• Title/Summary/Keyword: 완전 교정

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Long-term Results of Surgical Correction for Partial Atrioventricular Septal Defects -Seventeen-year Experience - (부분방실중격결손증에 대한 외과적 교정의 장기 결과)

  • 이정렬;박천수;임홍국;김용진;노준량;배은정;노정일;윤용수
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.911-920
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    • 2003
  • In this study, we analyzed the long-term surgical outcome of partial atrioventricular septal defects during the past 17 years at Seoul National University Hospital. Material and Method: A retrospective analysis on mortality, survival, and reoperation and their risk factors was done in 93 patients who underwent surgical correction of partial atrioventricular septal defects between April 1986 and December 2002. 32 patients were male and 61 were female with a median age of 68 months (3∼818 months) and a mean follow-up period of 108 months (1∼200 months). Result: There were 4 operative deaths (4.3%) and one mortality during the follow-up period. 3, 5, 10, and 15 year actuarial survival rates were 95.7%, 94.3%, 94,3%, and 94.3%, respectively. After the surgical correction, left atrioventricular valve Incompetence was improved in 61patients (67.7%), remained same as the preoperative status in 14 patients (15.1%), and was aggravated in 12 patients (12.9%). Reoperation was performed in 8 patients (9.0%) after a mean interval of 38.6 months (3∼136 months). Freedom from reoperation rates at 3, 5, 10, and 15 years after surgical correction were 94.0%, 91.4%, 91.4%, and 88,2%, respectively Reasons for reoperation were 7 left atrioventricular valve incompetence, 2 left ventricular outflow tract obstruction, a residual atrial septal defect, a left atrioventricular valve stenosis, and a right ventricular failure. Left ventricular outflow tract obstruction was the only statistically significant factor. In ten patients, significant arrhythmia was developed and three of them were supraventricular arrhythmia. Complete atrioventricular block occurred in 7 patients and permanent pacemakers were implanted in six of them. Conclusion: Surgical corrections of partial atrioventricular septal defects were performed with low operative mortality. Since left atrioventricular valve incompetence was the most common cause of reoperation and left ventricular outflow tract obstruction was the only risk factor for reoperation, a precise estimation of the left atrioventricular valve morphology and the structure of left ventricular outflow tract are needed. Although left ventricular outflow tract obstruction rarely developed, reoperation was frequently required and resection of subaortic tissue could be peformed but the possibility of recurrence was high, so modified Konno operation could be performed with satisfactory results. Complete atrioventricular block developed frequently in early periods, but was overcome with a precise anatomical understanding of conduction system and experience.

Surgical and Long Term Results for Double Outlet Right Ventricle by the Type of Ventricular Septal Defect (심실중격결손의 형태에 따른 양대혈관 우심실기시증의 수술 및 장기 결과)

  • Yu Song Hyeon;Park Han Ki;Cho Bum Koo;Park Young Hwan
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.181-190
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    • 2005
  • The results of biventricular repair for double outlet right ventricle have been improved in recent series. We studied the surgical and long term results for total correction of double outlet right ventricle by the type of ventricular septal defect. Material and Method: Between November 1979 and December 2003, 126 patients had biventricular repair for double outlet right ventricle. The mean age was 1.8 years (range 1$\~$44) and 86 patients ($68.3\%$) were male. We classified and studied this disease by the type of VSD. Result: The locations of VSD were subaortic in 79 ($62.7\%$), subpulmonary in 17 ($13.5\%$), doubly committed in 16 ($12.7\%$) and noncommitted in 14 ($11.1\%$). 28 patients had palliative operation before total correction and the mean interval to total correction was 41.0$\pm$45.1 months. The methods of total correction were intraventricular baffling in 37 ($29.4\%$), intraventricular baffling with patch enlargement of right ventricular outflow tract in 49 ($38.9\%$), intraventricular baffling with Rastelli procedure in 15 ($11.9\%$), arterial switch operation in 8 ($6.3\%$) and REV procedure in 4 ($3.2\%$), etc. Hospital mortality rate was $10.3\%$ (13 patients) and 25 reoperations were performed in 24 patients ($19.0\%$). The risk factors for hospital mortality and reoperation were cardiopulmonary bypass time (p=0.020) and previous palliative operation (p=0.013), respectively. Follow up was possible in 98 patients and mean follow up period was 118.9$\pm$70.7 months. The percent survival and survival for freedom from reoperation at 15 years were $82.5\%$ and $66.7\%$, respectively. The survival rate was significantly lower (p=0.003) in transposition of great artery type and remote type than in simple ventricular septal defect type and tetralogy of Fallot type, but there was no statistical differences in survival rate for freedom from reoperation. Conclusion: It is thought to be that acceptible surgical and long term results can be obtained with application of appropriate methods of repair for double outlet right ventricle.

Effect of presurgical nasoalveolar molding (PNAM) appliance and cheiloplasty on alveolar molding of complete unilateral cleft lip and palate patients (완전 편측성 순구개열 신생아 환자의 술전 비치조 정형장치와 구순열 수술이 치조골 정형에 미치는 효과)

  • Kim, Na-Young;Lee, Shin-Jae;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.33 no.4 s.99
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    • pp.235-245
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    • 2003
  • The goal of the present study was to evaluate the effects of PNAM appliance and cheiloplasty on alveolar molding. Samples consisted of 16 unilateral cleft lip and palate infants (10 males and 6 female, mean age=37.0 days after birth, average alveolar cleft gap=10.46m), who were treated with PNAM appliances by one orthodontist and rotation- advancement cheiloplasty by one surgeon in Seoul National University Hospital. Average duration of alveolar molding treatment was 13.10 weeks and these patients were recalled at average 8.31 weeks after cheiloplasty. These patients' models were obtained at initial visit (T0, mean age : $37.0\pm27.89$ days after birth), after successful alveolar molding (T1, mean age : $119.25\pm40.18$ days after birth), and after cheilopasty (T2, mean age : $190.81\pm42.78$ days after birth). Seven linear and five angular variables were measured using 1 : 1 photometry and soft ware program(V-ceph. Cybermed. Seoul, Korea). Paired t-test was performed to investigate statistical significance at p<0.05 level. 1 The posterior parts of alveolar segments were the stable structures during alveolar molding treatment period and after cheiloplasty in infants. 2. The closure of cleft gap during alveolar molding was usually due to backward bending of the whole part of the greater segment. 3. Although forward growth of the greater segment was hindered by alveolar molding, it resumed after cheiloplasty. 4. Increase of anterior inter-segment angle after cheiloplasty was due to the molding effect of the lip scar pressure.

Effects of Induced Dioptric Blur on Visual Acuity and Contrast Sensitivity (유발된 광학적 흐림이 시력과 대비감도에 미치는 영향)

  • Kim, Chang-Jin;Choi, Eun Jung
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.2
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    • pp.261-270
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    • 2014
  • Purpose: To study the effect of an artificially induced dioptric blur on acuity and contrast sensitivity using the $Optec^{(R)}$ 6500. Methods: Healthy 31 subjects aged $22.90{\pm}1.92$ (male 16, female 15) who were recruited from university students with 6/6 (20/20) or better corrected visual acuity and normal binocularity. They were measured objective and subjective refraction for full correction and dioptric blur using 0.00 ~ +3.00 D (+0.50 D steps) trial lenses and trial frame. They were measured binocularly visual acuity and contrast sensitivity with the $Optec^{(R)}$ 6500 (Stereo Optical Co., Inc., Chicago, Illinois, USA) under day conditions (photopic condition, $85cd/m^2$). Results: The higher dioptric blur, the less distance visual acuity and decrease rate of visual acuity. The higher dioptric blur, the less contrast sensitivity at all frequencies, and the peak of contrast sensitivity was shifted from middle frequency (6 cpd) to low frequency (1.5 cpd). When the visual acuity was best visual acuity to 0.77, there was the peak point at 6 cpd which was normal contrast sensitivity peak point. Conclusions: If the low refractive error is uncorrected or the refractive error is inappropriate, the contrast sensitivity is decreased and the peak point of contrast sensitivity frequency is shifted abnormally though small uncorrected refractive error. So it will be considered that regular eye test and decision of refractive error correction is important.

A Statistical Study on Characteristics and Treatment of Child and Adolescent Patients with Tooth Impaction (소아·청소년 환자의 매복치 특성과 치료에 관한 연구)

  • Jo, Wansun;Lee, Nanyoung;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.4
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    • pp.306-313
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    • 2014
  • Impacted teeth are teeth with a delayed eruption time or that are expected to erupt incompletely. Those teeth can cause a series of potential problems such as root displacement and resorption, periodontal problems in adjacent teeth, referred pain and the formation of cysts and odontogenic tumors. The purpose of this study was to investigate characteristics and treatment of child and adolescent patients younger than 15 years of age that were diagnosed with an impacted tooth who visited the Chosun University Dental Hospital. The impacted tooth, its etiology, treatment and traction period were surveyed through electric medical records, radiographs in 335 patients. We excluded the impacted third molar, supernumerary and deciduous teeth from this study. The most frequently impacted teeth are upper canine, followed by the upper incisor. The most common etiologies of impaction were an abnormal eruption pathway and localized pathologic lesions. The treatment of an impacted tooth was mostly orthodontic traction. The traction period was relatively short in cases with distinct obstacles, with an impacted upper incisor and if patients were younger. An orthodontic traction is considered to be more unfavorable if the patient gets older. Therefore, an early diagnosis and a precise treatment plan through a regular check-ups are mandatory.

Retrospective Study on Surgical Repair of 31 Canine Pelvic Fracture Cases (골반 골절의 수술적 교정을 실시한 31두 개에서의 후향연구)

  • Lee, Seung-Hoon;Park, Sung-Su;Kang, Byung-Jae;Kim, Yong-Sun;Kim, Wan-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.8-11
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    • 2012
  • The results of surgical repair for pelvic factures in 31 dogs were reviewed. Lameness and weight bearing scores were used to evaluate functional recovery of the hind limbs. Simple fracture occurred in sacroiliac joint (n = 5) and ilium (n = 3). Pelvic fractures had acetabular (n = 7) and non-acetabular fractures (n = 23). Acetabular fracture cases were composed of additional surgical treatments with femoral head and neck ostectomy (FHNO) (n = 4) and only acetabular rim fixation (n = 3). Simple fractures had more rapid initial and complete recovery times than multiple fractures. Non-acetabular fracture cases (initial recovery time: 2.7 weeks, complete recovery time: 9.1 weeks) had more rapid initial and complete recovery times than acetabular fracture cases (8.4, 12.5 weeks) (p < 0.05). In addition, the cases of additional surgical treatment with FHNO (5.3, 7 weeks) had more rapid mean recovery times than surgical treatment without FHNO (11.1, 16.3 weeks). Surgical approach with FHNO in acetabular fracture was an alternative method to treat pelvic fractures in small breed dogs.

Analysis of micro inorganic materials in linerboard mill (골판지 원지 제조 공정 내 미세 무기물질의 분석)

  • 윤혜정;류정용;김용환;신종호;송봉근
    • Proceedings of the Korea Technical Association of the Pulp and Paper Industry Conference
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    • 2000.11a
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    • pp.132-132
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    • 2000
  • 환경오염과 이상기후의 영향으로 인한 수자원의 고갈과 함께 국내의 경우 수자원 개발 계획 및 수요량을 감안할 때 향후 7 년 내에 물부족 현상을 겪을 것이라는 보고가 있 었으며, 환경부담을 줄이기 위해 폐수의 배출기준은 강화되고 있다. 이러한 상황에서 제조 특성상 타 업종에 비해 폐수 발생량이 높은 편인 국내의 제지산업은 여러 해전부터 이에 대 한 방안을 모색하여 왔다. 일반적으로 폐수 수질 관리와 청수 사용량의 절감을 위해 고가의 폐수 처리 장치를 설치하거나 폐수 재활용을 통해 공정을 극도로 폐쇄화하는 방안으로 연구 가 진행되어 왔다. 이 중 용수의 재활용이 가장 경제적인 방법이지만, 재활용이 지속될수록 각종 무기염과 콜로이드성 유기물질이 축적되어 각종 약품의 효능 저하, 탈수속도의 저하 및 생산 제품의 품질 악화 등의 문제를 유발한다고 알려져 있다. 이를 해결하고자 하는 노 력으로 펄프 원료에 따른 공정수 내 용해성 물질의 분석과 재활용 횟수에 따른 각종 SS와 D DS의 축적 정도에 대한 기초 연구가 수행되었으며, 고폐쇄화된 공정에서 성능을 발휘할 수 있는 첨가제의 개발과 적용 방법에 대한 연구도 수행된 바 있다.여러 지종 가운데 골판지 원지는 용수의 재활용률이 상당히 높은 지종이기 때문에 공정수의 재활용이 진행될수록 열악한 저급 원료로부터 각종의 다양한 물질이 용출 혹은 배 출되며, 이러한‘물질은 골판지 원지의 강도 발현에 더욱 악영향을 미칠 것으로 판단되었다. 미세분으로 구성된 SS의 경우 이미 많은 연구를 통해 특성이 파악되었기 때문에 본 연구에 서는 ss를 제외한 공정수를 두 가지로 크게 나누어 고려하였다. 즉, ss로 측정되지 않지만 닥도를 유발할 수 있는 미세 무기물질과, 용해성의 무기염, 첨가제 및 추출물 둥으로 이루어 진 용해성 성분으로 나누어 분석하였으며, 또한 각각이 초지 특성에 미치는 영향을 살펴보 고자 하였다.을 해석코자 하였으며, 그 방법으 로 수치해석기법을 도입하였다. 또 실제 캘린더링 전후의 두께 변화를 측정하여 유리전이온도 의 도달 깊이와 비교하였다. 지필의 압축 정도는 롤의 직경과 닙 폭을 이용하여 MD 방향으 로 함수화하였으며, 열전달 계수로는 겉보기 값을 사용하였다. 이때 지펼은 균질한 것으로 가 정하였다. 함수율은 유리전이온도를 좌우하는 가장 큰 인자이나 본 연구에서는 항온항습처리 를 통해 유입지의 함수율을 고정시켰으며 캘린더링 시 함수율의 변이는 없다고 가정하였다. 그 결과 열침투깊이가 증가할수록 지필은 보다 변형되기 쉬운 상태가 되어 주어진 압력 조건에 대해 소성변형 정도가 증가하는 것으로 나타났다. 이는 캘린더링 전후에 두께 변화를 측정하여 정량적으로 평가할 수 있었다. 수치해석기법을 통해 같은 압력 조건에서 온도가 증 가함에 따라 혹은 같은 온도 조건에서 압력이 증가함에 따라 지필 내의 유리전이온도의 침투 깊이가 증가함을 알 수 있었으며 이는 캘린더링 전후의 두께 변화의 측정 결과와 일치하였 다. 또 NRT가 증가함에 따라서도 유리전이온도 침투 깊이가 증가하였다.합편에 비해 일부 우수한 양상을 보였지만 본 실험의 범위내에서는 통계적 정량적 차이를 제시할 수는 없었다. 향후 보다 광범위한 동물 실험이 필요할 것으로 사료된다.된다.하고도 완전교정술 도달 확률이 높은 치료전략이라는 사실을 입증하였으며 주대동맥폐동맥혈관부행지의 크기나 숫자가 단일화하기 쉬운 형태학적 특징을 지닌 경우에는 조기에 일단계완전교정술을 시행하여 양호한 결과를 얻을 수 있다는 사실을 발견하였다. 반면 본 환아군 중 단일화술을 먼저 시도한 군에서는 비록 단계적인 단일화를 시도한 군에서 단일화술과 관계된 수술사망율이 약간 낮기는 하였으나 완전교정술까지 완료될 가능성에는 차이가 없었다. 그러나 이 경우 보다 정련된 적응 환자의 선택을 통한 단일화 우선전략의 시도와 장기 추

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Late Results of Total Correction for Tetralogy of Fallot (활로 4징증의 완전교정술에 대한 장기 성적)

  • Lee, Yeon-Jae;Hwang, Sang-Won;Kim, Han-Yong;Yu, Byeong-Ha
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1184-1189
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    • 1997
  • Tetralogy of Falloff is the most common cyanotic congenital cardiac malformation. Between April 1984 and December 1993, we experinced with 39 cases of total correction for the tetralogy of Falloff at the department of Thoracic and Cardiovascular Surgery, Masan Samsung General Hospital. The results were as follows; There were 14 males and 25 females, and their ages ranged from 2 to 36 years, with an average age of 13.33 $\pm$7.40 years. There was type I VSD in 10 cases(25.6%), type II VSD in 19 cases(48.8%) and type 1+ II VSD in 10 cases(25.6%) Types of right ventricular outflow tract obstruction were valvar + infundibular stenosis in 19 cases(48.7%), valvar + infundibular + annular stenosis in 10 cases(25.6%), infundibular stenosis in 9 cases(23.1%)and pure valvar stenosis in 1 case(2.6%). Right ventricular outflow tract patch widening was necessary in 33 cases(84.6%) and a Iransannular patch including 2 cases of Monocusp-bearing outflow patch was used in 10 cases. n 36 hospital survivors, 23 patients were evaluated by 2 dimensional and doppler echocardiography. The most common complication was arrthymia, especially complete right bundle branch block, in 30 cases (76.9%). The operative mortality was 7.7%, and the cause of death was low cardiac output syndrome.

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Surgical Correction of Tetralogy of Fallot in Adults over 20 Years of Age (20세이상 성인 팔로사징후의 완전교정술에 관한 임상적 고찰)

  • 류완준;강종렬;조창욱;김정철;구본일;이홍섭;김창호;우건화;이신영
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1197-1201
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    • 1996
  • From October, 1987 to December, 1995, nine patients underwent total correction of tetralogy of Fallot in adults over 20 years of age. There were 5 male and 4 female patients aged from 22 to 42 years(mean, 29.6 years). Three patients were in New York Heart Association(NYHA) functional class II, and 6 patients in class III. The hemoglobin values ranged from 10.8 to 20.7 gm/㎗ (average, l5.6gm/㎗). The preoperative clinical features were as follows: cyanosis, 8 patients; dyspnea on exertion, 6 patients; clubbing of fingers, 5 patients; frequent upper respiratory infection, 3 patients. At the operation both infundibular and valvular stenosis were present in all patients. Reconstruction of right ventricular outflow tract(RVOT) using Goretex was required in 7 patients, and transannular patching with Goretex in 2 pateints. Left pulmonary angioplasty with pericardium was done in 2 patients. No hospital deaths occurred. Four of 9 patients(44.4%) had postoperative low cardiac output syndrome, and postoperative bleeding in 5. One patient required reoperation due to residual ventricular septal defect and tricuspid regurgitation 3 months after the first operation. The mean follow-up period was 25 months, range 11 to 77 months. All was asymptomatic and in NYHA class I. We suggest that advanced age is not contraindication to surgery in tetralogy of Fallot, and tetralogy of Fallot in adults could be operated on due to low mortality.

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Staged Repair of Esophageal Atresia with Tracheoesophageal Fistula in a Very Low-birth-weight Infant - A case report- (극소저체중출생아에서 기관식도루를 동반한 식도폐쇄의 단계적 수술 - 1예 보고 -)

  • Sung, Si-Chan;Kim, Hyung-Tae;Ra, Yong-Joon;Byun, Shin-Yun;Kwon, Kyung-Ah;Jo, Yong-Hoon
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.820-823
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    • 2010
  • There are still some controversies in treatment strategy for the very low-birth-weight baby with esophageal atresia even though the result of primary repair has been improving. We report a successful end to end anastomosis with staged approach in one of twin weighing 1,270 g at birth.