• Title/Summary/Keyword: 코수술

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The Surgical Treatment of Atrial Fibrillation in Patients Undergoing Simultaneous Open Heart Surgery (심장세동의 수술요법)

  • Kim, Gi-Bong;Lee, Chang-Ha;Son, Dae-Won
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.287-292
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    • 1997
  • .Itrial fibrillation is one of the most common cardiac arrhythmias requiring treatment. About 60% of patients with mitral valvular disease have atrial fibrillation and one third of patients with atrial fibrillation may have the past history of thromboembolic events. Between April 1994 and June 1995, 20 patients with organic heart diseases combined with atrial fibrillation underwent open heart surgery including Cox-maze 111 procedure. There were 6 men and 14 women with an average age of 48 years (range, 31 to 66 years). Nineteen patients had valvular heart diseases and 1 ventricular septal defEct (VSD). Mean duration of atrial fibrillation was 36 months (:42 months) (range, 1 to 132 months). T e past medical history of thromboembolic events was positive in 7 patients (35%) and left atrial thrombus was detected in 9 patients (45%). The concomitant procedures were mitral valve replacement (MVR) and aortic valve replacement (AVR) in 5 patients, MVR in 4, MVd and tricuspid annuloplasty(TAP) in 4, mitral valvuloplasty(Mln) in 3, Mln and Tln in 1, MIW and coronary artery bypass surgery in 1, AVR in 1, and patch closure of VSD in 1. Mean aortic cross-clamping time was 175 minutes (range, 116 to 270 minutes). Atrial fibrillation recurred in 16 patients (80%) during the early postoperative period, but, recurrent atrial fibrillation was converted to regular rhythm at postoperative forty-first day in average. There was no early or late death in this series of 20 patients and postoperative complications were inappropriate tachycardia in 5 patients (25%), low cardiac output syndrome in 3 (15%), aggravated hemiplegic in 1, and acute renal failure in 1. Mean follow-up interval of patient was 16.5 months (range, 10.5 to 24 months) and all patients are currently in regular rhythm. Seventeen patients (85%) are in sinus rhythm and 3 (15%) in junctional rhythm. Right atrial contraction was detected in 95% of patients and left atrial contraction in 63% on postoperative transthoracic echocardiogram. The surgical treatment of atrial fibrillation concomitant with open heart surgery is warranted in the recent clinical setting of improved myocardial protection technique, considering the untoward side-effects of atrial fibrillation.

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Usefulness of Virtual Fluoroscopy in Emergency Interventional Radiology (응급 인터벤션 영상의학에서 가상 투시영상 검사의 유용성)

  • Yoshihiro Tanaka;Akitoshi Oosone;Asuka Tsuchiya
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.852-862
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    • 2020
  • Interventional radiology (IR) embolization requires image guidance to steer catheters to the site of bleeding, where embolic agents such as Gelfoam or coils are administered to stem blood flow. In addition to treating iatrogenic trauma, embolization is suitable for injuries precluding surgery such as blush-bleeding of the liver or kidney and for locating and treating intimal blood vessel tears. However, during hospital off-hours (such as nights and holidays), experienced IR personnel are not always available. In such situations, there is a dire need to build a coordinated IR team to treat seriously injured patients rapidly and reliably. This article reviews the current principles and techniques used in IR such as virtual fluoroscopy and their usefulness, and makes a convincing case for emergency IR.

A study on long-term soft tissue changes after superior repositioning of the maxilla (상악골의 수술적 상방이동에 대한 연조직의 장기적 변화에 관한 연구)

  • Lee, Dong-Yul
    • The korean journal of orthodontics
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    • v.29 no.5 s.76
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    • pp.627-635
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    • 1999
  • Soft tissue changes that occurred between presurgery to 5-years post-surgery in 49 orthognathic surgery patients whose maxillae were moved upward by Le Fort I osteotomy were examined by lateral cephalometric film. The objective of this paper was to document soft tissue changes at long-term follow-up after superior repositioning of the maxilla and to relate soft tissue and hard tissue changes in this group. The results were as follows. 1. On average, soft tissue landmarks in the nose and the upper lip were not changed statistically significantly except superior movement of superior labial sulcus and forward movement of pronasale between presurgery and 5 years postsurgery. 2. Upward and forward movement of the lower lip were found at 5 years postsurgery in comparison with presurgery and genioplasty added this effects. 3. Upper lip length and vertical dimension of upper vermilion didn't show any significant changes, but increase of lower lip length and decrease of vertical dimension of lower vermilion were statistically significant between presurgery and 5 years post-surgery. 4. The decrease of upper incisor exposure and interlabial distance from presurgery to 1 year were continued from 1 year to 5 years and the amount of the decrease was more than that of vertical movement of the maxilla by surgery. 5. Long term changes in soft tissue landmarks from 1 to 5 years postsurgery exceeded hard tissue changes, meaning soft tissue moved down more than skeletal changes.

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Nasolacrimal Duct Obstruction after Radioactive Iodine Therapy for Thyroid Cancer (갑상선암에서 방사성 요오드 치료 후 발생한 코눈물길 폐쇄)

  • Hwang, Moon Won;Lee, Eung;Yang, Jae Wook
    • Journal of The Korean Ophthalmological Society
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    • v.55 no.1
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    • pp.1-6
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    • 2014
  • Purpose: To investigate the clinical manifestation of nasolacrimal duct obstruction after radioactive iodine therapy for thyroid cancer. Methods: The authors examined 622 patients who were treated with radioactive iodine therapy after the operation for thyroid cancer from January 2009 to December 2011. Fourteen patients (18 eyes) were diagnosed nasolacrimal duct obstruction based on the lacrimal irrigation test, lacrimal probing test and dacryocystography in our oculoplastic clinic. We analyzed the dose of radioactive iodine therapy, number of treatments, clinical manifestation and treatment type by retrospectively reviewing the patients' medical records. Results: The mean radioactive iodine dose ($215.7{\pm}23.1mCi$, p = 0.01) and the mean number of treatments ($1.36{\pm}0.50$, p < 0.001) were significantly greater in 14 patients who had nasolacrimal duct obstruction than in patients who did not. The average onset of tearing symptoms occurred 10.2 months after radioactive iodine therapy. The mean time between correct diagnosis and therapy was 18.4 months. Three patients (3 eyes) had occlusion at the common cannaliculus and 11 patients (15 eyes) had occlusion at the nasolacrimal duct. Ten patients (13 eyes) underwent endonasal dacryocystorhinostomy for complete obstruction and 4 patients (5 eyes) underwent silicone tube intubation for partial obstruction. Conclusions: Nasolacrimal duct obstruction is a rare complication associated with radioactive iodine therapy for thyroid cancer, thus, clinicians should be aware of this complication and refer patients with symptoms of epiphora to the oculoplastic department for specialized evaluation and treatment.

Clinical Study on the Dental Abnomalities of Number and Morphology in Cleft Alveolus Patients (치조열 환자에서 치아의 선천결손과 형태이상에 관한 연구)

  • Seo, Min-Gyo;Leem, Dae-Ho;Ko, Seung-O;Shin, Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.13 no.1
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    • pp.1-10
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    • 2010
  • 구순구개열은 선천성 악안면 기형중에서 발생률이 가장 높은 질환이며 특히 동양인에게 높은 빈도로 발생된다. 그리고 순구개열에서는 파열부 조직의 선천적 상실과 파열부 봉합 수술 후 형성된 반흔에 의한 상악골의 열성장과 상악궁의 협착, 코의 형태 이상, 등과 함께 치아의 수, 크기와 형태 및 맹출 이상도 높은 빈도로 동반된다. 선천성 치아 발육 이상이 구순열 또는 구개열 가진 환자에게서 종종 보고되고 있다. 이런 치아 이상은 과잉치, 결손치, 크기, 형태, 맹출시기, 법랑질 광화 등의 많은 특징을 포함한다. 이번 연구의 목적은 다음과 같다. 1. 구순열 또는 구개열을 가진 환자의 선천성 치아 결손 발병률을 결정하여 정상인과 비교하는 것이다. 2. 상하악에서 파열이 있는 부위와 없는 부위의 제2소구치 결손가능성을 비교 하는 것이다. 구강악안면외과에서 구순구개열로 진단한 환자 중 2005년 1월~2009년 8월까지 전북대학교 구강악안면외과에서 치조열부위 자가골이식수술을 받은 32명의 환자로 초진시의 교정 chart, 구강악안면외과 chart, x-ray(파노라마, 치근단사진, 교합사진(상악), 석고 모델, 구강내 외 임상사진을 사용하여 순구개열군 별로 매복치, 과잉치, 결손치, 왜소치의 유무와 위치를 조사하여 다음과 같은 결론을 얻었다. 1. 결손치는 비교적 높은 발생빈도(53.1%)를 보였으며, 치아별 발생빈도는 상악 측절치와 상악 제2소구치, 하악 제2소구치 순이었다. 구순구개열군이 구순치조열군에 비해 발생률이 높게 나타났다. 그리고 구순구개열군 내에서 양측성이 편측성에 비해 결손치의 발생률이 높게 나타났다. 2. 왜소치는 71.6%에서 발견되었으며, 치아별 발생빈도는 상악측절치에서 가장 많았다. 구순치조열군이 구순구개열군에 비해 발생률이 높게 나타났다. 3. 치조열을 가진 환자에 있어 상/하악간 제2소구치의 선천적 결손에 유의한 차이가 있었다. 4. 구순구개열이 인접한 상악측절치의 발생중인 미성숙 조직에 영향을 미치며 파열부위와 좀 더 떨어져 있는 상악 제2소구치에도 일정한 영향을 미침을 이번 연구를 통해 다시 확인할 수 있었다.

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Treatment of giant iatrogenic pseudoaneurysm of the femoral artery (대퇴동맥에 발생한 의인성 거대 가성동맥류에 대한 치료)

  • Kang, Wu-Seong;Park, Chan-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.423-428
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    • 2019
  • The role of angioembolization has increased because of increases in nonoperative treatment for traumatic splenic injury. We report here a case of successful treatment of iatrogenic pseudoaneurysm of the femoral artery by thrombin injection with coil embolization. A 55-year-old female was admitted to our hospital because of blunt trauma. Computed tomography (CT) revealed a grade V splenic injury with contrast extravasation; therefore, angioembolization was performed. Three days after admission, follow-up CT scan revealed rebleeding from the spleen, and repeat angioembolization was performed. Seven days after admission, an approximately $7.0cm{\times}4.0cm-sized$ pseudoaneurysm was found on follow-up CT scan and there was no bleeding from the spleen. Although thrombin was injected into the aneurysmal sac, there was still inflow of blood, as observed on color-doppler ultrasound. Therefore, coil embolization to the neck of the aneurysm was performed. On angiography, there was no contrast filling into the sac. The size of the pseudoaneurysmal sac had decreased on follow-up CT scan, and the patient was discharged to home without complications. We successfully treated a giant pseudoaneurysm of the femoral artery using thrombin and coil embolization.

The Role of Perfusionists during the COVID-19 Pandemic and Clinical Laboratory Technologists: Comparison of Training Systems in Japan and the United States (코로나19를 통해서 바라본 체외순환사의 역할과 임상병리사: 일본과 미국의 양성체계를 비교)

  • Dong-Ok, Aum;Dae Jin, Kim;Dae Eun, Kim;Myong Soo, Kim;Bon-Kyeong, Koo
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.4
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    • pp.293-297
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    • 2022
  • In 2022, Korea reported a total of 224 perfusionists, employing nurses or clinical laboratory technologists (also known as medical technologists) to provide hospital self-education or reliable education. In 2021, the total number of perfusionists in Japan was 2,100, mainly supported by clinical engineering technologists. During the same period, the number of perfusionists reported in the United States was 4,212, who had received training in the master's program, post-bachelor certificate program, and bachelor's program. Most personnel in the USA were graduates of healthcare sciences or life sciences. Perfusionists must be knowledgeable in heart anatomy, physiology, pharmacology, pathology, hemodynamics, laboratory analysis, and quality assurance, as well as techniques to operate the cardiopulmonary bypass machine (heart-lung bypass machine). These are jobs similarly handled by clinical laboratory technologists. The importance of perfusionists became more prominent during two major crises: the MERS-CoV and COVID-19 pandemic. Currently, perfusionists play a significant role in the rapidly expanding field of extracorporeal membrane oxygenation (ECMO) and extracorporeal circulation during cardiac surgery. Results of the current study indicate that hospitals offering cardiac surgery and infectious disease hospitalization need to be institutionalized to secure a certain number of qualified perfusionists. In the future, we look forward to establishing a perfusion technology association under the Korean Society for Clinical Laboratory Physiology to provide academic exchanges.

OCULODENTODIGITAL SYNDROME : A CASE REPORT (Oculodentodigital syndrome의 1 증례)

  • Kang, Ho-Seung;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.3
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    • pp.492-498
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    • 1999
  • Oculodentodigital syndrome(ODD) was first reported by Lohmann in 1920 and termed by Meyer Schwicketath, which they called "dysplasia oculo-dento-digitalis" in 1957. It is somewhat rare heritable disease. ODD is generally inherited in an autosomal dominant pattern with a complex phenotype. The characteristic features are : (1) unique facial features, (2) microphthalmos, (3) syndactyly and camptodactyly of 4th and 5th fingers, (4) osseous anomalies of the middle phalanges of 5th fingers and toes, (5) enamel hypoplasia, (6) dry lusterless hair. We found several occlusal wearing and yellow discoloration of succedaneous teeth, multiple caries lesions, premature loss and pulpal involvement of primary teeth with associated enamel abnormalities caused by generalized enamel hypoplasia in a fairly constant oral finding. Occasionally partial anodontia, microdontia and cleft lip and palate can be manifested. This case, a 9-year-old female with repaired bilateral syndactyly was referred to pediatric dental clinic, Pusan National University Hospital for evaluation of severe attrition of teeth and caries lesions. She had most of the above mentioned typical manifestations of the syndrome. Dental treatment including caries control, stainless steel crown were performed.

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Transcatheter Embolotherapy of Giant Pulmonary Arteriovenous Malformation Using Amplatzer® Vascular Plug (Amplatzer® 혈관폐색장치를 이용한 거대 폐동정맥기형 색전술 1예)

  • Jung, Ki Hwan;Lee, Seung Hwa;Shin, Chol;Kim, Je Hyeong
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.52-58
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    • 2009
  • Pulmonary arteriovenous malformation (PAVM) is a rare pulmonary vascular anomaly due to an abnormal communication between the pulmonary artery and vein. The most common presenting symptom is a dyspnea on exertion related to this right-to-left shunt. If left untreated, PAVM has been known to result in serious complications. Incomplete pulmonary capillary network can be the cause of cerebral abscesses and other noninfectious neurological complications, such as stroke and transient ischemic attacks due to paradoxic embolism Transcatheter embolotherapy, using coils or balloons, has replaced surgical resection as the treatment of choice for PAVM. However, the risk of device embolization has limited the use of coil embolotherapy, while the size of PAVM is huge. Recently, Amplatzer$^{(R)}$ Vascular Plug has been proposed as an alternative endovascular occlusion device for arteriovenous malformation. We report a case of 81-year-old male patient with a giant PAVM, which was successfully treated by transcatheter embolotherapy using the Amplatzer$^{(R)}$ Vascular Plug.

A Case of Bronchial Artery Aneurysm with Bronchiectasis and Successful Coil Embolization (금속 코일 색전술로 치료된 기관지 확장증이 동반된 기관지 동맥류 1예)

  • Chung, Hyun Jung;Cho, Jae Hwa;Park, Byoung Do;Ryu, Jeong Seon;Kwak, Seung Min;Lee, Hong Lyeol;Jeon, Yong Sun
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.546-549
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    • 2008
  • Bronchial artery aneurysm (BAA) is a rare entity that requires early diagnosis and immediate treatment due to the possibility of a life-threatening massive hemorrhage through rupture. The standard treatment is a surgical resection of the aneurismal artery. However, various embolization techniques, including coil embolization, are currently used as the optimal treatment because they are less invasive. A 65-year-old woman was referred for the treatment of intermittent hemoptysis. A chest CT scan showed an approximately 2 cm sized vascular mass with strong contrast enhancement originating from the right bronchial artery on the bronchiectatic parenchyma. On the angiogram, the inferior portion of the bronchial artery with a hypertrophic aspect and a huge bronchial artery aneurysm was detected on the left side branch. The bronchial artery aneurysm was embolized successfully with coils at the proximal and distal portion of the aneurysm. After coil embolization, the selective bronchial angiogram confirmed complete occlusion. We report this case of a bronchial artery aneurysm that was treated successfully with coil embolization.