• Title/Summary/Keyword: Operative findings

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Clinical analysis of ostium secundum atrial septal defect (이차공형 심방중격결손증의 임상적 고찰)

  • 이종태
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.607-613
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    • 1984
  • Thirty seven patients with ostium secundum atrial septal defect, operated from January, 1976 to September, 1984 at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, were given clinical assessment. The following results were obtained. 1.Ostium secundum atrial septal defect was comprised of 18% of congenital heart disease. Their mean age was 15.7\ulcorner.42. Sex ratio [male:female] was 1:1.1. 2.Most frequent clinical symptom was dyspnea on exertion occurred in 26 patients [76.5%]. Only one patient had no symptom [2.9%]. 3.Pre-operative EKG findings revealed RVH in 61.8%, ICRBBB in 29.4%, and RAD in 41.2%. 4.Mean value of systolic pulmonary arterial pressure in patients over 20 years old was 37.8\ulcorner4.4mmHg and it was 28.1\ulcorner10.2mmHg in patients under 20 years old, but the difference between two groups was not statistically significant. 5. In large defect group [>3cm in diameter], Qp/Qs was significantly increased than small defect group [<3cm in diameter], but systolic pulmonary arterial pressure and Rp/Rs were not different between two groups. 6. Overall operative mortality was 5.4%.

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Approach in the Surgical Management of Cardiac Myxoma - Clinical Experience and Long-term Result - (심장 점액종의 외과적 고찰임상 경험 및 장기 성적)

  • 김응수
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.518-525
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    • 1988
  • Between 1977 and 1987, 8 patients underwent excision of cardiac myxomas at the Hanyang University Hospital. All had a left atrial myxoma. There were 4 female and 4 male patients ranging from 15 to 62 years of age. Preoperative findings consist of symptoms and signs of congestive heart failure except one. Diagnosis was confirmed by echocardiography[8 cases] and angiography[2 cases], preoperatively. A biatrial operative approach was utilized in all but 2, who were small sized. Complete excision of the tumor with a cuff of normal tissue[1 was atrial wall and 7 were atrial septum] was performed. all heart chambers were carefully explored for presence of multicentric myxomas or tumor debris. There were no operative deaths or intraoperative embolization. Follow-up has been 1/3 to 10 years. There has been 1 late death, due to recurrence and 1 patient had reoperation for mitral regurgitation due to dilatation of the annulus by a huge tumor mass. Surgical excision of the myxoma can be performed with low morbidity, and it provides excellent and sustained symptomatic relief. The recurrence rate is low, but long-term follow-up and serial echocardiography are advisable.

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Replacement of prosthetic heart valves Report of 5 cases (인공심장판막의 재치환술 5례 보고)

  • 신제균
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.655-662
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    • 1985
  • From January 1985 to July 1985, prosthetic heart valves were replaced in 5 patients at Keimyung University Dongsan Medical Center. The patients included three women and two men ranging in age from 22 to 41 years. Three mitral valve replacements, one aortic valve replacement and one double valve replacement [mitral and aortic valve replacement] were done at the first valve operations. Reoperation were performed 2 to 76 months after the first operations, Prosthetic valve endocarditis occurred in 3 patients, early in one and late in two and primary valve failure occurred in 2 patients. In operative findings, vegetation in prosthetic valve endocarditis and calcification in primary valve failure were found. All except one had relatively successful operative results. One died of early fungal prosthetic valve endocarditis due to relapsed prosthetic valve endocarditis with heart failure and block.

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Non-Operative Management of Traumatic Gallbladder Bleeding with Cystic Artery Injury: A Case Report

  • Kim, Tae Hoon
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.208-211
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    • 2021
  • Gallbladder injuries are rare in cases of blunt abdominal trauma and are usually associated with damage to other internal organs. If the physician does not suspect gallbladder injury and check imaging studies carefully, it may be difficult to distinguish a gallbladder injury from gallbladder stone, hematoma, or bleeding. Therefore, in order not to miss the diagnosis, the clinical findings and correlation should be confirmed. In the present case, a 60-year-old male presented to a local trauma center complaining of pain in the upper right quadrant and chest wall following a motor vehicle collision. Abdominal computed tomography (CT) showed a hepatic laceration and hematoma in the parenchyma in segments 4, 5, and 6 and active bleeding in the lumen of the gallbladder. Traumatic gallbladder injuries generally require surgery, but in this case, non-operative management was possible with cautious follow-up consisting of abdominal CT and angiography with repeated physical examinations and hemodynamic monitoring in the intensive care unit.

Clinical Outcomes according to Radiological Classification of Brainstem Hemorrhages (방사선학적 출혈양상에 근거한 뇌간출혈의 분류에 따른 임상결과)

  • Cho, Won Jung;Moon, Seong Ho;Lee, Seung Min;Yang, Jae Young;Choi, Chun Sik;Ju, Mun Bae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.217-221
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    • 2000
  • Objective : Brainstem hemorrhages usually result in much higher mortality and morbidty than any other intracranial vascular lesions. The purpose of the study is to evaluate the relationship of the radiological classification of the lesions and the clinical outcomes, and to evaluate the value of such classification on the choice of management modality. Method : Thirty seven patients with primary brainstem hemorrhage were managed medically or surgically between Oct. 1995 and Mar. 1998. The lesions were classified as two groups based on radiological findings as follows : Focal subependymal hematoma(group I, n=7) and diffuse tegmentobasilar hemorrhage(group II, n=30). The outcomes at discharge were retrospectively reviewed according to such classification. Result : The most common clinical pictures and radiological findings in each group were as followings : 1) Group I : focal compressive lesion which displaces rather than destroys brain tissue. It occurs in a younger age group and causes neurological deficits which are often partially reversible. Operative hematoma evacuation was performed in 43.3%. Their mean improved Glasgow Coma Scale(GCS) score was 4.7. 2) Group II : hypertensive brain stem hemorrhage. It usually causes a diffuse lesion occurring in an older age group and most often associated with profound irreversible neurological deficits which are often fatal. Operative hematoma evacuation was performed in 16.7%. Their mean improved GCS score was 1.4. In both conservatively treated group I and II has no siginificant clinical improvement. Conclusion : Although there is an overlap among them and the size of the group is small, the pathophysiologic classification of this lesion based on clinical features and radiological findings may be useful for decision of treatment method.

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Relationships of hepatic histopathological findings and bile microbiological aspects with bile duct injury repair surgical outcomes: A historical cohort

  • Guilherme Hoverter, Callejas;Rodolfo Araujo Marques;Martinho Antonio Gestic;Murillo Pimentel Utrini;Felipe David Mendonca Chaim;Elinton Adami Chaim;Francisco Callejas-Neto;Everton Cazzo
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.325-332
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    • 2022
  • Backgrounds/Aims: To analyze relationships of hepatic histopathological findings and bile microbiological profiles with perioperative outcomes and risk of late biliary stricture in individuals undergoing surgical bile duct injury (BDI) repair. Methods: A historical cohort study was carried out at a tertiary university hospital. Fifty-six individuals who underwent surgical BDI repair from 2014-2018 with a minimal follow-up of 24 months were enrolled. Liver biopsies were performed to analyze histopathology. Bile samples were collected during repair procedures. Hepatic histopathological findings and bile microbiological profiles were then correlated with perioperative and late outcomes through uni- and multi-variate analyses. Results: Forty-three individuals (76.8%) were females and average age was 47.2 ± 13.2 years; mean follow-up was 38.1 ± 18.6 months. The commonest histopathological finding was hepatic fibrosis (87.5%). Bile cultures were positive in 53.5%. The main surgical technique was Roux-en-Y hepaticojejunostomy (96.4%). Overall morbidity was 35.7%. In univariate analysis, liver fibrosis correlated with the duration of the operation (R = 0.3; p = 0.02). In multivariate analysis, fibrosis (R = 0.36; p = 0.02) and cholestasis (R = 0.34; p = 0.02) independently correlated with operative time. Strasberg classification independently correlated with estimated bleeding (R = 0.31; p = 0.049). The time elapsed between primary cholecystectomy and BDI repair correlated with hepatic fibrosis (R = 0.4; p = 0.01). Conclusions: Bacterial contamination of bile was observed in most cases. The degree of fibrosis and cholestasis correlated with operative time. The waiting time for definitive repair correlated with the severity of liver fibrosis.

Bronchogenic Cyst - 1 case report - (기관지성 낭종 -1례 보고-)

  • 고태환
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.468-472
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    • 1989
  • Bronchogenic cysts are uncommon congenital lesions which are derived from primitive foregut. Most of the bronchogenic cysts may occur at the tracheal bifurcation, both main bronchi, the lung parenchyme and the mediastinum. We experienced a case of bronchogenic cyst with a esophageal stalk. The diagnosis was made by simple chest x-ray and confirmed by bronchoscopy and chest CT. On the chest CT findings, 6.8X4.8 cm-sized oval shaped mass was located on the right posteroinferior side of the carina, elevating the right main bronchus and the thin wall of the mass was enhanced with contrast materials. On the operative findings, the esophagus and the cyst were connected with a stalk and the cyst was filled with mucinous materials. And on the histological findings, the mass was lined with pseudostratified ciliated columnar epithelium. Thus we report this case of bronchogenic cyst with review of literatures.

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Endoscopy after Gastric Surgery: For Each Reconstruction Method, Operator's Point of View (위 수술 전후의 내시경 시술: 재건법에 따른 접근, 수술의 관점)

  • Yilseok Joo;Hyunjin Cho;Sooin Choi
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.66-76
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    • 2023
  • Endoscopy is an important noninvasive procedure for patients with gastrointestinal problems. However, surgical techniques are shifting to laparoscopic surgery, and changes in endoscopic findings after laparoscopic surgery differ from those after previous surgical methods. Postoperative endoscopic findings differ from normal anatomical structures, and findings reportedly vary depending on the type of surgical technique. Therefore, we aimed to summarize the surgical and endoscopic findings for each surgical method from the surgeon's point of view. The causes of gastric emptying delay, bleeding, afferent loop syndrome, or anastomosis leakage occurring after gastric cancer surgery can be identified via upper gastrointestinal endoscopy that is relatively less invasive than the surgical method. Regarding postoperative anastomosis leakage, endoscopy can directly evaluate the degree of leakage at the anastomosis site more accurately than computed tomography and enable immediate intervention. As endoscopy is less invasive than the surgical method, patients can be evaluated and treated more safely. However, coordination between the surgeon and the endoscopist is necessary to perform the procedures effectively. Therefore, reviewing the changes in surgical and endoscopic findings is important.

Ultra-thin Rigid diagnostic and therapeutic arthroscopy during arthrocentesis: Development and preliminary clinical findings

  • Moon, Seong-Yong;Chung, Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.17.1-17.5
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    • 2015
  • Arthroscopy is useful to detect early changes in the temporomandibular joint (TMJ). Despite great advances in arthroscopy, many arthroscopic surgeries have now been replaced by arthrocentesis. We propose a simple diagnostic and therapeutic method having operative rigid ultra-thin arthroscopy with 16 gauge needle size combined with arthrocentesis.

Esophageal leiomyoma combined with achalasia; report of 1 case (아칼라지아와 동반된 식도 평활근종;수술 치험 1례 보고)

  • 백만종
    • Journal of Chest Surgery
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    • v.26 no.10
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    • pp.815-820
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    • 1993
  • We experienced a case of esophageal leiomyoma combined with achalasia that is very rare. Patient had suffered from severe dysphagia and postprandial vomiting and diagnosis was accomplished by esophagography, esophagoscopy, chest CT, and esophageal motility test. The operative treatment was done through left lateral thoracotomy by enucleation of the submucosal tumor and esophagomyotomy. By histopathological findings, the diagnosis of leiomyoma was confirmed and LES biopsy revealed absence of the ganglion cells of myenteric and Auerbach`s plexus. Symptoms of the patient were completely relieved and postoperative course was uneventful.

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