewed. Results: Underlying aortic pathologies included 21 degenerative aortic aneurysms, 20 blunt traumatic aortic injuries, six type B aortic dissections, five type B intramural hematomas, three endoleaks and two miscellaneous diseases. The mean age of the patients was $61.2{\pm}17.5years$ (range, 15 to 85 years). AKI was identified in 13 (22.8%) of 57 patients. There was an association of preoperative stroke and postoperative paraparesis and paraplegia with AKI. The average intensive care unit (ICU) stay in patients with AKI was significantly longer than in patients without AKI (5.3 vs. 12.7 days, p=0.017). The 30-day mortality rate in patients with AKI was significantly higher than patients without AKI (23.1% vs. 4.5%, p=0.038); however, AKI did not impact long-term survival. Conclusion: Preoperative stroke and postoperative paraparesis and paraplegia were identified as predictors for AKI. Patients with AKI experienced longer average ICU stays and greater 30-day mortality than those without AKI. Perioperative identification of high-risk patients, as well as nephroprotective strategies to reduce the incidence of AKI, should be considered as important aspects of a successful TEVAR procedure.

• 한국BIM학회 논문집
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• 제9권1호
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• pp.11-21
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• 2019

Recently, there is an increase in fire incidents in building structures. Due to this, the importance of fire-damaged buildings' safety diagnosis and evaluation after fire is growing. However, the existing fire-damaged safety diagnosis and evaluation methods are personnel-oriented, so the diagnostic results are intervened by investigators' subjectivity and unquantified. Thus, improper repair and reinforcement can result in secondary damage accidents and economic losses. In order to overcome these limitations, this study proposes using 3D laser scanning technology. The case analysis of fire-damaged building structures was conducted to verify the effectiveness of accuracy and manpowering by comparing the existing method and the proposed method. The proposed method using 3D laser scanning technology to obtain point cloud data of fire-damaged field. The point cloud data and BIM model is combined to inspect the fire-damaged area and depth. From inspection, quantified repair and reinforcement quantity take-off can be acquired. Also, the proposed method saves half of the manpowering within same time period compared to the existing method. Therefore, it seems that using 3D laser scanning technology in fire-damaged safety diagnosis and evaluation will improve in accuracy and saving time and manpowering.

• The Korean Journal of Pain
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• 제34권2호
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• pp.201-209
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• 2021

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures. Regional blocks might provide excellent analgesia and reduce complications in the postoperative period. We aimed to compare the postoperative analgesic effect of the ultrasound-guided transversalis fascia (TF) plane block versus the transmuscular quadratus lumborum (QL) block in patients undergoing unilateral inguinal hernia repair. Methods: Fifty patients enrolled in this comparative study and were randomly assigned into two equal groups. One group received an ultrasound-guided QL block. In comparison, the other group received an ultrasound-guided TF plane block. The primary outcome was the patient-assessed resting, and movement-induced pain on the numeric pain rating scale (NRS) measured at 30 minutes postoperatively. Secondary outcomes included the percentage of patients receiving rescue analgesia in the first postoperative day, ease of performance of the technique, and incidence of adverse effects. Results: There were no statistically significant differences in NRS at rest and with movement between the groups over the first 24 hours postoperatively. The proportion of patients that received postoperative rescue analgesics during the first 30 minutes postoperatively was 4% (n = 1) in the QL group compared to 12% (n = 3) in the TF group. However, the mean performance time of the TF block was shorter than that of the QL block, and the performance of the TF block appeared easier technically. Conclusions: The ultrasound-guided TF plane block could be as effective as the QL block in lowering pain scores and decreasing opioid consumption following non-recurrent inguinal herniorrhaphy.

• Clinics in Shoulder and Elbow
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• 제26권1호
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• pp.71-81
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• 2023

Background: This study evaluated the clinical and radiologic outcomes of onlay patch augmentation in rotator cuff repair for moderate-to-large tears in elderly patients. Methods: We reviewed 24 patients who underwent onlay augmentation with dermal allograft after arthroscopic rotator cuff repair from January 2017 to March 2020. Inclusion criteria were patients aged >65 years with tears >2.5 cm, who were followed for >12 months after surgery, and patients who could raise their arms above 90° preoperatively. American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, pain visual analog scale (VAS), and VAS for satisfaction were used as clinical outcomes. For the evaluation of cuff integrity, magnetic resonance imaging scans were performed every 3 months after surgery. The results were compared before and after surgery in all patients and between the retear and intact groups. Results: The average follow-up period was 16.38 months, and the mean age of patients was 71.05 years. All patients showed significant improvement in ASES score, Constant-Murley score, and pain VAS at the last evaluation. The average value of satisfaction VAS was 7.27/10. The retear rate was 25% (6/24) if Sugaya type 3 was categorized in the retear group, otherwise 16.7% (4/24), if Sugaya type 3 was categorized into the intact group. Irrespective of Sugaya type 3 being included in the retear group, there was no significant difference in outcome variables between the intact and retear groups during follow-up. Conclusions: In moderate-to-large rotator cuff tear in elderly patients, onlay patch augmentation improved clinical outcomes. Retear did not adversely affect clinical outcomes.

• 대한안전경영과학회지
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• 제25권3호
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• pp.73-81
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• 2023

This study uses FMECA (Failure Modes, Effects, and Criticality Analysis) and HAZOP (Hazard and Operability), which are widely applied in industrial areas, among risk assessment methods, and applies them to the same system. While FMECA evaluates system failure conditions and analyzes risks, HAZOP evaluates the system comprehensively by evaluating operational risks that may occur based on system parameters. According to data released by the Ministry of Land, Infrastructure and Transport, as of December 2021, the length of roads in Korea is 113,405 km, and the repair of guardrails that have expired must be fixed urgently in terms of traffic safety. Replacing all of these guardrails with new ones requires a very large cost, but if the guardrails are repaired with a vehicle equipped with the G-Save method, carbon emissions are reduced, the repair period is shortened, and great economic benefits can be obtained. However, risk assessment for guardrail coating vehicles has not been done so far. Focusing on this point, this study aims to evaluate the risk of these coating vehicles and describe the results. Finally, we found that the Risk Priority Numbers(RPN) in the FMECA risk assessment were greatly reduced, and 6 risk factors from HAZOP risk assessment and actions were taken.