• 제목/요약/키워드: persistent defects

검색결과 40건 처리시간 0.025초

총동맥간 잔류증 [IV 형]Rastelli 수술 치험 보고 (Rastelli operation in Persistent Truncus Arteriosus, Type IV: A Case Report)

  • 김형묵
    • Journal of Chest Surgery
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    • 제11권3호
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    • pp.333-341
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    • 1978
  • A 8 year old male was admitted to the Department of Thoracic Surgery, Korea University Hospital on June 22, 1978. The chief complaints were cyanosis and exertional dyspnea since at birth. EKG shows BVH and dextrocardia, phonocardiogram revealed the accentuation of second heart sound in aortic area. Echocardiogram from the left ventricle to the base of the heart, there is a discontinuity between the ventricular septum and the anterior aortic margin with a large aortic root & aortic overriding. His cardiac catheterization data and cardiac angiogram shows situs inversus totalis, dextrocardia, right aortic arch, large ventricular septal defect etc., and finally diagnosed Truncus Arteriosus. Edwards type IV with retrograde aortogram and selective bronchial angiogram. This is the first operative case reported as Rastelli operation for Truncus Arteriosus type IV in the literatures in Korea. Authors have experienced I case of Truncus Arteriosus, Edward type IV and Rastelli operation with Dacron Arterial Conduit Graft under cardiopulmonary bypass on July 3, 1978. The procedures were as follows; 2] Cardiopulmonary bypass: Origin of bronchial arteries excised from descending aorta bilaterally; defects in aorta closed. 2] Horizontal incision made high in right ventricle. 2] Ventricular septal defect [Kirklin type I+II] closed with Teflon patch. 4] Bifurcated dacron arterial graft with pericardial monocusp sutured to the bilateral pulmonary arteries. [Diameter 9 mm: Length 7 cm]. 5] Proximal end of the conduit graft anastomosed to right ventricle. [Diameter 19 mm: Length 5 cm]..Total perfusion time was 220 min. The result of operation was poor due to anastomotic leakage and increased pulmonary vascular resistance resulting acute right heart failure. The patient was died on the operation table. Literatures were briefly reviewed.

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Environmental Chemical-Dioxin Impacts on Biological Systems: A Review

  • Vo, Thuy Thi Bich;Le, Binh Thi Nguyen;Nong, Hai Van;Yang, Hyun;Jeung, Eui-Bae
    • 한국수정란이식학회지
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    • 제28권2호
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    • pp.95-111
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    • 2013
  • Worldwide there is concern about the continuing release of a broad range of environmental endocrine disrupting chemicals, including polychlorinated biphenyls, dioxins, phthalates, polybrominated diphenyl ethers (PBDEs), and other halogenated organochlorines persistent organic pollutants (POPs) into the environment. They are condemned for health adverse effects such as cancer, reproductive defects, neurobehavioral abnormalities, endocrine and immunological toxicity. These effects can be elicited via a number of mechanisms among others include disruption of endocrine system, oxidation stress and epigenetic. However, most of the mechanisms are not clear, thus several number of studies are ongoing trying to elucidate them in order to protect the public by reducing these adverse effects. In this review, we briefly limited review the process, the impacts, and the potential mechanisms of dioxin/dioxin like compound, particularly, their possible roles in adverse developmental and reproductive processes, diseases, and gene expression and associated molecular pathways in cells.

항공용 이동 무선 데이터 통신에 적합한 매체접속제어 프로토콜에 관한 연구 (A study on the MAC protocol for an aeronautical mobile data communication)

  • 이은주;박효달
    • 한국통신학회논문지
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    • 제22권11호
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    • pp.2604-2612
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    • 1997
  • 현재 항공기에서 사용중인 ACARS의 항공기국과 지상 통신국 사이의 MAC 프로토콜인 CSMA는 고정 터미날 라디오 통신이나 유선 LAN에서는 적합하지만 무선 이동 라디오 환경에는 부적합한 면이 있다. 본 논문에서는 이 문제의 해결을 위해 제안된 ICMA/CD를 살펴보고 이를 개선하기 위하여 별도의 제어 채널을 두지 않고 제어 신호를 메세지 신호에 삽입시키는 변형된 ICMA/CD를 제한하고 이의 성능을 분석한 후 시뮬레이션을 통해 검증하였다. 결과적으로 변형된 ICMA/CD는 CSMA의 성능을 저하시키는 잠복 터미날 문제를 해결하는것과 동시에 ICMA/CD의 성능을 저하시키는 패킷 감지 지연 시간이 제거되므로 유선통신에서 사용되는 CSMA/CD와 같은 좋은 채널 효율을 얻을 수 있다는 결론을 얻었다. 따라서, 이 결과는 변형된 ICMA/CD 프로토콜이 항공통신에서 사용하기에 적합하다는 것을 보여준다.

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A method to prevent cerebrospinal fluid leakage: Reinforcing acellular dermal matrix

  • Lee, Hojune;Eom, Ye Seul;Pyon, Jai-Kyong
    • 대한두개안면성형외과학회지
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    • 제21권1호
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    • pp.45-48
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    • 2020
  • In neurosurgical cases, problems related to wound healing can vary from simple wound dehiscence to multilayer defects. This study demonstrates an effective method to prevent persistent cerebrospinal fluid (CSF) leakage using reinforcing acellular dermal matrix in neurosurgical patients with wound dehiscence. A 52-year-old woman was admitted for management of recurrent glioblastoma. After tumor removal surgery, the patient experienced sustained CSF leakage from the wound despite reparative attempts. The plastic surgery team performed wound repair procedure after remnant tumor removal by the neurosurgery team. Acellular dermal matrix was applied over the mesh plate to prevent CSF leakage and the postoperative status of the patient was evaluated. No sign of CSF leakage was found in the immediate postoperative period. After 3 years, there were no complications including CSF leakage, wound dehiscence, and infection. We hereby propose this method as a feasible therapeutic alternative for preventing CSF leakage in patients experiencing wound problem after neurosurgical procedures.

유리 피판술과 동측 비골 전위술을 이용한 경골 결손의 재건 (Reconstruction of Tibia Defect with Free Flap Followed by Ipsilateral Fibular Transposition)

  • 정덕환;박준영;한정수
    • Archives of Reconstructive Microsurgery
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    • 제14권1호
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    • pp.42-49
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    • 2005
  • Between June 1989 and may 2004 Ipsilateral vascularized fibular transposition was performed on nine patients with segmental tibial defects combined with infection following trauma. Ipsilateral vascularized fibular graft was performed on two or three stage according to the degree of infection. Initially free vascular pedicled graft was done followed by ipsilateral vascularized fibular graft. Type of free flap used is scapular free flap 3 cases, latissimus dorsi free flap 5 cases and dorsalis pedis flap 1 cases. The patients were followed for an average of 3.4 years. the average time to union was 6.7 months, and in all patients the graft healed in spite of complication. Complication was free flap venous thrombosis in 1 cases, persistent infection in 1 cases, delayed bony union at the distal end of fibular graft in 2 cases. The results showed that more faster bony union was seen in which cases firmly internally fixated and more faster hypertrophy of graft in which cases was permitted to ambulate on early weight bearing and more faster healing in which cases debrided more meticulously. Reconstruction of tibia defect with free flap followed by Ipsilateral fibular transposition is a useful and safe method to avoid the potential risk of infection for patients with tibial large bone defect and soft tissue defect associated with infection.

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인공진피($Terudermis^{(R)}$)와 부분층 피부이식을 이용한 전완피판 공여부 수복 (APPLICATION OF ARTIFICIAL DERMIS($Terudermis^{(R)}$) AND SPLIT THICKNESS SKIN GRAFT ON THE DONOR SITE OF RADIAL FOREARM FLAP)

  • 오정환
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권3호
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    • pp.227-232
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    • 2007
  • The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

Use of a buccinator myomucosal flap and bilateral pedicled buccal fat pad transfer in wide palatal fistula repair: a case report

  • Choi, Jin Mi;Park, Hojin;Oh, Tae Suk
    • 대한두개안면성형외과학회지
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    • 제22권4호
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    • pp.209-213
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    • 2021
  • Primary palatoplasty for cleft palate places patients at high risk for scarring, altered vascularity, and persistent tension. Palatal fistulas are a challenging complication of primary palatoplasty that typically form around the hard palate-soft palate junction. Repairing palatal fistulas, particularly wide fistulas, is extremely difficult because there are not many choices for closure. However, a few techniques are commonly used to close the remaining fistula after primary palatoplasty. Herein, we report the revision of a palatal fistula using a pedicled buccal fat pad and palatal lengthening with a buccinator myomucosal flap and sphincter pharyngoplasty to treat a patient with a wide palatal fistula. Tension-free closure of the palatal fistula was achieved, as well as velopharyngeal insufficiency (VPI) correction. This surgical method enhanced healing, minimized palatal contracture and shortening, and reduced the risk of infection. The palate healed with mucosalization at 2 weeks, and no complications were noted after 4 years of follow-up. Therefore, these flaps should be considered as an option for closure of large oronasal fistulas and VPI correction in young patients with wide palatal defects and VPI.

Single-flap versus double-flap approach for periodontal pocket reduction in supraosseous defects: a comparative study

  • Mathala, Venkata Lakshmi;Konathala, Santosh Venkata Ramesh;Gottumukkala, Naga Venkata Satya Sruthima;Pasupuleti, Mohan Kumar;Bypalli, Vivek;Korukonda, Radharani
    • Journal of Periodontal and Implant Science
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    • 제51권4호
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    • pp.239-253
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    • 2021
  • Purpose: The single-flap approach (SFA) is a minimally invasive technique with limited mucoperiosteal flap elevation to gain access to the buccal/palatal aspects, thus limiting post-surgical complications. The purpose of the present study was to gain insights into the impact of the SFA over the double-flap approach (DFA) on periodontal flap treatment outcomes and patient compliance in terms of discomfort and time taken for surgical procedures. Methods: Twenty patients with persistent probing pocket depths of ≥5 mm were scheduled for the SFA (test site) and for the DFA (control site). All the clinical periodontal parameters were recorded at baseline, 3 months, and 6 months. Radiographic bone level (cone-beam computed tomography) was evaluated at baseline and 6 months. Patients' postoperative pain perception and wound healing were also assessed. Results: The SFA showed a significant reduction in periodontal pocket depth, gain in clinical attachment level (CAL), and gain in bone level when compared with the DFA. The SFA substantially improved wound healing and induced less postoperative pain than the DFA. Conclusions: The SFA resulted in substantial improvement in the composite outcome measures, as shown by a reduction in pocket depth with minimal gingival recession, gain in CAL, early wound healing, less postoperative discomfort, and better patient-centered outcomes.

관상동맥 질환에서 우회로 수술 전 T1-201 휴식-24시간 지연 심근 관류 SPECT를 이용한 심근생존능의 평가 (Viability Assessment with T1-201 Rest-24 hour Delay Redistribution SPECT before Coronary Artery Bypass Graft in Coronary Artery Diseases)

  • 윤석남;김기봉;이원우;정준기;이명철;서정돈;고창순;이동수
    • 대한핵의학회지
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    • 제30권4호
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    • pp.493-501
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    • 1996
  • 관상동맥 질환으로 관동맥 우회로 수술을 받은 환자에서 수술 전에 휴식-24시간 지연 영상을 얻어 휴식기 T1-201 섭취와 24시간 후의 재분포 여부를 평가하여 수술 후 심근벽 운동이 호전되었는지 여부와 비교하여 다음과 같은 결과를 얻었다. 1) 대상 환자 17명에서 휴식기 관류가 정상이 아닌 분절이 56분절이었으며 이 중 조금 감소된 분절이 31 분절, 감소가 심한 분절이 14분절, 결손인 분절이 11 분절이었다. 24시간 지연 영상에서 재분포를 보인 분절이 19분절, 재분포가 없었던 분절이 37분절이었다. 2) 56분절 중 수술 후에 호전된 분절이 34분절(61%), 호전되지 않은 분절이 22분절(39%)이었다. 호전된 분절을 생존심근 호전되지 않은 심근을 비생존 심근으로 보았다. 3) 휴식기 T1-201 섭취가 조금 감소한 경우 수술 후 심근벽 운동이 호전될 가능성이 컸다. 4) 휴식기 T1-201섭취에 비해 지연기에 재분포된 19개 분절 중 74%에서 심근벽 운동이 호전되었다. 재분포가 없었던 37개 분절도 54%가 호전되었다. 5) 휴식기 관류감소가 심하지 않거나 재분포되었을 때 생존심근을 76%에서 예측할 수 있었다. 휴식기 관류감소가 심하며 동시에 지연기에 재분포되지 않은 경우 비생존심근임을 85%에서 예측할 수 있었다. 관동맥 우회로 수술 전에 얻은 휴식-24시간 지연 T1-201 SPECT로 휴식기 T1-201 섭취 정도와 지연기 재분포 여부를 관찰함으로써 수술 후 심근벽 운동의 호전 여부를 예측할 수 있었다. 휴식 T1-201/디피리다몰 부하 Tc-99m-MIBI/지연 T1-201 SPECT 검사로 관상동맥 질환을 진단할 수 있을 뿐 아니라 생존심근을 찾는 데 바람직한 검사로 생각하였다.

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Fontan 수술후 저심장박출증 및 지속성 흉막 삼출액이 발생되는 해부생리학적 원인 (Modified Fontan Operation: Physio-anatomic Causes of Low Cardiac Output and Persistent Pleural Effusion)

  • 한재진;서경필
    • Journal of Chest Surgery
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    • 제23권2호
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    • pp.213-221
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    • 1990
  • We have experienced 62 cases of modified Fontan operations in Seoul Nat’l University Hospital from Apr. 1986 to Jul. 1989, They were 38 males and 24 females, and their age was ranged from 16 months to 15.5 years of age. [mean age : 5.73$\pm$2.99 years] There were 16 operative deaths and 2 late deaths, therefore 29% of overall mortality. Their diagnoses were as follows; 28 single ventricle, 11 tricuspid atresia, 6 DORV with LV hypoplasia, 3 pulmonary atresia with hypoplastic RV, 3 TGA with hypoplastic RV, 3 cor\ulcornerGA with hypoplastic LV and PA, 6 AV canal defects with PA, and 2 others. Low cardiac output and pleural effusion were developed frequently, so we divide 40 patients into some groups to analyze the physiologic and anatomic causes of them. By the degree of the LCO, group A was no LCO[mean amount of inotropics used: 0-5 \ulcornerg/kg/min] with 17 cases, B mild LCO [5-10] with 11, C moderate to severe LCO but alive[>10] with 8, D severe LCO to death with 4 cases. For the pleural effusion, group 1 was to be removed the chest tube within 1 week with 8 cases, group II within 3 weeks with 21 cases, group III beyond 3 weeks with 12 cases. We considered their age, diagnosis, pulmonary artery size[PA index], pulmonary artery abnormality, palliative shunt, systemic ventricular type, pulmonary artery wedge pressure, as preoperative factors, and operative methods, and as postoperative factors, CVP, LAP, arrhythmia, thrombosis, atrioventricular valvular insufficiency, etc. In the view of LCO, pulmonary artery size and PCWP were statistically significant [P<0.05], and arrhythmia, A-V valve insufficiency were inclined to the group C and D Pleural effusion was influenced by the pulmonary artery size, pulmonary artery resistance, PCWP, and CVP significantly. [P<0.05] And arrhythmia, residual shunt, and A-V valvular insufficiency were inclined to group II and III, too. As a results, the followings are to be reminded as the important factors at the care of post-Fontan LCO, and persistent pleural effusion [1] pulmonary artery size, [2] pulmonary artery resistance, [3] PCWP, [4] CVP, [5] arrhythmia, [6] residual shunt, [7]A-V valvular insufficiency.

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