• Title/Summary/Keyword: defect cases

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Usefulness of using Tissue Expander in Pediatric Patient (소아 환자에서 조직확장기 사용의 유용성)

  • Lee, Jun-Woo;Park, Chul-Gyoo;Park, Jong-Lim;Kim, Yong-Kyu
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.763-768
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    • 2010
  • Purpose: Reconstruction of soft tissue defect using tissue expander can provide better flap which is more similar to surrounding tissue in color, skin texture and hair compared to other methods. Many pediatric patients need reconstruction of soft tissue defect because of giant congenital nevi, congenital or acquired malformations and burn scars. Reconstruction using tissue expander is adequate to minimize dysmorphism in these patients. We intended to assess outcomes of using tissue expander in pediatric patients by retrospective study. Methods: Total cases were 168 of pediatric patients who received soft tissue reconstruction using tissue expander by the same surgeon from February, 1982 to May, 2009. All patients who received soft tissue reconstruction were under 10 years old. Mean age was 4.3 years old, the youngest 13 months, the oldest 8 years. Eightynine cases were male and 79 cases were female. Most common cause was giant hairy nevi (67 cases, 39.9%), secondary cause was burn scar/scar contracture (61 cases, 36.3%). Trunk (38 cases, 22.6%) was most common anatomical location. Results: Soft tissue defects were successfully covered using tissue expander in 149 cases (88.7%) without major complications. There was infection on 8 cases (4.7%) and we treated by adequate antibiotics in these cases. There were tissue expander folding or valve displacement on 5 cases (3%). Conclusion: Usage of tissue expander is useful on pediatric patients because tissue expansion is rapid on children and there are less secondary contractures on operation site than full thickness skin graft. Because of psychological stress due to tissue expander, operation should be performed before school age.

The First Web Space Free Flap of the Foot to Reconstruct the Pulp of Fingers (수지 수질부 재건을 위한 족부의 제 1물갈퀴부 유리 피판술)

  • Kong, Byeong Seon;Kim, Yun Seok;Lee, Hyeong Seok;Jung, Dae Won;Kwak, Jae Yong;Lee, Hyun Suk
    • Archives of Reconstructive Microsurgery
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    • v.21 no.2
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    • pp.153-158
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    • 2012
  • Purpose: The first web space of the foot has a similar thickness and skin texture of the pulp of the fingers. Moreover, it has a reliable blood vessel and sensory nerve. The purpose of this study was to evaluate the clinical results of the first web space free flap to reconstruct the pulp of fingers. Materials and Methods: Authors have performed 23 cases of first web space free flap to reconstruct the pulp defect of the fingers between June 2004 and May 2009. The age of the patients ranged from 20 years old to 55 years old. The size of the flap ranged from $1{\times}1.5cm$ to $8.5{\times}2.5cm$. The mean flap area was 5.4 cm2. In 4 cases, we elevated the flap including lateral aspect of the big toe and medial aspect of the second toe. And then we made an artificial syndactyly to reconstruct the pulps on two fingers at the same time. In all cases, we performed 1 digital artery and 1 dorsal vein anastomosis. Every donor site that had a small defect healed spontaneously without any additional operations to cover it. Results: Of this type of surgery 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. There was no severe complication in the donor sites. There was no walking disturbance due to the skin defect of the donor site. The static 2 point discrimination in 11 cases that we could check ranged from 3 mm to 15 mm. Conclusion: The authors believe that the first web space free flap of the foot is a good option for the reconstruction of the pulp of the fingers and it has a minimal donor site morbidity.

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Robot-Assisted Cardiac Surgery Using the Da Vinci Surgical System: A Single Center Experience

  • Kim, Eung Re;Lim, Cheong;Kim, Dong Jin;Kim, Jun Sung;Park, Kay Hyun
    • Journal of Chest Surgery
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    • v.48 no.2
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    • pp.99-104
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    • 2015
  • Background: We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. Methods: Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasive robot-assisted cardiac surgery. Results: Robot-assisted cardiac surgery was employed in two cases of minimally invasive direct coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20 cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass time and average aorta cross-clamping time were $194.8{\pm}48.6$ minutes and $126.1{\pm}22.6$ minutes in mitral valve repair operations and $132.0{\pm}32.0$ minutes and $76.1{\pm}23.1$ minutes in myxoma removal operations, respectively. During atrial septal defect closure operations, the average cardiopulmonary bypass time was $128.3{\pm}43.1$ minutes. The median length of stay was between five and seven days. The only complication was that one patient needed reoperation to address bleeding. There were no hospital mortalities. Conclusion: Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team.

Radiographic evaluation of the zygomatic air cell defect

  • Park Young-Hee;Lee Soo-Kyung;Park Byeong-Hyun;Son Hyo-Sun;Choi Mi;Choi Karp-Shik;An Chang-Hyeon
    • Imaging Science in Dentistry
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    • v.32 no.4
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    • pp.207-211
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    • 2002
  • Purpose : The purpose of this study was to determine the prevalence, radiographic appearance, and characteristics of patients with zygomatic air cell defect (ZACD), and to give recommendations concerning radiographic evaluation and surgery. Materials and Methods: Routine panoramic radiographs of 1,400 patients admitted to the Kyungpook National University Hospital Dental Clinic, were retrospectively examined for the clinical and radiographic features of ZACD. Results: ZACD was found in 31 cases, representing a prevalence of 2.2%. Patients with ZACD had a mean age of 27.5 years and a range of 9-52 years. Most ZACD cases were in their thirties. ZACD showed a strong male prediliction, 22 of the 31 subjects were males and 9 were females. Twenty-four cases of ZACD (77.4%) were unilateral, with the half occurring on the right side. In seven cases (22.6%), ZACD was bilateral. Twenty-six (68.4%) of the defects were of unilocular, while twelve (31.6%) of the defects were multilocular. Conclusion: Knowledge of ZACD may be helpful in interpreting images, including panoramic radiographs, in planning surgical treatment of the TMJ and in understanding the spread of pathological processes into the joint.

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Risk of Down syndrome in duodenal atresia and atrioventricular septal defect: Is there an ethnic difference?

  • Lee, Seung Mi;Jun, Jong Kwan;Kim, Hyun-Young;Shin, Seung Han;Park, Jeong Woo;Kim, Min Kyoung;Park, Chan-Wook;Park, Joong Shin
    • Journal of Genetic Medicine
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    • v.17 no.1
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    • pp.16-20
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    • 2020
  • Purpose: Duodenal atresia (DA) and atrioventricular septal defect (AVSD) are well known ultrasonographic findings associated with Down syndrome. The risk of Down syndrome in fetuses with these anomalies has been reported as 30% to 40%. However, on the basis of our clinical experience, the risk of Down syndrome of DA may be lower in Korean population. To clarify this issue, we compared the risk of Down syndrome between cases with DA and AVSD. Materials and Methods: The study population consisted of neonates who were confirmed as DA or AVSD by postnatal diagnosis. Postnatal diagnosis was made by surgery, postnatal echocardiography, or autopsy. Medical record was reviewed retrospectively. Results: A total of 213 neonates with DA or AVSD were included: 67 cases with DA and 146 cases with AVSD. The risk of Down syndrome was 4.5% (3/67) in DA vs. 29.5% (43/146) in AVSD. When confining analysis to those whose karyotyping were not performed during antenatal period, the risk of Down syndrome were 7.9% (3/38) in DA and 35.4% (35/99) in AVSD. Conclusion: The risk of Down syndrome in cases with DA was much lower in Korean population than previously reported risk in the literature. The significance of some antenatal sonographic markers for Down syndrome may be different according to ethnicity.

Coverage of the Wrist and Hand Soft Tissue Defects with the Posterior Interosseous Forearm Island Flap (후 골간 혈관경을 이용한 도상피판에 의한 손목 및 수부 연부조직 결손의 수복)

  • Choi, Soo-Joong;Na, Seong-Ju;Chang, Ho-Geun;Chang, Jun-Dong;Lee, Chang-Ju
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.28-34
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    • 1998
  • The traditionally useful coverage methods of the wrist and hand soft tissue defect are the chinese forearm flap, the ulnar forearm flap. But, this flaps are inevitably sacrifice major vessel to the hand. Advantages of the posterior interosseous artery island flap(PIA Flap) is no need to sacrifice blood supply to the hand and supply relatively large thin, good quality flap and more cosmetic than other forearm flaps. But, it is difficult to dissect and raise because of deep seat, close relation with the posterior interosseous nerve and anatomic variation. Authors evaluated 8 cases of 7 patients in the department of orthopaedic surgery, college of medicine, Hallym University from January, 1993 to December, 1995. The results are as follows: 1. The satisfactory coverage was achieved 7 cases and 1 case failed because of anatomic variation. 2 The pedicle length is average 9cm and the flap size is variable from 3cm by 4cm to 5cm by 8cm. 3. The donor site defect was repaired by direct closure in 5 cases, remained 3 cases combined with skin graft. From our experience we conclude that the PIA flap is one of the useful coverage methods of the wrist and hand soft tissue defect.

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Effect of Structural Geometry and Crack Location on Crack Driving Forces for Cracks in Welds (용접부 균열의 균열진전력에 대한 구조물 형상과 균열 위치의 영향)

  • Oh Chang-Kyun;Kim Jong-Sung;Jin Tae-Eun;Kim Yun-Jae
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.30 no.8 s.251
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    • pp.931-940
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    • 2006
  • Defect assessment of a weld zone is important in fitness-for-service evaluation of plant components. Typically a J and $C^*$ estimation method for a defective homogeneous component is extended to a mismatched component, by incorporating the effect due to the strength mismatch between the weld metal and the base material. The key element is a mismatch limit load. For instance, the R6/R5 procedure employs an equivalent material concept, defined by a mismatch limit load. A premise is that if a proper mismatch limit load solution is available, the same concept can be used for any defect location (either a weld centre defect or a heat affected zone (HAZ) defect) and for any material combination (either two-material or multi-material combinations; either similar or dissimilar joints). However, validation is still limited, and thus a more systematic investigation is needed to generalise the suggestion to any geometry, any defect location and any material combination. This paper describes the effect of structural geometry on the $C^*$ integral for defective similar welds, based on systematic elastic-creep 2-D and 3-D finite element (FE) analyses, to attempt to elucidate the questions given above. It is found that the existing 'equivalent material' concept is valid only for limited cases, although it provides conservative estimates of $C^*$ for most of cases. A modification to the existing equivalent material concept is suggested to improve accuracy.

Reconstruction of Soft Tissue Defect Caused by Excision of Soft Tissue Tumor Using Dorsalis Pedis Pedicled Island Flap (하지 연부조직 종양의 절제 후 발생한 결손의 재건을 위한 도서형 유경 피판술로서의 족배동맥 피판술)

  • Han, Chung-Soo;Shin, Dong-Jun;Moon, Jee-Soo;Park, Hyun-Chul
    • Archives of Reconstructive Microsurgery
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    • v.12 no.1
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    • pp.38-43
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    • 2003
  • Purpose : Various free flaps and pedicled island flaps are effective for reconstruction of soft tissue defect developed after tumor excision. We want to know the advantage of dorsalis pedis island flap for reconstruction of soft tissue defect caused by soft tissue tumor excision. Materials and Methods : Between 1992 and 2002, we performed 4 dorsalis pedis island flap procedure for reconstruction of soft tissue defect of lower limb developed after soft tissue tumor excision. Average age was 54.7 years old $(40{\sim}68)$, and male 2 cases, female 2 cases. The kinds and number of soft tissue tumors were 2 squamous cell carcinoma and 2 malignant melanoma. The procedures that we performed were all dorsalis pedis island flap. The analysis for the result of treatment was retrospectively accessed by physical examination and questionnaire for whether the change of symptom after operation, range of adjacent joint motion. Also we reviewed associated complication after operative treatment. Results : All dorsalis pedis island flaps were alive. There is no problem for activity of daily living, no skin necrosis and no limitation of motion of adjacent joint. In 1 case of them, the patients died of distant metastasis. Conclusion: Dorsalis pedis island flap procedure as a pedicled island flap procedure is very effective and easy operative procedure for reconstruction of soft tissue defect of lower limb developed after tumor excision compared to free flap procedure because there is no need for microvascular surgery, we can obtain relatively large flap and the lesion and flap donor site locate in the same limb.

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Optimal Test Condition by Ultrasonic Simulation (초음파 시뮬레이션을 이용한 최적의 탐상조건)

  • Huh, Sun-Chul;Park, Young-Chul;Boo, Myung-Hwan;Kang, Jung-Ho
    • Journal of Ocean Engineering and Technology
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    • v.13 no.4 s.35
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    • pp.45-54
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    • 1999
  • Non destructive test is applied to revise mechanical strength and assume material strength or defect of material, equipment and structure, instead of fracture test. Especially, ultrasonic test has the characteristics such as an excellent permeability high-sensitiveness to fine defect and an almost exact measurement for position, size and direction of inner defect which differ from other non destructive tests. In this study, the program is developed to evaluate optimal testing condition, to distinguish obstacle echo and defect position. This program on the basic of Ray-Tracing model shows generation and processing of ultrasonic pulse. The simulation is compared with testing in the 3 cases of an oblique angle transducer like $45^{\circ},\;60^{\circ}\;and\;70^{\circ}$. The test result for all conditions is well compared with simulation result when relative not is within $0.1{\sim}7.2%$. And the course of several echos is simply assumed through simulation.

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