• Title/Summary/Keyword: Perforation repair

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Double Bypass of Esophagus and Descending Thoracic Aorta for the Treatment of Esophagapleural and Aortopleural Fistula (식도파열 후 발생한 식도 흉막루와 대동맥루의 수술적 치료: 식도 및 대동맥 이중 우회술)

  • Park, Sung-Joon;Kang, Chang-Hyun;Kim, Kyung-Hwan;Yao, Byung-Su;Kim, Young-Tae;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.753-757
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    • 2010
  • We report hereon a case of double bypass of the esophagus and descending thoracic aorta for the treatment of esophagopleural fistula and aortopleural fistula due to an infected aortic aneurysm after esophageal rupture. A 48 year old man was diagnosed as having esophageal rupture after an accidental explosion. Although he had been treated by esophageal repair and drainage at another hospital, the esophageal leakage could not be controlled and subsequent empyema developed in the left pleura. Further, bleeding from the descending thoracic aorta had developed and he was managed with endovascular stent insertion to the descending thoracic aorta. He was transferred to our hospital for corrective surgery. We performed esophago - gastrostomy via the substernal route, without exploring posterior mediastinum and we let the empyema resolve spontaneously. While he was being managed postoperatively Without any signs and symptoms of infection, sudden bleeding developed from the left pleural cavity. After evaluation for the bleeding focus, we discovered an Infected aortic aneurysm and an aortospleural fistula at the stent insertion site. We performed a second bypass procedure for the infected descending thoracic aorta from the ascending aorta to the descending abdominal aorta via the right pleural cavity. We found leakage at the distalligation site during the immediate postoperative period, and we occluded the leakage using a vascular plug. He discharged without complications and he is currently doing well without any more bleeding or other complications.

Treatment of Esophageal Injury (식도 손상의 치료)

  • Sim, Hee-Jae;Jang, In-Seok;Park, Hyun-Oh;Lee, Chung-Eun;Kim, Jong-Woo;Choi, Jun-Young;Rhie, Sang-Ho
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.705-709
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    • 2010
  • Background: Esophageal injury requires early and proper management. We want to determine the results of various esophageal injuries. Material and Method: We respectively analyzed 22 patients who were managed for esophageal injury between 1999 and 2009. Based on the medical records, we reviewed the causes of injury, the diagnoses, the treatment methods, the complications and the prognosis. Result: The main causes of esophageal injury were a foreign body in 9 cases (41%) and vomiting in 5 cases (23%). We treated the patients with esophageal primary repair in 12 cases (55%), abscess drainage in 4 cases (18%) and conservative management in 6 cases (27%). There was esophageal leakage in 7 cases (32%) and death occurred in 3 cases (14%). Conclusion: For minor esophageal injury, conservative management was sometimes possible to treat the esophagus, yet aggressive and urgent surgical treatment should be applied for cases of major esophageal injury, including mediastinal abscess.

Regenerative Endodontic Procedure in Korean Children and Adolescents: A Case Report (한국 소아청소년 근관치료 영역에서 재생치료, 근관치료재생술에 대한 증례보고)

  • An, So-Youn;Kim, Jin-Kyoung;Shim, Youn-Soo
    • Journal of dental hygiene science
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    • v.16 no.4
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    • pp.317-322
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    • 2016
  • Mineral trioxide aggregate (MTA) is widely used in endodontic therapy as a pulp-capping material, root or furcal perforation repair material, and for apexification and obturation of the root canal system. The purpose of this study was to formally document cases of MTA application in South Korean children and adolescents. Through this research, the practice of using MTA will be introduced and familiarized to the clinical practitioners. This study involved endodontic treatment using MTA for fractured crowns in 11- and 12-year-old. The children were followed up for 12 months until the pulp vitality was confirmed; in young permanent teeth with immature roots, the pulp is integral to the process of apexogenesis. These observational results regarding the use of MTA as an apexification material in non-vital immature permanent incisors appear to provide promising results in the search for new materials to meet existing endodontic needs.

Massive pneumoperitoneum following cardiopulmonary resuscitation (심폐소생술 후 발생한 다량의 기복증)

  • Choi, Jeonjwoo;Shin, Sangyol;Hwang, Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.5
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    • pp.3303-3307
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    • 2015
  • The purpose of this study was attemped to investigate the clinical presentation and pathophysiology of 74-year-old female who developed pneumoperitoneum as complications of chest compression from sudden cardiac arrest. Such chest compression is the same one excercised to by-stander and paramedics. A healthy 74 year female had a sudden mental deterioration while working at a restaurant. She was transfered from 119 emergency medical system to the hospital. After the symptom developed, by-stander called 119 who carry out 6 minutes Cardiopulmonary resuscitation(CPR). Defibrillation and CPR was carried out by health provider after the arrival, and the patients spontaneous circulation returned. After Return of spontaneous circulation(ROSC), patients was transferred to the nearst hopspital, but suspicious of myocardial infarction, she was again transferred to a larger scale hospital. At the hospital she took X-rays and Abdominal CT, and the results of suspicious gastro-intestinal perforation near gastro-esophageal junction, surgical repair was recommended. But in operation room, while operation went on, cardiopulmonary arrest appeared again, and she expired. For this reason, prehospital CPR needs more accurate localization of cardiac massage and serious consideration of positive pressure ventilation. Moreover, treatment of pneumoperitoneum after CPR needs more cautious consideration of patients hemodynamic stability.

A Study on the Performance Change of Insulation Sheath Due to Accelerated Degradation of IV and HIV Insulated Wire (IV 및 HIV 절연전선의 가속열화에 따른 절연피복의 성능변화에 관한 연구)

  • Choi, Su-Gil;Kim, Si-Kuk
    • Fire Science and Engineering
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    • v.33 no.2
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    • pp.114-123
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    • 2019
  • The paper relates to a study on the changes in performance of insulation sheath resulting from accelerated degradation of IV and HIV insulated wire. To assume insulation degradation of IV and HIV insulated wire, accelerated life tests using Arrhenius equation were conducted among accelerated life test models, and experimental samples of 0 year, 10 years, 20 years, 30 years, and 40 years in equivalent life were produced. Whereas the maximum tensile load were increased as accelerated degradation of IV and HIV insulated wire progressed, elongation percentage, rupture time, and flexibility of insulated wires were found to be gradually reduced. According to the additional surface analysis results for the insulated wires per equivalent life using a scanning electron microscope, mechanical properties of the insulator were observed to be reduced as insulation degradation resulting from aging progressed since phenomena such as formation of crystalline structures and perforation, etc. occurred on the sample surface with progression of accelerated degradation. Consequently, institutional replacement of insulated wires and preparation of repair times considering performance degradation of the insulator installed inside buildings are considered necessary in order to prevent in advance the risks of electrical fire resulting from degradation in insulation performance.