• Title/Summary/Keyword: Complete arch

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Total Aortic Replacement - A Case Report - (대동맥 전장 치환 치험 1례)

  • Kim, Doo-Sang;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.173-177
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    • 1998
  • A 28 years old pregnant woman(Gestational age 35 weeks) had been operated emergency Cesarian section for delivery and emergency graft replacement of ascending aorta and total arch for acute type A aortic dissection. 1 year and 6 months later, she underwent aortic graft replacement from descending thoracic aorta to both common iliac arteries because of further progression of aortic dissection. So far she has a complete artificial graft aorta.

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Surgical Management of Coarctation of the Aorta with a Ventricular Septal Defect and Coexisting Partial Anomalous Pulmonary Venous Connection -A case report- (부분 폐정맥 환류 이상과 심실 중격 결손을 동반한 대동맥 축착증의 완전교정 -1예 보고-)

  • Kim Si-Ho;Lee Young-Seok;Woo Jong-Soo;Cho Kwang-Jo
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.479-481
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    • 2006
  • A newborn girl with a partial anomalous pulmonary venous connection, coarctation of the aorta, and ventricular and atrial septal defects underwent a complete repair successfully at 49 days of age. In this case, the left upper pulmonary vein was connected to the left innominate vein via an atypical vertical vein.

Computer Analysis of the Church of Notre-Dame de Lamourguier

  • Hong, Seong Woo
    • Architectural research
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    • v.4 no.1
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    • pp.25-31
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    • 2002
  • For more than a hundred years, art and architectural historians, architects, and engineers interested in structure have attempted to interpret Gothic architecture, one of the most technologically complex and sophisticated structural systems in history. Indigenous Gothic, however, such as non-vaulted Gothic in the Lower Languedoc region of southern France, has been largely ignored. This study intends to analyze the Gothic non-vaulted nef unique (aisleless) structures of Lower Languedoc which have never been scientifically tested, and to provide as comprehensive an explanation as possible of the way in which these non-vaulted buildings work. In order to achieve this goal, this paper is to examine, by means of finite element computer analysis, a selected example of an existing building. The church of Notre-Dame de Lamourguier, the earliest surviving example of a Gothic nef unique with wide-span diaphragm arches in Lower Languedoc, is selected. Thus, hypothetical models of diaphragm arch buildings and an existing building as a complete structural system were scientifically analyzed in order to provide a comprehensive explanation of how the non-vaulted nef unique system works. The result of the analysis, allows us better to understand the structural behavior of this type of masonry arcuated system and the processes involved in the design and construction of medieval buildings.

Arterial switch operation for the complex congenital heart anomalies with malposition of the great arteries (대혈관 변위를 동반한 선천성 복잡심기형에 대한 동맥전환술)

  • 이정렬
    • Journal of Chest Surgery
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    • v.26 no.1
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    • pp.36-43
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    • 1993
  • Sixty four children [aged 2 days to 9 years] , 58 with complete transposition of the great arteries, 5 with Taussig-Bing double outlet right ventricle, and 1 with double outlet left ventricle plus left ventricular type single ventricle, have undergone anatomic correction from November 1987 to August 1992. Eleven underwent previous operations: pulmonary artery banding[7], modified Blalock-Taussig shunt[2], coarctoplasty[2], aortic arch reconstruction[1] . Of 58 patients with TGA, Type A coronary arteries of Yacoub were seen in 50[86%]. U-shaped coroanry arterial flaps were transfered to the neoaorta using trap door technique, and neopulmonary arterial tract was constructed using glutaraldehyde fixed autopericardium with Lecompte maneuver. There were 18 hospital deaths [28.1%] with no late mortality. Mean follow-up of 20.4\ulcorner11.9 months were achieved in all survivors. Postoperative cardiac catheterizations were done in 14 cases. Mean pressure gradients of pulmonary and aortic outflow tract were 15.0 $\pm$2.6 and 4.2$\pm$1.4mmHg, mild aortic valve insufficiencies were found in 2, and mean cardiac index was 5.18$\pm$0.19 L/min/M2. We conclude that we should continue anatomic correction for the complex congenital heart anomalies with the malposition of the great arteries because myocardial function seems to be well preserved, though we are still on the learning curve.

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Evaluation of Conotruncal Anomalies by Electron Beam Tomography (Conotruncal 기형 평가에서 전자선 단층 촬영 (EBT)의 정확성)

  • 최병욱;박영환;최병인;최재영;김민정;유석종;이종균;설준희;이승규
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.290-300
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    • 2000
  • Background: To evaluate the diagnostic accuracy of EBT(Electron Beam Tomography) in the diagnosis of conotruncal anomaly and to determine whether it can be used as a substitute for cardiac angiography. Material and Method: 20 patients(11M & 9F) with TOF(n=7, pulmonary atresia 2), DORV(n=7), complete TGV(n=4), & corrected TGV(n=2) were included. The age ranged from 7 days to 26 years(median 60 days). We analyzed the sequential chamber localization, the main surgical concenrn in each disease category (PA size, LVED volume and coronary artery pattern for TOF & pulmonary atresia, the LV mass, LVOT obstruction, coronary artery pattern for complete TGV, and type of VSD and TV-PV distance for DORV, etc) and other associated anomalies(e.g., VSD, arch anomalies, tracheal stenosis, etc). Those were compared with the results of echocardiography(n=19), angiography (n=9), and surgery(n=11). The interval between EBT and echocardiography/angiography was within 20/11 days, respectively except for an angiography in a patient with corrected TGV (48 days). Result: EBT correctly diagnosed the basic components of conotruncal anomalies in all subjects, compared to echocardiography, angiography or surgery. These included the presence, type and size of VSD(n=20), pulmonic/LV outflow tract stenosis(n=15/2), relation of great arteries and the pattern of the proximal epicardial coronary arteries(16 out of 20). EBT proved to be accurate in quantitation of the intrapericardial and hilar pulmonary arterial dimension and showed high correlation and no difference compared with echocardiography, angiography, or surgery(p>0.05) except for left pulmonary arterial & ascending arterial dimension by echocardiography. LVED volume in seven TOF(no difference: p>0.05 & high correlation: r=0.996 with echocardiography), and LV mass in 4 complete TGV were obtained. Additionally, EBT enabled the cdiagnosis of subjlottic tracheal stenosis and tracheal bronchus in 1 respectively. Some peripheral PA stenosis were not detected by echocardiography, while echocardiography appeared to be slightly more accurate than EBT in detecing ASD or PDA. Conclusion: EBT can be a non-invasive and accurate modality of for the evaluation of most anatomical alteration including peripheral PS or interruption in patients with conotruncal anomalies. Combined with echocardiography, EBT study provides sufficient information for the palliative or total repair of anomalies.

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TOOTH MOVEMENTS TO THE SITE OF ALVEOLAR BONE GRAFT (구순구개열 환아에서의 치조골이식)

  • Cho, Hae-Sung;Park, Jae-Hong;Kim, Gwang-Chul;Choi, Seong-Chul;Lee, Keung-Ho;Choi, Yeung-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.1
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    • pp.140-149
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    • 2007
  • Cleft lip and palate are congenital craniofacial malformation. Reconstruction of dental arch in patient with alveolo-palatal clefts is very important, because they have many problems in functions and esthetics. Malnutrition, poor oral hygiene, respiratory infections, speech malfunctions, maxillofacial deformity, and psychological problems may be occured without proper treatment during the long period of management of the cleft lip and palate. So the treatment should be managed with a multidisciplinary approach. Bone grafting is a consequential step in the dental rehabilitation of the cleft lip and palate patient A complete alveolar arch should be achieyed of the teeth to erupt in and to form a stable dentition. And the presence of the cleft complicate the orthodontic treatment. Therefore bone grafting in patients with cleft lip and palate is a widely adopted surgical procedure. Grafted bone stabilizes the alveolar process and allows the canine or incisor to move into the graft site. After the bone grafting, orthodontic closure of the maxillary arch has become a common practice for achieving dental reconstruction without any prosthodontic treatment. Various grafting materials have been used in alveolar clefts. Iliac bone is most widely fovoured, but tibia, rib, cranial bone, mandible have also been used. And according to its time of occurrence, the bone graft may be divided into primary, early secondary, secondary, late secondary. Bone grafting is called secondary when performed later, at the end of the mixed dentition. It is the most accepted procedure and has become part of treatment of protocol A secondary bone graft is performed preferably before the eruption of the permanent canine in order to provide adequate periodontal support for the eruption and preservation of the teeth adjacent to the cleft. In this report, we report here on a patient with unilateral cleft lip and palate, who underwent iliac bone graft. The cleft was fully obliterated by grafted bone in the region of the alveolar process. The presence of bone permitted physiologic tooth movement and the orthodontic movement of adjacent tooth into the former cleft area. Satisfactory arch alignment could be achieved in by subsequent orthodontic treatment.

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A Study Model Analysis of Complete Unilateral Cleft Lip & Palate Patients (편측성 완전 구순 구개열 환자의 구개열 형태 및 치궁의 분석)

  • Leem Dae-Ho;Kim Seung-Young;Shin Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.2 no.1_2
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    • pp.5-14
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    • 1999
  • The aim of treatment of cleft lip and palate is to correct the cleft and associated problems surgically and thus hide the anomaly so that patients can lead normal lives. This correction involves surgically producing a face that does not attract attention, a vocal apparatus that permits intelligible speech, and a dentition that allows optimal function and esthetics. In neonatal periods, gross distortion of tissues surrounding the cleft requires considerable effort and time due to post operative functional defect and scarring and induces milk feeding problem, malocclusion of deciduous or permanent dentition, congenital missing teeth, skeletal dysplasia. The occurrence of a cleft deformity is a source of considerable shock to the parents of an afflicted baby, and the most appropriate approach is very important things. Thus we tried to analysis of dental arch, shape and size of deformity in cleft patients. The results were obtained as follows. 1. When the cast measurements of UCLP subjects at first visit it was found that the mean length was 9.29mm at the alveolar cleft width, also that was 11.7mm at the anterior width and 14mm at the posterior cleft width. 2. Comparison of UCLP group at first visit and just lip surgery, it was found that the older group showed a insignificant reduction in the width of the cleft in the alveolar, canine, and tuberosity regions. 3. The maxillary casts of the UCLP group at 6 months differ Significantly from those of the at 3 months in both length and width. but there was no statistical difference except anterior ridge length of nonclefted site. 4. Comparison at 6 months and 18 months, there was a greater change in length of the alveolar cleft width, intercanine width, and anterior cleft width. Maxillary arch became wider at both the canine region and intertuberosity region. also posterior anteroposterior length was increased but anterior AP length was decreased from 8.1mm to 7.7mm. There was meaningful increase at intertuberosity length; however, a significant reduction in width t-t'

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Rationale and criteria for excellent finishing (양호한 Finishing을 위한 이론적 근거 및 기준)

  • Ryu, Young-Kyu;Kim, Young-Joon
    • The korean journal of orthodontics
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    • v.29 no.6 s.77
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    • pp.637-648
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    • 1999
  • Finishing is usually accomplished about four to seven months before the removal of orthodontic appliance in order to achieve ideal occlusion and excellent aesthetics. This process, called finishing, is the key to obtain excellent final results. Some of orthodontists believe it can be accomplished at the final stage of orthodontic treatment, and they complete it without their special rationale and criteria for finishing. However, it should be considered as a part of the total treatment plan from the beginning to end, and a guideline for finishing, which is based on rationale and criteria for the removal of orthodontic appliance, is needed to obtain the desired results. The guideline should include a checklist for finishing. This checklist is divided into four categories: occlusal, aesthetic, periodontal, and habitual factors. Occlusal fators include alignment, marginal ridge discrepancy, interproximal contact, anterior inclination, posterior inclination, over-jet over-bite, arch fen and functional occlusion. Aesthetic factors include gingival form, crown fen crown width, and crown length. Periodontal factors include root angulation, bone level, and black hole in periodontal factors. Habitual factors consist of mouth breathing, tongue position at rest, tongue thrust, lip biting, nail biting, and finger sucking

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FUNCTIONAL RECONSTRUCTION OF DENTO-PALATAL AND MAXILLARY DEFECT USING STAGED OPERATION OF PREFABRICATED SCAPULAR FREE FLAP AND DENTAL IMPLANTS (분층피부와 분말골로 이식 전 처리된 유리견갑골근피판과 임플란트 보철을 이용한 경구개와 상악골의 기능적 재건)

  • Lee, Jong-Ho;Kim, Myung-Jin;Park, Jong-Chul;Kim, Yung-Soo;Ahn, Kang-Min;Paeng, Jun-Young;Kim, Sung-Min;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Choung, Pill-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.301-307
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    • 2004
  • The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

Evaluation of Validity of Edentulous Digital Model for Complete Denture Fabrication (총의치 제작을 위한 무치악 디지털 모형의 정확도 평가)

  • Kim, Won-Soo;Kim, Ki-Baek
    • Journal of dental hygiene science
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    • v.15 no.4
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    • pp.393-398
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    • 2015
  • One of the most critical causes in determining the clinical outcomes of dental prostheses is the validity of models. However, studies that evaluated validity of digital models are few. The objectives of this study were to evaluate validity of edentulous digital models for full denture fabrication. Twenty stone models (edentulous model) were manufactured and scanned by dental blue light emitting diode scanner. Twenty digital models were manufactured. Six linear distances (inter-canine distance, inter-molar distance, two dental arch lengths (right, left), two diagonal of dental arch lengths (right, left) were measured for validity evaluation. The measurements of distances of stone models were used by digital vernier caliper and digital models were used by computer program. The mean${\pm}$deviations values of six distances were calculated. The means were compared by the Mann Whitney U test (${\alpha}=0.05$). All statistical analysis were performed using IBM SPSS Statistics ver. 20.0. Although digital models were smaller than stone models in six distances, there were no significant differences (p>0.05) and non exceeded the clinical acceptable range. The edentulous digital models for full denture fabrication can be considered clinically acceptable.