• Title/Summary/Keyword: Postoperative Symptoms

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Clinical Investigation about the Result of Surgically Treated Myasthenia Gravis (중증 근무력증의 수술적 치료결과에 대한 임상적 고찰)

  • 김대현;황은구;조규석;김범식;박주철
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.15-20
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    • 2003
  • Myasthenia gravis is a rare autoimmune disease involving acetylcholine receptor and its autoantibody on neuromuscular junction. The methods of treatment are medical treatment and surgical thymectomy. In this paper we analyzed the result of thymectomy and the factors affecting the postoperative symptom improvement. Material and method : This study obtained medical records of 37 patients who received the thymectomy for myasthenia gravis from March 1986 to December 1998. Result Out of 37 cases, 21 cases(57%) showed improvement, of which 8 cases (50%) in the group of thymoma(n=16), and 13 cases (62%) in the group of thymic hyperplasia(n=21) showed the improvement of symptoms. Postoperative complications were respiratory insufficiency due to aggravation of symptoms after operation, including tracheal intubation for ventilator support in 9 cases, pneumonia in 3 cases, pneumothorax in 2 cases and left vocal cord palsy in 1 case. There was one postoperative mortality. The relation between postoperative improvement and sex(P=0.3222), age(P=0.7642), thymic pathologic variants,(P=0.4335) and classification of thymoma(P=0.20) showed no statistically significant correlation. However, the lower grade of preoperative symptoms can predict the lower grade of postoperative symptoms significantly(P=0.0032). Follow up study to 36 postoperative survivors was performed in October 2002 based on the out-patient records and call with patients. Out of 36 cases, 33 cases(91.7%) could be investigated and 3 cases could not. Mean follow up period was 83.2 months. Out of 33 cases, 25 cases(75.8%) showed symptomatic improvement, of which 8 cases(53.3%) in the group of thymoma(n=15) and 17 cases(94.4%) in the group of thymic hyperplasia(n=18) showed the improvement of$\boxUl$ symptoms. Conclusion : In myasthenia gravis, thymectomy showed the good improvement, and more important factor affecting the improvement of symptoms was the grdae of preoperative symptoms. Also midterm and long term follow up results showed good symptomatic improvement.

The Role of Postoperative Magnetic Resonance Imaging of Microvascular Decompression of the Facial Nerve in Patients with Hemifacial Spasm (반측성 안면경련증 환자에서 안면신경의 미세혈관감압술 후에 시행한 자기공명영상의 역할)

  • Han, In Bo;Chang, Jong Hee;Chang, Jin Woo;Park, Yong Gou;Kim, Dong Ik;Chung, Sang Sup
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.44-50
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    • 2001
  • Objectives : The objective of this study was to investigate the role of postoperative three dimensional short-range magnetic resonance angiography(3D-TOF MRA) in predicting the clinical outcomes following microvascular decompression(MVD) for the treatment of a hemifacial spasm(HFS). Material and Method : Postoperative magnetic resonance(MR) imaging was performed on 123 patients with a HFS between March 1999 and May 2000. All patients who had postoperative MR imaging were undertaken preoperative MR imaging. Of the 123 patients, 122 patients were included in this retrospective study. The degree of the detachment of vascular contact, and change of the position of offender were determined by pre- and postoperative 3D-TOF MRA. These findings were compared with the surgical findings and clinical outcomes. Results : Of 122 patients who had successful MVD, clear decompression of offenders of the root entry zone(REZ) of facial nerve was found in 106 patients(86.9%), partial decompression in 10 patients(8.2%) and contact of offenders to the REZ of facial nerve in 6 patients(4.9%) by the postoperative 3D-TOF MRA. Our patients demonstrated that the types of offender did not influence with the degree of decompression of REZ of facial nerve and with surgical outcomes(p>0.05). Also, there was no significant relationship between the degree of decompression of the REZ of facial nerve from offenders and an improvement of symptoms(p>0.05). Futhermore, there was no significant relationship between the degree of decompression of the REZ of facial nerve from offenders and an improvement time (p>0.05). Conclusion : Our data suggests that MVD of facial nerve alone may not be sufficient to resolve the symptoms in all patients with hemifacial spasm. Therefore, another unknown factors besides vascular compression may be involved to cause symptoms in certain patients and it may be necessary to remove these factors with MVD simultaneously to obtain the resolution of symptom.

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Clinical Study for Five Cases Received Hospital Treatment because of Hysterectomy Sequelae (자궁적출술 후유증으로 입원치료를 받은 환자 5례에 대한 보고)

  • Woo, Chang-Yun;Jang, Se-Ran;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.3
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    • pp.121-131
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    • 2016
  • Objectives: This paper was aim to report the clinical study for five cases received Korean medicine hospital treatment because of hysterectomy sequelae within 5 days after surgery.Methods: The patients having treated with hospital management, from March 1st in 2014 until March 24th in 2015, was enrolled in this study. We collected their age, chief complaint, vice complaint, diagnosis, visit days after surgery, treatment period, and etc. We treated the patients with acupuncture, moxibustion, and herbal medicine.Results: All of the cases treated with Korean medicine in this study revealed the recovery. The vice complaint also had improved.Conclusions: Korean medicine is effective on patients having variable postoperative symptoms following hysterectomy. And it is necessary to conduct an additional treatment about menopause symptoms.

Pulmonary arteriovenous fistula -One case report- (폐동정맥루 수술치험 1례)

  • 김학제
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.335-340
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    • 1986
  • Pulmonary arteriovenous fistula is unusually congenital malformation consisting of an abnormal connection between a pulmonary artery and vein. It may appear as an isolated anomaly or with hereditary hemorrhagic telangiectasis. In the classic form, symptoms and signs are caused by the abnormal right to left shunt. since severe clinical symptoms such as paradoxical embolism, infection, and spontaneous rupture with massive bleeding may occur, surgical treatment is often indicated. Recently we have experienced a surgical treatment of pulmonary arteriovenous fistula in 54 years old housewife. She was admitted in May 1986 with recurrent hemoptysis for 1 month. On admission, the PaO2 was 65.2 mmHg without specific findings. Pulmonary arteriovenous fistula was confirmed by preoperative pulmonary arteriography. A well circumscribed cystic mass was noted in visceral subpleural and inferior lingular segment of left upper lobe. Left upper lobectomy was performed with good results. Histologically angiomatous dilatation of abnormal vessels embedded in lung parenchyma was noted. Postoperative PaO2 was 90 mmHg. Postoperative results were good.

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Occurrence of Alopecia After Open Heart Surgery [6 Cases Report] (개심술후 후두부에 발생한 국소 탈모증6례 보고)

  • 임진수
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.279-282
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    • 1985
  • Occipital alopecia after Open Heart Surgery under the Cardiopulmonary bypass is an uncommon minor complication. We had experienced Occipital alopecia in 6 cases after Open Heart Surgery. The cause of the alopecia was transient circulatory disturbance due to pressure effect of the patient`s head and intraoperative hypotension. The prodromal symptoms of the alopecia were erythema, itching, and watery discharge, but some patients showed non-specific symptoms. The common site of the alopecia was right occipital region and the size was 2-4 cm in diameter. The regrowth of the hair was completed at postoperative 3 to 5 months without specific treatment except conservative treatment. Fortunately the postoperative alopecia is a self-limiting condition, and spontaneous regrowth of hair is the rule without other complications.

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Midterm Clinical Outcomes after Modified High Ligation and Segmental Stripping of Incompetent Small Saphenous Veins

  • Hong, Ki Pyo
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.398-403
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    • 2015
  • Background: The aim of this study was to evaluate the midterm clinical outcomes after modified high ligation and segmental stripping of small saphenous vein (SSV) varicosities. Methods: Between January 2010 and March 2013, 62 patients (69 legs) with isolated primary small saphenous varicose veins were enrolled in this study. The outcomes measured were reflux in the remaining distal SSV, the recurrence of varicose veins, the improvement of preoperative symptoms, and the rate of postoperative complications. Results: No major complications occurred. No instances of the recurrence of varicose veins at previous stripping sites were noted. Three legs (4.3%) showed reflux in the remaining distal small saphenous veins. The preoperative symptoms were found to have improved in 96.4% of the cases. Conclusion: In the absence of flush ligation of the saphenopopliteal junction, modified high ligation and segmental stripping of small saphenous vein varicosities with preoperative duplex marking is an effective treatment method for reducing postoperative complications and the recurrence of SSV incompetence.

Surgical treatment of primary heart tumor -Report of 22 cases- (원발성 심장 종양의 수술적 치료)

  • 강면식
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.116-122
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    • 1989
  • During 22-year period ending in June 1988, operation was performed on 22 patients with primary heart tumor at Yonsei University College of Medicine. Mean age was 38.8*3.03[mean \ulcornerEM] ranging from 14 to 63 years old. Twenty cases were myxomas. Others were fibromyxoma and rhabdomyosarcoma. All patients complained of dyspnea on exertion. Nine cases had palpitation. Other constitutional symptoms were weight loss [7 cases], headache [4 cases], generalized edema [3 cases] and cough [3 cases]. Five cases had neurological symptoms and signs preoperatively. Preoperative NYHA Class was poor [Class II; 8 cases, III; 9 cases and IV; 5 cases]. The most common site of tumor origin was fossa ovalis limbus [16 cases; 72.8%]. Because of severe mitral regurgitation and of recurrent myxoma, 2 cases were reoperated for mitral valve replacement. Postoperative complications were postoperative mitral regurgitation [5 cases; 22.8%] and arrhythmia [4 cases; 18.2%], one of which was supra-His bundle block. All patient survived operation. Follow-up of 15 patients [mean 28.95*8.3 months] was good as functional class 1[8 cases] or II [7 cases]. More effective adjuvant therapy will be necessary to improve long-term prognosis for malignant primary heart tumor.

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Early Esophageal Carcinoma(2 Cases report) (조기식도암 -2례 보고-)

  • 이헌재
    • Journal of Chest Surgery
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    • v.23 no.3
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    • pp.537-541
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    • 1990
  • Early esophageal carcinoma is defined as a lesion wherein invasion is confined to the mucosa and submucosa without metastasis to lymph node or other organs. Postoperative 5-year survival rate for early esophageal carcinoma is much superior than advanced carcinoma. Unfortunately, because of the anatomic characteristic of esophagus and absence of specific early symptoms, detection is frequently belated, and advanced disease is present at the time of the initial diagnosis. We experienced 2 cases of early esophageal carcinoma. They complained no specific symptoms. The diagnosis was made by barium esophagogram, esophagofiberscopy with dye staining and endoscopic biopsy. We performed esophagectomy with esophagogastrostomy. All had good postoperative course without any complication. We concluded that the combined use of double contrast radiography, esopagofiberscopy aided by intraluminal staining with Toluidine blue or Lugol`s solution, and endoscopic biopsy is very important in the diagnosis of early esophageal carcinoma in high risk patient group.

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Clinical Characteristics of Postoperative Maxillary Cyst

  • Sharma, Aditi;Kim, Do-Hyung;Choi, So-Young;Kim, Jin-Wook;Kwon, Tae-Geon;Paeng, Jun-Young
    • Journal of Korean Dental Science
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    • v.10 no.2
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    • pp.60-65
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    • 2017
  • Purpose: The purpose of this study is to analyze the clinical features of postoperative maxillary cyst (POMC) according to the patient's medical history of previous sinus operation and symptoms with radiological characteristics. Materials and Methods: The subjects of this study were 41 patients who had been diagnosed with POMC via clinical and histological examination from 2007 to 2016. Result: Thirty-five patients had medical histories of Caldwell-Luc procedures and four patients had maxillary sinus surgery, such as cyst enucleation and open reduction for maxillary bony fractures. From the computed tomography images, 25.6% (11/43) showed multilocular cysts and 74.4% (32/43) showed unilocular lesions. As for the treatment methods, cyst enucleation was conducted on 34 patients, and among them, three were treated previously with marsupialization. Their symptoms included diverse locations of pain and swelling. Conclusion: The clinical features of POMC varied from unilocular to multilocular and the symptoms included pain and swelling.

Congenital esophageal atresia with tracheoesophageal fistula -Report of one case- (선천성 식도폐쇄 및 기관식도루 -1예 보고)

  • 김종진
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.358-362
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    • 1986
  • Esophageal atresia and tracheoesophageal fistula may occur as separate entities but usually occur in combination. Recently we were experienced a case of esophageal atresia with distal tracheoesophageal fistula in infant patient who presented the symptoms of projectile vomiting and dyspnea. The diagnosis was made by the esophagography and the Haight`s operation was performed transpleurally through 4th intercostal space after gastrostomy. Operative patient tolerated all the operative procedures well in spite of postoperative respiratory complication and recovered uneventfully, permitted feeding on 10th postoperative day. On follow up study after 5th months, Patient reveals good health without other problem.

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