• Journal of Chest Surgery
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• v.45 no.5
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• pp.330-333
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• 2012

Aortoenteric fistula is a rare but potentially fatal condition causing massive gastrointestinal bleeding. In particular, double primary aortoenteric fistulae are vanishingly rare. We encountered a 75-year-old male patient suffering from abdominal pain, hematochezia, hematemesis, and hypotension. His computed tomography images showed abdominal aortic aneurysm and suspected aortoenteric fistulae. During surgery, we found two primary aortoenteric fistulae. The one fistula was detected between the abdominal aorta and the third portion of the duodenum, and the other fistula was detected between the abdominal aorta and the sigmoid colon. We conducted the closure of the fistulae, the exclusion of the aneurysm, and axillo-bifemoral bypass with a polytetrafluoroethylene graft. The patient was discharged with no complications on the 21st postoperative day.

• Journal of Chest Surgery
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• v.51 no.4
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• pp.260-265
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• 2018

Background: A method of wound closure using knotless suture material in the chest tube site has been introduced at our center, and is now widely used as the primary method of closing chest tube wounds in video-assisted thoracic surgery (VATS) because it provides cosmetic benefits and causes less pain. Methods: We included 109 patients who underwent VATS pulmonary resection at Samsung Medical Center from October 1 to October 31, 2016. Eighty-five patients underwent VATS pulmonary resection with chest drain wound closure utilizing knotless suture material, and 24 patients underwent VATS pulmonary resection with chest drain wound closure by the conventional method. Complications related to the chest drain wound were compared between the 2 groups. Results: There were 2 cases of pneumothorax after chest tube removal in both groups (8.3% in the conventional group, 2.3% in the knotless suture group; p=0.172) and there was 1 case of wound discharge due to wound dehiscence in the knotless suture group (0% in the conventional group, 1.2% in the knotless suture group; p=0.453). There was no reported case of chest tube dislodgement in either group. The complication rates were non-significantly different between the 2 groups. Conclusion: The results for the complication rates of this new chest drain wound closure method suggest that this method is not inferior to the conventional method. Chest drain wound closure using knotless suture material is feasible based on the short-term results of the complication rate.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.5
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• pp.361-366
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• 2020

Guided bone regeneration (GBR) is a surgical procedure that utilizes bone grafts with barrier membranes to reconstruct small defects around dental implants. This procedure is commonly deployed on dehiscence or fenestration defects ≥2 mm, and mixing with autogenous bone is recommended on larger defects. Tension-free primary closure is a critical factor to prevent wound dehiscence, which is critical cause of GBR failure. A barrier membrane should be rigidly fixed without mobility. If the barrier is exposed, closed monitoring should be utilized to prevent secondary infection.

• Journal of Yeungnam Medical Science
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• v.37 no.2
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• pp.133-135
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• 2020

Intercostal nerve injury is known to occur during thoracotomy; however, rectus abdominis muscle atrophy has rarely been reported. We describe a 52-year-old man who underwent primary closure of esophageal perforation and lung decortication via left thoracotomy. He was discharged 40 days postoperatively without any complications. He noticed an abdominal bulge 2 months later, and computed tomography revealed left rectus abdominis muscle atrophy. We report thoracotomy induced denervation causing rectus abdominis muscle atrophy.

• Geomechanics and Engineering
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• v.15 no.5
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• pp.1039-1046
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• 2018

This paper presents a limit analysis of the series of construction stages of shallow tunneling method by investigating their respective safety factors and failure mechanisms. A case study for one particular cross-section of Beijing Subway Line 7 is undertaken, with a focus on the effects of multiple soil layers and construction sequencing of dual tunnels. Results show that using the step-excavation technique can render a higher safety factor for the excavation of a tunnel compared to the entire cross-section being excavated all at once. The failure mechanisms for each different construction stage are discussed and corresponding key locations are suggested to monitor the safety during tunneling. Simultaneous excavation of dual tunnels in the same cross-section should be expressly avoided considering their potential negative interactions. The normal and shear forces as well as bending moment of the primary lining and locking anchor pipe are found to reach their maximum value at Stage 6, before closure of the primary lining. Designing these struts should consider the effects of different construction stages of shallow tunneling method.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.1084-1094
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• 1988

Conservative management of 3 iatrogenic perforations of intrathoracic esophagus was reviewed. The primary disorders were achalasia in 2 patients and congenital tracheoesophageal fistula in 1 patient. Perforation occurred after treatment of the primary disorders in the distal esophagus in 2 patients and mid-thoracic esophagus in 1 patient. All the perforations appeared late after the previous treatments and the inflammation spread to mediastinum and pleural cavity in all the 3 patients. Conservative management of esophageal perforation was carried out with intraluminal drainage from the perforated site of esophagus[insertion of Levin`s tube and continuous suction], pleural drainage and feeding of liquid diet through gastrostomy tube with Fowler`s position. The patients revealed spontaneous closure of perforated sites about 3 to 4 weeks after this conservative management without open thoracotomy. This result suggests that this conservative management may be accepted as therapeutic method in the thoracic esophageal perforations regardless of cause and time of the perforation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.4
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• pp.462-467
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• 1991

Aspergillus is a fungus of Ascomycetes class that occurs world wide and found in many of the molds on foods, frutis, grains and plants. Its ubiquitous spores, present in dust, enter the respiratory system of man, where, under proper condition, they become pathogenic. We present a case of primary maxillary sinus aspergillosis developed from a 52-year old male patient when has oroantral fistula after extraction of maxillary Lt. 1st molar tooth. The treatment composed with Caldwell-Luc's operation, Oro-antral fistula closure and associated anit-fungal treatment with Amphoatrisin B.

• Korean Journal of Bronchoesophagology
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• v.18 no.1
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• pp.9-12
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• 2012

Boerhaave's syndrome is a very fatal condition occuring esophageal rupture during emesis and has the worst prognosis of the esophageal perforation. From May 2007 to March 2012 11 patients underwent surgical treatment for Boerhaave's syndrome at Inje University Sanggye Paik Hospital. There were 11 males whose mean age was 49.9 years ranging from 42 to 59. 2 cases of primary closure was performed and 9 cases of anastomosis using EEA (Esophago-Enteric Anastomisis) stapler. Mean operation time was 154.4 minutes and one patient who undergone primary repair died because of mediastinitis and sepsis on $35^{th}$ post-operative day. There was no leakage at other patients. Post-operative complication was one operative wound infection and one post-operative bleeding which was treated completely. Surgical treatment for Boerhaave's syndrome using EEA stapler is simple and effective technique but further studies with large number of cases should be carried out for better outcome.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.43.1-43.5
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• 2018

Background: Functional closure of the orbicularis oris muscle and esthetic reconstruction of nasolabial components are impossible in patients with severely deformed premaxilla. Here, we review a surgical strategy for patients with unremedied premaxilla retrospectively. Results: Vomerine ostectomy and premaxillary setback with nasolabial repair were performed in 12 patients with bilateral cleft lip and palate. The mean age of patients was 21.7 months. The extent of ostectomy varied between 3 and 11 mm. There were no serious complications from defective perfusion to the premaxilla or the philtral flap. The follow-up period ranged from 2 to 25 months. Proper positioning of the premaxilla and satisfactory nasolabial esthetics were achieved in all patients. Conclusions: We performed nasolabial repair after premaxillary setback without jeopardizing the premaxillary segment or the philtral flap. Our surgical strategy could be recommended in poor socio-economic circumstances due to the cost effectiveness of limiting the number of surgeries.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.6.1-6.8
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• 2016

Background: Intravenous bisphosphonates have been used in metastatic breast cancer patients to reduce pathologic bone fracture and bone pain. However, necrosis of the jaw has been reported in those who received intravenous bisphosphonates. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is caused by dental extraction, dental implant surgery, and denture wearing; however, it occurs spontaneously. The purpose of this study was to report BRONJ in metastatic breast cancer patients. Methods: Consecutive 25 female patients were referred from the Department of Oncology from 2008 to 2014 for jaw bone discomfort. Staging of breast cancer, history of bisphosphonate infusion, etiology of BRONJ, and treatment results were reviewed. Average age of the patients was 55.4 years old (38-74). Twelve maxillae and 16 mandibles were involved. Conservative treatments such as irrigation, antibiotic medication, analgesics, and oral gargle were applied for all patients for the initial treatment. Patients who had sequestrum underwent debridement and primary closure. Results: The etiologies of BRONJ were dental extraction (19 cases), dental implant (2 cases), and endodontic treatment (1 case). However, three patients did not have any risk factors to cause BRONJ. Three patients died of progression of metastasis during follow-up periods. Surgical debridement was performed in 21 patients with success in 18 patients. Three patients showed recurred bone exposure and infection after operation. Conclusions: Prevention of the BRONJ is critical in metastatic breast cancer patients. Conservative treatment to reduce pain, discomfort, and infection is recommended for the initial therapy. However, if there is a sequestrum, surgical debridement and primary closure is the key to treat the BRONJ.