• Journal of Chest Surgery
• /
• 제32권11호
• /
• pp.1004-1008
• /
• 1999

Background: Total anomalous pulmonary venous return is a relatively rare disease which has a very high mortality(80% within a year) if not properly corrected surgically. Material and Method: Twenty-six infants with total anomalous pulmonary venous return underwent repair between May, 1991 and February, 1996. Result: There were 19 boys and 7 girls. The mean age at operation was 2.6 months(range: 5 day to 11 month) and the mean body weight was 4.3kg(range:2.8 to 6.7 kg). Preoperative stabilization included ventilator for 5 patients and inotropic support for 6 patients. There were 6 hospital mortalities. Significant risk factors of operative mortality were preoperative ventilator care(p<0.03) and preoperative inotropic support(p<0.05). Age, body weight at operation, pulmonary venous obstruction, high pulmonary arterial pressure, spurasystemic right ventricular pressure or emergency operation did not affected the operative outcome. Postperative pulmonary venous obstruction occurred in three patients 2 or 3 months later, among them one patient was reoperated. The actuarial survival was 76% at 40 months. Conclusion: Although early mortality was high, repair of total anomalous pulmonary venous return should be attempted in early life, but the patients receiving ventilator care or inotropic support need special attention.

• Journal of Chest Surgery
• /
• 제48권1호
• /
• pp.1-6
• /
• 2015

Although development of surgical technique and critical care, ruptured abdominal aortic aneurysm still carries a high mortality. In order to obtain good results, various efforts have been attempted. This paper reviews initial management of ruptured abdominal aortic aneurysm and discuss the key point open surgical repair and endovascular aneurysm repair.

• 가정과삶의질연구
• /
• 제23권2호
• /
• pp.11-22
• /
• 2005

The purpose of this study is 1) to clarify that the house is no long the safe place through the cases of the senior safety accidents and to argue the need for housing repair and 2) to present the minimum standards for housing repair by comparing the cases here as well as the abroad and to back up the standards with the current senior housing environment 300 people at least 60 years old living in Seoul$\cdot$Metropolitan area were interviewed using the structured questionnaire. As the result, the following conclusions were made: 1. There was high accident rates of the senior residents due to physical deficits within the house, causing excessive medical cost and decreased housing satisfaction. This problem can be sufficiently prevented by housing repair which can not only solve the safety problem but also support self sufficient living for the senior residents. 2. Proper housing repair required the architectural know how as well as the expertise knowledge of the physical characteristics of the senior people. Therefore, it is essential to secure the professional (i.e., occupational therapist) who can analyze the needs of the senior residents and evaluate and/or predict the obstacles during repair. Furthermore, development and distribution of the standardized manual are also needed. 3. The minimum standard for housing repair could be approached in view of 'barrier-free' concept. First, the bumps should be removed, slippery prevented, and safety grab-bar installed for safety. Second, the entrance should be widened and the bathroom and kitchen restructured to support for the senior residents' self sufficiency. To make housing repair policy more efficient, the legal basis is required. It can be incorporated into the existing senior citizens 'Welfare Act' or the 'Senior Residents Medical Insurance' which will be effective starting in 2007.

• The Korean Journal of Pain
• /
• 제34권2호
• /
• pp.201-209
• /
• 2021

Background: Inguinal hernia repair is one of the most commonly performed surgical procedures. Regional blocks might provide excellent analgesia and reduce complications in the postoperative period. We aimed to compare the postoperative analgesic effect of the ultrasound-guided transversalis fascia (TF) plane block versus the transmuscular quadratus lumborum (QL) block in patients undergoing unilateral inguinal hernia repair. Methods: Fifty patients enrolled in this comparative study and were randomly assigned into two equal groups. One group received an ultrasound-guided QL block. In comparison, the other group received an ultrasound-guided TF plane block. The primary outcome was the patient-assessed resting, and movement-induced pain on the numeric pain rating scale (NRS) measured at 30 minutes postoperatively. Secondary outcomes included the percentage of patients receiving rescue analgesia in the first postoperative day, ease of performance of the technique, and incidence of adverse effects. Results: There were no statistically significant differences in NRS at rest and with movement between the groups over the first 24 hours postoperatively. The proportion of patients that received postoperative rescue analgesics during the first 30 minutes postoperatively was 4% (n = 1) in the QL group compared to 12% (n = 3) in the TF group. However, the mean performance time of the TF block was shorter than that of the QL block, and the performance of the TF block appeared easier technically. Conclusions: The ultrasound-guided TF plane block could be as effective as the QL block in lowering pain scores and decreasing opioid consumption following non-recurrent inguinal herniorrhaphy.

• 대한구순구개열학회지
• /
• 제15권2호
• /
• pp.69-82
• /
• 2012

Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

• Archives of Plastic Surgery
• /
• 제50권1호
• /
• pp.30-36
• /
• 2023

Background Most children with facial lacerations require sedation for primary sutures. However, sedation guidelines for invasive treatment are lacking. This study evaluated the current status of the sedation methods used for pediatric facial laceration repair in Korea. Methods We surveyed one resident in each included plastic surgery training hospital using face-to-face interviews or e-mail correspondence. The health care center types (secondary or tertiary hospitals), sedation drug types, usage, and dosage, procedure sequence, monitoring methods, drug effects, adverse events, and operator and guardian satisfaction were investigated. Results We included 45/67 hospitals (67%) that used a single drug, ketamine in 31 hospitals and chloral hydrate in 14 hospitals. All health care center used similar sedatives. The most used drug administered was 5 mg/kg intramuscular ketamine (10 hospitals; 32%). The most common chloral hydrate administration approach was oral 50 mg/kg (seven hospitals; 50%). Twenty-two hospitals (71%) using ketamine followed this sequence: administration of sedatives, local anesthesia, primary repair, and imaging work-up. The most common sequence used for chloral hydrate (eight hospitals; 57%) was local anesthesia, administration of sedatives, imaging work-up, and primary repair. All hospitals that used ketamine and seven (50%) of those using chloral hydrate monitored oxygen saturation. Median operator satisfaction differed significantly between ketamine and chloral hydrate (4.0 [interquartile range, 4.0-4.0] vs. 3.0 [interquartile range, 3.0-4.0]; p <0.001). Conclusion The hospitals used various procedural sedation methods for children with facial lacerations. Guidelines that consider the patient's condition and drug characteristics are needed for safe and effective sedation.

• Journal of Yeungnam Medical Science
• /
• 제40권2호
• /
• pp.187-192
• /
• 2023

Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

• Korea Journal of Cosmetic Science
• /
• 제2권1호
• /
• pp.11-19
• /
• 2020

The aim of this study is to investigate the effect of various pentapeptides on hair repair depending on the characteristics of comprising amino acids using crosslinking agents in hair. Total ten peptides were synthesized with two kinds of amino acids respectively, of which were previously categorized according to R group of the amino acids contributing to the characteristic of each peptide: STTSS (Ser-Thr-Thr-Ser-Ser), LIILL (Leu-Ile-Ile-Leu-Leu), CMMCC (Cys-Met-Met-Cys-Cys), DEEDD (Asp-Glu-Glu-Asp-Asp), RKKRR (Arg-Lys-Lys-Arg-Arg), TAMRA-STTSS, TAMRA-LIILL, TAMRA-CMMCC, TAMRA-DEEDD, and TAMRA-RKKRR. Pentapeptide alone, or pentapeptides with crosslinking agents such as polymeric carbodiimide (PCI) and 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) were treated to chemically damaged hair. Hair diameter and break strength (N = 40/case) were measured to calculate tensile strength of hair for computing hair repair ratio, and fluorescence yields (N = 20/case) were collected for hair treated with TAMRA-peptides. The tensile strength of hair treated with pentapeptides alone, or pentapeptides with cross-linking agents is consistent with the fluorescence yield from the microscope images of the cross-sectioned hair in vision and in numerical values. Pentapeptides consisting of hydrophobic amino acids (LIILL), amino acids with sulfur (CMMCC), and basic amino acids (RKKRR) increased the tensile strength in perm-damaged hair. Pentapeptides with no extra carboxyl/amine groups in R group of amino acids resulted in no significant differences in hair strength and fluorescence yield among hairs treated with alone and with crosslinkers. Pentapeptides with extra carboxyl groups or amine groups enabled further strengthening of hair due to increased bonds within the hair after carbodiimide coupling reaction. The hair repairs of pentapeptides with various amino acid sequences were studied using crosslinking. Depending on the physical characteristics of comprising amino acids, the restoration of damaged hair was observed with tensile strength of hair and fluorescence signals upon cross-sectioned hair in parallel to possibly understand the binding tendency of each pentapeptide within the hair.

• 콘크리트학회논문집
• /
• 제17권4호
• /
• pp.637-643
• /
• 2005

Reinforced concrete beams or slabs are often strengthened or repaired using polymer modified cement concrete Stresses can develop in the structure by ambient temperature changes because thermal coefficients of the repair material and the existing concrete are typically different. Especially, shear stress often causes debonding of the interface. In this study, a rational procedure was developed where anchors can be designed in strengthened or repaired concrete members to prevent debonding at the interface. The current design procedure considers thicknesses and elastic moduli of the repair material and existing concrete, ambient temperature change, length, and beam-vs.-slab action. The procedure is also applicable to stresses developed by differential drying shrinkage.

• 대한신경집중치료학회지
• /
• 제11권2호
• /
• pp.148-151
• /
• 2018