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Surgical Correction of Peritoneopericardial Diaphragmatic Hernia with Hepatic Necrosis in a Himalayan Cat (히말라얀 고양이에서 간괴사를 동반한 복막심낭횡격막 허니아의 외과적 치료)

  • Kim, Joon-young;Jeong, Soon-wuk;Park, Bo-yeon;Go, Hiw-gon;Yoon, Hun-young;Jeong, Man-bok;Han, Hyun-jung;Min Hwang;No, Byung-kuk
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.45-48
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    • 2004
  • A five months old, female Himalayan cat was referred to the Veterinary Medical Teaching Hospital at Konkuk University, because of suspecting peritoneopericardial diaphragmatic hernia (PPDH). After consecutive examination, the patient was diagnosed as PPDH and hepatic dysfunction. In spite of medical therapy for a month, the serum chemistry profiles for liver enzymes (aspartate transferase: 469 U/L, alanine transferase: above analysis, gamma-glutamyl transferase: above analysis) did not decrease to the normal range. In operation, some of liver was necrotized and was adhesive to diaphragm, these were gently dissected from thoracic structures, and resected. After debriding, the edges of the defect of diaphragm were closed with a simple continuous suture pattern. One month after operation, the cat had normal condition, recovery was uncomplicated, and the serum chemistry profiles for liver enzymes decrease to the normal range.

The Effective Reduction Method of Unstable Zygomatic Arch Fracture with Thermo-Splint (Thermo-splint를 이용한 불안정한 관골궁골절에 대한 효과적인 고정방법)

  • Kim, Sun Heum;Lee, Soo Hyang;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Song, Wu Chul
    • Archives of Plastic Surgery
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    • v.35 no.1
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    • pp.110-115
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    • 2008
  • Purpose: The objective of this study is to propose an effective management of unstable zygomatic arch fracture. The reduction methods of arch fracture were relatively simple but the maintenance of reduction state is very troublesome. On this, authors introduce an effective management method of unstable zygomatic arch fracture. Methods: Authors experienced 23 cases of unstable segmental zygomatic arch fractures and used Thermo-splint in all cases. All the arch fractures were reduced through Gillies' approach under the general anesthesia. After the reduction, the most effective suspension points were marked on the covering skin of the fractured arch. A needle of heavy nonabsorbable suture material was inserted toward the marking site under the reduced zygomatic arch. And then Therm-splint was dipped in the hot water, and we got the splint pattern of patient face. Reshaped Thermo-splint was trimmed and fixated with previous suspension suture materials. More additive suspension was done if necessary. The splint was applied for in two to three weeks postoperatively. Results: In all the cases, good cosmetic and functional results were observed without severe complications. There were 4 cases of incomplete reductions but they also had no specific problems. There were no facial nerve symptom and scar(stitch mark). Postoperative slight tenderness and trismus were completely subsided after removal of the splint. Conclusion: The Thermo-splint safely protect and maintain the postoperative reduction state. The application, maintenance and removal were easy and simple. It could be reformed to any contour of face and had enough rigidity for supporting. Above all these things, effective prevention of displacement and easy manipulation were significant merit. Authors experienced good results with Thermo-splint, and would introduce it for another method of management of zygomatic arch fracture.

Reconstruction Techniques for Tissue Defects Formed after Preauricular Sinus Excision

  • Lee, Myung Joon;Yang, Ho Jik;Kim, Jong Hwan
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.45-49
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    • 2014
  • Background Preauricular sinuses are congenital abnormalities caused by a failure of fusion of the primitive tubercles from which the pinna is formed. When persistent or recurring inflammation occurs, surgical excision of the infected tissue should be considered. Preauricular defects inevitably occur as a result of excisions and are often difficult to resolve with a simple suture; a more effective reconstruction technique is required for treating these defects. Methods After total excision of a preauricular sinus, the defect was closed by a plastic surgeon. Based on the depth of the defect and the degree of tension when apposing the wound margins, the surgeon determined whether to use primary closure or a posterior auricular flap. Results A total of 28 cases were examined. In 5 cases, including 2 reoperations for dehiscence after primary repair, reconstruction was performed using posterior auricular transposition flaps. In 16 cases of primary closure, the defects were closed using simple sutures, and in 7 cases, closure was performed after wide undermining. Conclusions If a preauricular defect is limited to the subcutaneous layer and the margins can be easily approximated, primary closure by only simple suturing may be used to perform the repair. If the defect is deep enough to expose the perichondrium or if there is tension when apposing the wound margins, wide undermining should be performed before primary closure. If the extent of the excision exposes cartilage, the procedure follows dehiscence of the primary repair, or the tissue is not sufficiently healthy, the surgeon should use a posterior auricular flap.

CLINICAL STUDY OF BLEPHAROPLASTY USED BY SUTURED METHOD (봉합법을 이용한 중검술의 임상적 연구)

  • Park, Kwang;Seo, Ku-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.3
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    • pp.353-357
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    • 1996
  • One of the most common cosmetic surgery, the blepharoplasty can be divided two method. there were incisional method and sutured method. Authors try to understand the anatomic difference between the oriental upper eyelids and apply the surgical techniques of constructing upper eyelid crease of oriental case effectively. And we discussed the postoperative complications of the blepharoplasty and proposed the solve of these problems. The sutured method of blepharoplasty was more simple technique than conventional incision method and had low occurrence of complications. Even though slight recurrence, suture method was more esthetic due to no scar formation.

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Surgical Treatment of Atrial Septal Defect: Secundum Type (심방중격결손증의 외과적 요법)

  • 안광필;이영균
    • Journal of Chest Surgery
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    • v.8 no.2
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    • pp.81-88
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    • 1975
  • Up to October 31, 1975, 34 cases of atrial septal defect, secundum type, operated in this department, were presented. This is 23.2% of all congenital heart diseases, operated utilizing cardiopulmonary bypass, in this department during this period [34 out of 146]. Out of 34 cases, 32 cases are pure ostium secundum type and one case is sinus venosus and another one is ostium secundum type with partial anomalous pulmonary venous drainage. Six cases of endocardial cushion defect and 3 cases of trilogy of Fallot are excluded in this report. All 34 cases are repaired under direct vision utilizing extracorporeal circulation. Among 34 cases of atrial septal defect, 16 cases are male, and 18 cases are female. Their ages range between 3 to 48 years, but over 59% of the cases are below the ages of 20 years. Thirty-two cases are repaired by direct sutures while 2 cases are repaired with Teflon patches. The average perfusion time is 30 minutes; the shortest 12 and the longest 81 minutes. The number of the defect is single in 31 cases, double in 2 cases, triple in one case. But the associated defect except the main defect are so small as can be closed by simple direct suture. The size of the defect is average $12cm^2$; the smallest 0.7 and the largest $25cm^2$. The surgical mortality is 2 cases [5.6%] and other cases are found to be excellent in the follow up studies.

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Surgical Treatment for Dissecting Aneurysm of the Aorta using Sutureless Intraluminal graft (무봉합 혈관내 인조이식혈관을 이용한 박리성 대동맥류의 수술요법)

  • 이재원
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.305-313
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    • 1985
  • Surgical therapy for dissection of the aorta has had a high mortality. One contributing factor has been hemorrhage from the prosthesis and the suture lines. Recently, a new method of treatment with an intraluminal graft that requires no end-to-end anastomosis has been developed. Of the four patients with dissecting aneurysm of the aorta treated by inserting sutureless ringed intraluminal graft at the Department of Thoracic and Cardiovascular Surgery, S.N.U.H., three were DeBakey type I [one with associated aortic insufficiency] and the other was DeBakey type III. Suspected etiology of the dissection was Marfan`s syndrome in one and hypertension in the others. Total cardiopulmonary bypass was utilized in repairing dissecting aneurysms of the ascending aorta [type A] and simple aortic crossclamping was used for the patient with dissecting aneurysm of the descending aorta. The basic technique consists of inserting the whole ringed graft into the true lumen of the dissected aorta and circumferentially ligating the aorta against the groove in the rings. The proximal ring of the graft effectively stabilized the flail aortic valve in patient with aortic insufficiency associated with dissection of the ascending aorta. There were no hospital deaths and one patient with type III dissecting aneurysm developed postoperative paraparesis and renal insufficiency which was resolved. Follow-up has been from 1 month to 16 months with no evidence of prosthetic problems, such as erosion, migration, or thrombosis.

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Surgical Treatment of Endocardial Cushion Defects (A Report of 5 Cases) (심내막상 결손증 치험 5례)

  • 류지윤
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.574-582
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    • 1988
  • Endocardial cushion defects is a rare congenital heart disease. We experienced two complete endocardial cushion defects[ECD] and three partial ones, which were successfully repaired between 1986 and 1987. In a patient of complete ECD, associated with secundum ASD, Pulmonary stenosis and Down`s syndrome, the atrial and ventricular septal defects were closed separately with bovine pericardium and Dacron patches respectively, and then pulmonary stenosis was relieved by transannular patch widening in addition to valvotomy and infundibulectomy. In another patient with complete ECD, small interventricular communication was closed with simple suture with pledget and primum ASD was closed with pericardial patch. In first patient of partial ECD, primum atrial septal defect was closed with pericardial patch. In second patient of partial ECD, associated with secundum ASD, direct closure of secundum ASD and patch closure of primum ASD were performed. In third patient of partial ECD, associated with patent foramen ovale[PFO], primum ASD was closed with bovine pericardial patch and PFO was closed directly. In all patient except third patient of partial ECD, mitral clefts were closed with three or four 5-0 prolene interrupted sutures. Transient A-V dissociation developed postoperatively in two patients and transient nodal rhythm developed postoperatively in other two patients. Heart failure in complete ECD with Down`s syndrome was overcome with medical treatment.

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Arthroscopic Cannulated Screw Fixation of Avulsion Fracture of the Intercondylar Eminence of the Tibia in a Child -A Case Report- (소아에서 발생한 전방 십자인대 견열 골절에서 유관 나사못을 이용한 관절경적 정복술 -증례보고-)

  • Moon, Kyu Pill;Kim, Kyung Taek;Kang, Min Soo;Park, Won Ro
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.62-65
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    • 2012
  • Avulsion fractures of the intercondylar eminence of the tibia are uncommon. This kind of fracture is most commonly found in adolescents, with an increasing incidence for those involved in competitive athletics. Recently, an arthroscopic procedure is preferred to reduce the operation-related morbidity. Screws, K-wires, Suture anchor have been described as fixation devices. Cannulated screw fixation is a simple method, but this instrument has the risk of causing damage to the growth plate. The authors report good results using cannulated screw in arthroscopic treatment for pediatric anterior cruciate ligament avulsion fracture.

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Midwife's role for mother and infant wellbeing (태아의 안녕과 안전한 출산 : 조산사의 역할)

  • Lee, Kyung-Hye
    • Korean Parent-Child Health Journal
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    • v.3 no.2
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    • pp.67-80
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    • 2000
  • This study was described as midwife's role and obstacle of midwife's role expansion. Midwife as primary medical personal who practices for a mother and infant health care and promotion of mother infant interaction. As the trend of increasing natural childbirth, midwifery has to provide childbearing care those who want delivery in a midwifery center. This study conducted to survey for 44 midwives who work at the midwifery center. The results of the study as fellows. 1. Most of the midwives role was care of pregnancy, delivery, postpartum women and babies. Another role was conducted educational classes childbirth, breast feeding, contraception and sexual education. 2. Some midwives role perform breech, vaccum delivery, episiotomy and suture, pitocin induction and augmentation, ultrasonogram, giving medication, anesthesia, collecting specimen from Pap smear and vaginal discharge. Midwife perform these roles without medical law support. 3. Most of the obstacles of the midwife role was the medical law limitation. Midwives want revise medical law to perform simple treatment for childbearing women and babies. 4. Half of the midwives refer cases to medical doctor in case of complication of women and newborns. 5. Current frequency of home birth rate is slightly higher than before and me cases like to have delivery under water. Finally, midwife and midwifery have to prepare to meet childbearing woman, baby and family's need. For activation and expansion of midwife's role, every midwife has to be aware of medical law accurately and they must know what practice they can do and what practice they can not do.

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A Study of Double-Layered Dangui I - Focusing on the Remains of Double-Layered Dangui - (두벌당의(唐衣)에 관한 연구 I - 겹당의 유물을 중심으로 -)

  • Ku, Nam-Ok
    • Journal of the Korean Society of Costume
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    • v.59 no.9
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    • pp.87-96
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    • 2009
  • Dangui is a formal dress of the wives of high officers and royalty in Chosun Dynasty and it was worn as a day dress in palace and a semi-ceremonial dress in upper-class households. Among the remains of Dangui a double-layered Dangui was found in which two sets of Dangui were combined to be worn as a single piece. The double-layered Dangui consists of an Over-Dangui and an Under-Dangui. The results of the examination of the remains for the Over-Dangui are as follows. As lone as the colors of the remains are identifiable, all of the Over-Dangui were green, whereas the Under-Dangui and lining materials were red. The textile was mostly in woven silk with pattern and it was frequently decorated with golden wefts or foils. A breast embroidery with phoenix and a dragon embroidery were also found. Such Dangui was worn mostly by the high members of the king's palace including the queen, crown princess, bastard princess, and monarch. There were two exceptions of wearing Dangui outside the king's palace. A simple Under-Dangui was made to enable a comfort fit of the two sets of Dangui and the suture was partially sewn. With three doth strings and cuffs, two pieces of Dangui were eventually assembled into one piece of clothing. Differences between the remains and the documents were also found in regards to textile and wearers of Dangui.