• Title/Summary/Keyword: surgical correction

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A Case of Tracheal Hamartoma (기관내 과오종 1예)

  • Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;HwangBo, Bin;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Sung, Sook-Hwan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.383-388
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    • 1999
  • Background: Tracheal hamartoma is a very rare cause of upper airway obstruction. Its clinical features can mimic medical conditions, such as bronchial asthma, chronic bronchitis, and so on. Case; This report presents the case of a 65 year old man whose major symptom was dyspnea. We found a tumor in his distal tracheal lumen, and the tumor was removed with success using rigid bronchoscope. The tumor was histologically proven to be a hamartoma, and his symptoms were much improved. Conclusion: It is important to distinguish it from other conditions because medical management is often not helpful. Surgical correction-with or without thoracotomy-is inevitable.

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Single-Stage Repair of Coarctation of the Aorta and Ventricular Septal Defect in Infants Younger than 6 Months (생후 6개월 이하 환아에서 대동맥 축착증과 심실중격결손의 일차 완전교정)

  • 백만종;김웅한;이영탁;한재진;이창하
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.733-744
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    • 2001
  • Background: The optimal therapeutic strategies for patients with coarctation of the aorta(CoA) and ventricular septal defect(VSD) remain controversial. This study was undertaken to determine the outcome and the need for reintervention following single-stage repair of coarctation with VSD in infants younger than 6 months. Material and Method: Thirty three consecutive patients who underwent single-stage repair of CoA with VSD, from January 1995 to December 2000, at Sejong General Hospital were reviewed retrospectively. Mean age and body weight at repair were 54$\pm$37 days(12 days-171 days) and 3.9$\pm$1.1 kg(1.5~6 kg), respectively. The surgical repair of CoA was performed under deep hypothermic circulatory arrest(CA) in the early period of the study and under regional cerebral perfusion through a direct innominate arterial cannulation without CA in the later period. The technique used in the repair of the CoA was resection and extended end-to-end anastomosis(EEEA; n=16) and extended side-to-side anastomosis(ESSA; n=2) in the early period, and resection and extended end-to-side anastomosis(EESA; n= 15) in the later period. The simultaneous closure of VSD was done with a Dacron patch(n= 16) and autologous pericardium(n=17). Aortic arch hypoplasia was present in 29 patients(88%) and its types were distal(n=18), complete(n=5), and complex(n=6)

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Surgical Correction of a Congenital or Acquired Phimosis in Two Cats (두 마리 고양이에서 선천적 또는 후천적 포피 폐쇄증의 외과적 치료 증례)

  • Yoon, Hun-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.123-126
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    • 2013
  • A 3-month-old male domestic shorthair cat was presented for evaluation of stranguria and hematuria and a 4-year-old male domestic shorthair cat was presented for evaluation of stranguria. For cat 1, a swollen prepuce, erythematous preputial orifice, and urine pooling from the preputial orifice were noted. The preputial orifice was a pinpoint opening and penis was not extruded from the prepuce. For cat 2, a necrotic skin around the preputial orifice, small preputial orifice, and severe urine pooling from the preputial orifice were noted. The round-shaped resection of the tip of the prepuce was performed to increase the diameter of the preputial orifice and remove erythematous fragile skin or a necrotic skin around the preputial orifice and the edematous, redundant preputial mucosa in these 2 cats. The preputial mucosa was then apposed to the ipsilateral incised skin edge. There was no recurrence of clinical signs over 22- and 24-month follow-up period, respectively. The round-shaped resection technique provided adequate enlargement of the preputial orifice to allow extrusion of penis in these 2 cats with a phimosis. This technique could be helpful in cases with skin and mucosa necrosis around the preputial orifice that require round-shaped resection.

The Change in Binocular Function and Sensory Anomaly After vision Training on Intermittent Exotropia and Recurrent Intermittent Exotropia Patients After Surgical Correction (간헐성 외사시 및 외사시 재발환자에 대한 시기능 훈련 후 양안시 기능 및 감각이상 변화)

  • Lee, Chang-Seon;Kim, Jong-Ki;Shin, Jeong-Hoon;Kim, Dae-Nyoun;Lee, Hyun Mee;Kim, Ki-Hong
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.3
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    • pp.345-350
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    • 2011
  • Purpose: This was a study of the effects of the vision training on binocular function and sensory anomaly for intermittent exotropia and recurrent intermittent exotropia patients. Mehtods: The change was examined weekly at the clinic during the 8 week vision training. The sample group of 17 patients, intermittent exotropia and recurrent intermittent exotropia patients without amblyopia, were chosen from the patients with the short and the long-distance deviation angle p=0.558 and p=0.338, and also greater than 10${\Delta}$, respectively. Results: The longdistance deviation angle was reduced by 67.9(${\pm}$32.7)%, and the short-distance deviation angle by 75.4(${\pm}$32.9)% after the vision training. There is an improvement on the binocular function and sensory anomaly according to the fusion reverse and Worth 4 dot tests. Conclusions: This study shows that the vision training is effective for phoria, function and sensory anomalyon of the intermittent extropia and recurrent intermittent exotropia patients.

The Fate of Proximal Junctional Vertebral Fractures after Long-Segment Spinal Fixation : Are There Predictable Radiologic Characteristics for Revision surgery?

  • Jang, Hyun Jun;Park, Jeong Yoon;Kuh, Sung Uk;Chin, Dong Kyu;Kim, Keun Su;Cho, Yong Eun;Hahn, Bang Sang;Kim, Kyung Hyun
    • Journal of Korean Neurosurgical Society
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    • v.64 no.3
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    • pp.437-446
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    • 2021
  • Objective : To investigate the radiographic characteristics of the uppermost instrumented vertebrae (UIV) and UIV+1 compression fractures that are predictive of revision surgery following long-segment spinal fixation. Methods : A total 27 patients who presented newly developed compression fracture at UIV, UIV+1 after long segment spinal fixation (minimum 5 vertebral bodies, lowest instrumented vertebra of L5 or distal) were reviewed retrospectively. Patients were divided into two groups according to following management : revisional surgery (group A, n=13) and conservative care (group B, n=14). Pre- and postoperative images, and images taken shortly before and after the occurrence of fracture were evaluated for radiologic characteristics Results : Despite similar degrees of surgical correction of deformity, the fate of the two groups with proximal junctional compression fractures differed. Immediately after the fracture, the decrement of adjacent disc height in group A (32.3±7.6 mm to 23.7±8.4 mm, Δ=8.5±6.9 mm) was greater than group B (31.0±13.9 mm to 30.1±15.5 mm, Δ=0.9±2.9 mm, p=0.003). Pre-operative magnetic resonance imaging indicated that group A patients have a higher grade of disc degeneration adjacent to fractured vertebrae compared to group B (modified Pfirrmann grade, group A : 6.10±0.99, group B : 4.08±0.90, p=0.004). Binary logistic regression analysis indicated that decrement of disc height was the only associated risk factor for future revision surgery (odds ratio, 1.891; 95% confidence interval, 1.121-3.190; p=0.017). Conclusion : Proximal junctional vertebral compression fractures with greater early-stage decrement of adjacent disc height were associated with increased risk of future neurological deterioration and necessity of revision. The condition of adjacent disc degeneration should be considered regarding severity and revision rate of proximal junctional kyphosis/proximal junction failures.

Approach to prosthetic treatment for patients with open bite due to mandibular displacement: Case report (하악변위로 인한 개방교합 환자의 보철치료: 증례보고)

  • Seo, Min-Gyung;Chi, Seung-Seok;Ko, Kyung-Ho;Park, Chan-Jin;Cho, Lee-Ra;Huh, Yoon-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.420-430
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    • 2022
  • Open bite is accompanied by decrease in tooth contact and overbite, and causes collapse of occlusal plane, mastication difficulties, speech disorders, changes in appearance, and lower occlusal force than normal. Open bite caused by temporomandibular joint disorder in adults with complete occlusion must be corrected after removal or stabilization of the causative factors. Orthodontic treatment, occlusal adjustment, prosthetic treatment, and surgical treatment can be the option of occlusal correction. This report describes about estimating the cause of occlusion change in two patients who developed an open bite due to mandibular displacement in adults with complete occlusion and different treatment approaches accordingly. In one patient, satisfactory result was obtained in functional and esthetic aspects through occlusal adjustment after stabilization of the temporomandibular joint.

Surgical Treatment of Acyanotic Tetralogy of Fallot (비청색성 팔로사징의 외과적 치료)

  • 천종록;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.749-755
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    • 1998
  • Background: Twelve patients with acyanotic tetralogy of Fallot(TOF), characterized by the combination of a malaligned ventricular septal defect(VSD) and infundibular pulmonic stenosis with the clinical finding of acyanosis at rest, underwent surgical correction between January 1988 and July 1997. Materials and methods: 9.92% of patients with the diagnosis of TOF were acyanotic TOF in the same period. Ages ranged from 12 to 42 months(mean 25.2 months). 2D-echocardiographic studies, cardiac catheterization, and angiocardiograms were performed in all patients before operation. The preoperative mean systemic arterial oxygen saturation was 93.5%. According to the 2D-echocardiographic analysis, there was Lt-to-Rt shunt through VSD in 4 patients, bidirectional shunt in 2 patients, and no shunt in 6 patients. Results: The preoperative mean right ventricle to pulmonary artery(RV-PA) pressure gradients were 52.3 mmHg on 2D- echocardiogram and 48.4 mmHg on cardiac catheterization. The repair of ventricular septal defect was performed through a right atrial approach and the hypertrophic infundibular muscle bundles were resected by the transatrial and transpulmonary approach. Six patients(50%) received a transannular patch. The mean cardiopulmonary bypass time was 135.0 minutes, and the aortic crossclamp time was 87.8 minutes. Postoperative complications included bleeding necessitating reentry in one and chylothorax in one. No patient died after operation and there were no late deaths. Postoperative 2D-echocardiograms revealed tiny patch dehiscence in 5 cases and a moderate RV-PA pressure gradients(mean 15.3 mmHg). All patients were in New York Heart Association functional class 1 after operation. Conclusions: acyanotic TOF is the uncommon form of TOF, and acyanotic TOF can be repaired with a good outcome.

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Mid-term and Long-term Outcomes of Posterior Plication Annuloplasty(Modified Davila Annuloplasty) for Functional Tricuspid Regurgitation (기능성 삼첨판막부전증에 대한 삼첨판후판륜주름술(Davila Technique)의 중장기결과)

  • Lee, Mi-Kyung;Kim, Jong-Hun;Kim, Min-Ho;Jo, Jung-Ku;Choi, Jong-Bum
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.580-585
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    • 2008
  • Background: Many types of tricuspid annuloplasty are used in surgical correction of functional tricuspid regurgitation (FTR). We evaluated the mid-term and long-term outcomes in patients treated with a posterior annular plication technique (a modified Davila technique) for FTR. Material and Method: Between January 1991 and August 2006, 58 adult patients (male, 22; female, 36) with FTR of grade 2/4 or more or with tricuspid annular dilatation of more than 5.0cm in diameter, even with an FTR of less than grade 2, had received a posterior annular placation. Preoperatively, 26 patients (44.8%) had a grade 3 or more FTR. All patients had received a mitral valve replacement, and 20 (34.5%) had concomitant aortic valve replacement. Result: During the mean follow-up period of $101.4{\pm}51.6$ months, FTR disappeared or remained trivial in 28 patients (49.1%), was grade $2{\sim}3$ (${\geq}$grade 2 and $2.66{\pm}0.73\;vs.\;0.82{\pm}0.89$; p<0.0001). Patients did not require a second surgery for FTR and did not show further FTR aggravation. Conclusion: The modified Davila posterior annular plication technique for FTR has reasonable mid-term and long-term results and is a useful surgical procedure.

Surgical Treatment of Ventricular Tachycardia After Total Correction of Tetralogy of Fallot- Report of a case (TOF 완전교정술후 발생한 심실빈맥의 외과적 절제술 -치험1례보고-)

  • 장병철;김정택
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.639-645
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    • 1996
  • A 14-year-old male patient with previous surgical repair of tetralogy of Fallot was admitted with hemodynamically significant ventricular tachycardia (VT). On preoperative electrophysiologic study (EPS), the morphology of documented VT was RBBB of vertical axis with 320 msec cycle length. The endocardial mapping during VT delineated the origin of VT at right ventricular outflow tract (RVOT), where the patch was attached. The clinical VT had a clockwise reentry circuit around the patch with the earliest activation at the same site seen during the preoperative EPS. The previously placed right ventricular outflow patch and fibrous tissue were removed. During a postoperative EPS, it was no longer possible to induce the VT. Ventricular tachycardia following repair of tetralogy of Fallot seen in this patient was caused by a macro-reentry around the right ventricular outflow patch. We were able to ablate the VT with the aid of a detailed mapping of its epicardial activation sequence.

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Open Heart Surgery after Pulmonary Artery Banding in Children (소아에서 폐동맥밴딩술후의 개심술 치료)

  • 김근직;천종록;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.781-789
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    • 1999
  • Background: Pulmonary artery banding(PAB) accompanies some risks in the aspect of band complications and mortality in the second-stage operation. To assess these risks of the second-stage operation after PAB, we reviewed the surgical results of the second-stage operation in the pediatric patients who had undergone PAB in infancy. Material and Method: From May 1988 to June 1997, a total of 29 patients with preliminary PAB underwent open heart surgery. Ages ranged from 2 to 45 months(mean 20.6$\pm$9.0 months). Preoperative congestive heart failure conditions were improved after PAB(elective operation group) in 27 patients, but early second-stage procedures were required in the remaining 2 patients due to sustaining congestive heart failure(early operation group). Preoperative surgical indications included 2 double outlet right ventricles(DORV group) and 27 ventricular septal defects as the main cardiac anomaly(VSD group). Result: The mean time interval from PAB to the second-stage operation was 15.5$\pm$8.7 months(range 5 days to 45 months). One patient in the DORV group underwent intraventricular tunnel repair and modified Glenn procedure in the other. In the VSD group, the VSD was closed with a Dacron patch in all patients. Concomitant procedures included a right ventricular infundibulectomy in 4 patients and a valvectomy of the dysplastic pulmonary valve in 1 patient. At the second-stage operations, pulmonary angioplasty was required due to the stenotic banding sites in 18 patients. One patient underwent complete ligation of the main pulmonary artery with the modified Glenn procedure. The mortality at the second-stage operation was 17.2%(5 patients). Causes of death were 4 low cardiac output, and 1 autoimmune hemolytic anemia. Diagnosis with DORV and the early operative group were the risk factors for operative death in this series. There was 1 late death. Conclusion: This study revealed the second-stage operation for pulmonary artery debanding and closure of VSD in children was complicated by the correction of the acquired lesions with a significantly high incidence of morbidity and early postoperative deaths. Primary repair is recommended for isolated VSD, if possible.

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