• Title/Summary/Keyword: defect cases

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Thigh Perforator Free Flap for Reconstruction of the Soft Tissue Defect of the Lower Extremity (하지의 연부조직 결손 재건을 위한 대퇴부 천공지 유리 피판술)

  • Kong, Byeong-Seon;Seo, Moo-Sam;Ha, Jung-Min
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.232-237
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    • 2007
  • Introduction: To report the result of the thigh perforator free flap for the reconstruction of the soft tissue defect of the lower extremities and usefulness of this flap. Materials and Methods: We have performed 23 cases of thigh perforator free flap to reconstruct the soft tissue defect of the lower extremities between February 2004 and July 2005. The anterior aspect of the legs were 9 cases, the ankle joints were 4 cases, the dorsal aspect of the feet were 6 cases, the sole of the feet were 4 cases as recipient sites. The anterolateral thighs were 13 cases, the anteromedial thighs were 10 cases as donor sites. The size of the flap ranged from $4{\times}5\;cm$ to $12{\times}18\;cm$. The mean flap area was $73.2\;cm^2$. The length of the pedicle ranged from 5 cm to 15 cm. Every patient except children was operated under the spinal anesthesia. Results: 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. In the 21 flaps that had survived, there were partial necrosis in 4 cases, which healed without any additional operation. In the 13 anterolateral thigh perforator flaps, 9 cases survived totally, 3 cases had the partial necrosis, 1 case failed. In the 10 anteromedial thigh perforator flaps, 8 cases survived totally, 1 case had the partial necrosis, 1 case failed. Conclusion: The authors had a good result with the thigh perforator free flap and believe that this flap is a good option for the reconstruction of the soft tissue defect of the lower extremities, because this flap has a thin thickness and it is easy to dissect the vessels. Moreover the patients can be operated with supine position.

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Surgical Treatment of Ventricular Septal Defect Associated with Aortic Insufficiency (대동맥판 폐쇄부전을 동반한 심실중격결손의 외과적 치료)

  • 허동명
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.135-142
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    • 1991
  • From January 1980 to December 1989, thirteen patients underwent operation for ventricular septal defect associated with aortic insufficiency in Kyungpook national university hospital. Ten male and three female patients ranged in age from 3 years to 25 years, with an average age of 11.5 years. Aortic cusp prolapse was found in eight cases[61.5%]. The aortic regurgitation was classified by Sellers` method with grade I in 2 cases, grade II in 9 cases, and grade III in 2 cases. Direct suture or patch repair of ventricular septal defect was performed through the right ventricle. Eight cases were treated only by closure of VSD, 3 cases by plication, but two of the letter were reoperated due to the persistent of aortic regurgitation and fungal endocarditis respectively. Aortic valve replacement were performed in 2 cases at the first operation. There was only one late death[7.7%], which was caused by postoperative fungal endocarditis. Follow-up for twelve patients except one death were followed up for 3 months to six years after operation. Residual aortic regurgitation was noted in six cases[46.2%], but the postoperative course of them were uneventful.

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성인의 선천성 심장질환의 외과적 교정

  • 김광호
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.34-40
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    • 1980
  • Total 193 patients over 16 years of age who have underwent a surgical correction of congenital heart diseases during the period 1964 to September of 1979 were reviewed. 106 patients were male and 87 patients were female. 85 patients were in the ages of 16 years through 20 years. The oldest patient was 54 years old male who had atrial septal defect. The commonest defects were atrial septal defect that accounted for 66 cases [34.2%]. Ventricular septal defect was next one that accounted for 66 cases [34.2%]. Patients with tetralogy of Fallot defects were 34 cases [17.6%]. 25 cases had patent ductus arteriosus [13.0%]. Patients with pulmonary stenosis were 17 cases [8.8%] and transposition of the great arteries cases were 2 cases [1%]. There were 14 cases of operative death in this series. So operative mortality rate was 7.3%. The commonest cause of death was low output syndrome and next was renal failure. This reviewed series reveals the incidence of operable congenital heart defects appearing in adult cardiac surgical patients and an aggressive surgical approach can be justified with low operative mortality like as pediatric age group.

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A Clinical Evaluatuin on Open Heart Surgery of Congenital and Acquired Heart Disease (선천성 및 후천성 심질환의 개심술)

  • 김근호
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.33-42
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    • 1979
  • The present study reports 41 cases of congenital and acquired heart diseases, who received open heart surgery under extracorporeal circulation [ECC] by Sarns Heart-Lung-Machine [HLM] at the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the` period between July 1975 and February 1979. The priming of pump oxygenator was carried out by the hemodilution method using Hartman`s solution, whole blood, and fresh human plasma. The rate of hemodilution was in the average of 50.8 ml/kg. ECC was performed at the average perfusion flow rate of 85.0 ml/kg/min [2.43 L./ kg/2] and at moderate hypothermia. In the total cardiopulmonary bypass, arterial pressure ranged between 55 mmHg and 90 mmHg, but generally maintaining over 70 mmHg. Patient age ranged between 2 and 54 year old, in congenital heart diseases, between 2 and 28, in acquired heart diseases, between 17 and 54 Sex ratio of male to female was 20:21. The cases include a case of pulmonary valvular stenosis, 4 cases of atrial septal defect, 9 cases of ventricular septal defect, 9 cases of tetralogy of Fallot, 5 cases of pentalogy of Fallot, 3 cases of atypical multiple anomalies 7 cases of mitral stenosis or insufficiency, a case of myxoma in left atrium, and a case of ruptured aneurysm of Valsalva`s sinus. The surgical managements were 16 valvulotomy for pulmonary valvular stenosis, 2 Teflon patch graft closure and 5 simple suture closure of atrial septal defect, 16 Teflon patch graft closure and 5 simple suture closure of ventricular septal defect, 12 pericardial patch graft for infundibular stenosis of right ventricle, one anastomosis between left superior vena cava and right atrium, 2 open mitral commissurotomy, 5 mitral valve replacement using Starr-Edward`s ball valve, porcine xenograft by Hancock, by Carpentier-Edward, or Angell-Shiley, one removal of left atrial myxoma, and a repair of ruptured aneurysm of Valsalva`s sinus. Four [9.7%] out 41 cases expired postoperatively and the rest of 37 cases survived with satisfactory results. The causes of death were one coronary embolism in tetralogy of Fallot, 2 postoperative lower cardiac output in atypical multiple anomalies, and one right heart failure in large: ventricular septal defect with pulmonary hypertension.

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Left Ventricular-Right Atrial Canal Three Cases Treated Surgically (좌심실-우심방 단락 치험 3예)

  • 송명근
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.233-236
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    • 1980
  • Left Ventricular-Right atrial canal, which permits a communication between the left ventricle and right atrium has been reported with increasing frequency. Kirby made the first successful surgical correction in 1957. Recently we experienced 3 cases of left ventricular-Right atrial canal, which were corrected surgically. In one patient the diagnosis of left ventricular-Right atrial canal had been suggested before operation. Preoperative diagnosis had been incorrect in 2 cases; one as an atrial septal defect and the other as combined atrial septal defect and ventricular septal defect. The entire patients were discharged with good results within 2 weeks after operation.

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Large Defect May Cause Infectious Complications in Cranioplasty

  • Park, Jong-Sun;Lee, Kyeong-Seok;Shin, Jai-Joon;Yoon, Seok-Mann;Choi, Weon-Rim;Doh, Jae-Won
    • Journal of Korean Neurosurgical Society
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    • v.42 no.2
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    • pp.89-91
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    • 2007
  • Objective : Cranioplasty is necessary to repair the cranial defect, produced either by decompressive craniectomy or removal of the contaminated depressed skull fracture. Complications are relatively common after cranioplasty, being reported up to 23.6%. We examined the incidence and risk factors of infectious complications after cranioplasty during last 6 year period. Methods : From January 2000 to December 2005, 107 cranioplasties were performed in our institution. The infectious complications occurred in 17 cases that required the removal of the bone flap. We examined the age of the patients, causes of the skull defect, timing of the cranioplasty the size of the defect, and kinds of the cranioplasty material. The size of the skull defect was calculated by a formula, $3.14{\times}long\;axis\;{\times}short$ axis. The cranioplasty material was autogenous bone kept in a freezer in 74 patients, and polymethylmetacrylate in 33 patients. Statistical significance was tested using the chi-square test. Results : The infection occurred in 17 patients in 107 cranioplasties (15.9%). It occurred in 2 of 29 cases of less than $75\;cm^2$ defect (6.9%), and 6 in 54 cases of $75{\sim}125\;cm^2$ defect (11.1%). Also, it occurred in 9 of 24 cases of more than $125\;cm^2$ defect (37.5%). This difference was statistically significant (p <0.01). Conclusion : During the cranioplasty, special attention is required when the skull defect is large since the infection tends to occurr more commonly.

Surgical Treatment of Incomplete Endocardial Cushion Defect: 2 Cases Report (심장내막상결손증의 외과적 치료: 2예 보고)

  • 송요준
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.101-108
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    • 1974
  • Repair of incomplete endocardial cushion defect was accomplished in two cases in September 1973 in this department. In each case a low atrial septal defect and a cleft of mitral septal cusp were found. Interrupted suture repair on the cleft mitral cusp and closure of the atrial septal defect with dacron patch were done successfully. Rigg-Kyvsgaard bubble oxygynator and Sigma motor were utilized for extracorporeal circulation. Follow up study, six months after discharge, revealed satisfactory results.

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The Infection Rate in Case of Cranioplasty According to Used Materials and Skull Defect Duration (두개골 성형술의 사용 재료와 수술 시기에 따른 감염율)

  • Kim, Young-Woo;Yoo, Do-Sung;Kim, Dal-Soo;Huh, Pil-Woo;Cho, Kyung-Suck;Kim, Jae-Gun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.216-220
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    • 2001
  • Objective : Cranioplasty is required to protect underlying brain, to correct major aesthetic deformities, or both. The ideal material for this purpose is autogenous bone. When this is not available, alloplastic or artificial materials may be used. In this study authors compared the infection rate according to the cranioplasty materials(the frozen autologous bone vs. bone cement), and duration of the skull defect. Materials : Between May 1994 and December 1999, 111 patients with skull defect treated with cranioplasty(82 cases of frozen autologous bone and 29 cases of artificial bone material) were included in this study. There were 77 males and 34 females with a mean age of 41.4 years(range 1-85 years). 57 patients had head trauma and 54 had non-traumatic insults. According to the duration of skull defect, there were 28 cases under 1 month, 33 cases of 1-2 months, 15 cases of 2-3 months, 20 cases of 3-6 months and 15 cases over 6 months of duration. Results : Overall infection rate was 9.9%. In cases with frozen autologous bone and artificial bone material, the infection rate was 8.5% and 13.7%, respectively. The infection rate according to the duration of skull defect was 3.6%(among 28 cases) under 1 month of age, while those were 12%(4 among 33 cases) at 1-2 months, 20%(3 among 15 cases) at 2-3 months, 5%(1 among 20 cases) at 3-6 months and 13%(2 among 15 cases) over 6 months. Accoring to the underlying disease, the infection rate in traumatic cases was 12%(7 among 57 cases) and that in non-traumatic one was 3.7%(2 among 54 cases). Conclusion : From this study, it appears that skull defect should be repaired as soon as possible, because early cranioplasty can lower the infection rate. And surgeons could save the patients' cranial bone as possible as they can because autologous bone is not only cost effective in cosmatic purpose but lower the infection rate.

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Analysis of Ventricular Septal Defect (심실중격결손증의 외과적 고찰)

  • 신제균
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.151-156
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    • 1985
  • A clinical analysis was done on 50 cases of ventricular septal defect, operated from April 1981 to March 1984 at the department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. Among 50 cases, 34 cases were males and 16 cases were females. Their age ranged from 1 to 26 years and the mean age was 9.7 years. The main symptoms at admission were frequent upper respiratory infection [50%], exertional dyspnea [42%] and palpitation [34%]. In anatomical classification by Kirklin, type I constituted 20%, type II 76%, type IV 4%. Associated congenital cardiac lesions were pulmonic stenosis [6 cases], patent foramen ovale [5 cases], aortic insufficiency [3 cases] and persistent left superior vena cava [1 case]. When a normal electrocardiogram pattern was present, Qp/Qs, Rp/Rs and pulmonary artery systolic pressure and Pp/Ps were relatively low. Among cases of above 1 cm2/M2 BSA in size of defect, Pp/Ps and pulmonary artery systolic pressure were increased than the cases of below 1 cm2/M2 BSA [P=0.01]. The postoperative right bundle branch block was occurred in 21 cases [75%] among 28 cases of right ventriculotomy approach. The operative mortality was 2% [1 case] among 50 cases and complication rate was 14% [7 cases].

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Developmental salivary gland defect : Literatures review and case analysis of 12 cases (발육성 타액선 골 결손의 문헌 고찰 및 증례 분석)

  • Kim Hak-Kyun;Kim Jin-Soo;Kim Jae-Duk
    • Imaging Science in Dentistry
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    • v.36 no.2
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    • pp.81-88
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    • 2006
  • Purpose : To review developmental salivary gland defect based on 12 reported cases and literature, and to guide radiographic diagnosis of this entity. Materials and Methods : The 12 cases of developmental salivary gland defect of Chosun University Dental Hospital in the last 4 years were analyzed and compared with previous reported cases. Result : 11 of the 12 cases were found in men, indicating a very strong male predilection. The peak age was in the 6th decade. These defects were situated just above or at the inferior border of mandible between the first molar and the mandibular angle, and always Inferior to the mandibular canal. Only one case was superimposed with the mandibular canal, 6 cases were superimposed with the inferior border of the mandible. Conclusion : Characteristically, these defects had a special radiographic features such as ovoid shaped well-defined radiolucency located just above or at the inferior border of the mandible between the first molar and the mandibular angle, and always inferior to the mandibular canal. The recognition of these radiographic features were diagnostically valuable.

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