• 대한영상의학회지
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• 제82권6호
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• pp.1628-1633
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• 2021

척수 경막외 동정맥루는 매우 드문 질환으로 진단과 치료가 어렵다. 무증상 환자도 있으나 동정맥단락으로 척수주위정맥으로 역류되고 늘어난 정맥이 인접한 신경근을 압박하면서 증상이 생길 수 있다. 본 증례는 31세 남자 환자로 2년 동안 지속되는 요통, 방사성 허벅지통증, 하지 감각변화로 내원하였다. 컴퓨터단층촬영, 자가공명장치 및 척수혈관조영술에서 요추의 경막외 공간에서 동정맥단락에 의해 늘어난 정맥이 신경근을 압박하고 있는 척수 경막외 동정맥루로 진단하였다. 코일색전술을 시행하여 동정맥단락을 차단하였고 수일 내에 신경근 압박증상이 호전되었다. 이번 증례에서는 척수 경막외 동정맥루에서 외과적 수술의 대안으로 코일 색전술이 효과적인 치료가 될 수 있다는 것을 보여주었다.

• Journal of Chest Surgery
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• 제20권1호
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• pp.139-147
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• 1987

in general rapid and complete resolution of pulmonary emboli, even massive, is the natural history. However, rarely, the emboli do not resolve but rather became fibrotic organization and densely adherent to the arterial wall, therefore, may lead to significant clinical disability. In patients with chronic pulmonary embolism, medical management usually has little effect and only surgical treatment can offer improvement. The case was 30-year-old man who had admission to the Hanyang University Hospital due to fall-down from 11th floor 407 days before operation and then transferred to our department for surgical management under the diagnosis of chronic pulmonary embolism, Pulmonary angiogram demonstrated multifocal thromboembolism with infarction and lung scans showed no improvement in spite of anticoagulant and thrombolytic therapy. At median sternotomy for pulmonary artery thromboembolectomy, the well organized and multiple septic emboli could be removed by gallstone forceps. But reoperation of left upper lobectomy was performed because of the repeated hemoptysis and suspicious pulmonary arterio-bronchial fistula 19 days postoperatively. Despite of ventilatory support and drug treatment, the patient died due to right heart failure associated with cor pulmonale 27 days after first operation. Discussion of the operative and perioperative problems are offered.

• 대한자기공명의과학회:학술대회논문집
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• 대한자기공명의과학회 2001년도 제6차 학술대회 초록집
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• pp.166-166
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• 2001

목적： 척수의 질환에 대한 확산강조영상 소견에 대하여 알아본다. 대상 및 방법： 임상적으로 진단된 척수질환 환자 8명을 (acute transverse myelitis (n=3), spinal dural AV fistula (n=2), multiple sclerosis (n=1), spinal cord tumor (n=2)) 대상으로 하였다. 영상은 Philips Intera 1.5 T system을 이용하였고, multishot spin echo EPI 펄스열 및 EKG gating을 이용하여 영상을 얻었다. 3R-R 간격으로 영상을 얻었으며 TE=72msec, FOV=25cm, 256 matrix, 5mm thickness, b value=400으로 영상매개변수를 정하였다. 척수 중심으로 3개의 절편을 얻었으며 T2 강조 영상과 겉보기확산계수 영상을 같이 구하였다.

• 대한기관식도과학회지
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• 제7권2호
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• pp.140-145
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• 2001

Background and Objectives： Intractable aspiration in patients with impaired protective function of the larynx often results in multiple episode of aspiration pneumonia, repeated hospitalizations and expensive nursing care. The purpose of this study was to review the authors’experience and Patient outcome with the laryngotracheal separation (LTS) procedure. Materials and Methods A retrospective review of 9 patients who underwent LTS between 1996 and 2001 was conducted. Ages ranged from 3 to 72 years. Results : Seven patients were expected to have morbid aspiration as a consequence of acquired neurologic injuries and two were congenital neurologic injuries. Two patients had a postoperative fistula, which was well controlled with local wound care and minor procedure. Following LTS, aspiration was effectively controlled in all patients and four were able to tolerate a regular diet. Conclusion : LTS is a low-risk, successful. definitive procedure which decreases the potential for aspiration, pulmonary complication, hospitalizations and increases quality of life, especially in patent with irreversible upper airway dysfunction and Poor speech potential.

• Journal of Yeungnam Medical Science
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• 제25권1호
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• pp.72-77
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• 2008

Liver abscess in children is rare in developed countries; the incidence is 25 per 100,000 admissions in USA. Common complications are pleural effusion, empyema, pneumonitis, hepatopleural or hepatobronchial fistula, intraperitoneal or intrapericardiac rupture, septic shock, cerebral amebiasis, etc. These complications may lead to death if the management is delayed. However, recent management results in a mortality of less than 15%. We report a case of liver abscess in a child. He manifested with fever and abdominal pain in the right upper quadrant. On computerized tomography scans, multiple cystic lesions were seen in both lobes of the liver and were 5 to 55 mm in size. In laboratory findings, neutrophilic leukocytosis, peripheral eosinophila, elevated values of ESR, C-reactive protein, and elevated serum AST, ALT, ALP and GGT were detected. Furthermore, we determined the organisms in the blood culture and serum. Blood culture was positive for Streptococcus spp., and amebic indirect hemagglutination antibody titer was increased to 1:512.

• Journal of Chest Surgery
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• 제22권6호
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• pp.1049-1055
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• 1989

We have reviewed 73 patients who experienced hemoptysis with pulmonary tuberculosis to analyze the factors contributing hemoptysis and its management The result are; 1. The age group between 30 * 50 years old was major prevalent group [59%]. 2. Sexual ratio was 3.9 to 1, as 58 men and 15 women. 3. In 58 patients [79.5 %], the number of hemoptysis in frequency was less than 5 times. 4. The quantity of hemoptysis was ranged from less than 50 ml to more than 600 ml and 20 patients [27.4%] experienced bleeding more than 600 ml at once. 5. There was no seasonal difference in hemoptysis. 6. The common prodromal symptoms of hemoptysis were coughing, fatigability, hot foreign sensation of throat in order of frequency. 7. In chest roentgenographic finding, the cavitary lesion was the most common finding, 67% [51 cases], and the multiple cavity was 19.2%[14 cases]. 8. 23 patients [31.37%] were operated for control of hemoptysis and pulmonary tuberculosis itself, 7[30.43 %] of them suffered from complication of empyema, respiratory failure, empyema with bronchopulmonary fistula. 9. One patient [4%] was died due to respiratory failure after left thoracoplasty.

• 한국수의병리학회:학술대회논문집
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• 한국수의병리학회 2002년도 추계학술대회초록집
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• pp.138-138
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• 2002

A 10-day old male calf exhibited multiple congenital anomalies of the urinary and gastrointestinal tracts, including renal fusion (horseshoe kidney), ureteral fusion, rectovesicular fistula, and atresia ani. The single kidney was fused at the caudal poles. The left kidney and cranial half of right kidney were shrunken, while the remaining lobules were hypertrophic. Ureters were fused cranially and bifurcated caudally. The terminal rectum was narrowed and connected with the bladder. The anus was imperforate. The cause of these anomalies could not be determined. This is the first report of this constellation of congenital anomalies in a calf.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.55-58
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• 2022

In Van der Woude syndrome (VWS), a rare congenital disease, lower lip pits (LLPs) can cause an aesthetically significant deformity. Surgical treatment of LLPs is necessary if they cause recurrent inflammation or aesthetic problems. Intraoperatively, surgeons should keep in mind the possibility of deep extension of the sinus tract and the relative deficiency of the midline in VWS, which increases the risk of lip disfigurement. Herein, we emphasize the importance of using a tissue-preserving technique to improve aesthetic results in VWS patients with a sinus tract.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제26권2호
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• pp.223-226
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• 2024

Percutaneous techniques for femoral arterial access are increasingly being performed due to advances in endovascular cerebral procedures, as they provide a less morbid and minimally invasive approach than open procedures. Common complications associated with this peripheral puncture include hematoma, bleeding, pseudoaneurysm, arteriovenous fistula, retroperitoneal bleeding, inadvertent venous puncture, dissection, etc. The retrograde femoral access is currently the most frequently used arterial access as it is technically straightforward, allows for the use of larger size sheaths and catheters, allows repeated attempts, etc. Although being technically less challenging, grave complications can occur due to hardware failure. Here, we present a case of unruptured posterior inferior cerebellar artery (PICA) aneurysm, who underwent uneventful diagnostic cerebral digital substraction angiography (DSA) via right femoral artery route on first attempt, but on second attempt for therapeutic intervention, landed up with stuck guide wire and faced decannulation difficulty due to unravelling of guide wire and multiple knot formation, which was finally removed after multiple attempts at pulling and improvised manoeuvres. Such cannulation and decannulation difficulties have been reported multiple times for central venous access, but extremely rarely for femoral routes, making this case a rarity and worth reporting.

• Journal of Chest Surgery
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• 제20권1호
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• pp.65-70
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• 1987

Empyema thoracis following pneumonia, pulmonary tuberculosis, trauma and surgical procedures continues to be a source of major morbidity and mortality. We retrospectively reviewed the hospital records of 330 patients [child:87, adult243] treated for empyema thoracis at Catholic Medical Center between 1964 and 1986. The causes of empyema in these patients were as follows: pneumonia [C***:66%, A***:30%], pulmonary tuberculosis [C:2%, A:20%], lung abscess [C:3%, A:5%], postoperative complication [C:0%, A:13%], trauma [C:1%, A:4%] and unknown origin [C:23%, A:17%]. Three patients in this series died of sepsis from necrotizing pneumonia. Staphylococcus [29.3%], Streptococcus [8.8%], E. coli [8%], Mycobacterium tuberculosis [7.9%], Klebsiella [7.4%], Pseudomonas [6.4%], Bacteroides [3.4%] were the organisms most commonly isolated. Bacterial isolates were single in 68.3%, multiple 7.5% and absent 24.2%. The type of organism did not correlate with severity of disease or eventual requirement for closed thoracotomy drainage, open thoracotomy drainage [Modified Eloesser*s procedure], thoracoplasty, decortication or pleuropneumonectomy. Successful methods of treatment included aspiration in 44%, tube thoracotomy in 66%, open thoracotomy drainage in 98.7%, thoracoplasty in 98%, decortication in 96% and pleuropneumonectomy in 73%. Initial mode of management in empyema thoracis are thoracentesis and closed thoracotomy drainage. If the initial management was failed, we performed another surgical procedures. Before 1973, we manage with Schede`s thoracoplasty in the postpneumonectomy empyema patients. But thoracoplasty, with or without the use of muscle flaps, is a hazardous operation in the poor-risk patients. The permanent, open thoracotomy drainage is a relatively minor operation which is well tolerated even by cachexic, septic patients. It controls infection, and sometimes results in the bronchopleural fistula closing spontaneously.