• Journal of Chest Surgery
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• v.26 no.2
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• pp.129-134
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• 1993

We compared postoperative results according to the different surgical approach in 180 cases of isolated ventricular septal defects operated at the department of Thoracic and Cardiovascular Surgery in Kyungpook University Hospital from January 1987 to December 1991. Of the 180 cases, 109 were males and 71 females, age ranging from 6 months to 15 years (mean: 5.6 years) and body weight ranging from 6 to 52㎏(mean : 20㎏). According to Soto's classification, perimembranous types were comprised of 119 cases (66％), doubly committed subarterial type 49 cases(27％), and muscular type 12 cases(7％). Patients were divided into three groups according to the incision methods: right atriotomy group (39％), right ventriculotomy group (47％), and pulmonary arteriotomy group (14％). The mean aortic cross clamp time was shorter in right atriotomy group (39 min.) than right ventriculotomy group (79min.) in the cases of large perimembranous VSD (P＜0.001). Spontanous recovery rate of cardiac rhythm after VSD closure was higher in right atriotomy group (51％) than right ventriculotomy group (32％) in the cases of perimembranous VSD (P＜0.05). The incidence of postoperative RBBB was 17.6％ with no statistical differences between right atriotomy group(17.9％) and right ventriculotomy group(19.2％). Overall mortality rate was 5.6％(10 cases) with no significant differences according to surgical approach.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.90-97
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• 1982

Two hundred one patients of ventricular septal defect, which were operated at Seoul National University Hospital, were analysed on clinical background during the period from January, 1975 to December, 1980. The results were as follows: 1. Of the 201 patients, 118 patients were male [58.7%] and 83 patients were female [41.3%]. Their age ranged from 15 months to 40 years, and the mean age was 8.7 years. 40% of the patients were between 4 and 8 years. 2. The most common symptoms showed frequent U RI and exertional dyspnea. 3. On Kirklin`s anatomical classification, type I constituted 26.9%, type II 58.2%, type III 12.4%, and type IV 1.0%. We showed marked increased incidence of type I VSD as compared to Caucasians* 4. 46 cases were associated with other congenital cardiac diseases. They were PDA [13 cases], AI[11 ], ASD[6], PS[10], MI[4], and Double aortic arch [1]. 5. In 128 patients, who had complete hemodynamic data and were not associated with other congenital cardiac diseases, an attempt was made to correlate the EKG findings with the hemodynamic data, and defect size with the hemodynamic data. The children had variable distribution of PA syst. pr. and Rp/Rs. But most of adults had $R_P$/$R_S$of 0.15 or less. As $P_P$/$P_S$increased, the rate of operative complication increased also. 6. When a normal EKG pattern was present, $Q_P$/$Q_S$and $R_P$/$R_S$and $P_P$/$P_S$were relatively low. When EKG findings were LVH pattern, there was diastolic volume overload to left ventricle. As RVH, there was systolic pressure overload to right ventricle. And as BVH, there was mixed pattern of diastolic volume overload to left ventricle and systolic pressure overload to right ventricle. 7. Among patients in defect was less than 1 $cm^2$ per $M^2$ of BSA, $Q_P$/$Q_S$was less than 2:1, and $R_P$/$R_S$less than 0.25, and PAsyst. pr. less than 50 mmHg, and $P_P$/$P_S$was less than 0.5. But patients with the defect greater than 1 $cm^2$ per $M^2$ of BSA had no correlationship between $Q_P$/$Q_S$, $R_P$/$R_S$, PAsyst. pr. and defect size in each other. Most of patients with the defect greater than 2 $cm^2$/$M^2$ BSA, $R_P$/$R_S$was greater than 0.5. 8. Operative mortality rate was 9.5% [19 cases] among 201 patients. And complication rate including mortality rate was 22.9% [46 cases].

• Archives of Craniofacial Surgery
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• v.19 no.4
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• pp.254-259
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• 2018

Background: The esthetic and functional outcomes of periorbital defect reconstruction are very important because of the complex anatomy and specialized functions of this region. The orbicularis oculi myocutaneous (OOMC) flap is useful for the reconstruction of periorbital defects. But, according to the location and depth of the defects, the reconstruction using OMC flaps with various techniques is rare. The authors have used various kinds of OOMC flaps in various situations and we present an analysis of our experiences. Methods: From November 2001 to July 2017, we used 36 OOMC flaps to reconstruct 30 periorbital defects in 25 patients. We analyzed the cause of the defect, its location, the type of concomitant surgery, the method of flap movement, and complications. Results: Of the 30 defects, basal cell carcinoma was the most common cause, accounting for 20 cases. When the used OOMC flap was classified according to the location of the defects, the switch flap was used in nine cases among 15 defects of lower eyelid, and the V-Y advancement flap was mainly used for other parts. As surgical methods according to the depth of defect were classified, all cases involving the tarsal plate were reconstructed with a composite graft. In case of skin and muscles, they were reconstructed only with OOMC flap or with full-thickness skin graft. Conclusion: The OOMC flap provides good skin quality that is very similar to that of the defect tissue. Depending on the location and depth of the defect, the OOMC flap may be used properly in a variety of ways to achieve good results.

• Archives of Plastic Surgery
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• v.32 no.4
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• pp.447-453
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• 2005

The coverage of soft tissue defects around the knee joint or upper one third of lower leg presents a difficult challenge to the reconstructive surgeon. Various reconstructive choices are available depending on the location, size and depth of the defect. The authors present their clinical application of a medial sural artery perforator island flap as a useful alternative method for upper one third of lower leg and knee reconstruction. From 2002 to 2004, we operated total 4 patients (total 4 flaps) using the medial sural artey perforator island flap for coverage of the defect on upper one third of lower leg and knee, of 4 patients, 3 patients was men and one was woman. Average patient age was 54.6 years. The largest flap obtained was 10x8cm2. Postoperative follow up of the patients ranged from two to 33 months. In two cases, defects was located on upper one third of lower leg and in other two cases, defects were on the knee. All four cases had bone exposure open wound. In angiography, 2 cases had injured in the anterior tibial artery, 1 case had injured in the posterior tibial artery. There were no diabetes or other vascular disease. All 4 flaps were survived completely, without minor complications such as venous congestion and hematoma. Donor morbidity was restricted substantially to the donor linear scar. There were no functional impairment. As the main advantages of the medial sural perforator island flap, it ensures constant location and reliable blood supply without sacrificing any main source artery or damaging underlying muscle. This procedure is valuable extension of local flap for defect coverage with minimal functional deficit donor site and good aesthetic result on the defect. We consider it as one of the useful methods of the upper one third of lower leg and knee reconstruction.

• 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.

• Journal of Chest Surgery
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• v.26 no.7
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• pp.543-547
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• 1993

Cor triatriatum is a rare entity of congenital heart disease characterized by the presence of a fibrousmuscular diaphragm that subdivides the left atrium into a proximal or "accessory" chamber and a distal or "true" left atrial chamber. In the other hand, cor triatriatum is a variant of abnormal connection between the pulmonary vein and true left atrium which is separated from accessory left atrium receiving pulmonary venous blood flow by fibromuscular diaphragm. We experienced two cases of cor triatriatum. One of them was classical, and the other case was combined with atrial septal defect and all pulmonary veins were drained into the " common pulmonary venous chamber " which connected with right atrium and there was no direct communication between the accessory chamber and true left atrium. The abnormal diaphragms were excised and the atrial septal defect was repaired with pericardial patch in case II. The postoperative courses were not eventful and the patients were discharged with good result, and have been in good condition upto now.n good condition upto now.

• KIEAE Journal
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• v.7 no.6
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• pp.127-132
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• 2007

Recently, the cases of lawsuit are growing on residential defects. Though, mostly residential construction companies are trying to mitigate resident's dissatisfaction due to keep the company's brand image by operating customer service team, some representatives of apartment buildings initiate litigations without any negotiation with countrepartner companys incited by planned suit lawyers. But lawsuit takes longtime to sentence(about more than one year), and judged amount of money are very few (averaging about 14%) compared with asserted amount of it. To suggest the improving alternatives, the types and problems of defect lawsuit on apartment complex are analyzed.

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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• v.19 no.2
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• pp.215-223
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• 2021

The domestic CANDU nuclear power plants have been operated for a long time and various unforeseen spent fuel defects have been discovered. As the spent fuel defects are important factors in the safety of the nuclear power plant, a study on the analysis of the spent fuel defects to prevent their recurrence is necessary. However, in cases where the fuel rods inside the fuel assembly are defected, it is difficult to dismantle the fuel assembly owing to their welded structure and the facility conditions of the plant. Therefore, it is impossible to analyze the spent fuel defect because it is difficult to visually check the shape of the fuel defect. To resolve these problems, an analysis technology that can predict the number of defected fuel rods and defect size was developed. In this study, we developed a methodology for investigating the root cause of spent fuel defects using a database of the earlier fuel defects in the plants. It is anticipated that in the future this analysis technology will be applied when spent fuel defects occur.

• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.17-23
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• 2019

Background: The resection of head and neck cancer can result in postoperative defect. Many patients have difficulty swallowing and masticating, and some have difficulty speaking. Various types of flaps are used for palatal reconstruction, but flap selection remains controversial. Therefore, our study will suggest which flap to choose during palatal reconstruction. Methods: Thirteen patients who underwent palatal reconstruction from 30 January, 1989 to 4 October, 2016 at our institution. Size was classified as small when the width was < $4cm^2$, medium when it was $4-6cm^2$, and large when it was ${\geq}6cm^2$. Based on speech evaluation, the subjects were divided into a normal group and an easily understood group. After surgery, we assessed whether flap selection was appropriate through the evaluation of flap success, complications, and speech evaluation. Results: Defect size ranged from $1.5{\times}2.0cm$ to $5.0{\times}6.0cm$. In four cases, the defect was in the anterior third of the palate, in eight cases it was in the middle, and there was one case of whole palatal defect. There were three small defects, two medium-sized defects, and eight large defects. Latissimus dorsi free flaps were used in six of the eight large defects in the study. Conclusion: The key to successful reconstructive surgery is appropriate selection of the flap with reference to the characteristics of the defect. Depending on the size and location of the defect, the profiles of different flaps should be matched with the recipient from the outset.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.527-532
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• 2008

Purpose: Transverse type or volar oblique type of defect of thumb tip can be covered by Moberg flap or second toe pulp free flap. We compared these two methods in functional result, patients' satisfaction, and sensation, etc. to find a better way to cover the defect of the thumb tip. Methods: From 2003 to 2006, we chose the patients randomly with preoperative pictures. The patients had the defect of the thumb tip which is either transverse or volar oblique type. The 6 patients were treated with Moberg flap and other 6 patients were treated with second toe pulp free flap. We have analyzed the results by 2 point discrimination, side pinching power test, pulp to pulp pinching power test, pain scales (visual analogue scale), satisfaction scales of the patients (functional and aesthetic), the degree of the range of motion, etc. Results: All flaps survived without any complications. In the cases of Moberg flaps, the value of static 2 point discrimination test was 5.6 mm, and the value of moving 2 point discrimination test was 4.8 mm. In the cases of second toe pulp free flaps, the values were 9.6 mm and 9.3 mm. In the cases of Moberg flaps, the value of the Side pinch power test was 6.6 kg, 4.4 kg. In the case of second toe pulp free flaps, the values were 4.8 kg and 2.5 kg. The value of aesthetic satisfaction scale of the patients in Moberg flaps was 5.6, the value of functional satisfaction scale of the patients was 3.6. In cases of second toe pulp free flaps, the values were 5.6 and 3.6. The active range of motion of Interphalangeal joint in the cases of Moberg flaps was 46.6 degree, and the active range of motion of metacarpophalangeal joint was 55 degree, in the cases of second toe pulp free flaps, the values were 36.6 degree and 59 degree. Conclusion: As a result, when the defect of the thumb tip is transverse or volar oblique type, we suggest that the operators choose Moberg flap to cover the defect of the thumb tip.