• Title/Summary/Keyword: Repair of defect

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Clinical Results of Surgical Treatment of an Isolated Complete Atrioventricular Septal Defect (완전방실중격결손증의 외과적 요법에 관한 임상적 고찰)

  • 이정상
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.123-134
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    • 1991
  • Twenty eight patients had undergone repair of an isolated complete atrioventricular septal defect between April 1986 and September 1990 in Seoul National University Children`s Hospital. The group comprised 13 male and 15 female patients. They ranged in age from 2 months to 8 years[mean 18.6months] and in weight from 3. 4kg to 23kg[mean 9.0$\pm$4.6kg]. They were analysed as Rastelli type A in 17 patients, Rastelli type B in 2 patients, and Rastelli type C in 9 patients. Seven patients had concomitant Down`s syndrome. All patients had large left-to-right shunt[mean pulmonary to systemic flow ratio 3.5 $\pm$2.2 ranging from 0.68 to 10.0] and high pulmonary systolic pressure[mean 74$\pm$18.8mmHg, ranging from 35 to 110]. In 11 patients, one patch technique was used to close the atrial and ventricular septal defect and 16 patients were undergone by two patch technique. We urgently managed only one patient by pulmonary artery banding whose anatomy was Rastelli type C and severe mitral regurgitation was identified. Postoperative complete A - V block was noted in 3 patients, two of whom were dead in operating room due to combined LVOTO and myocardial failure, and one patient with Rastelli type C was undergone by VVI type permanent pacemaker insertion 1wk later after two patch technique, but we had to manage him by modified Konno operation and total correction due to LVOTO and VSD leakage and severe mitral regurgitation 3 years later. Another two reoperation cases due to severe mitral regurgitation after two patch technique were undergone, one of whom we managed by mitral annuloplasty 3 months later but aggravated mitral regurgitation made us to control him by MVR 3 months later. Another one case of VSD leakage and tricuspid regurgitation was managed by total correction but she died of respiratory insufficiency 14 days later. We experienced pulmonary hypertensive crisis in 3 patients, who were dead in two cases comparing with one control case. So operative mortality is 9/27[33.6%], in one patch group of 3/11[29.2%] comparing with two patch group of 6/16[37.5%]. In summary, causes of death were pump weaning failure, myocardial failure and low cardiac output syndrome and pulmonary hypertensive crisis, resp. failure, complete AV block. Mean follow up period is 15.8$\pm$10.7 months[ranging from 3months to 37 months]

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Magnetic Resonance Imaging (MRI) of a Hypertrophy of Cartilage and Simultaneous Regeneration of a Damaged Meniscus after Autologous Bone Marrow Aspirates Concentrate (BMAC) Transplantation: a Case Report and Literature Review

  • Bae, Sung Hwan;Kim, Hyun-joo;Oh, Eunsun;Hwang, Jiyoung;Hong, Seong Sook;Hwang, Jung Hwa
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.187-191
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    • 2017
  • Bone marrow aspirates concentrate (BMAC) transplantation is a well-known technique for cartilage regeneration with good clinical outcomes for symptoms in patients with osteoarthritis (OA). Magnetic resonance imaging (MRI) has an important role in evaluating the degree of cartilage repair in cartilage regeneration therapy instead of a second assessment via an arthroscopy. We experienced a case of hypertrophic regeneration of the cartilage and a presumed simultaneous regeneration of the posterior horn of the lateral meniscus after BMAC transplantation for a cartilage defect at the lateral tibial and femoral condyle. This report provides the details of a case of an unusual treatment response after a BMAC transplant. This report is the first of its kind to demonstrate a MR image that displays the simultaneous regeneration of the cartilage and meniscus with a differentiation ability of the mesenchymal stem cell to the desired cell lineage.

Aortic Periannular Abscess Invading into the Central Fibrous Body, Mitral Valve, and Tricuspid Valve

  • Oh, Hyun Kong;Kim, Nan Yeol;Kang, Min-Woong;Kang, Shin Kwang;Yu, Jae Hyeon;Lim, Seung Pyung;Choi, Jae Sung;Na, Myung Hoon
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.283-286
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    • 2014
  • A 61-year-old man was diagnosed with aortic stenoinsufficiency with periannular abscess, which involved the aortic root of noncoronary sinus (NCS) that invaded down to the central fibrous body, whole membranous septum, mitral valve (MV), and tricuspid valve (TV). The open complete debridement was executed from the aortic annulus at NCS down to the central fibrous body and annulus of the MV and the TV, followed by the left ventricular outflow tract reconstruction with implantation of a mechanical aortic valve by using a leaflet of the half-folded elliptical bovine pericardial patch. Another leaflet of this patch was used for the repair of the right atrial wall with a defect and the TV.

Resolution of Protein-Losing Enteropathy after Congenital Heart Disease Repair by Selective Lymphatic Embolization

  • Kylat, Ranjit I;Witte, Marlys H;Barber, Brent J;Dori, Yoav;Ghishan, Fayez K
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.594-600
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    • 2019
  • With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, postdouble switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ${\leq}0.9g/dL$) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.

Incarcerated Hiatal Hernia with Perforation after Laparoscopic Total Gastrectomy with Roux-en-Y Reconstruction: a Case Report

  • Wang, Nai-Yu;Tsai, Chung-Yu;Liu, Yuan-Yuarn;Chen, I-Shu;Ho, Kai-Hung
    • Journal of Gastric Cancer
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    • v.19 no.1
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    • pp.132-137
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    • 2019
  • The occurrence of hiatal hernia after total gastrectomy with Roux-en-Y reconstruction is rare. We report the case of a 76-year-old man who presented with dyspnea, vomiting, and fever around 8 days after total gastrectomy with Roux-en-Y reconstruction. Abdominal computed tomography revealed a hiatal hernia containing part of the small intestine in the left thoracic cavity. Emergent reduction and repair of the hiatal hernia were performed later. Operative findings revealed that the Roux limb was incarcerated in the left pleural cavity. Esophagojejunostomy leakage, perforation of the small intestine with transient ischemic change, and pyothorax were also found. Thus, feeding jejunostomy, thoracoscopic decortication, and diversion T-tube esophagostomy were performed. Considering that the main cause of hiatal hernia is blunt dissection with division of the phrenoesophageal membrane, approximating the crus with 1 or 2 figure-8 sutures, according to the size of the defect, to prevent the incidence of hiatal hernia after total gastrectomy may be performed.

Contemporary Concept for Prevention and treatment of MRONJ (Medication Related Osteonecrosis of Jaw) (MRONJ 예방과 치료를 위한 최신지견)

  • Park, Jung-Hyun;Kim, Sun-Jong
    • The Journal of the Korean dental association
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    • v.54 no.4
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    • pp.274-283
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    • 2016
  • Bisphosphonates are widely used mainly for the treatment of osteoporosis and bone metastasis of malignancy. Since the first report of MRONJ, there have been many studies associated, however the pathogenesis of MRONJ is not yet clear. Medication-related osteonecrosis of the jaws (MRONJ) is a serious complication associated with long-term medication therapy. It is characterized by exposed necrotic bonein the jaw, which has persisted for more than 8weeks despite continuous treatment by dentist. The mechanism of development of MRONJ is still unclear and there is no definitive standard treatment for MRONJ. The purpose of this study is to investigate the jaw bone destruction mechanism of accumulated bisphosphonates, so that we can develop therapeutic method to repair the defect and stop the destruction process. The authors performed simultaneous application of PRF(Platelet rich fibrin) and BMP-2(Bone morphogenetic protein-2) to stimulate not only soft tissue healing but also osseous regeneration. Our case series demonstrate that simultaneous application of platelet rich fibrin and bone morphogenetic protein-2 can be a treatment of choice for MRONJ.

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Three-Dimensional Pre-Bent Titanium Implant for Concomitant Orbital Floor and Medial Wall Fractures in an East Asian Population

  • Lee, Kyung Min;Park, Ji Ung;Kwon, Sung Tack;Kim, Suk Wha;Jeong, Eui Cheol
    • Archives of Plastic Surgery
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    • v.41 no.5
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    • pp.480-485
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    • 2014
  • Background The objective of this article is to evaluate clinical outcomes of combined orbital floor and medial wall fracture repair using a three-dimensional pre-bent titanium implant in an East Asian population. Methods Clinical and radiologic data were analyzed for 11 patients with concomitant orbital floor and medial wall fractures. A combined transcaruncular and inferior fornix approach with lateral canthotomy was used for the exposure of fractures. An appropriate three-dimensional preformed titanium implant was selected and inserted according to the characteristics of a given defect. Results Follow-up time ranged from 2 to 6 months (median, 4.07 months). All patients had a successful treatment outcome without any complications. Clinically significant enophthalmos was not observed after treatment. Conclusions Three-dimensional pre-bent titanium implants are appropriate for use in the East Asian population, with a high success rate of anatomic restoration of the orbital volume and prevention of enophthalmos in combined orbital floor and medial wall fracture cases.

Hair Growth Promoting Effect of Radish Crude Saponin Extract on Athymic Nude Mice

  • Kim, Hyun-Kyoung
    • International journal of advanced smart convergence
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    • v.8 no.1
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    • pp.184-195
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    • 2019
  • This study investigates the hair restoration efficacy of selected radish saponin extracts on nude mice. Nude mice genetically predisposed to pattern balding were used in this study. Our study revealed the underlying mechanism of stimulating hair growth in athymic nude mice by repair the nu/nu follicular keratin differentiation defect. Thus, the topical application of radish saponin may represent a novel strategy for the management and therapy of certain forms of alopecia. The term of hair density of PEE treated nude mice were significantly increase as compared with of control nude mice. Histological observation of skin sample showed no hair follicle or only distorted hair follicles were observed in the control samples, in contrast, by the PEE treatment groups showed a fully formed and increased the number of hair follicles up to three times higher than that of control group in terms of the number of hair follicles in nude mouse skin.PEE treated mice the number of BrdU-labeled keratinocytes per anagen follicle increased significantly, especially in the follicular bulbs and outer root sheath compared with the control mice. Moreover, PEE-treated nude mice also exhibited a significant increase in the number of BrdU-labeled epidermal keratinocyte proliferation.

Surgical correction of congenital heart defects in adult (성인 선천성 심장기형의 외과적 치료)

  • 신현종
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.95-105
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    • 1989
  • The records of 248 patients over 16 years of age who had undergone a surgical correction of a congenital cardiovascular malformation during the period of 10 years from August, 1978 to July, 1988 were reviewed. During this period, the incidence of congenital cardiovascular malformation in adult was 18.2% of 1376 total heart disease operated on and 25.5% of 986 congenital heart defects. Among them, there were 200 patients in acyanotic group and 48 patients in cyanotic group. Male versus female ratio was 1:1.28. The oldest patient was 59 years old female who had atrial septal defect. The mean age was 24.4 years old. The distribution of the lesions showed a large preponderance of atrial septal defects [37.19o] followed in frequency by ventricular septal defects [918.1%], patent ductus arteriosus [17.3%], tetralogy of Fallot [16.1%], and a variety of other complex malformations[3.2%]. In the pediatric age group, relative frequency was different from that of this adult group, showing ventricular septal defects, tetralogy of Fallot, patent ductus arteriosus and atrial septal defects in order of incidence. The hospital mortality and late mortality were 6.0% and 1.7% respectively. The causes of hospital death were low cardiac output in 10 patients, arrhythmia in 2, air embolism in 1, sepsis in 1 and respiratory failure in l. Clinical improvement upto NYHA functional class I or II postoperatively has been achieved and sustained in all patients following repair except the patients of late death and receiving reoperation. This result confirms that congenital heart defects in the adults can be corrected with a good outcome and an aggressive operative approach seems justified.

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Evaluation of the Adhesion Stability According to the Backfilling Area of the Tile back of the Bathroom of an Apartment House (공동주택 욕실의 타일배면 뒤채움 피착면적에 따른 부착안정성 평가)

  • Kim, Bum Soo;Song, Je Young;Oh, Sang Keun
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2021.05a
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    • pp.14-15
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    • 2021
  • Recently, the size of tiles used for bathroom walls in apartment houses is gradually increasing in size. The problem is that when these large-sized tiles are attached by the sticking method, due to the nature of the method, there is a concern about the stability of the attachment to the part (pupil) where the tile and the adhesive are not attached. The problem is serious as it leads to lawsuits in the outbreak court. In addition, it is urgent to verify the adhesion stability of the sticking method because secondary damage occurs due to a safety accident caused by the falling of the tile. Ministry of Land, Infrastructure and Transport [Investigation of defects in apartment houses, calculation of repair cost and defect determination criteria] ① The tile adhesion strength is 0.39N/mm2 or more and ② It is specified to fill 80% or more of the base area of the tile backside, but this is currently trendy. It is considered that large-sized tiles need to be verified from multiple angles, and as part of that, we intend to verify the adhesion stability according to the area to be attached to large-sized tiles.

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