• Archives of Plastic Surgery
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• v.38 no.3
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• pp.329-332
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• 2011

Purpose: In developed countries, vesicovaginal fistula occur from various pelvic operations including total hysterectomy, leading to urinary leakage and incontinence. Although various methods have been proposed for adequate tissue coverage in fistula repair, the surgical treatment of is not simple and still controversial. We report a case of neobladder-vaginal fistula repair using modified Martius fat pad flap. Methods: A 62-year-old female patient underwent radical cystectomy with total abdominal hysterectomy and neobladder formation due to invasive bladder tumor 5 years ago. For 3 years following the operation, urine leakage was observed. Exploration demonstrated neobladder-vaginal fistula and primary repair including fistulectomy and direct closure was performed. Urinary incontinence relapsed 2 years after primary repair, and after demonstrating the recurrence of fistula on urography, repair of recurrent fistula was performed. After dissection of vagina and neobladder and closure of fistula by urologic surgeon, fibroadipose flap was elevated, rotated and advanced through the tunnel at vaginal sidewall, and interpositioned to the fistula site between neobladder and vagina. Results: There was no acute complication after the surgery and urethral catheter was extracted on the 8th day after the operation. During six month follow-up period after the operation, there is no clinical evidence of fistula recurrence. Conclusion: From our clinical experience and literature review, we think Martius fat pad flap is a useful technique in management of neobladder-vaginal fistula, for it provides enough vascularity, major epithelization surface and better lymphatic drainage, and also prevents overlapping of vesical, vaginal suture lines at the same time.

• Structural Engineering and Mechanics
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• v.6 no.2
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• pp.125-141
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• 1998

Recent test results of steel moment connections repaired with a haunch on the bottom side of the beam have been shown to be a very promising solution to enhancing the seismic performance of steel moment-resisting frames. Yet, little is known about the effects of using such a repair scheme on the global seismic response of structures. When haunches are incorporated in a steel moment frame, the response prediction is complicated by the presence of "dual" panel zones. To investigate the effects of a repair on seismic performance, a case study was conducted for a 13-story steel frame damaged during the 1994 Northridge earthquake. It was assumed that only those locations with reported damage would be repaired with haunches. A new analytical modeling technique for the dual panel zone developed by the author was incorporated in the analysis. Modeling the dual panel zone was among the most significant consideration in the analyses. Both the inelastic static and dynamic analyses did not indicate detrimental side effects resulting from the repair. As a result of the increased strength in dual panel zones, yielding in these locations were eliminated and larger plastic rotation demand occurred in the beams next to the shallow end of the haunches. Nevertheless, the beam plastic rotation demand produced by the Sylmar record of 1994 Northridge earthquake was still limited to 0.017 radians. The repair resulted in a minor increase in earthquake energy input. In the original structure, the panel zones should dissipate about 80% (for the Oxnard record) and 70% (for the Sylmar record) of the absorbed energy, assuming no brittle failure of moment connections. After repair, the energy dissipated in the panel zones and beams were about equal.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.4
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• pp.325-332
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• 2022

Backgrounds/Aims: To analyze relationships of hepatic histopathological findings and bile microbiological profiles with perioperative outcomes and risk of late biliary stricture in individuals undergoing surgical bile duct injury (BDI) repair. Methods: A historical cohort study was carried out at a tertiary university hospital. Fifty-six individuals who underwent surgical BDI repair from 2014-2018 with a minimal follow-up of 24 months were enrolled. Liver biopsies were performed to analyze histopathology. Bile samples were collected during repair procedures. Hepatic histopathological findings and bile microbiological profiles were then correlated with perioperative and late outcomes through uni- and multi-variate analyses. Results: Forty-three individuals (76.8%) were females and average age was 47.2 ± 13.2 years; mean follow-up was 38.1 ± 18.6 months. The commonest histopathological finding was hepatic fibrosis (87.5%). Bile cultures were positive in 53.5%. The main surgical technique was Roux-en-Y hepaticojejunostomy (96.4%). Overall morbidity was 35.7%. In univariate analysis, liver fibrosis correlated with the duration of the operation (R = 0.3; p = 0.02). In multivariate analysis, fibrosis (R = 0.36; p = 0.02) and cholestasis (R = 0.34; p = 0.02) independently correlated with operative time. Strasberg classification independently correlated with estimated bleeding (R = 0.31; p = 0.049). The time elapsed between primary cholecystectomy and BDI repair correlated with hepatic fibrosis (R = 0.4; p = 0.01). Conclusions: Bacterial contamination of bile was observed in most cases. The degree of fibrosis and cholestasis correlated with operative time. The waiting time for definitive repair correlated with the severity of liver fibrosis.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.118-123
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• 2002

Purpose: To report modified technique of inside-out suture in repair of tear of postero medial corner of medial meniscus. Operative technique: Arthroscope is placed through anterolateral portal. Suture hook is delivered through anteromedial portal. By rotating the suture hook, it penetrates the inner portion of the torn meniscus from femoral surface to tibial surface of the meniscus for vertically oriented suture. A PDS suture is delivered through the lumen of suture hook, and the suture hook is withdrawn. The both ends of the suture are retrieved through anteromedial portal by a retriever, either grasper or crochet hook.A Zone-specific cannula is positioned below the inferior surface of the meniscus through anterolateral portal. The Looped Needle designed by the authors is delivered through the lumen of the Zone-specific cannula. The suture end of the tibial surface is placed in the loop of the Looped Needle and pulled out to the surface of posteromedial joint line. The suture end of the femoral surface is pulled out in same manner. A transverse skin incision of 1cm size is made adjacent to pulled out suture and the suture is tied. Discussion: Even though modified inside-out suture technique requires longer operation time than conventional inside-out technique, it provides vertically oriented suture and good tissue coaptation. The authors recommend this modified inside-out suture technique to be good alternative in repairing tear of the posteromedial corner of medial meniscus.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.181-189
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• 2002

Purpose: We try to evaluate the functional outcomes of the ankle with isokinetic plantaflexion torque for acute achilles tendon rupture cases those treated by primary repair with the Krackow suture technique and early rehabilization. Materials and Method: The authors studied retrospectively, 15 patients of acute achilles tendon rupture treated and followed over six months, from July 1997 to May 2001. There were 12 men and 3 women, and mean age was 39.6year. The repair method of ruptured tendon was single or double Krackow suture technique. One week(5days-2weeks) after operation, early ROM with ankle-foot orthosis was started. We used Arner-Lindholm Scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. We analyzed the dorsiflexion peak torque and plantarflexion peak torque of the ankle statistically with strength test with Cybex dynamometer. Result: In clinical results, we had 11 excellent cases(73%) and 3 good cases(20%). In patients satisfaction degree, 11 excellent cases(66.6%), 3 good cases(20%) and 2 fair cases(13.4%). And in strength deficit, 3 none deficit (20%), 9 minimal deficit(60%). We evaluated the isokinetic plantar flexion torque in 3months or 6months after operation. After 3 months, isokinetic test showed the mean functional deficits, 32% and 25% at $30^{\circ}$ and $120^{\circ}/sec$, in 7 cases(46.6%) of 15 cases respectively. After 6 months, the mean deficits were in 21%, 24% at 30. and $120^{\circ}/sec$, respectively. At 3 and 6 months' follow up, absolute value of isokinetic test showed increase of 25. 31bs to 421bs and 19.61bs to 271bs at $30^{\circ}$ and $120^{\circ}/sec$, respectively. Conclusion: We had good result for acute achilles tendon rupture treated by Krakow suture technique and early range of motion exercise of the ankle. After 6 months, strength deficit was 21% in all of cases but were able to return pre-injured state. This study shows Krakow suture technique was recommended method for primary repair and early rehabilization of achilles tendon ruptue.

• Journal of the Korea institute for structural maintenance and inspection
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• v.23 no.2
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• pp.10-19
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• 2019

Management plan with repairing is essential for RC structures exposed to chloride attack since durability problems occur with extended service life. Conventionally deterministic method is adopted for evaluation of service life and repair cost, however more reasonable repair cost can be obtained through continuous repair cost from probabilistic maintenance technique. Unlike the previous researches considering only normal distribution of life time, PLTFs (Probabilistic Life Time Function) which can be capable of handling log and normal distributions are attempted for initial and repair service life, and repair cost is evaluated for OPC and GGBFS concrete. PLTF with log distributions in initial service life is more effective to save repair cost since it is more dominant after average than normal distribution. Repair cost in GGBFS concrete decreases to 30% of OPC concrete due to longer initial service life and lower repairing event. The proposed PLTF from the work can handle not only normal distributions but also log distributions for initial and repair service life, so that it can provide more reasonable repair cost evaluation.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.9-15
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• 2019

Background: Although aortic valve repair can reduce prosthesis-related complications, rheumatic aortic regurgitation (AR) caused by leaflet restriction is a significant risk factor for recurrent AR. In this study, we evaluated the long-term results of the leaflet extension technique for rheumatic AR. Methods: Between 1995 and 2016, 33 patients underwent aortic valve repair using the leaflet extension technique with autologous pericardium for rheumatic pure AR. Twenty patients had severe AR and 9 had combined moderate or greater mitral regurgitation. Their mean age was $32.2{\pm}13.9$ years. The mean follow-up duration was $18.3{\pm}5.8$ years. Results: There were no cases of operative mortality, but postoperative complications occurred in 5 patients. Overall survival at 10 and 20 years was 93.5% and 87.1%, respectively. There were no thromboembolic cerebrovascular events, but 4 late deaths occurred, as well as a bleeding event in 1 patient who was taking warfarin. Twelve patients underwent aortic valve reoperation. The mean interval to reoperation was $13.1{\pm}6.1$ years. Freedom from reoperation at 10 and 20 years was 96.7% and 66.6%, respectively. Conclusion: The long-term results of the leaflet extension technique showed acceptable durability and a low incidence of thromboembolic events and bleeding. The leaflet extension technique may be a good option for young patients with rheumatic AR.

• Proceedings of the Korea Concrete Institute Conference
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• 1999.10a
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• pp.545-548
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• 1999

The purpose of this study is application of strengthening technique of R/C concrete bridge by standardization of repair and rehabilitation. For that, experiment to bridge is necessary, and through the experiment, this study can identify the efficiency o applied method and analysis of design parameters with can't get in the laboratory experiment. This study will prove the structural behavior of R/C type girder bridge which is deteriorated but repaired and rehabilitation from standardized strengthening method with fiber plastic.

• Proceedings of the Korea Concrete Institute Conference
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• 1991.04a
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• pp.117-120
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• 1991

Cracks of concrete structure must be analyzed and estimated synthetically in order to have a maintenance and to insure the safety and the durability of structure. Concrete cracks have to be surveyed with respect to depth, width, shape and direction etc, but crack depth among these items is not measured easily. Occasionally, it needs to measure the crack depth of concrete structure for the purpose of evaulating the safe capacity and the necessity of repair. Therefore, this research is performed to verify the applicability and the accuracy of Ultra-sonic Pulse Velocity Technique(Tester), in non-destructive testing methods of concrete crack depth.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.53-61
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• 2009

Purpose: This study was designed to evaluate the clinical usefulness of serial ultrasonography (USG) after arthroscopic rotator cuff repair and to assess the re-tear rate and the re-tear time according to the tear sizes and the repair method. Materials and Methods: Between January 2008 and June 2008, 52 patients were treated with arthroscopic rotator cuff repair, Of the 52 patients, 29 patients that had undergone more than six months follow-up underwent preoperative USG examinations and subsequent arthroscopic examinations. MRI and USG findings were compared with intraoperative results of arthroscopic examinations. The postoperative integrity of the rotator cuff was observed using serial USG examination performed postoperatively at two weeks, six weeks, three months, and six months. Results: Small to medium rotator cuff tear were identified in 10 patients where the double pulley suture bridge (DPSB) technique was performed; the re-tear rate was 20%. For 19 patients with large to massive rotator cuff tears, the re-tear rates was 100% for six patients who had undergone tendon to tendon (TT) repair, the re-tear rate was 50% for two patients who had undergone tendon to tendon and bone to tendon (TTBT) repair and the re-tear rate was 55% for11 patients where the DPSB technique was performed. Re-tear rates according to follow-up periods were 7% from two to six weeks, 66% from six weeks to three months and 27% from three to six months postoperatively. Conclusion: Serial USG examinations after arthroscopic rotator cuff repair were useful to assess the re-tear rate and the re-tear time. In addition, USG examination were useful for treatment planning during postoperative rehabilitation.