• Title/Summary/Keyword: 치명적 합병증

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Brachial Artery Thrombosis in an 8-year-old Boy with Antiphospholipid Antibodies Induced by Mycoplasma pneumoniae Infection: a Case Report

  • Woo, Jung Hee;Kwon, Jung Hyun;Je, Bo-Kyung;Shin, Jae Seoung;Seo, Won Hee;Jang, Gi Young
    • Pediatric Infection and Vaccine
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    • v.26 no.1
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    • pp.60-65
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    • 2019
  • Antiphospholipid antibodies may be produced in cases involving autoimmune diseases and can sometimes be caused by infections, such as Mycoplasma pneumoniae infection. However, antiphospholipid antibodies causing thrombosis associated with M. pneumoniae pneumonia in children have rarely been reported. We report a case of an 8-year-old boy with M. pneumoniae pneumonia with antiphospholipid antibodies, complicated by brachial artery thrombosis. He was found to have antiphospholipid antibodies and low protein S levels. The brachial artery thrombus was removed via thrombectomy. The titers of antiphospholipid antibodies turned normal within 5 months. This is a rare case of M. pneumoniae infection with brachial artery thrombosis associated with transient antiphospholipid antibodies.

Percutaneous Catheter Drainage of Lung Abscess (폐농양의 경피적 카테타 배농법)

  • Kim, Chang-Ho;Cha, Seoung-Ick;Han, Chun-Duk;Kim, Yeon-Jae;Lee, Yeung-Suk;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.158-164
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    • 1993
  • Background: Recently, lung abscess tends to be increased in patients with underlying disease, most of whom are unsuitable for surgery when medical treatment fails. The patients with giant lung abscesses do not frequently respond to antibiotics and often have life-threatening complications. Therefore, more intensive cares are required in these patients. We studied the results and effects of percutaneous catheter drainage in these patients. Method: We performed fluoroscopy-guided percutaneous pigtail catheter (8.3 F) drainage by Seldinger technique in 9 cases of lung abscess (in 7 cases, intractable to medical treatment for an average of 8.4 days and in 2 cases, catheter drainage immediately performed due to a large cavity that was initially 10 cm in diameter). We compared 10 cases of lung abscess as control group which had receieved conventional medical treatment alone. Results: Seven of the 9 patients in study group of percutaneous drainage and 7 of the 10 patients in control group of medical treatment alone clinically improved in the average of 1.8 and 8.7 days, respectively. The mean duration of drainage was 13.2 days. There were 3 cases of death from massive hemoptysis, asphyxia of pus, and sepsis in control group, as compared with 2 cases of death from hepatic encephalopathy and sepsis in study group. The malfunctions of catheter occurred in these 2 cases, obstruction and dislodgement. But there were no significant pleuropulmonary complications of percutaneous drainage. Conclusion: Percutaneous drainage is effective and relatively safe in the management of lung abscesses refractory to medical therapy or giant lung abscesses.

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Surgical Treatment of Complications after Fontan Operation (Fontan수술후의 합병증에 대한 수술적 치료)

  • 박정준;홍장미;김용진;이정렬;노준량
    • Journal of Chest Surgery
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    • v.36 no.2
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    • pp.73-78
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    • 2003
  • The Fontan operation has undergone a number of major modifications and clinical results have been improving over time. Nevertheless, during the follow-up period, life-threatening complications develop and affect the long-term outcomes. Surgical interventions for these complications are needed and are increasing. Material and Method: From April 1988 to January 2000, 16 patients underwent reoperations for complications after Fontan operation. The mean age at reoperation was 8.8 :-5.5 years. Initial Fontan operations were atriopulmonary connections in 8 and total cavopulmonary connections in 8. Total cavopulmonary connections were accomplished with intracardiac lateral tunnel in 5 and extracardiac epicardial lateral tunnel in 3. Five patients had variable sized fenestrations. The reasons for reoperations included residual shunt in 6, pulmonary venous obstruction in 3, atrial flutter in 3, atrioventricular valve regurgitation in 2, Fontan pathway stenosis in 1, and protein-losing enteropathy in 1 Result: There were 3 early and late deaths respectively Patients who had residual shunts underwent primary closure of shunt site (n=2), atrial reseptation for separation between systemic and pulmonary vein (n=2), conversion to lateral tunnel (n=1), and conversion to one and a half ventricular repair (n=1). Four patients who had stenotic lesion of pulmonary vein or Fontan pathway underwent widening of the lesion (n=3) and left pneumonectomy (n=1) In cases of atrial flutter, conversion to lateral tunnel after revision of atriopulmonary connections was performed (n=3). For the atrioventricular valve regurgitation (n=2), we performed a replacement with mechanical valve. In one patient who had developed protein-losing enteropathy, aorto-pulmonary collateral arteries were obliterated via thoracotomy. Cryoablation was performed concomitantly in 4 patients as an additional treatment modality of atrial arrhythmia. Conclusion: Complications after Fontan operation are difficult to manage and have a considerable morbidity and mortality. However, more accurate understanding of Fontan physiology and technical advancement increased the possibility of treatment for such complications as well as Fontan operation itself. Appropriate surgical treatment for these patients relieved the symptoms and improved the functional class, Although the results were not satisfactory enough in all patients.

Treatment of Coronary Artery Perforation and Tamponade Complicating Balloon Angioplasty by PTFE-Covered Stent. A Case Report

  • Park, Jong-Seon;Hong, Gu-Ru;Bae, Jun-Ho;Cho, Ihn-Ho;Shim, Bong-Sup;Kim, Young-Jo;Shin, Dong-Gu
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.90-95
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    • 2005
  • A coronary artery perforation is a rare but often fatal complication of angioplasty. We experienced a coronary artery perforation and cardiac tamponade during balloon angioplasty. A polytetrafluorethylene (PTFE)-covered stent was used to successfully close the perforation.

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Emergency Bilobectomy under the Extracorporeal Membrane Oxygenation Support for Pediatric Patient with Blunt Traumatic Bronchial Transection - A case report- (둔상에 의한 기관지 절단 환아에게 체외막형 산화기 보조하에 시행한 응급 이엽 절제술 - 1예 보고 -)

  • Chang, Won-Ho
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.804-807
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    • 2010
  • Blunt bronchial injuries rarely occur in children. This can be a life threatening condition and respiratory management is important for successful treatment. We present here a pediatric patient who had traumatic bronchial transection with difficult airway management. Surgical treatment was carried out under ventilatory support using extracorporeal membrane oxygenation (ECMO) in the emergency room. During the application of ECMO, systemic heparization was unnecessary and. there were no thrormbotic complications. In conclusion, ventilatory SUpport using ECMO is useful for treating selected patients with blunt trauma regardless of using heparin.

Pulmonary Embolism Complications after Knee Arthroscopy - 2 Cases Report - (슬관절의 관절경적 시술 후 발생한 폐 색전증 - 2례 보고 -)

  • Kyoung, Hee-Soo;Baek, Seung-Hoon;Kim, Sung-Jung;Sohn, Soo-Min;Yang, Dong-Ryeol
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.112-117
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    • 2006
  • Deep vein thrombosis and pulmonary embolism are serious fatal complication after orthopedic surgery. Most of them occur after large operation such as total knee/hip arthroplasty. Some reports about deep vein thrombosis after simple arthroscopic procedure were on the Western literatures, but there was no report on the Korean literature. So we report two cases of pulmonary embolism after knee arthroscopic procedures.

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Surgical Treatment of Acute Necrotizing Klebsiella Pneumonia -Two cases report- (급성 괴사성 클렙시엘라 폐렴의 외과적 치료 -2례 보고-)

  • 류경민;김삼현;박성식;류재욱;최창휴;박재석;서필원
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.484-488
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    • 1999
  • Massive lung gangrene is a rare but very rapidly progressing fatal complication of lobar pneumonia. Etiologic agents are Klebsiella pneumoniae, Pneumococcus and Aspergillus, etc. Chest X-ray shows firm consolidation of the involved pulmonary lobe and bulging fissure due to the volume expansion of involved lung. CT-scan shows extensive lung parenchymal destructions with multiple small cavitary lesions. Recommended treatment is the early surgical intervention combined with antibiotics. Without surgical intervention, lung gangrene is known to progress toward sepsis, multiorgan failure, and high mortality. We report two cases of rapidly progressing massive lung gangrene by Klebsiella pneumonia treated by the resectional surgery.

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A case of pulmonary vascular air embolism in a very-low-birth-weight infant with massive hydrops (초극소 미숙아에서 발생한 중증 태아 수종을 동반한 폐혈관 공기 색전증 1례)

  • Kim, Myo Jing;Yu, Hee Joon;Lee, Cha Gon;Park, Soo Kyoung;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.52 no.12
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    • pp.1392-1395
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    • 2009
  • Pulmonary vascular air embolism is a rare and, universally, almost a fatal complication of positive pressure ventilation in newborn infants. Here, we report a case of this unusual complication in a very-low-birth-weight infant who showed the clinical and radiological features of this complication along with pulmonary hypoplasia and massive hydrops. The possible pathogenesis has been discussed and a brief review of related literature has been presented.

Management of Empyema Thovacis with Bronchopleural Fistula Using Muscle Flap Transposition (근성형술을 이용한 기관지 늑막루를 갖는 농흉의 치료)

  • 김형국;김정택
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.63-66
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    • 1996
  • Postoperative empyema thoracis with bronchopleural fistula (BPF) Is uncommon but serious complication. The management remains troublesome area in the field of the general thoracic surgery During the period of October 1993 to December 1994, four patients with postresectional empyema thoracic with BPF were treated consecutively in Ewha Womans University Mokdong Hosp tal. The treatment procedures include irrigation and debridement of the empyema cavity and muscle flap transposition. Follow-up periods after surgery were 4-12 months. Three patients were thought successful, one patient failed. We think that the cause of failure is muscle necrosis of rectos abdominis muscle flap due to vascular injury and infection of muscle due to residual infected debridement of empyema cavity.

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A case of dapsone syndrome (Dapson 증후군 1례)

  • Won, Yoo Jong;Kim, Ok Lan;Yu, Seung Taek;Yoon, Young Wook;Choi, Du Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.493-496
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    • 2007
  • Diamino-diphenyl-sulfone (Dapsone) is widely used in the treatment of leprosy and a variety of blistering skin diseases. It sometimes has adverse side effects with common usual doses, such as skin, nervous system, gastrointestinal tract, liver, kidney and hematologic toxicity. One of these side effects is a rare but serious hypersensitivity reaction called dapsone syndrome, which occurs several weeks after the initial administration of the drug and results in unpredictable, sometimes fatal outcomes. This report deals with a 13-year-old girl's case with typical features of dapsone syndrome that included fever, exfoliative dermatitis, jaundice, hemolytic anemia and pleural effusion after being treated with dapsone for four weeks.