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Long term resuls of De Vega tricuspid annuloplasty (삼첨판 성형술 [De Vega 술식]의 원격 성적에 대한 고찰)

  • 김병열
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.827-832
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    • 1993
  • From Jan 1982 through Dec.1991, thirty-three DeVega`s tricuspid annuloplasties were performed in association with mitral and combined mitral and aortic valve disease. Preoperatively,all of the patients were in NYHA functional class III or IV.There were one early death and 4 patients died during follow up period of 18 to 138 months [ mean follow up : 67.3 months ]. Nine patients required reoperation because of biological mitral valve failure at 4.7 to 11 years after tricuspid annuloplasty[TAP]. Among these patients,2 cases needed for reoperation of TAP due to loosening of suture material. Twenty four [86%] of the survivors were in NYHA functional class I or II after TAP.The actuarial survival rate for the TAP was 74% at 138 months. Rt atrial pressure of 9 reoperation cases were significantly decreased [P<0.05] compared with initial Rt.atrial pressure [ Mean period; 93.6 months].Doppler echocardiographic studies for tricuspid regurgitation were performed in 15 cases after TAP [Mean period: 42.3 months].These results showed significantly reduced [P<0.01] tricuspid annulus diameter and tricuspid regurgitation distance [ P<0.05 ].Our surgical experience that the DeVega`s TAP is a simple,safe,effective procedure and resulted in good hemodynamic improvement with moderate to severe functional tricuspid regurgitation.

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Surgical Reconstruction of the Severe Tongue Laceration with Mandibular Fracture in a Siberian Husky Dog

  • Lee, Jae-Hoon;Kim, Tae-Hoon;Yang, Wo-Jong;Kang, Eun-Hee;Chang, Hwa-Seok;Chung, Dai-Jung;Choi, Chi-Bong;Lee, Jeong-Ik;Kim, Hwi-Yool
    • Journal of Veterinary Clinics
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    • v.25 no.6
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    • pp.545-548
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    • 2008
  • A 3-year-old castrated male Siberian husky was presented for evaluation after being hit by a car. On physical examination, the dog showed open-mouth, displacement of mandible and hypersalivation with blood ting. The base of tongue was transected almost 80% on the bias from right dorsal side to the left ventral side. Radiography demonstrated separation of mandible symphysis, and fracture of right condyle and vertical ramus. After debridement of the necrotic tissue, tongue apposition with simple interrupted suture was performed. Mandibular symphysis, condyle and mandibular vertical ramus fractures were fixed using pin, cerclage wire, T-plate, and K-wires. The mouth was irrigated daily using chlorhexidine after surgery. The sutures that were loose here or untied at tongue were re-sutured under sedation. The transected tongue was healed and recovered its normal movement after 6 weeks.

Long V-Y advancement technique for large nipple reconstruction in Asian women

  • Jang, Nam;Kim, Junekyu;Shin, Hyun Woo;Suk, Sang Woo
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.44-48
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    • 2021
  • Previously reported nipple-areolar complex reconstruction (NAR) methods involve multiple incisions and wide skin redraping, which increase retraction forces and heighten the risk of nipple-areolar complex (NAC) flattening. We introduce a NAR method using the long V-Y advancement technique that can overcome these disadvantages. A V-shaped flap is designed with the width of the flap base 4-5 mm larger than the diameter of the normal nipple. The flap length is designed to be at least 2.5 times its width. Dissection is performed to the top of the artificial dermal matrix or muscle layer. The nipple is constructed with the same projection as the contralateral side by folding the elevated flap. The tip of the elevated flap is apposed in the middle of the donor defect to minimize the deformity during donor site closure. A 3-point skin suture is applied to the upper third of the folded flap to mold its shape. Using this long V-Y advancement technique, we successfully decreased skin tension in NAC flaps and improved the maintenance of reconstructed nipple projection. The long V-Y advancement technique provides an easy, simple NAR method, effectively maintaining longer nipple projections and reducing breast deformities, especially in Asian women with relatively large nipples.

Flexor Digitorum Avulsion Secondary to Enchondroma of the Distal Phalanx (원위지골 내연골종에 이차적으로 발생한 심수지 굴곡건의 견열손상)

  • Moon, Sung Hoon;Hong, Chul Gie;Lee, Woon Sang;Park, Jin Woo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.447-451
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    • 2019
  • This case report describes the unusual occurrence of a flexor digitorum profundus avulsion secondary to an enchondroma of the distal phalanx of the middle finger. The enchondroma was treated by simple curettage with an autogenous bone graft harvested from the olecranon. The avulsed bone fragment was reattached to the distal phalanx using the pull-out suture technique. Bony union and full function of the digit were achieved.

Emergency Trephination Site of Acute Subdural Hematoma (급성 경막하 혈종에서 응급 두개골 천공의 위치)

  • Moon, Soo-Hyeon;Kim, Geun-Hoe;Kwon, Taek-Hyun;Park, Youn-Kwan;Chung, Hung-Seob;Suh, Jung-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.659-663
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    • 2000
  • The motality rate of acute subdural hematoma(ASDH) associated with closed head injury is high in spite of recent advances in neurosurgery. Many variables in regard to outcome of ASDH have been assessed. But among them, intracranial pressure(ICP) control and the time interval between injury and operative evacuation are the only things that can be affected by doctor. We introduced a simple method to the management of ASDH for reducing the time interval between injury and operation. When the immediate decompressive operation of ASDH was impossible by any causes, we made a burr hole at the center of hematoma, usually on 2-3cm above temporal squama and 1-2cm behind coronal suture under local anesthesia before main operation. Partial hematoma evacuation was achieved through the burr hole and it was effective in preventing further worsening of patients neurological status before main operation. Prompt hematoma evacuation through the burr hole seemed to be effective in delaying secondary ischemic brain damage and made easy to closing the dura opening and replacement of the bone flap at the end of main decompressive operation. This easy method may reduce the time interval between injury and operation. We represent surgical technique with two cases of ASDH managed with this simple method.

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Direct Brow Lift Combined with Suspension of the Orbicularis Oculi Muscle

  • Lee, Jeong Woo;Cho, Byung Chae;Lee, Kyung Young
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.603-609
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    • 2013
  • Background Although the conventional direct brow lift operation provides a simple means of managing lateral brow ptosis, the scars produced have been unacceptable. However, using the modifications proposed here, scarring showed remarkable improvement. This article reviews our experiences with the presented technique, mainly with respect to postoperative scarring. Methods Measured amounts of supra-eyebrow skin and subcutaneous fat were excised en bloc in the conventional manner under 'hyper-hydrated' local infiltration anesthesia. The lower flap and the edge of the upper flap were undermined above the muscular plane, and the orbicularis oculi muscle was directly suture-plicated and suspended upward to the distal frontalis muscle. Skin closure was performed in a basic plastic surgical manner. Results From April 2007 to April 2012, a consecutive series of 60 patients underwent surgery using the above method. The average width of the excised skin was 8 mm (range, 5-15 mm) at the apex of the eyebrow. Preoperative complaints were resolved without occurrence of significant complications. The surgical scars showed remarkable improvement and were negligible in the majority of the cases. Conclusions The direct brow lift operation combined with plication/suspension of the superior and lateral portion of the orbicularis oculi muscle provides a simple, safe, and predictable means of correcting lateral brow ptosis. The scars were acceptable to all of the patients. For proper management of the frontalis tone, upper blepharoplasty and/or repair of eyelid levator function must be considered in addition to brow lift procedures.

Verification of wrinkle improvement effect by animal experiment of suture for skin wrinkle improvement by applying CO2 gas and RF radio frequency (CO2 gas와 RF 고주파를 적용한 피부 주름 개선용 봉합사 동물 실험에 따른 주름 개선 효과 검증)

  • Jeong, Jin-Hyoung;Shin, Un-Seop;Song, Mi-Hui;Lee, Sang-Sik
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.13 no.3
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    • pp.226-234
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    • 2020
  • As the average life expectancy of human beings is extended in addition to the entry of the aging society, there is a tendency for the interest in the appearance of men and women in modern society to increase. The most external judgment of human aging is the wrinkles on the facial skin. People are undergoing various procedures to have clean, wrinkled, and resilient healthy skin. Many thread lifting procedures are being implemented because they tend to want simple and effective procedures during the procedure. In this study, in order to improve lifting effect in thread lifting, animal experiments were conducted to confirm the improvement of wrinkles by injecting RF high frequency and CO2 gas into existing PDO suture procedures. The experimental groups consisted of natural aging groups, PDO treatment groups, groups with RF high frequency in PDO procedures, groups with CO2 gas injected into PDO procedures, and groups with CO2 gas and RF injected simultaneously into PDO procedures. The individuals in the natural aging group had an average wrinkle depth of 0.408mm before the procedure, and the average wrinkle depth of the 10th week was 0.68mm. The depth of wrinkles in the PDO treatment group averaged 0.384mm before the procedure, and 0.348mm on the 10th week after the procedure. The average crease depth of pre-procedure objects injected with RF high frequency in PDO was 0.42mm, and the average crease depth for 10 weeks was 0.378mm. The average crease depth of the CO2 gas injected into the PDO was 0.4mm before the procedure, and the average crease depth was reduced to 0.332mm in the 10th week after the procedure. On average, the number of objects injected with CO2 gas and RF high frequency in the PDO procedure decreased to 0.412mm before and 0.338mm in the 10th week after the procedure. The procedure of injecting CO2 gas and RF into the PDO suture showed the highest reduction rate of 17.96%.

Epicardial Repair of Acute Atrioventricular Groove Disruption Complicating Mitral Valve Replacement - A case report - (승모판막치환술 후 발생한 급성 제1형 좌심실 파열에 대한 심외막적 봉합 - 1예 보고 -)

  • Cho, Kwang-Ree;Kang, Jae-Geul;Jin, Sung-Hoon
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.855-858
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    • 2007
  • A left ventricular rupture might be one of the most disastrous complications after a mitral valve replacement. An acute atrioventricular groove rupture (type I) was detected in a 54-year-old female diagnosed with a mitral stenosis combined with severe tricuspid regurgitation. She had a prior medical history of an open mitral commissurotomy in Japan at 30 years ago. The surgical findings suggested that the previous procedure was not a simple commissurotomy but a commissurotomy combined with a posteromedial annuloplasty procedure. After a successful mitral valve replacement and a measured (De Vega type) tricuspid annuloplasty, the weaning from a cardiopulmonary bypass was uneventful. However, copious intraoperative bleeding from the posterior wall was detected and the cardiopulmonary bypass was restarted. Exposure of the posterior wall of the left ventricle showed bleeding from the atrioventricular groove 3 cm lateral to the left atrial auricle. Under the impression of a Type I left ventricular rupture, epicardial repair (primary repair of the Teflon felt pledgetted suture, continuous sealing suture using auto-pericardial patch and application of fibrin-sealant) was attempted. Successful local control was made and the patient recovered uneventfully. The patient was discharged at 14 postoperative days without complications. We report this successful epicardial repair of an acute type I left ventricular rupture after mitral valve replacement.

The Clinical Analysis of Patent Ductus Arteriosus (동맥관개존증의 임상적 고찰)

  • 박상섭
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.510-517
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    • 1988
  • With the ligation of a patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease, and treatment of the patent ductus is representative of the rapid advance made in thoracic surgery in the last 40 years. We have had clinical experiences about 36 cases of this in the department of Thoracic & Cardiovascular surgery, Pusan Paik Hospital, Inje medical college from March 1891 to June 1987. And the results were summarized as follows. 1. There were 11 males, 25 females. The age range of the patients were from 8 months to 36 years with the mean age of 7.9 years. 2. The chief complaints of the patients on admission were frequent URI[50%], dyspnea on exertion[29.8%], chest pain[11.1% k 1%], growth retardation[2%], cough[2.8%], anorexia[2.8%]. But there were 11 patients[30.6%] having no subjective symptoms. 3. In auscultation, the usual continuous machinery murmur was noticed in 30 patients[83.3%], only systolic murmur in 6[16.7%]. 4. In the preoperative chest P-A views, there were noticed cardiomegaly in 20 cases, enlarged pulmonary conus and / or pulmonary plethora in 22 patients[61.1%]. 5. In the preoperative EGG findings, there were noticed pattern of LVH in 8 patients[22.2`], RVH in 2[5.6%], BVH in 4[11.5%] and normal in 19[52.89o]. 6. The size of PDA[mean] was 9.5 mm[length] and 8.8 mm[width], the range of length was from 4 to 29 mm and the range of width was from 4 to 18 mm. 7. There were noticed 6 cases which were combined with other anomalies[VSD in 2 cases, Coarctation of aorta in 2, Mitral regurgitation in 1, and AP window in 1]. 8. On operation, simple ligation of the ductus was performed in 30 cases[83.3%], division and suture-ligation in 5[13.9%]. 9. Postoperative complications were noticed in 4 cases[pneumonia in one case, wound infection or disruption in 3], but there were no mortality.

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Calcific Tendinitis of Shoulder Associated with Intraosseous Involvement -A Case Report- (골내 침범을 동반한 견관절 석회화 건염 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Park, Man-Jun;Kim, Jeong-Cheol
    • Clinics in Shoulder and Elbow
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    • v.14 no.2
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    • pp.242-247
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    • 2011
  • Purpose: We present an atypical case of calcific tendinitis of the shoulder with intraosseous loculation. Materials and Methods: A 59 year-old female complained of acute exacerbation of chronic left shoulder pain and restricted range of motion. Simple radiographs showed a subacromial calcific deposit and magnetic resonance imaging revealed cortical erosion with intraosseous extension of calcific material mimicking infection or tumor. She was managed with arthroscopic excision of the calcific deposit, curettage of the intraosseous lesion and subsequent rotator cuff repair with a suture anchor. Results: Her acute pain promptly subsided. Her rehabilitation was uneventful and she gained full range of motion. Radiographs five months after the operation showed no recurrence of calcific material. Conclusion: Calcific tendinitis of the shoulder can present with a variety of images involving the adjacent bone. The correct recognition of this disorder may avoid unnecessary investigation and treatment.