• Journal of Chest Surgery
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• v.18 no.1
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• pp.62-68
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• 1985

10 patients with mitral regurgitation associated with various congenital cardiac anomalies were treated by reconstructive techniques in the Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital during the period of 2 years from 1982 to 1984. There were mitral valvular cleft in one case, chordae tendineae rupture associated with congenital multiple cardiac-anomalies [VSD, PDA, prolapse of aortic non-coronary cusp through VSD] in one case, elongated chordae tendineae after removal of left atrial myxoma in one case, and mitral annular dilatation associated with VSD in 3 cases, large PDA in 2 cases, aortic regurgitation [bicuspid valve] in one case, and unknown origin in one case. Owing to the various pathology above mentioned, reconstructive surgical approach to mitral incompetence is accordingly complicated and a combination of the following different procedures were properly used case by case, that is, suture of chordae tendineae, shortening of elongated chordae tendineae, closure of VSD, ligation of PDA, aortic valvuloplasty, mitral annuloplasty with mattress suture, etc. All patients were survived and they have been excellent postoperative results.

• Journal of Veterinary Clinics
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• v.9 no.1
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• pp.311-316
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• 1992

Four retention sutures were used to correct the vaginal prolapse in a dairy cow. The methods used were two modified Caslick operation of vulva using absorbable(catgut chromic) and nonabsorbable(supramid) materials, and a modified mattress closure and a modified Buhner method of vulva using trocar and wire insulated by vinyl. The lasting periods for retention of bovine vaginal prolapse by the suture methods described above, were 12 days, 49 days, 39 days and 62 days respectively.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.299-303
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• 2005

The epicanthal fold is common natural finding in Asian eyes. It is very common that patients, who look for oriental blephaloplasty for double eye lid, request correction epicanthal fold. It is very often difficult to achieve satisfactory results if the correction of the epicanthal fold is not corrected concomitantly. Many authors described surgical procedures for correction of epicanthal folds. But most of them leave additional scars which tend to be hypertrophic and noriceable. We achieved satisfactory result in epicanthoplasty with invisible scar, using combination of procedures, such as upward incision, double eyelid operation, anchoring suture of the medial upper lid skin to the medial canthal tendon, trans-nasal root subcutaneous mattress suture of the epicanthal fold itself and combined rhinoplasty. For past six years (1998 to 2003) 17 patients have been operated with one of these mentioned procedures. The mean follow up was 4months (2weeks to 6months). All patients were satisfied and no major complication was noted. This method can be one of the effective procedures for correcting the Asian epicanthal fold for avoiding potential visible scar and ancillary procedure in double eye lid blephaloplasty.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.91-94
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• 1981

Coronary arterial fistula was first described by Krause in 1865. Since then more than 200 examples of this lesion have been reported In the literature. It is relatively rare disease and it more commonly originate in the right than in the left coronary artery. A 9-year old male was admitted with the chief complaint of cardiac murmur and diagnosed as coronary A-V fistula at middle segment of the right coronary artery by cardiac catheterization and aortography. On the operation field, the right coronary artery was markedly dilated as one cm. in diameter from the aorta to the middle segment at acute angle of the right ventricle. Fistula opening was obliterated by one stitch horizontal mattress suture with pledget. Postoperative course was uneventful and discharged without problem.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.112-117
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• 1982

Communications of coronary arteries with the cardiac cavities have first time been described by Krause in 1865 in a case of an accessory artery draining into the pulmonary artery and later Cayla in a case of a right coronary artery entering the right ventricle. The initial cases have been found accidentally at autopsies, however In recent years after the Introduction of angiography and coronary arteriography, the malformation Is diagnosed during life and is corrected surgically. These conditions are unusual entitles since the advent of angiography they are being diagnosed with increasing frequency. Three patients who had surgical correction of coronary-cardiac chamber fistula at our hospital are presented. In the first case and second case, coronary arteriovenous fistula was corrected horizontal mattress suture ligation with pladget under the cardiopulmonary bypass and third case was corrected double ligation with cardiopulmonary bypass standby. The postoperative courses were uneventful. They discharged without any fistula related complica-tions.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.183-187
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• 2002

Purpose : We report a result of arthroscopic treatment of the recurrent prepatellar bursitis. Materials and Methods : Between March 2001 and May 2002, we treated 4 patients with prepatellar bursitis, the average follow-up period was 14.5 months. The causes were acute trauma 3 cases and repeated minor trauma 1 case. All cases were recurred after previous history of the conservative therapy at other hospital but one was a recurred case after operative excision. Operative technique was as follows. Before inserting the arthroscope, the bursa was inflated with saline. The portals fur 4 mm diameter arthroscope were placed 1cm away from the bursal sac through small skin incision. Superficial layer of the bursa was resected first and then deep portion was the next. Several percutaneous mattress sutures were applied to the overlying skin with deep tissue, and compressive dressing was applied and maintained for 2 weeks. Results : All 4 cases were no recurrence, no pain, no tenderness. The results were considered satisfactory, Two cases of mild skin dimpling at suture site were observed. Conclusion : Arthroscopic treatment of the prepatellar bursitis is an another method of operation technique fur recurrent prepatellar bursitis, however long term follow-up will be needed about recurrence.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.149-154
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• 2006

The levator and $M{\ddot{u}}ller^{\prime}s$ muscle balanced tucking was performed to correction myogenic or aponeurotic blepharoptosis. Through the blepharoplasty incision, the upper half of tarsal plate was exposed and the orbital was opened to show the levator aponeurosis. the $M{\ddot{u}}ller^{\prime}s$ muscle dissected from the upper border of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. $M{\ddot{u}}ller^{\prime}s$ muscle was advanced about 3 mm to 8 mm on anterior surface of the tarsal plate and fixed approximately upper one third of the tarsal plate with three horizontal 6-0 Nylon mattress sutures. The amount of tucking of $M{\ddot{u}}ller^{\prime}s$ muscle was controlled by the location of the upper eyelid margin 2 mm below the upper limbus in primary gaze after first temporary fixations suture in the maximum superior point of the limbus. The amount of advancement of levator aponeurosis was controlled by the location of the upper eyelid margin 1 mm below the upper limbus in primary gaze after first temporary fixations suture in the maximum superior point of the limbus. And then levator aponeurosis was fixed with three horizontal 6-0 Nylon mattress on beside the point that was tucked $M{\ddot{u}}ller^{\prime}s$ muscle. We have been thirty cases with levator and $M{\ddot{u}}ller^{\prime}s$ muscle balanced tucking from January 2004 to Jun 2005. 3 cases were traumatic blepharoptosis with 3-5 mm ptosis and poor levator function. 27 cases were myogenic or aponeurotic blepharoptosis with 2-5 mm ptosis with and more than 4 mm of levator function. the age of the patients ranged from 6 to 78 years. The levator aponeurosis and $M{\ddot{u}}ller^{\prime}s$ muscle tucking procedure can reduce the amount of the levator and $M{\ddot{u}}ller^{\prime}s$ muscle resection, and improve discomfort when the patients open eyes.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.512-515
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• 2009

Purpose: Neurofibromatosis(NF) is an autosomal - dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop - shaped ligation before removal of the giant NF in both buttocks. And then we could successfully reduce the amount of hemorrhage during the operation. Methods: A 46 - year - old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about $30{\times}20cm$ in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop - shaped suture ligation(weaving the thread up and down in a loop - shaped pattern, leaving a space of 2 cm between each loop) with a straight needle and prolene 2 - 0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged - shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop - shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscense did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow - up, the functional and cosmetic result was excellent. Conclusion: A continuous loop - shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.844-853
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• 1990

We have performed 27 cases of orthotopic homologous cardiac transplantation using Korean mongrel dogs and one case of sham operation for the evaluation of harmful effect of cardiopulmonary bypass itself on the dog from April, 1989 to June, 1990. Our previous reports have already demonstrated basal hemodynamic and hematologic data on the canine homologous heart transplantation and the fundamental principles of transplantation of the heart. The mean body weight of recipients was 13.2$\pm$1.2kg with a rage of 11 ~ 15kg, and the hemodynamic and hematologic pictures were almost same as the result of previous reports from our hospital, except marked decrease in postoperative platelet count[from 3.18 $\pm$0.80x106/mm3 to 1.41$\pm$0 37x 106/mm3]. Mean survival time was 24.82$\pm$49.40 hours with the longest survival of 264 hours. Donor cardiectomy included coronary vasodilatation with diltiazem, potassium arrest, and the rapid cooling of the heart suspending in the specially designed ice-bath. Median sternotomy provided excellent exposure of the surgical field. 6 \ulcorner0 prolene suture was used for the anastomosis of both atrial cuffs and the great arteries, and we found the fact that stenosis, bleeding, thrombus formation around the anastomotic site could be decreased with the use of everted horizontal mattress suture techniques. Immunosuppression was done with a combination of lower dose Cyclosporin-A, Azathioprine, methyl-prednisolone, but our cases still showed too short survival to worry about graft rejection. Still poor was our quality control of experimental animal, we had much difficulties in postmortem evaluation of the dogs. Low cardiac output due to biventricular failure, intractable supraventricular or ventricular tachyarrhythmia, postoperative massive bleeding, sepsis were most frequent findings that could be thought as a cause of death. A few cases showed subendocardial patch hemorrhage in both ventricular cavity or atrial septum at autopsy, suggesting acute subendocardial infarction. Although our team overcome most of the technical problems of orthotopic heart transplantation, we should pile up further knowledges about donor heart preservation, quality control of animal, infection, rejection, the effect of the cardiopulmonary bypass to improve the results.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.67-70
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• 1981

Aneurysms of the extracranial carotid artery are rare. This is a case report of the rapidly expanding false carotid aneurysm at left common carotid artery, which was repaired surgically with internal shunt This 20 year old male patient had a large pulsatile mass on left lateral aspect of neck at the time of admission. About 1 month before admission, he had received a trauma on left neck by glass piece and noted massive blood loss. And its skin of lesion was sutured simply at local clinic and well healed. 10 days before the admission, he had the sudden onset of the adult thumb sized and pulsatile mass and the mass had been enlarged more and more to the adult first-sized one. The cervical film showed a egg-sized and soft tissue mass. There was systolic bruit on the mass. The diagnosis was confirmed with the angiogram of left carotid artery and this showed the man`s thumb tip-sized extravasation at the point 2 Cm below the bifurcation of Internal and external carotid arteries. The emergency operation was performed by the internal shunt with carotid artery. The aneurysm was enclosed with the adventitia and carotid sheath, and the intima and media were Intact and had the opening of 0.5 cm in diameter. The opening was sutured by the one-hand mattress suture method and firmed with the Aron Alpha-A "Sankyo." The postoperative course was uneventful and the patient was discharged with good general condition.