• Title/Summary/Keyword: primary closure

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An Analysis of the Variation in the Settling Properties of Cohesive Sediments before and after Closure of the Saemankeum Seadike (새만금 끝막이 공사 전후의 점착성 퇴적물의 침강특성 변화 해석)

  • Yang, Su-Hyun;Hwang, Kyu-Nam
    • Journal of Ocean Engineering and Technology
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    • v.22 no.4
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    • pp.20-26
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    • 2008
  • The primary purpose of this study was to quantitatively examine whether there was a difference in the settling velocities of cohesive sediments in the Saemankeum artificial lake before and after the closure of the Saemankeum seadike. Through in situ sediment sampling and laboratory experiments, the settling velocities were estimated as a function of the suspension concentration and their physico-chemical properties, such as grain size distribution, the percentage of organic contents, mineralogical composition, etc. were also examined. In this study, their inter-relation with settling velocities were also analyzed qualitatively. The result of the settling tests for Saemankeum sediments showed that there was a big difference in the settling velocities before and after the closure of the Saemankeum seadike. Its settling velocities in a flocculated settling region became remarkably larger after the closure compared to those before the closure, while they were similar but relatively smaller in a hindered settling region. This was found to be mainly due to the difference in their grain size.

Two Cases Reports of Dextrocardia with Congenital Heart Disease (우심증에 동반된 선천성 심장질환의 치험 2례)

  • Kim, Jun-U;Kim, Won-Gon;Yu, Se-Yeong
    • Journal of Chest Surgery
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    • v.28 no.7
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    • pp.698-703
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    • 1995
  • Dextrocardia means right-sided position of the heart in the chest irrespective of the cause. For the absolute diagnosis of the dextrocardia, the segmental analysis of heart is necessary. Once the segmental analysis of the dextrocardia is made, it is often relatively easy to identify the presence of any associated defects based on conventional methods including physical examination, EKG, echocardiography, and angiocardiography. Two cases of dextrocardia with congenital heart disease were treated surgically.A eleven - months old boy was operated under diagnosis of ASD, VSD, and bilateral SVC with mirror - image dextrocardia {I,L,I} by primary closure of ASD and VSD.A twenty-four months old girl was operated under diagnosis of ASD, VSD, and PS with corrected TGA {I,D,D} by primary closure of ASD, VSD and dilatation of pulmonary stenosis. Both of them were discharged healthily after operation.

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Opening and Closure Body Space Expressed in the Fashion Art

  • Huh Jung-Sun;Geum Key-Sook
    • International Journal of Costume and Fashion
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    • v.5 no.1
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    • pp.14-25
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    • 2005
  • The objective of this study is to understand bodily extension and identity in contemporary fashion art through the analysis of 'the fashion acting on the body' among the fashion theory excluding body and the conspicuous works on the opening and covering images as a fashion art as a body-space'. This study also investigated identity problems where there are poles apart in opening and closure their bodies and body-space in which its clothing types were distorted by being de-bodilization out of the traditional and ideological expression method in contemporary fashion art from a opening and closure point of view. Image of opening and closure among body-space in fashion art can be classified into opposing structure of opening and closure. Destroying the boundary between bodily opening and closure for a primary function of clothing and dismantling the role and boundary between body and clothing, opening body-space in appearance as a reemergence of body image or the border between inner and outer are being ambiguous because of transparent material. Being representative work of this study opening body-space was expressed as an opening space image using transparency. On the contrary, closure body-space was isolated from external environment and confined in the certain space, which could limit or restraint body- action. Excluding boundary of body and clothing on the whole or in part, boundary of work becomes body-space. However, these were appeared to be a work inducing unlimited curiosity and meaning from the audience. The interpretation of artistic and body-space in fashion art are indicating the role and function of the fashion art exceeding the suggestible dimensions in the every day life of fashion. The body-space of fashion art showing similar aspect of body art today could be understood that it is substituted into an metaphorical, critical space by seeing it as a symbol system connected with social space. Therefore, contemporary fashion art should be interpreted as an equivocal space looking at the body-space with open mind.

Free gingival graft for the increase of peri-implant attached keratinized mucosa decreased after guided bone regeneration (골 유도 재생술 후 감소된 임플란트 주위 부착 각화 점막 증대를 위한 유리 치은 이식술 증례)

  • Kim, Deug-Han;Ji, Suk;Pang, Eun-Kyoung
    • Journal of Periodontal and Implant Science
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    • v.38 no.4
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    • pp.723-728
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    • 2008
  • Purpose: During guided bone regeneration procedures for the augmentation of deficient alveolar ridge, primary closure of flap is necessary. For primary flap closure, flap is repositioned coronally and the zone of attached keratinized mucosa may decreased. The need for attached keratinized mucosa around dental implants is still controversial, but sufficient peri-implant attached keratinized mucosa would be beneficial for functional and esthetic aspects. This case report presents three cases that demonstrated free gingival graft for increasing the zone of peri-implant attached keratinized mucosa which was decreased after guided bone regeneration. Materials and Methods: In first case, maxillary incisors were extracted and guided bone regeneration was performed simultaneously. Because the membrane was exposed at 3 weeks after operation, the membrane was removed and free gingival graft was performed for primary flap closure. Free gingival graft was performed again at implant placement for the increase of attached keratinized mucosa. In second case, guided bone regeneration was performed on lower right first molar area, and implant was placed with free gingival graft. In third case, lower right molar area showed insufficient attached keratinized mucosa after implant placement with guided bone regeneration. When abutments were connected, free gingival graft with apically positioned flap was performed. Result: In these three cases, the zone of attached keratinized mucosa around dental implants was decreased after guided bone regeneration. And the increase of peri-implant attached keratinized mucosa could be obtained effectively by free gingival graft. Conclusion: Free gingival graft could be a effective treatment method increasing the zone of attached keratinized mucosa which was decreased after guided bone regeneration procedures.

Reconstruction of nasal ala and tip following skin cancer resection

  • Park, Young Ji;Kwon, Gyu Hyeon;Kim, Jun Oh;Ryu, Woo Sang;Lee, Kyung Suk
    • Archives of Craniofacial Surgery
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    • v.20 no.6
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    • pp.382-387
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    • 2019
  • Background: Defects of the nasal ala and tip have a complex three-dimensional structure that makes them challenging to reconstruct. Many reconstructive options have been described for nasal ala and tip defects, ranging from primary closure to local flaps and skin grafts. However, it is difficult to determine which method will yield the best cosmetic results in each individual case. Thus, the purpose of this study was to determine which surgical procedures for reconstructing defects of the nasal ala and tip have better cosmetic results. Methods: From 2008 to 2018, 111 patients underwent surgery to reconstruct skin defects after resection of skin cancer in the nasal ala or tip. Their charts were reviewed to obtain data on age, sex, surgical location, size of the defect, surgical method, and cosmetic results using a visual analog scale (VAS). Results: For nasal ala reconstruction, the most commonly used surgical technique was the nasolabial flap (n= 42). This method also had the highest VAS score (7/10). The most commonly selected surgical method for nasal tip reconstruction was the bilobed flap (n= 13), and bilobed flaps and primary closure had the highest VAS score (7/10). Conclusion: Nasolabial flaps showed excellent cosmetic results for the reconstruction of nasal ala defects, while primary closure and bilobed flaps yielded excellent cosmetic results for the reconstruction of nasal tip defects.

Feasibility of the AtriClip Pro Left Atrium Appendage Elimination Device via the Transverse Sinus in Minimally Invasive Mitral Valve Surgery

  • Shirasaka, Tomonori;Kunioka, Shingo;Narita, Masahiko;Ushioda, Ryohei;Shibagaki, Keisuke;Kikuchi, Yuta;Wakabayashi, Naohiro;Ishikawa, Natsuya;Kamiya, Hiroyuki
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.383-388
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    • 2021
  • Background: Achieving external access to and manual occlusion of the left atrial appendage (LAA) during minimally invasive mitral valve surgery (MIMVS) through a small right thoracotomy is difficult. Occlusion of the LAA using an epicardial closure device seems quite useful compared to other surgical techniques. Methods: Fourteen patients with atrial fibrillation underwent MIMVS with concomitant surgical occlusion of the LAA using double-layered endocardial closure stitches (n=6, endocardial suture group) or the AtriClip Pro closure device (n=8, AtriClip group) at our institution. The primary safety endpoint was any device-related adverse event, and the primary efficacy endpoint was successful complete occlusion of blood flow into the LAA as assessed by transthoracic echocardiography at hospital discharge. The primary efficacy endpoint for stroke reduction was the occurrence of ischemic or hemorrhagic neurologic events. Results: All patients underwent LAA occlusion as scheduled. The cardiopulmonary bypass and aortic cross-clamp times in the endocardial suture group and the AtriClip group were 202±39 and 128±41 minutes, and 213±53 and 136±44 minutes, respectively (p=0.68, p=0.73). No patients in either group experienced any device-related serious adverse events, incomplete LAA occlusion, early postoperative stroke, or neurologic complication. Conclusion: Epicardial LAA occlusion using the AtriClip Pro during MIMVS in patients with mitral valve disease and atrial fibrillation is a simple, safe, and effective adjunctive procedure.

Surgical Management of Ventricular Septal Defect in Infancy (영아기의 심실중격결손에 대한 이라완전교정술과 단계교정술의 비교)

  • 김병호
    • Journal of Chest Surgery
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    • v.27 no.1
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    • pp.24-30
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    • 1994
  • Eighteen infants with a large ventricular septal defect[VSD] underwent primary surgical repair from January 1986 to December 1992. Operation was done because of failure to thrive, medically intractable heart failure, recurrent pneumonia, increased pulmonary vascular resistance[PVR]. Four patients[22.2%] died in the early postoperative period. Relief of heart failure and normalization of growth and weight gain was evident in all survivor. There was no late postoperative death. The results of primary surgical repair of VSD in infancy are compared with those of palliative pulmonary artery banding[PAB] and of VSD closure after PAB. Twenty-seven patients with isolated VSD or with VSD associated with atrial septal defect, patent ductus arteriosus, or coarctation of the aorta underwent initial palliative PAB. There were 3 early postoperative deaths[11.1%]. Severe elevation of PVR persisted in two patients. Closure of VSD and pulmonary artery debanding was done in twenty patients, with 2 early postoperative deaths[10.0%]. Placement of the PAB too close to the pulmonary annulus necessitated trasannular patching in one patient, but any problem caused by migration of the band was not developed. It is concluded that primary surgical repair of VSD in infancy is reasonable and that PAB is indicated only for those patients less than 6 months old with a complicated defect or in an emergency situation.

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Delayed Left Atrial Perforation Associated with Erosion After Device Closure of an Atrial Septal Defect

  • Kim, Ji Seong;Yeom, Sang Yoon;Kim, Sue Hyun;Choi, Jae Woong;Kim, Kyung Hwan
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.110-113
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    • 2017
  • A 43-year-old man who had had a history of atrial septal defect (ASD) device closure 31 months previously presented with abrupt chest and back pain along with progressive cardiogenic shock and cardiac arrest. After resuscitation, he was diagnosed with cardiac tamponade. Diagnostic and therapeutic surgical exploration revealed left atrium (LA) perforation due to LA roof erosion from a deficient aortic rim. Device removal, primary repair of the LA perforation site, and ASD patch closure were performed successfully. The postoperative course was uneventful. The patient was discharged after 6 weeks of empirical antibiotic therapy without any other significant complications.