• Title/Summary/Keyword: 완전 교정

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Surgical Correction of Total Anomalous Pulmonary Venous Connection in Early Infancy (조기 영아에서 전폐정맥연결이상의 외과적 교정)

  • 성시찬;방정희;전희재;조광조;최필조;우종수;이인규;이형두
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.510-517
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    • 1999
  • Background: Total anomalous pulmonary venous connection (TAPVC) is still one of the more challenging congenital heart defects in newborns and young infants. The purpose of the study is to evaluate the early and midterm results of the surgical corrections for patients in early infancy with isolated TAPVC. Material and Method: Hospital records of 15 consecutive patients in early infancy (January 1993 to August 1998) were retrospectively reviewed. There were 8 boys and 7 girls whose ages ranged from 4 days to 3.5 months (median age 22 days). Their body weight ranged from 1.75 kg to 4.9 kg (mean 3.54 kg). The abnormal anatomical connections were supracardiac in 11, cardiac in 3, and infracardiac in 1. In 6 patients (40%), the pulmonary venous drainage was obstructive. Total circulatory arrest was used in 13 patients. Anastomosis between the common pulmonary vein and the left atrium was performed with a continuous suture technique using a fine nonabsorbable polypropylene suture through a lateral approach behind the right atrium. Result: There was one hospital death (6.5%) caused by a sepsis 17 days after the operation in a neonate who had supracardiac drainage and was dependent on a ventilator preoperatively. There were 2 late deaths. One died sudde`nly of an unknown cause at home 2.5 years after the operation and the other died of a recurrent pulmonary hypertension 3 months after the reoperation due to pulmonary venous obstruction (PVO). Two patients required reoperations because of PVO 5 months and 10 months respectively after the initial operation. Of these patients, one patient is alive at the present time with persistent pulmonary hypertension. All survivors without postoperative PVO (78.6%) were in NYHA functional class I at mean follow-up of 25.8 months (0.5∼67 months). Conclusion: Surgical correction of TAPVC in early infancy can be performed at low risk. However, there were 2 postoperative PVOs (14.3%) which had bad results. The survivors without postoperative PVO had excellent functional status.

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EARLY HISTO(PATHO)LOGIC CHANGES AND RECOVERY OF TOOTH AND PERIODONTAL TISSUE IN INTRUSION OF PREMOLAR ON YOUNG ADULT DOGS (유성견의 소구치 압하시 초기 치아 및 치주 조직의 조직학적 변화와 재생에 관한 연구)

  • Ahn, Byeong-Kyo;Cha, Kyung-Suk;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.28 no.2 s.67
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    • pp.297-310
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    • 1998
  • The purpose of this study was to investigate the initial tissue change, to repair on the teeth & surrounding tissue under the intrusive orthodontic forces by use of elastic chain, through the microscopic findings. For this study, three young adult mongrel dogs were used, and were divied into three group : the control group was deliveried only casting crown and the experimental group 1 was equipped with energy chain during 1 week and experimental 2 group was deliveried using energy chain during 1 week and 3 weeks observation. All experimental groups and control groups were sacrificed to make the samples for microscopic findings on premolar teeth. All samples were examed and compared the histologic changes through the microscopic with H-E stain. The obtained results were as follows. 1. In hematoxylin-eosin stain of the control group, the periodontal ligament was constant width from apical third to cervical third of the root, and the periodontal fiber arrangement was horizontal or oblique in cervical third, oblique in middle and apical third of the root. 2. In Masson Trichrome stain of the control group, osteoblast and osteoclast appeared in cervical third of root, and bone resorption and new bone formation was observed in middle and apical third of the root. 3. In experimental 1, osteoclasts were increased highly, and hyperemia of blood vessels and new bone formation and bone resorption by reversal line in apical third of the root were seen. PDL width was increased apprarently from crest to apex of the root and more in apical third. 4. In experimental 2, osteoclasts and hyperemia of blood vessels were more increased than control material in apical third of the root. PDL width was increased more than control group in root apex, and was seen less than experimental 1. PDL arrangement was similar to experimental 1 and was mixed only in root apex. Therefore, in premolar intrusion of the young adult dog, there were increased osteoclast, hyperemia and dilation of blood vessel, resorption of alveolar bone and cementum and different arrangement of PDL in initial tissue change. There was not observed complete repair after remove intrusive force.

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A New Technique of Angioplasty of the Left Pulmonary Artery Using an Autologous Main Pulmonary Artery Flap (활로 4징 환자에서 자가 주폐동맥 플랩을 이용한 새로운 좌폐동맥 성형술)

  • 이창하;전양빈;이택연;이석기;백만종;김수철;이영탁
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.255-260
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    • 2003
  • Background: Stenosis of the left pulmonary artery (LPA) after repair of tetralogy of Fallot (TOF) is troublesome. A new technique of LPA angioplasty using an autologous MPA flap was performed in patients with TOF Material and Method: From October 1998 to January 2001, 24 patients (median age; 10 months, range; 4 to 145 months) underwent total correction of TOF with LPA angioplasty using the autologous MPA flap. Five patients underwent pulmonary angioplasty without any patch over the MPA and LPA. The patches were required to enlarge only the MPA in 4 patients, and transannular RVOT widening was performed in 15. Result: There were no operative or late deaths. During follow-up (range: 6~42 months), reoperation for LPA stenosis was not required in any patients, but balloon angioplasty for branch pulmonary artery stenosis was performed in 3 patients. Echocardiography and CT angiography at the recent follow-up showed an obtuse angle between the MPA and LPA. Conclusion: Although further follow-up is needed, the angioplasty using the autologous MPA flap can be easily performed, avoiding patch-related complications, and allowing growth of the MPA flap. This angioplasty technique creates a more natural and obtuse angle between the MPA and LPA, which can minimize kinking of the LPA, especially in the patients who underwent transannular patch widening.

Spinal Tuberculosis in Children: Predictable Kyphotic Deformity after Cure of the Tuberculosis (소아 척추 결핵: 투약 후의 병의 정지와 치유점, 그리고 후만 변형)

  • Moon, Myung-Sang;Kim, Dong-Hyeon;Kim, Sang-Jae;Moon, Hanlim;Kim, Sung-Soo;Kim, Sung-Sim
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.73-82
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    • 2017
  • Purpose: To assess the chronological changes of disease-related kyphosis after chemotherapy alone. Materials and Methods: A total of 101 children aged 2 to 15 years with spinal tuberculosis, accompanied by various stages of disease processes were enrolled for analysis. By utilizing the images in them, the growth plate condition and chronological changes of kyphosis after chemotherapy were analyzed at two points in time; the first assessment was at post-chemotherapy one-year and second at the final discharge. Results: Complete disc destruction in the cervical, dorsal and lumbosacral spines was observed in 2 out of 40 children (5.0%), 8 out of 30 children (26.7%), and 6 out of 31 children (19.4%), respectively. In those cases, the residual kyphosis inevitably developed. In the remaining children, the discs were intact or partially damaged. Among the 101 children kyphotic deformity was maintained without change in 20 children (19.8%). Kyphosis decreased in 14 children (13.9%), while it increased in 67 children (66.3%) with non-recoverably damaged growth plate. Conclusion: Although it is tentatively possible to predict the deformity progress or non-progress and spontaneous correction at the time of the initial treatment, its predictive accuracy is low. Therefore, assessment of the chronological changes should be performed at the end of chemotherapy. In children with progressive curve change, assessment of deformity should be continued until maturity.

Surgical Repair of Secundum Type Atrial Septal Defects Using Extracorporeal Circulation in 48 Patients (심방중격 결손증의 외과적 완전교정 48례 보고)

  • 서경필
    • Journal of Chest Surgery
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    • v.10 no.2
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    • pp.268-273
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    • 1977
  • During the period from March, 1963, to November, 1977, forty-eight patients with secundum type atrial septal defects have undergone surgical repair using cardiopulmonary bypass with a pump oxygenator at the Seoul National University Hospital. Twenty-six [55 percent] of the patients were females and Twenty-two [45 percent] were males. The patients varied in age from 3 years to 51 years. We have divided secundum defects into three types. These are: 1] the high defect; 2] Ovale type defect; and 3] low defect including the defect in the area of the coronary sinus. An ovale type defect was present in forty-one cases [85 percent]. Partial anomalous pulmonary venous connections were present in two patients in the high defect group. All of the forty-eight patients had had right heart catheterization before operation. The pulmonary to systemic flow ratio [Qp/Qs] was determined in our 38 patients. The Qp/Qs was less than 1.5/1 in only five of the 38 patients. Among the 33 patients with moderate and severe left-to-right shunts [Qp/Qs 1.6-3.5/1], the systolic pulmonary artery pressures. ranged from 30 to 80 mm Hg. Large left-to-right shunts [Qp/Qs>3.6/1] were present in 13 patients. The postoperative complications occurred in 13 patients [27. 1 percent]. Postoperative wound infections were the most frequent complications being present in 6 patients [12.5%]. Forty-six of the patients with secundum atrial septal defects survived surgical repair of their defects. Thus the hospital mortality of surgery was 4.2 percent. The causes of death in the early postoperative period were: 1] low cardiac output syndrome related to severe pulmonary hypertension in one case; and 2] postoperative several bleeding in one case.

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Analysis of far & near distance of lateral phoria by various testing methods (검사 방법에 따른 원·근거리 수평사위의 분석)

  • Hong, Dong-Gyun;Jung, Han-Sub;Park, Sang-An
    • Journal of Korean Ophthalmic Optics Society
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    • v.9 no.2
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    • pp.423-430
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    • 2004
  • This Study on three different methods which are Von Graefe test, Maddox Rod test and Howell card test of measuring far and near lateral phoria investigated. It reviewed that 420 subjects aged from 15 to 35 years old. The result were as follows; 1. Using Von Graefe lateral phoria measurement, they were measured 6% for orthophoria, 62% for exophoria, 32% for esophoria at far distance. 2. Using Von Graefe lateral phoria measurement, they were measured 2% for orthophoria, 74% for exophoria, 24% for esophoria at near distance. 3. Using Maddox Rod lateral phoria measurement, they 59% for exophoria, 37% for esophoria at far distance. 4. Using Maddox Rod lateral phoria measurement, they 67% for exophoria, 30% for esophoria at near distance. 5. Using Howell card lateral phoria measurement, they 60% for exophoria, 32% for esophoria at far distance. 6. Using Howell card lateral phoria measurement, they 69% for exophoria, 27% for esophoria at near distance.

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Expectation of Astigmatism by Spherical Equivalent Visual Acuity (등가구면 시력으로부터 난시량의 예측)

  • Kim, Sang-Yoeb;Moon, Byeong-Yeon;Cho, Hyun Gug
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.2
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    • pp.167-170
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    • 2011
  • Purpose: This study was tried whether expectation of astigmatism from spherical equivalent visual acuity was possible. Methods: For 54 men and women (108 eyes) corrected to emmetropia, average age of 23.3, changes of visual acuity (5m) were measured with an increasing the powers at every ${\pm}$0.25D when the (-) axis of cross cylinder is $180^{\circ}$, $90^{\circ}$, and $45^{\circ}$, respectively. Results: As the power of cross cylinder was increased, visual acuity was decreased. When the powers of cross cylinder were ${\pm}$2.50D ($180^{\circ}$ and $90^{\circ}$) and ${\pm}$2.25D ($45^{\circ}$), visual acuity was 0.05 which is the minimum measurement possible. Conclusions: The diagram on astigmatism dealing with each spherical equivalent visual acuity was able to tabulate.

Investigation of the horizontal heterophoria measurement at distance by various testing method (사위검사 방법의 차이에 따른 원거리 수평사위 검사값 비교)

  • Sim, Hyun-Seog;Lee, Seang-Wook;Jang, Seong-Joo
    • Journal of Korean Ophthalmic Optics Society
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    • v.6 no.2
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    • pp.155-160
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    • 2001
  • To investigate the subjective refractive error with Von Graefe test. Maddox Rod test and polarizing lens test of Horizontal Heterophoria Measurement at distance on normal 109 subjects aged from 18 to 30 years old. The results were as follows: 1. Using Von Graefe Horizontal Heterophoria Measurement, they were measured 15% for orthophoria, 65% for exophoria and 20% for esophoria at distance. 2. Using Maddox Rod Horizontal Heterophoria Measurement, they were measured 14% for orthophoria, 57% for exophoria and 29% for esophoria at distance. 3. Using polarizing lens test of Horizontal Heterophoria Measurement, they were measured 15% for orthophoria, 72% for exophoria and 13% for esophoria at distance. 4. Each test average were $1.32{\Delta}BI$ for Von Graefe test, $0.88{\Delta}BI$ for Maddox Rod test and $1.76{\Delta}BI$ for polarizing lens test. 5. Patient's preference distribution were 44% for Von Graefe test, 28% for Maddox Rod test and 28% for polarizing lens test.

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Availability of Astigmatism Expectation by Jin's and Beam Project Chart (진용한 시력표와 투영식 시력표에서 난시량 예측의 용이성)

  • Kim, Sang-Moon;Kang, Hye-Sook;Shim, Hyun-Seog
    • Journal of Korean Ophthalmic Optics Society
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    • v.17 no.1
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    • pp.53-58
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    • 2012
  • Purpose: The purpose of this study was to predict the amount of astigmatism through logMAR visual acuity by Jin's chart at best vision spherical power and to compare availability of astigmatism expectation by Jin's and beam project chart. Methods: LogMAR and decimal visual acuity were measured for 150 college students and visual acuity and compared the amount of astigmatism under full correction. Results: Jin's chart was showed marked differences at least more than 0.25 D intervals per line than beam project chart. Correlation with the amount of astigmatism was higher the logMAR visual acuity r = 0.8578 than decimal visual acuity r = -0.7199. Conclusions: LogMAR visual acuity at best vision spherical power was able to predict to amount of astigmatism and Jin's chart was easier than beam project chart to predict difference of each lines.

Animal Experiments of Heart Transplantation for Complicated Congenital Heart Disease in Neonate (신생아의 복잡심장기형에서 심장이식을 위한 동물실험)

  • 박영환;윤치순;정원석;김명옥;조범구
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.504-509
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    • 1999
  • Background: Heart transplantation is considerated for a selected certain group of complicated congenital heart disease in neonates because corrective surgery is very difficult and has high mortality. Precise planning of transplantation is necessary to adequately fit the donor heart to the recipient. Material and Method: We have performed 4 neonatal pig heart transplantations to test the technical feasibility. Experiment 1: The transplantation was performed using the same technique as the adult heart transplantation. Experiment 2: The transplantation for hypoplastic left heart syndrome was simulated as we reconstructed the whole aortic arch with donor aorta. Experiment 3: The heart transplantation was done with radical pulmonary artery reconstruction. Experiment 4: The experiment was performed for a long term survival. Result: Preoperative planning was very important for adequate fitting. All animals could be weaned from cardiopulmonary bypass, however, two animals died due to bleeding at pulmonary artery and left atrium. Conclusion: We concluded that the neonatal heart transplantation can be applied in some complicated Further using animal model is mandatory.

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