• Korean Journal of Cleft Lip And Palate
• /
• v.13 no.2
• /
• pp.77-84
• /
• 2010

Vomer flap is used to repair anterior hard palate in complete cleft lip and palate patients. As the midline structure located in between the two cleft segments of hard palate, the vomer flap is very useful because of its vicinity to cleft site and their ease of execution when it is done with primary cheiloplasty simultaneously. In addition, the quality of tissue is very similar to that of the nasal mucosa with good vascularity. In cases of simultaneous repair of cleft lip with anterior palate using vomer flap, the hard palate can be repaired at the same time with primary cheiloplasty which is earlier period than other techniques. With simultaneous close of cleft lip and cleft hard palate by vomer flap, subsequent palatoplasty does not require wide dissection, and consequently chance of oronasal fistula formation will be minimized. Additionally, surgical time will be reduced and, the harmful effects on mid-facial growth will be diminished. In this article, we will introduce the comprehensive vomer flap technique with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with vomer flap.

• Advances in pediatric surgery
• /
• v.14 no.1
• /
• pp.21-26
• /
• 2008

There is significant morbidity and mortality associated with the combination of esophageal atresia (EA) and duodenal atresia (DA). Nevertheless, the management protocol for the combined anomalies is not well defined. The aim of this study is to review our experience with the combined anomalies of EA and DA. From May 1989 to August 2006, seven neonates were diagnosed as EA with DA at Asan Medical Center. In all cases, the type of EA was proximal EA and distal tracheoesophageal fistula (TEF). The diagnosis of DA was made in theprenatal period in 1, at birth in 4, 4 days after birth in 1 (2 days after EA repair) and at postmortem autopsy in 1. Except the one case where DA was missed initially, primary simultaneous repair was attempted. DA repair with gastrostomy followed by EA repair in 2, EA repair followed by DA repair without gastrostomy in 2, and TEF ligation followed by DA repair with gastrostomy in 1. There were two deaths. One baby had a large posterolateral diaphragmatic hernia, and operative repair was not attempted. The other infant who had a TEF ligation and DA repair with gastrostomy expired from cardiac failure due to a large patent ductus arteriosus. Simultaneous repair of EA and DA appears to be an acceptable management approach for the combined anomalies, but more experience would be required for the selection of the primary repair of both anomalies.

• Communications for Statistical Applications and Methods
• /
• v.29 no.2
• /
• pp.151-160
• /
• 2022

The total system is composed of the main system (MS) and the failure detection equipment (FDE) which detects failures of MS. The analysis of system reliability is performed when the failure of FDE is possible. Several repair policies are considered to determine the order of repair of failed systems, which are sequential repair (SQ), priority repair (PR), independent repair (ID), and simultaneous repair (SM). The states of MS-FDE systems are represented by Markov models according to repair policies and the main purpose of this paper is to derive the system availabilities of the Markov models. Analytical solutions of the stationary equations are derived for the Markov models and the system availabilities are immediately determined using the stationary solutions. A simple illustrative example is discussed for the comparison of availability values of the repair policies considered in this paper.

• Korean Journal of Cleft Lip And Palate
• /
• v.15 no.2
• /
• pp.61-68
• /
• 2012

Cleft lip and palate is the most common congenital facial malformation and has a significant developmental, physical, and psychological impact on those with the deformity and their families. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation advancement flap method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, Millard's rotation advancement flap method has its advantage in designing the flap using the patient's anatomic landmarks. For performing this rotation advancement technique, skillful operation is needed to obtain esthetically satisfactory results. Vomer flap sometimes is used to repair anterior hard palate in complete cleft lip and palate patients. Vomerine tissue is readily available in the vicinity of the palatal defect and elevation of the vomerine flap is relatively simple procedure. In this article, we will introduce the comprehensive vomer flap technique conjunction with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with Millard's rotation advancement method and vomer flap.

• Journal of Chest Surgery
• /
• v.34 no.10
• /
• pp.784-786
• /
• 2001

We at Keimyung University Dongsan Medical Center experienced simultaneous repair of pectus excavatum and secundum atrial septal defect We used resection deformed perichondrium, raising sternum at right angle to secure good operative field for open heart surgery. Mechanical ventilation was applied which could be weaned on postoperative 2 hours. The hospital course was uneventful without any other sequale. The patient was discharged on postoperative day 6.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.4
• /
• pp.384-389
• /
• 1994

A female child with unilateral midpalatal cleft was successfully treated by Wardill V-Y pushback palatal flap and superiorly based pharyngeal flap simultaneously. The advantages of this method are to prepare the favorable background of postoperative speech correction and additional nasal lining. We can try this simultaneous operation in delayed cleft palate repair.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.6
• /
• pp.360-365
• /
• 2012

The simultaneous surgical correction of bilateral cleft lip and nasal deformity has become a more common surgical technique that has greatly changed conventional strategies for secondary nasal correction. Mulliken has been known as one of the earliest proponents for the synchronous repair of bilateral cleft lip and nasal deformity, and he emphasized the responsibility of the treating surgeon to evaluate nasolabial growth by comparing anthropometric measurements with age-matched normal patients. Good outcomes from this surgical method have been reported in clinical cases worldwide. Herein, we describe the management of two cases of bilateral cleft repair, following the principles and methods established by Mulliken. We also provide a relevant review of the literature.

• Korean Management Science Review
• /
• v.26 no.1
• /
• pp.209-223
• /
• 2009

In this paper, an analysis problem of repair levels and spare part allocation for MIME(Multi indenture multi echelon) systems is studied using simulation and meta-heuristics. We suggest a method to determine simultaneously repair levels and spare parts allocation to minimize the life cycle cost of MIME system under availability constraint. A simulated annealing method is used to analyze the repair levels and genetic algorithm is used to obtain the optimal allocation of spare parts. We also develop a simulation system to calculate the life cycle cost and system availability. Some numerical examples are also studied.

• Advances in pediatric surgery
• /
• v.14 no.1
• /
• pp.48-57
• /
• 2008

Prophylactic contralateral exploration in unilateral inguinal hernia repair is still controversial. The purpose of this study is to analyze the contralateral incidence of hernia and to verify the necessity of the simultaneous contralateral exploration. Infants and children operated on for inguinal hernia or hydrocele at the Department of Pediatric Surgery of Asan Medical Center from January 1996 to December 2005 were analyzed retrospectively. A total of 383 patients (9.8 %) out of 3,925 patients underwent a simultaneous bilateral operation. A total of 222 patients (6.2 %) out of 3,542 patients underwent a secondary metachronous contralateral operation after primary unilateral inguinal hernia or hydrocele repair. Because simultaneous bilateral operation cases included true bilateral inguinal hernia or hydrocele, and unilateral hernia and simultaneous contralateral exploration, bilateral incidence of inguinal hernia and hydrocele could be maximally considered as 15.4% (605 patients). Therefore, the prophylactic contralateral exploration in unilateral inguinal hernia or hydrocele should be determined carefully in considering history and physical examination of the patients, and postoperative complications.

• Journal of Chest Surgery
• /
• v.46 no.5
• /
• pp.365-368
• /
• 2013

We report a case of concurrent saccular aneurysms caused by a penetrating atherosclerotic ulcer of the thoracic and abdominal aorta that were successfully treated by staged endovascular repair. Even though surgical open repair or endovascular repair is the treatment option, use of endovascular repair is now accepted as an alternative treatment to surgery in selected patients. To prevent contrast medium-induced nephropathy and spinal cord ischemia caused by a simultaneous endovascular procedure, a saccular aneurysm of the descending thoracic aorta was excluded by stent graft, followed by the placement of a bifurcated stent graft in the infrarenal abdominal aorta one month later.