• Title/Summary/Keyword: Concomitant disease

Search Result 182, Processing Time 0.026 seconds

Aortic Valve Replacement Using Continuous Suture Technique in Patients with Aortic Valve Disease

  • Choi, Jong Bum;Kim, Jong Hun;Park, Hyun Kyu;Kim, Kyung Hwa;Kim, Min Ho;Kuh, Ja Hong;Jo, Jung Ku
    • Journal of Chest Surgery
    • /
    • v.46 no.4
    • /
    • pp.249-255
    • /
    • 2013
  • Background: The continuous suture (CS) technique has several advantages as a method for simple, fast, and secure aortic valve replacement (AVR). We used a simple CS technique without the use of a pledget for AVR and evaluated the surgical outcomes. Materials and Methods: Between October 2007 and 2012, 123 patients with aortic valve disease underwent AVR alone (n=28) or with other concomitant cardiac procedures (n=95), such as mitral, tricuspid, or aortic surgery. The patients were divided into two groups: the interrupted suture (IS) group (n=47), in which the conventional IS technique was used, and the CS group (n=76), in which the simple CS technique was used. Results: There were two hospital deaths (1.6%), which were not related to the suture technique. There were no significant differences in cardiopulmonary bypass time or aortic cross-clamp time between the two groups for AVR alone or AVR with concomitant cardiac procedures. In the IS group, two patients had prosthetic endocarditis and one patient experienced significant perivalvular leak. These patients underwent reoperations. In the CS group, there were no complications related to the surgery. Postoperatively, the two groups had similar aortic valve gradients. Conclusion: The simple CS method is useful and secure for AVR in patients with aortic valve disease, and it may minimize surgical complications, as neither pledgets nor braided sutures are used.

Risk factors for anticoagulant-associated gastrointestinal hemorrhage: a systematic review and meta-analysis

  • Fuxin Ma;Shuyi Wu;Shiqi Li;Zhiwei Zeng;Jinhua Zhang
    • The Korean journal of internal medicine
    • /
    • v.39 no.1
    • /
    • pp.77-85
    • /
    • 2024
  • Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation-related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions: The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.

Update on treatment in acute stage of Kawasaki disease (가와사끼병 급성기 치료의 최신 지견)

  • Han, Ji Whan
    • Clinical and Experimental Pediatrics
    • /
    • v.51 no.5
    • /
    • pp.457-461
    • /
    • 2008
  • Kawasaki disease (KD) was first described by Dr. Tomisaku Kawasaki in his 1975 study, published in Pediatrics. Its pathogenesis is still not clearly understood. Early diagnosis and treatment are very important to preventing concomitant coronary artery complications. Most KD patients respond well to the standard treatment of aspirin and intravenous immunoglobulin; however, some of them are refractory to the standard treatment, and so adjuvant therapies with corticosteroids and anti-tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) antibody are necessary. In this article, the author reviews and summarizes the most recent literature on the treatment of refractory KD.

Two Cases of Primary Localized Amyloidosis of Larynx (원발성 국소 후두아밀로이드증 2례)

  • 김형태;조승호;전범조;김민식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.9 no.2
    • /
    • pp.147-151
    • /
    • 1998
  • Primary localized laryngeal amyloidosis is an uncommon disorder of unknown cause that occurs in the absence of systemic amyloidosis or associated disease. There is a risk of either missing concomitant systemic amyloidosis or exhaustively investigating for this when it is not present through failure to appreciate the nature of the disease. We present 2 cases of primary localized laryngeal amyloidosis in supraglottic region. Biopsy of the mass of patients revealed findings consistent with amyloidosis, which were Congo red reaction with a apple green birefringence in polarized light fluorescence microscopy. An extensive workup for systemic amyloidosis was negative. All of two cases were treated by vaporization via $CO_2$ LASER using "Swiftlase Flshscan" for creating a wide, shallow char-free treatment site by precisely controlling ablation depth without causing residual thermal damage to tissue. The postoperative recovery of all cases was uneventful with good vocal quality and no aspiration. At the present time, the patients have no evidence of disease, recurrence and complication.

  • PDF

The Relationship between Airway Inflammation and Exacerbation in Chronic Obstructive Pulmonary Disease

  • Perng, Diahn-Warng;Chen, Pei-Ku
    • Tuberculosis and Respiratory Diseases
    • /
    • v.80 no.4
    • /
    • pp.325-335
    • /
    • 2017
  • Chronic obstructive pulmonary disease (COPD) is associated with abnormal inflammatory response and airflow limitation. Acute exacerbation involves increased inflammatory burden leading to worsening respiratory symptoms, including dyspnea and sputum production. Some COPD patients have frequent exacerbations (two or more exacerbations per year). A substantial proportion of COPD patients may remain stable without exacerbation. Bacterial and viral infections are the most common causative factors that breach airway stability and lead to exacerbation. The increasing prevalence of exacerbation is associated with deteriorating lung function, hospitalization, and risk of death. In this review, we summarize the mechanisms of airway inflammation in COPD and discuss how bacterial or viral infection, temperature, air pollution, eosinophilic inflammation, and concomitant chronic diseases increase airway inflammation and the risk of exacerbation.

CT Assessment of Myocardial Perfusion and Fractional Flow Reserve in Coronary Artery Disease: A Review of Current Clinical Evidence and Recent Developments

  • Chun-Ho Yun;Chung-Lieh Hung;Ming-Shien Wen;Yung-Liang Wan;Aaron So
    • Korean Journal of Radiology
    • /
    • v.22 no.11
    • /
    • pp.1749-1763
    • /
    • 2021
  • Coronary computed tomography angiography (CCTA) is routinely used for anatomical assessment of coronary artery disease (CAD). However, invasive measurement of fractional flow reserve (FFR) is the current gold standard for the diagnosis of hemodynamically significant CAD. CT-derived FFRCT and CT perfusion are two emerging techniques that can provide a functional assessment of CAD for risk stratification and clinical decision making. Several clinical studies have shown that the diagnostic performance of concomitant CCTA and functional CT assessment for detecting hemodynamically significant CAD is at least non-inferior to that of other routinely used imaging modalities. This article aims to review the current clinical evidence and recent developments in functional CT techniques.

Role of Concomitant Chemoradiation in Locally Advanced Head and Neck Cancers

  • Lasrado, Savita;Moras, Kuldeep;Pinto, George Jawahar Oliver;Bhat, Mahesh;Hegde, Sanath;Sathian, Brijesh;Luis, Neil Aaron
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.10
    • /
    • pp.4147-4152
    • /
    • 2014
  • Standard therapy for advanced head and neck cancer consists of a combination of surgery and radiation. However, survival of this patient population has not improved during the past 20 years. Many different multimodality treatment schedules have been proposed, and chemotherapy is often used with the intent of organ preservation. The present study was intended to establish the efficacy of concomitant chemoradiation with a single agent carboplatin in advanced head and neck cancers.The objectives were to investigate the feasibility of concomitant administration of carboplatin, monitor acute toxicity during radiotherapy, and determine subacute side effects, such as wound healing following surgery after chemoradiotherapy. A prospective study was conducted wherein a total of 40 patients with stage III and IV squamous cell carcinomas of oral cavity, oropharynx, hypopharynx and larynx were enrolled. All patients were treated with external beam radiotherapy and weekly carboplatin area under curve (AUC of 5). Radiotherapy was given in single daily fractions of 1.8-2 grays (Gy) to a total dose of 66-72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Neck dissection was recommended for all patients with neck disease showing less than a complete response after chemoradiation. A total of 40 patients were enrolled of whom 32 were males and 8 were females. Highest incidence of cancer was seen in the 5th-6th decades of life with a median age of 47.7 years. Oropharyngeal tumours constituted a maximum of 21 patients followed by hypopharynx in 10, larynx in 7 and oral cavity in 2. 80% of the patients had a neck node on presentation of which 40% had N2-N3 nodal status. TNM staging revealed that 58% of patients were in stage III and 43% in stage IV. Evaluation of acute toxicity revealed that 50% had grade II mucositis, 25% grade III mucositis, 2.5% grade IV mucositis. 50% of patients had grade I skin reactions, 65% of patients had grade I thrombocytopenia, and 24% of patients had grade I anaemia. After completion of treatment 65% of patients had complete response at the primary and regional sites, and 35% of patients had a partial response of whom 23% underwent neck dissection and 5% of them underwent salvage surgery at the primary site. At the end of one year there were six deaths and four recurrences and 70% were free of disease. Concurrent chemoradiation with carboplatin provided good locoregional control for locally advanced head and neck cancers. This regimen, although toxic, is tolerable with appropriate supportive intervention. Primary site conservation is possible in many patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancers.

Clinical Evaluation of Prosthetic Valve Replacement in Valvular Heart Disease (인공심장판막치환 환자에 대한 임상적 고찰)

  • 곽문섭
    • Journal of Chest Surgery
    • /
    • v.21 no.6
    • /
    • pp.1003-1019
    • /
    • 1988
  • From 1982 to 1987, six patients underwent left ventricular aneurysmectomy with concomitant myocardial revascularization. Simultaneous repair of postinfarction ventricular septal defect was performed in 3 patients and left ventricular thrombectomy in two. There was no hospital mortality and late mortality during 220 months* follow up period-.[Mean 36.7 months, range 13 to 72 months] Their condition was improved in all. They live in physical condition of NYHA class I-II. We believe early surgical intervention can be life-saving, and can be done without undue surgical risk, even in cases of postinfarction VSD and LV aneurysm with failing heart.

  • PDF

Pediatric Cerebral Vascular Malformations : Current and Future Perspectives

  • Edward R. Smith
    • Journal of Korean Neurosurgical Society
    • /
    • v.67 no.3
    • /
    • pp.326-332
    • /
    • 2024
  • Intracranial vascular malformations typically encountered by pediatric neurosurgeons include arteriovenous malformations, vein of Galen malformations and cavernous malformations. While these remain amongst some of the most challenging lesions faced by patients and caregivers, the past decade has produced marked advances in the understanding of the pathophysiology of these conditions, with concomitant innovations in treatment. This article will highlight present and future perspectives relevant to these diseases, with a focus on an emerging approach utilizing disease-specific mutations to develop a novel taxonomy for these conditions.

Incidentally Detected Asymptomatic Perianal Abscess in an Adolescent during Crohn's Disease Diagnosis: Is Routine Pelvic Imaging Required in Korean Pediatric Patients at Diagnosis?

  • Um, Soo Hyun;Lee, Sang Woo;Song, Ki Hwan;Lee, So Mi;Choe, Byung-Ho;Lee, Yoo Min;Kang, Ben
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.24 no.6
    • /
    • pp.564-570
    • /
    • 2021
  • Perianal fistulizing diseases, namely perianal fistulas and/or abscesses, are well-known complications of Crohn's disease (CD). These are known to develop more frequently in Asian children with CD, especially in the early stages of the disease course. Approximately half of the pediatric CD cases in Korea present with perianal fistulizing diseases at diagnosis. We report a rare case of a 12-year-old boy with CD with an incidental discovery of a perianal abscess on pelvic magnetic resonance imaging during CD diagnosis. No symptoms or signs of perianal fistulizing disease were identified. The early diagnosis of the perianal abscess enabled timely and effective treatment. Considering the high incidence of concomitant perianal CD in Korean children at diagnosis, perianal imaging may be useful and should be considered during diagnostic evaluation, even in patients with no subjective or objective findings indicating perianal CD.