• 제목/요약/키워드: Open reconstruction

검색결과 189건 처리시간 0.028초

개심술후 조기 혈행동태심실중격결손증 교정과 승모판재건술에 대한 비교 (Hemodynamic studies early after open heart surgery: comparison of repair of ventricular septal defect and mitral valvular reconstruction)

  • 문병탁
    • Journal of Chest Surgery
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    • 제17권1호
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    • pp.59-66
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    • 1984
  • After open heart surgery, the patient must be carefully observed and adequately managed for his survival. This report reviewed 10 cases of ventricular septal defect and 12 mitral valvular diseases as hemodynamics early after open heart surgery. For postoperative 24 hours, clinical status was evaluated for left atrial pressure, central venous pressure,DP[LAP-CVP], peak systolic pressure, heart rate, urine amount, and other clinical findings. Especially, on postoperative fourth hour, cardiac output was most decreased, when the changes of monitoring were compared with two groups with or without using cardiotonics. Finally, we concluded as followings; 1.Postoperatively, variation of CVP was noted in VSD, but mitral valvular disease was more variable change of LAP. 2.DP was 1.3\ulcorner.4 cmH2O in VSD, and 6.4\ulcorner.2 cmH2O in mitral valvular disease. 3.Parameter using cardiotonic was CVP in VSD, and LAP in mitral valvular disease.

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Clinical study of keratocystic odontogenic tumors

  • Tomomatsu, Nobuyoshi;Uzawa, Narikazu;Michi, Yasuyuki;Kurohara, Kazuto;Okada, Norihiko;Amagasa, Teruo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권1호
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    • pp.55-63
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    • 2012
  • The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.

Reconstruction of Large Bone and Soft Tissue Defect Combined with Infection in the Lower Extremity with Free Flap Followed by Ipsilateral Vascularized Fibular Transposition

  • Chung, Duke Whan;Han, Chung Soo;Lee, Jae Hoon;Kim, Eun Yeol;Park, Kwang Hee;Kim, Dong Kyoon
    • Archives of Reconstructive Microsurgery
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    • 제22권2호
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    • pp.57-62
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    • 2013
  • Purpose: The aim of this study is to report on the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of large bone and soft tissue defect combined with infection by open tibia fracture. Materials and Methods: During the research period, lasting from December 2002 to June 2008 (Kyung Hee University Medical Center), data were collected from three patients who underwent IVFT after free flap. We analyzed the successiveness and persistency of the infection using free flapping, bone union, and hypertrophy between transposed fibula and tibia. Results: Regarding free flap, successive results were observed in all examples. In the final follow-up results, transposed fibulas all survived, having hypertrophy similar to that of adjacent tibia. Conclusion: Reconstruction of tibia defect with free flap followed by IVTF is a useful and safe method for avoidance of the potential risk of infection for patients with a large tibial bone defect and soft tissue defect associated with infection.

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안와-관골골절 환자에서 안와하 접근법의 유용성 (The usability of Infraorbital Approach on the patients with Orbito-Zygomatic Fracture)

  • 윤치선;김종환;양호직
    • 대한두개안면성형외과학회지
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    • 제10권1호
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    • pp.19-22
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    • 2009
  • Purpose: There are various approaches for open reduction surgery for orbitozygomatic fractures. After the incisions are performed, patients might have various complications. In this point of view, we conducted a retrospective study of the usability of infraorbital incision on elderly patients, generally more vulnerable to scleral show and ectropion. Methods: In this study, 20 patients who are relatively more vulnerable to scleral show and ectropion through snap-back test having infraorbital incision were reviewed. We monitored the duration of the surgery, and complications resulted from the incision. We evaluated the scars with the researcher's observations and with the patient's level of satisfaction on a scale of 1 to 5. Results: On average, 5 minutes was spent between the skin incision and the fracture exposure. No case of scleral show and ectropion occurred. One year follow-up observation revealed 4 cases of visible scars, 9 cases of barely visible scars, and 7 cases of invisible scars. The subjective satisfaction level of the patients' scar is an average of 4.0. Conclusion: Infraorbital incision has many advantages. First, it can reduce the complications such as scleral show and ectropion. Second, it can shorten the operation time. Third, it can diminish incision-related scars.

Attributes of a Good Microsurgeon-A Brief Counsel to the Up-and-Coming Prospects

  • Joon Pio Hong;Zulqarnain Masoodi;Chieh-Han John Tzou
    • Archives of Plastic Surgery
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    • 제50권1호
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    • pp.130-140
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    • 2023
  • Microsurgery, which deservedly sits on top of the reconstruction ladder, has been a boon to plastic surgery. It is because of this marvelous tool that plastic surgeons the world over have been able to tackle many reconstructive dilemmas, which were once considered to be an improbability. Microsurgery-aided revolutions have rendered a new meaning to all forms of reconstruction-whether it is postoncological, posttraumatic, or postlymphedema reconstruction. As the most advanced reconstructive medium at our disposal that has broadened the horizons of plastic surgery exponentially, it is but obvious that many budding plastic surgeons are drawn toward this subspecialty. In lieu of the aforementioned facts, it is necessary to sensitize all such aspiring surgeons about the various intricacies concerning the field of microsurgery. This article with its focus on the six desirable microsurgical attributes of "Clarity, Curiosity, Perseverance, Passion, An Open Mindset and Action," is meant to be a modest attempt on part of the authors to share their microsurgical insights, procured through their respective journeys, with budding aspirants, hoping to sensitize as well as motivate them for the challenging path that lies ahead.

하악두 골절의 미진한 처치로 인해 metallic condylar prostheses까지 사용한 증례 (A CASE REPORT OF RECONSTRUCTION USING METALLIC CONDYLAR PROSTHESES FOR THE CORRECTION OF COMPLICATIONS RESULTED BY UNSUCCESSFUL MANAGEMENT OF FRACTURED MANDIBULAR CONDYLE)

  • 정훈;성춘수;이태영
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제16권1호
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    • pp.43-50
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    • 1994
  • It is a generally known fact that the patient can experience mouth opening limitation, mandibular deviation and malocclusion as a result of injury of tissues around the articular disc and complications even after successful open reduction surgery for fractured mandibular condyle. We have experienced a rare case of reconstruction using metallic condylar prostheses for a patient with complications resulted by unsuccessful management of fractured mandibular condyle. The case strongly suggested to us that careful selection of treatment methods should be taken for patient with fractured mandibular condyle. Accordingly, we are presenting a case in conjunction with reviews of fractured mandibular condyle.

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스테레오 영상에서의 깊이정보를 이용한 3D 가상현실 구현 (Reconstruction of 3D Virtual Reality Using Depth Information of Stereo Image)

  • 이성재;김정훈;이정환;안종식;이동준;이명호
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 1999년도 하계학술대회 논문집 G
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    • pp.2950-2952
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    • 1999
  • This paper presents the method of 3D reconstruction of the depth information from the endoscopic stereo scopic images. After camera modeling to find camera parameters, we performed feature-point based stereo matching to find depth information. Acquired some depth information is finally 3D reconstructed using the NURBS(Non Uniform Rational B-Spline) method and OpenGL. The final result image is helpful for the understanding of depth information visually.

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죠르죠 그라씨 건축형태 구성원리에 관한 연구 (A Study on the architectural composition of Giorgio Grassi)

  • 곽기표
    • 한국실내디자인학회논문집
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    • 제32호
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    • pp.13-20
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    • 2002
  • This study is purposed to find fundamental characteristics in Grassi's architecture which has architectural principles in architecture itself and in the general frame of the historical facts of architecture. His architectural theories can be explained for rationality, historicity, universality. The method of architectural composition can be divided into urban morphological characteristic and compositional characteristic of architecture. The characteristics of the former are the reconstruction of the urban structure by the readjustment of an urban axis which is based on historical continuity of the city, the open court which is a passage transformed from colonnade that is the historical vernacular type and the respect for the city-line which goes with historical context. The characteristics of the latter are the use transformed of nine square which gives consideration to centrality and typology at the same time and the hierarchic division of the principal space and the subordinate space for the functional typical purpose. This analysis shows that Grassi's architecture is on the base of historical continuity and urban reality and for him architectural work is mental work which conflict with the real world for the reconstruction of the city.

Direct Open Venous Drainage: An Alternative Choice for Flap Congestion Salvage

  • Park, Su Han;Choi, Woo Young;Son, Kyung Min;Cheon, Ji Seon;Yang, Jeong Yeol
    • 대한두개안면성형외과학회지
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    • 제16권3호
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    • pp.143-146
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    • 2015
  • In this report, we present a scalp defect reconstruction with lateral arm free flap. We highlight the difficulty in obtaining a recipient vein and the venous drainage managed through an open end of the donor vein. A 52-year-old woman presented with a pressure sore on the left scalp. A lateral arm free flap was transferred to cover this $8{\times}6cm$ defect. The arterial anastomosis was successful, but no recipient vein could be identified within the wound bed. Instead, we used a donor venous end for the direct open venous drainage. In order to keep this exposed venous end patent, we applied heparin-soaked gauze dressing to the wound. Also, the vein end was mechanically dilated and irrigated with heparin solution at two hour intervals. Along with fluid management and blood transfusion, this management was continued for the five days after the operation. The flap survived well without any complication. Through this case, we were able to demonstrate that venous congestion can be avoided by drainage of the venous blood through an open vessel without the use of leeches.

Free Flap Transplantation in Open Tibial Fracture with Vessel Injury in the Elderly

  • Yu, Chang Eun;Yoo, Myung-Jae;Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • 제23권1호
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    • pp.18-20
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    • 2014
  • Two aged patients who had open tibial fractures with arterial injury caused by high energy accidents underwent emergency arterial reconstruction using a greater saphenous vein and soft tissue repair using free flaps. In the patients, soft tissue necrosis developed and tibias were exposed at postoperative third week. Follow-up angiography through the superficial femoral artery showed occlusion of the anterior tibial artery. The anterior tibial artery was reconstructed using the contralateral greater saphenous vein graft and the latissimus dorsi myocutaneous and rectus abdominis muscle free flaps were transplanted for repair of necrotic soft tissue. The reconstructed arteries showed good perfusion to the new free flaps until union of the tibias occurred. The patients were followed-up for 21 years and 17 years postoperatively, respectively. In management of open comminuted fracture of the tibia, injury of the arterial system must be ruled out by angiography in addition to evaluation of the degree of soft tissue injury.