• Title/Summary/Keyword: defect cases

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Reconstruction of Midface Defect with Latissimus Dorsi Myocutaneous Free Flap (광배근 근피 유리피판술(Latissimus dorsi myoctaneous free flap)을 이용한 상악부 복합조직결손의 치험례)

  • Kim, Jeang-Cheal;Woo, Sang-Hyun;Lee, Tae-Hoon;Choi, See-Ho;Seul, Jung-Hyun
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.173-179
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    • 1990
  • We report 2 cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap. In these cases, the main points to cover the defects were as follows ; 1. For the contour of zygoma and maxilla, it was well preserved without bone graft which was not used for second stage reconstruction. In first case, for application of artificial eye and in second case, for, operation after full development. 2. For the drainage of paranasal sinuses, we made the nostril with skin graft, and it was well preserved without any complications during follow up. 3. It was sufficient to cover the defect with latissimus dorsi muscle well designed before surgery and thick enough to fill the defect. 4. In second case, the remained defect of palate and maxilla was not covered for the appropriate reconstructions after full development. In conclusions, we experienced two cases of midface defect reconstructed with latissimus dorsi myocutaneous free flap without any complication and with good results.

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Large Auricular Chondrocutaneous Composite Graft for Nasal Alar and Columellar Reconstruction

  • Son, Daegu;Kwak, Minho;Yun, Sangho;Yeo, Hyeonjung;Kim, Junhyung;Han, Kihwan
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.323-328
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    • 2012
  • Background Among the various methods for correcting nasal deformity, the composite graft is suitable for the inner and outer reconstruction of the nose in a single stage. In this article, we present our technique for reconstructing the ala and columella using the auricular chondrocutaneous composite graft. Methods From 2004 to 2011, 15 cases of alar and 2 cases of columellar reconstruction employing the chondrocutaneous composite graft were studied, all followed up for 3 to 24 months (average, 13.5 months). All of the patients were reviewed retrospectively for the demographics, graft size, selection of the donor site and outcomes including morbidity and complications. Results The reasons for the deformity were burn scar (n=7), traumatic scar (n=4), smallpox scar (n=4), basal cell carcinoma defect (n=1), and scar contracture (n=1) from implant induced infection. In 5 cases of nostril stricture and 6 cases of alar defect and notching, composite grafts from the helix were used ($8.9{\times}12.5$ mm). In 4 cases of retracted ala, grafts from the posterior surface of the concha were matched ($5{\times}15$ mm). For the reconstruction of the columella, we harvested the graft from the posterior scapha ($9{\times}13.5$ mm). Except one case with partial necrosis and delayed healing due to smoking, the grafts were successful in all of the cases and there was no deformity of the donor site. Conclusions An alar and columellar defect can be reconstructed successfully with a relatively large composite graft without donor site morbidity. The selection of the donor site should be individualized according to the 3-dimensional configuration of the defect.

Analysis on the Structure of Defect Consulting Report in Apartment Building (공동주택 하자감정서의 구성체계 분석)

  • Park, Jun-Mo;Seo, Deok-Suk;Kim, Ok-Kyue;Park, Gil-Bum
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2013.05a
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    • pp.166-167
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    • 2013
  • There has been a defect dispute of apartment building in Korea. The defect dispute is complicated by main issues and details of dispute. It is yet to be solved. Meanwhile, a judge does not a inspection and analysis, but, related field expert who contracted professional engineer does. As a result, defect consulting report that an important judgment is used in a defect dispute. Therefore, this study does research on structure of defect consulting report. A defect consulting report has same items, irrespective of a defect consultant as a result that check 7 indexes about 10 cases. It has different structure's details depending on each defect consultants. And, it inserts new detail or deletes existing detail, does not show clear distinction.

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Clinical experience of open heart surgery: 12 cases (개심술 치험 보고: 12예)

  • 최영호
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.289-294
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    • 1983
  • The report is concerned to our experience of 12 cases of open heart surgery under the extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital during the period between Nov, 1979 and April, 1983. 1. There were 4 cases of congenital anomaly and 8 cases of acquired heart disease. 2. There were 6 male and 6 female patients with a mean age of 20 years. [range 9 to 33 years]. 3. The cases induced 2 ventricular septal defect, 2 atrial septal defects and 8 acquired valvular heart diseases. 4. The surgical managements were 2 primary repair for atrial septal defect and 2 patch closure for ventricular septal defect, 1 triple valve replacement [AVR MVR TVR], 1 aortic valve replacement, 4 double valve replacement [AVR MVR] and 2 open mitral commissurotomy for pure mitral stenosis. 5. The average cardiopulmonary bypass time was 61.5 minutes for congenital heart disease and 201.4 minutes for acquired valvular heart disease and the average aortic cross clamping time was 36.75 minutes for the former and 165.6 minutes for the latter. 6. Postoperatively, there were 1 Alopecia, 1 Electric burn and 1 wound infection as complication. 7. Overall operative mortality was 8.3%. 7. All patients received valve replacement were recommended anticoagulation with persantin.

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Reconstruction for Soft Tissue Defect of Dorsum of Hand or Foot with Free Temporal Fascial Flap (유리 측두 근막판을 이용한 수배부 및 족배부 연부조직 결손의 재건)

  • Lee, Byoung Ho;Nam, Yun Kwan;Ju, Pyong
    • Archives of Reconstructive Microsurgery
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    • v.9 no.1
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    • pp.37-43
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    • 2000
  • Vascularized tissue coverage is necessary for treatment of soft tissue defect with bone and tendon exposure on hand and foot dorsum, which cannot be successfully covered with simple skin graft or local flap. The temporal fascia is one of the most ideal donor for coverage of soft tissue defect of dorsum of hand or foot in term of ultra-thin, pliable and highly vascular tissue. Also, this flap offers the advantage of a well-concealed donor site in the hair-bearing scalp and smooth tendon gliding. We have experienced 11 cases of reconstruction for soft tissue defect in the hand or foot using temporal fascial flap with skin graft. All cases survived completely and we could gain satisfactory functional results. There were no specific complications except one donor site alopecia We think that the free temporal fascial flap coverage is a highly reliable method for soft tissue defect in hand and foot dorsum. However, the potential pitfalls is secondary alopecia and requirement of skin graft after its transfer.

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Pulmonary Artery Banding for Ventricular Septal Defect: Report of 2 Cases (심실중격결손의 Pulmonary Banding: 2 치험례)

  • 조범구
    • Journal of Chest Surgery
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    • v.5 no.1
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    • pp.29-34
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    • 1972
  • Interventricular Septal Defect is probably the most common congenital cardiac lesion. Despite rapid technical advances and increasing surgical experience the risk of surgical intervention for correction of Ventricular Septal Defect in infants with pulmonary hypertension remains formidable. Since Sirak et al [1959] reported a succesful case of two stage approach to their surgical correction, it has led to a policy of primary palliation,followed by complete correction as a secondary procedure, after age 3 to 4 years. Most surgeon prefer to perform complete correction of Ventricular Septal Defect when body weight exceeds 30 Lbs. and before development of so-called Eisenmengers complex, for the good postoperative results. Authors report 2 cases of Ventricular Septal Defect with pulmonary hupertenslon, who was underwent pulmonary artery banding as a palliative procedure in the Department of Surgery,Severance Hospital Yonsei University. Case 1:4 year old male, initially a complete correction of Ventricular Septal Defect was attempted by the help of mild hypothermia and extracorporeal circulation. During the procedure of a construction of an extracorporeal by- pass, a sudden cardiac arrest developed. After resuscitation of the heart,pulmonary artery banding was performed as a palliation. On the first postoperative day the patient developed generalized tonic convulsion, cyanosis, vomiting and eventually shock. Patient discharged home after a full recovery. Case 2.: 9 month old female, the pulmonary artery constricted with Teflon patch successfully. After the patients first postoperative day several cyanotic spells developed followed by 3 cardiac arrests. This repeated until when she expired with respiratory failure.

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Eisenmenger syndrome: report of 3 cases (Eisenmenger 증후군 3례 보)

  • Song, Won-Yeong;Lee, Jong-Tae;Lee, Gyu-Tae
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.250-256
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    • 1984
  • Eisenmenger syndrome is a condition which systemic arterial blood oxygen unsaturation occurs if obstruction in the pulmonary capillaries raises the pulmonary vascular resistance and pulmonary arterial pressure to or beyond systemic levels and then a significant right to left shunt develops across a preexisting cardiac septal defect or an aortopulmonary communication-We have experienced 3 cases of similar condition. Case I is 24 year old man who has had cyanosis and dyspnea on exertion since childhood. His pulmonary arterial pressure was 110/80mmHg. He was operated under diagnosis of the mitral stenosis and tetralogy of Fallot, but it was finally discovered that he had patent ductus arteriosus and ventricular defect was closed with perforated prosthetic patch, but the patient expired due to right heart failure low cardiac output. Case II was 16 year old female who had pulmonary hypertension of 110/85mmHg. She was diagnosed as Eisenmenger syndrome combining with atrial septal defect and patent ductus arteriosus. Case III was 20 year old male. His pulmonary arterial pressure was 110/70mmHg and the underlying defect was patent ductus arteriosus.

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Analysis of Defect Cases by Construction Types in Apartments (공동주택 공사종류별 하자사례분석)

  • Go, Seong-Seok;Song, Hyuk;Lee, Jae-Hong
    • Journal of the Korean Society of Safety
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    • v.21 no.6 s.78
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    • pp.64-73
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    • 2006
  • Due to the lack of available land for housing in Korea, apartment has been supplied in great quantities to raise the rate for land-use since the middle of 1980s. Many people in Korea live in apartment because the number of apartment occupies more than half of total houses. Nevertheless, the concern on the house management with respect to the quality is insufficient, it is currently required the concern on the quality of housing. Moreover, many defects in apartment has been occurred repeatedly now, so, it is necessary to analyze the defect in order to raise the quality of living environment. This study aimed to survey the types of defect in apartment according to the construction types through the questionnaire analysis about apartment residents in Gwangju city for the purpose of reducing the defects.

Microsurgical Reconstruction of Giant Cell Tumor of Distal Epiphysis of Radius (미세 수술을 이용한 광범위한 요골 원위 골단부 거대세포종의 재건술)

  • Kwon, Boo-Kyung;Chung, Duke-Whan;Han, Chung-Soo;Lee, Jae-Hoon
    • Archives of Reconstructive Microsurgery
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    • v.16 no.2
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    • pp.100-107
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    • 2007
  • Treatment of giant cell tumor of distal radius can be treated in several ways according to the aggressiveness of the tumor. But the management of giant cell tumor involving juxta-articular portion has always been a difficult problem. In some giant cell tumors with bony destruction, a wide segmental resection may be needed for preventing to recur. But a main problem is preserving of bony continuity in bony defect as well as preservation of joint function. We have attempted to overcome these problems by using a microvascular technique to transfer the fibula with peroneal vascular pedicle or anterior tibial vessel as living bone graft. From April 1984 to July 2005, we performed the reconstruction of wide bone defect after segmental resection of giant cell tumor in 14 cases, using Vascularized Fibular Graft, which occur at the distal radius. VFG with peroneal vascular pedicle was in 8 cases and anterior tibial vessel was 6 cases. Recipient artery was radial artery in all cases. Method of connection was end to end anastomosis in 11 cases, and end to side in 3 cases. An average follow-up was 6 years 6 months, average bone defect after wide segmental resection of lesion was 6.8 cm. All cases revealed good bony union in average 6.5 months, and we got the wide range of motion of wrist joint without recurrence and serious complications. Grafted bone was all alive. In functional analysis, there was good in 7 cases, fair in 4 cases and bad in 1 case. Pain was decreased in all cases but there was nearly normal joint in only 4 cases. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence.

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Reconstruction of a Mangled Foot with an Anterolateral Thigh Free Flap

  • Cook, Kyung Hoon;Park, Myong Chul;Park, Dong Ha;Lee, Il Jae;Song, Hyung Keun;Park, Young Uk
    • Archives of Reconstructive Microsurgery
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    • v.25 no.1
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    • pp.7-11
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    • 2016
  • Purpose: In recent decades, amputation is still recommended for patients with extensive lower extremity wounds requiring coverage. Although the feet contribute relatively little to total body surface area, they are essential organ for ambulation, and a high mortality rate after amputation has been reported. We report on 10 challenging cases of a mangled foot which was reconstructed using an anterolateral thigh (ALT) free flap, and analyze the advantages and disadvantages of this technique. Materials and Methods: This retrospective study was conducted on 10 patients who underwent reconstructive surgery on a foot. Patients' charts were reviewed for age, sex, causes, defect size and site, flap size and type, flap type, and complications. Cases with a defect size of > $100cm^2$ were included. Results: Seven of the 10 patients were male, and overall mean age was 38.5 years (range, 22 to 61 years). Mean defect size was $179.6cm^2$ (range, 104 to $330cm^2$), and mean flap size was $193cm^2$ (range, 120 to $408cm^2$). Three cases were reconstructed with a musculocutaneous free flap and seven cases were reconstructed with a fasciocutaneous free flap. There were two occurrences of local wound complication. All ten flaps survived well, however five patients underwent a debulking procedure to reduce flap volume. Conclusion: Reconstruction of a near completely degloved soft tissue defect or a wide defect containing two or more surfaces of extremity with an ALT free flap was performed. The purpose of this case study is to report on free tissue transfer using the ALT flap for salvage of the lower extremity.