• Clinical Endoscopy
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• 제51권6호
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• pp.596-599
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• 2018

An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.

• Journal of Yeungnam Medical Science
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• 제26권2호
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• pp.148-155
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• 2009

Brugada syndrome is characterized by an ECG pattern of right bundle branch block and ST segment elevation in the right precordial leads ($V_1-V_3$) without structural heart disease. It is also characterized by sudden cardiac death that's caused by ventricular fibrillation. This is a familial syndrome with an autosomal dominant inheritance pattern and it may be considerably more common in Southeast Asia. Many factors during anesthesia can precipitate malignant dysrrhythmia in these patients, so careful choice of anesthetics is required. We experienced a case of Brugada syndrome in a 59-year-old male patient who was under general anesthesia for trans-sphenoidal surgery to treat a pituitary adenoma, and the patient was diagnosed as having Brugada syndrome without any untoward cardiovascular events.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권2호
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• pp.89-93
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• 2020

We experienced an unusual case of accelerated junctional rhythm with severe hypotension after infiltration of lidocaine containing epinephrine during dental surgery under general anesthesia. The patient's electrocardiogram exhibited retrograde P-waves following the QRS complex, which could be misinterpreted as ST-segment depression. As a temporary measure, administration of ephedrine restored the patient's blood pressure to normal levels. The importance of this case lies in its demonstration of an unexpected and serious side effect of commonly used epinephrine infiltration. This case also highlights the need for accurate interpretation of the electrocardiogram and comprehensive understanding of best practices for patient management.

• Journal of Korean Neurosurgical Society
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• 제59권6호
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• pp.655-658
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• 2016

Parkinson's disease (PD) patients frequently have several spinal deformities leading to postural instabilities including camptocormia, myopathy-induced postural deformity, Pisa syndrome, and progressive degeneration, all of which adversely affect daily life activities. To improve these postural deformities and relieve the related neurologic symptoms, patients often undergo spinal instrumentation surgery. Due to progressive degenerative changes related to PD itself and other complicating factors, patients and surgeons are faced with instrument failure-related complications, which can ultimately result in multiple revision surgeries yielding various postoperative complications and morbidities. Here, we report a representative case of a 70-year-old PD patient with flat back syndrome who had undergone several revision surgeries, including anterior and posterior decompression and fusion for a lumbosacral spinal deformity. The patient ultimately benefitted from a relatively short segment fixation and corrective fusion surgery.

• Journal of Chest Surgery
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• 제17권4호
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• pp.691-697
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• 1984

After the real birth of vascular surgery occurred with the introduction of the first practical arterial prosthesis about 50 years ago, a variety of potential vascular graft had been tested and rejected. Polytetrafluoroethylene [Teflon, PTFE] was first used as a vascular prosthesis in 1957. Thereafter this pros-thesis was first used clinically in 1972 and has subsequently been widely applied as a small and medium sized vessel replacement because it is easy to use and readily available. There are numerous reports of good results about Polytetrafluoroethylene graft. We experienced the three cases of arterial bypass graft using polytetrafluoroethylene vascular pros-thesis. First, 21 years old female patient had suffered from Takayasus disease which affected the left subclavian artery and right subclavian-left axillary extra anatomical bypass graft as done. Second, 64 years old male patient had suffered from Leriche syndrome for 12 years and the left axillofemoral and femorofemoral extra anatomical bypass graft was done. Third, 34 years old male patient had suffered from recurrent Buergers disease which affected the left popliteal artery and the isolated popliteal artery segment bypass graft was done. Relatively satisfactory result was obtained in early post-operative period in all three cases.

• Journal of Yeungnam Medical Science
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• 제37권1호
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• pp.54-58
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• 2020

Achromobacter xylosoxidans is a gram-negative bacterium that can oxidize xylose. It is commonly found in contaminated soil and water but does not normally infect immunocompetent humans. We report a case of a cavitary lung lesion associated with community-acquired A. xylosoxidans infection, which mimicked pulmonary tuberculosis or lung cancer in an immunocompetent man. The patient was hospitalized due to hemoptysis, and chest computed tomography (CT) revealed a cavitary lesion in the superior segment of the left lower lobe. We performed bronchoscopy and bronchial washing, and subsequent bacterial cultures excluded pulmonary tuberculosis and identified A. xylosoxidans. We performed antibiotic sensitivity testing and treated the patient with a 6-week course of amoxicillin/clavulanate. After 2 months, follow-up chest CT revealed complete resolution of the cavitary lesion.

• The Korean Journal of Pain
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• 제26권1호
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• pp.76-79
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• 2013

During the early stage of postherpetic neuralgia, an epidural block on the affected segment is helpful in controlling pain and preventing progression to a chronic state. The main neurologic complication following an epidural block is cord compression symptom due to an epidural hematoma. When neurologic complications arise from an epidural block for the treatment of postherpetic neuralgia, it is important to determine whether the complications are due to the procedure or due to the herpes zoster itself. We report a case of a patient who was diagnosed with herpes zoster myelitis during treatment for postherpetic neuralgia. The patient complained of motor weakness in the lower extremities after receiving a thoracic epidural block six times. Although initially, we believed that the complications were due to the epidural block, it was ultimately determined to be from the herpes zoster myelitis.

• International journal of advanced smart convergence
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• 제13권2호
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• pp.187-194
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• 2024

For precise cardiac diagnostics and treatment, we introduce a novel method for patient-specific mapping between myocardial and coronary anatomy, leveraging local variations in myocardial thickness. This complex system integrates and automates multiple sophisticated components, including left ventricle segmentation, myocardium segmentation, long-axis estimation, coronary artery tracking, and advanced geodesic Voronoi distance mapping. It meticulously accounts for variations in myocardial thickness and precisely delineates the boundaries between coronary territories according to the conventional 17-segment myocardial model. Each phase of the system provides a step-by-step approach to automate coronary artery mapping onto the myocardium. This innovative method promises to transform cardiac imaging by offering highly precise, automated, and patient-specific analyses, potentially enhancing the accuracy of diagnoses and the effectiveness of therapeutic interventions for various cardiac conditions.

• Journal of Chest Surgery
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• 제15권1호
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• pp.73-76
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• 1982

For the treatment of acute respiratory failure and emergency care of an urgent patient, tracheostomy in itself may have been a life saving procedure. But, among the variable complications following tracheostomy, the tracheal stenosis gives serious clinical manifestation which can only be corrected by surgical intervention in many occasions. At the Dept. of thoracic surgery, CAFGH, we have experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Tracheogram showed a 2.5 cm segmental narrowing 5 cm below the tracheostoma. Before recon-struction, we tried to dilate the stenotic segment for about 2 months, but the result was not satisfactory to relieve dyspnea. So, we resected the narrowed segment and tracheal reconstruction was performed with an excellent result in postoperative periods till now.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2002년도 ICCAS
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• pp.77.3-77
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• 2002

In this paper, the algorithm for detecting the transient change of ST-segment and the device for measuring ECG from patient without restriction of activity are introduced. ST-segment elevation and depression is considered as the main characteristic in diagnosis of myocardial ischemia, but the change of pattern is also important. To consider all of the former and the latter, we used polynomial approximation for diagnosis of ECG. The feature points(R, S and T are detected through the signal processing processes including wavelet transform, and then R-S and S-T are approximated to polynomial. This method allows comparison of two signals that have different sampling time or different numbers of...