• 제목/요약/키워드: heart surgery

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함치성 낭종의 조대술 후 미맹출 변위 영구치의 교정적 정출: 증례보고 (Forced Eruption of Severe Angulated and Impacted Permanent Teeth after Marsupialization of Dentigerous Cyst: Case Report)

  • 남정훈;노경록;유우근;이병민;전지현;박수현;안장훈;김정희
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권1호
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    • pp.83-88
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    • 2011
  • The goal of this treatment is the surgical-orthodontic eruption of impacted permanent teeth associated with a large dentigerous cyst in a preadolescent patient. Although enucleation of the entire cyst and the extraction of impacted teeth are common treatments, missing permanent teeth cause several problems in young patients. In this report, an 11-year-old female visited with the chief complaint of a large radiolucent lesion from the mandibular anterior area to the left mandibular posterior area. The permanent left canine and premolars were displaced toward the mandibular inferior border area. The extraction of infected deciduous teeth and marsupialization were performed. After 4 months, orthodontic buttons for forced eruption were applied to the impacted permanent teeth. The teeth emerged into the oral cavity 3 months after the orthodontic treatment. Although the root form was abnormal, there were no other pathogenic signs. The alveolar bone had a normal trabecular pattern and the teeth appeared to be well maintained at postoperative 24 months.

폐동맥 협착과 심실 중격 결손을 동반한 대혈관 전위에서 시행한 반회전 동맥간 전환술 (Half-turned Truncal Switch Operation for Transposition of Great Arteries, Ventricular Septal Defect and Pulmonic Stenosis)

  • 임홍국;황성욱;이철;김종환;김준석;이창하
    • Journal of Chest Surgery
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    • 제39권2호
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    • pp.145-149
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    • 2006
  • 폐동맥 협착과 심실 중격 결손을 동반한 대혈관 전위를 갖는 환자들에 대한 수술은 Rastelli 수술법이나 Lecornpte 수술법이 전통적으로 시행되어 왔으나, 심실 내 터널에 의한 뒤틀린 좌심실 유출로와 부자연스러운 우심실 유출로에 의해 장기 성적은 만족스럽지 않다. 이에 대한 대안으로 저자들은 이 기형으로 진단된 3세 환아(체중 9.6 kg)에서 반회전 동맥간 전환술(half-turned truncal switch operation)을 시행하였다. 술 후 심초음파 검사에서 좌심실유출로와 우심실유출로가 곧고 넓게 형성되어 향후 좋은 장기 결과가 기대된다.

전기화상에서 시행한 유리피판의 소실과 재건시기에 대한 연구 (Study of Loss of Free Flap and Safer Timing of the Operation in Electrical Injury)

  • 정의영;이종욱;고장휴;서동국;정찬민;장영철;오석준
    • Archives of Plastic Surgery
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    • 제32권5호
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    • pp.567-572
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    • 2005
  • An electrical burn used to result in the damage of the skin and underlying deep soft tissue injury. Thus, in order to preserve devitalizing tissues and promote the structural survival free flaps with ample blood supply are frequently employed. However, early unpredictable vascular injury and progressive tissue necrosis may cause the free flaps full of hazards. We applied 50 free flaps upon 41 acute electrical burn cases between 1998 and 2004. Injured areas, timing of operation and causes of flap loss were studied. The victim's ages ranged from 13 to 60 years. (an average 37.8 years) Thirteen out of 50 free flaps were lost totally: three cases were due to arterial insufficiency and ten venous congestion. Total loss of flaps were observed in 5 of 12 cases in the postoperative 3 weeks, 6 of 20 cases between 3 and 6 weeks and 2 of 18 cases after 6 weeks. In three of 12 cases the free flap was lost partially in the postoperative 3 weeks, 4 of 20 cases between 3 and 6 weeks and 1 of 18 cases after 6 weeks. The result was statistically significant by a T-test (p<0.05). This study showed that timing of the operation is accountable for the loss of free flap. It is most important to conduct the free flap procedure on an electrical injury at the time when the recipient vessel is definitely discernible and intact so as to minimize the loss of flap and spare the structures.

Upper eyelid reconstruction using a combination of a nasal septal chondromucosal graft and a Fricke flap: a case report

  • Lee, Ju Ho;Woo, Sang Seok;Shin, Se Ho;Kim, Hyeon Jo;Kim, Jae Hyun;Kim, Seong Hwan;Suh, In Suck
    • 대한두개안면성형외과학회지
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    • 제22권4호
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    • pp.204-208
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    • 2021
  • Sebaceous carcinoma is a malignant neoplasm that usually arises in the sebaceous glands of the eyelids. Its pathogenesis is unknown; however, irradiation history, immunosuppression, and use of diuretics are known risk factors. The mainstay of treatment for sebaceous carcinoma of the eyelid is wide surgical resection with a safety margin of 5 to 6 mm, which often results in full-thickness defects. The reconstruction of a full-thickness defect of the eyelid should be approached using a three-lamella method: a mucosal component replacing the conjunctiva, a cartilage component for the tarsal plate, and a flap or skin graft for the skin of the eyelid. In this case, a full-thickness defect of the upper eyelid was reconstructed after tumor removal using a combination of a nasal septum chondromucosal composite graft and a forehead transposition flap, also known as a "Fricke flap." The flap was designed to include a line of the eyebrow on the lower margin of the flap to replace the eyelash removed during tumor excision. The wound healed completely, without any early or late complications, and the outcome was satisfactory.

Unexpected Restart Failure of Durable Left Ventricular Assist Devices: A Report of Two Cases

  • Hyo Won Seo;Ga Hee Jeong;Sung Min Kim;Minjung Bak;Darae Kim;Jin-Oh Choi;Kiick Sung;Yang Hyun Cho
    • Journal of Chest Surgery
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    • 제57권3호
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    • pp.315-318
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    • 2024
  • The HeartWare Ventricular Assist Device (HVAD) was widely used for mechanical circulatory support in patients with end-stage heart failure. However, there have been reports of a critical issue with HVAD pumps failing to restart, or experiencing delays in restarting, after being stopped. This case report describes 2 instances of HVAD failure-to-restart during heart transplantation surgery and routine outpatient care. Despite multiple attempts to restart the pump using various controllers and extensions, the HVAD failed to restart, triggering a hazard alarm for pump stoppage. In one case, the patient survived after receiving a heart transplantation, while in the other, the patient died immediately following the controller exchange. These cases highlight the rare but life-threatening complication of HVAD failure-to-restart, underscoring the importance of awareness among clinicians, patients, and caregivers, and adherence to the manufacturer's guidelines and recommendations for HVAD management.

Transposition of Great Arteries and Ventricular Septal Defect in Jehovahs Withnesses

  • Yang-Bin Jeon, M.D;Seog-Ki Kee, M.D;Jun-Yong Cho, M.D;Man-Jong Baek, M.D;Soon-Ho Chun, M.D
    • Journal of Chest Surgery
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    • 제34권3호
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    • pp.243-245
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    • 2001
  • 여호와의 증인을 부모로 둔 환아는 생후 4개월, 5.6kg이었다. 심초음파상 완전 대혈관 전위와 심실 중격 결손, 심방 중격 결손, 동맥관 개존중 및 양측상대 정맥이 관찰되었다. 수술전 혈색소 값은 14.9 g/dl이었다. 수혈없이 심실 중격 결손 교정과 대혈관 치환술을 시행하였으며, 별문제 없이 수술 후 16일에 환아는 퇴원하였다. 퇴원 당시 혈색소 값은 12.8 kg/dl 였다. 복잡 심기형을 가진 영아에서 수술전 eryrhropoietin의 투여, 수술중 철저한 지혈 및 초여과법등의 방법으로 수혈 없이 완전 교정술이 가능하였기에 보고하는 바이다.

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개심술 211례에 대한 임상적 고찰 (Clinical experience of open heart surgery: 211 cases)

  • 강인득
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.804-810
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    • 1984
  • Two hundred twenty one cases of open heart surgery were done in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July, 1981 to October, 1984. 1.There were 154 cases [73%] of congenital anomalies and 57 cases [27%] of acquired valvular heart diseases. Among the congenital cases, 128 cases were acyanotic and 26 cases were cyanotic. Among the 57 cases of acquired valvular replacement surgery, 3 cases had open heart commissurotomy, one had Kay annuloplasty. 2.The age distribution of the congenital acyanotic anomalies ranged from 5 to 32 years with mean age of 12.8 years, the congenital cyanotic anomalies from 3 to 29 years with mean age of 14.2 years and the acquired valvular diseases from 9 to 51 years with mean age of 30 years. The difference of sex distribution was no significance. 3.Three methods for debubbling process were used in our institute, in 133 cases, the vent was inserted into the left ventricular apex, in 61 cases inserted into the left atrium through right superior pulmonary vein and in 17 cases used needle aspiration only. 4.For cardioplegia, the GIK solution was infused repeatedly from 30 to 40 minutes interval and brought excellent results for myocardial protection during open heart surgery. 5.Overall mortality was 7.6%. The mortality along with each disease is 1.56% in congenital acyanotic cases, 26.9% in congenital cyanotic cases and 12.3% in acquired valvular disease.

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78세 고령에서의 심장이식 (Heart Transplantation in a 78-year-old Patient)

  • 박병준;박표원;최선우;성기익;양지혁
    • Journal of Chest Surgery
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    • 제41권5호
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    • pp.640-642
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    • 2008
  • 고령은 심장이식 후 사망의 위험인자로 상대적 금기로 알려져 왔으나 최근 일부 연구에 의하면 젊은 환자에 비교하여 초기 및 중기 생존률의 통계적 차이가 없다고 보고되고 있다. 평균 수명의 연장과 보전적 투약 치료의 발전으로 심장이식수술이 유일한 치료로서 합당한 고령의 말기 심질환 환자가 증가하는 추세이다. 본 저자들은 78세의 고령의 환자에게 성공적으로 심장이식수술을 시행하였기에 그 사례를 보고하는 바이다.

Heart Transplantation in a Patient with Left Isomerism

  • Bang, Ji Hyun;Oh, You Na;Yoo, Jae Suk;Kim, Jae-Joong;Park, Chun Soo;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • 제48권4호
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    • pp.277-280
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    • 2015
  • We report the case of a 37-year-old man who suffered from biventricular failure due to left isomerism, inferior vena cava interruption with azygos vein continuation, bilateral superior vena cava, double outlet of right ventricle, complete atrioventricular septal defect, pulmonary stenosis, and isolated dextrocardia. Heart transplantation in patients with systemic venous anomalies often requires the correction and reconstruction of the upper & lower venous drainage. We present a case of heart transplantation in a patient with left isomerism, highlighting technical modifications to the procedure, including the unifocalization of the caval veins and reconstruction with patch augmentation.

규폐증 환자에서 기관지 결석증으로 인한 기관지식도루 -1예 보고- (Bronchoesophageal Fistula Complicated by Broncholithiasis in a Patient with Silicosis - 1 case -)

  • 황여주;전양빈;박철현;박국양;이재익
    • Journal of Chest Surgery
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    • 제38권6호
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    • pp.450-453
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    • 2005
  • 규폐증 환자에서 기관지 결석증은 드물게 발생판다. 특히 기관지 결석증의 합병증으로 기관지식도루가 발생한 예는 매우 드물어 국내에서는 1예 보고된 바 있다. 기관지 결석증과 기관지 식도루의 수술치료는 손상되지 않은 폐실질을 최대한 보존하고, 누공의 비혈관성 조직들을 완전히 제거하여 식도와 기관지 봉합 부위를 흉막 피판이나 늑간근 피판으로 완전히 감싸주는 것이 중요하다. 저자들은 규폐증 환자에서 기관지 결석증으로 인한 기관지식도루 1예를 수술 치험하였기에 이를 보고하는 바이다.