• Journal of Chest Surgery
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• 제22권2호
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• pp.308-314
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• 1989

Pulmonary sequestration is a congenital malformation characterized by an area of embryonic lung tissue that derives its blood supply from an anomalous systemic artery. Two forms recognized: extralobar and intralobar. Extralobar form is a very rare congenital malformation, usually located in the lower chest, and may be found in newborn infants at the time a congenital diaphragmatic hernia is repaired. Large sequestrated segments may be cause acute respiratory distress in the neonate. The condition is asymptomatic in 15 per cent of patients. This report presents two cases of pulmonary sequestration which misdiagnosed a superior mediastinal tumor and a benign lung tumor. First case was 30-year-old male patient and chief complaints were dyspnea, dry cough and right chest pain. Chest X-ray showed a homogenous increased density of smooth margin at the right superior mediastinal area and suggested a benign mediastinal tumor. And so explothoracotomy was made without other special studies. Second case was 28-year-old male patient. One month ago, he had tracheostomy and right closed thoracostomy due to massive hemoptysis and spontaneous hemothorax. Chest X-ray showed a benign cystic lesion at RLL area. At the time of operation, in first case, a mass of adult fist size was placed medial to the right upper lobe and densely adhesive to trachea, SVC and esophagus. Blood supply of the mass was bronchial arteries of trachea and RUL bronchus and drained to SVC and azygos vein through anomalous systemic veins. There was no bronchial communication on Frozen biopsy. In 2nd case, large cystic lesion contained old blood hematoma was located in RLL and anomalous blood vessel from thoracic aorta was drained to posterior segment of RLL. In operation field, intralobar pulmonary sequestration was diagnosed, and RLL lobectomy was carried out.

• Journal of Chest Surgery
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• 제28권6호
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• pp.606-609
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• 1995

We have experienced ten cases of emergent operation for the complications of cardiac catheterization during the period from 1985 to September 1994.Catheterization was done for the evaluation of the cardiac or vascular problem in 8 cases and 2 cases of neurosurgical problem. The extracardiac injection of contrast material have occurred in 3 cases[primum ASD,Trilogy,VSD . Six cases were unable to remove the catheter from femoral artery or vein. The catheters were knotted, coiled, impacted or broken. An embolectomy was done 40 years old man who suffered from chronic left subclavian artery obstruction a day after angiography. Open heart surgery was performed in 5 cases of cardiac perforation,impacted catheter in left inferior pulmonary vein and broken catheter of VSD. Arteriotomy was done in 4 cases to remove the knotted and coiled catheter. There was no complication or mortality for the emergent operation.

• Clinical and Experimental Pediatrics
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• 제56권11호
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• pp.500-504
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• 2013

Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

• 한국임상수의학회지
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• 제27권5호
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• pp.600-604
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• 2010

10년령의 암컷 잡종견이 식욕부진, 쇠약, 혈색소뇨를 주증으로 충북대학교 동물의료센터에 내원하였다. 환자는 내원 하루 전 지역동물병원에서 효소 면역 측정법에 의해 심장사상충증을 진단 받았으며 성충구제제를 투여 받았다. 혈액검사를 통해 저색소성 소적혈구성 재생성 빈혈과 혈소판감소증, 중등도의 호중구증가증, ALT AST ALP의 상승이 확인되었다. 방사선 촬영을 통해 주페동맥의 확장, 폐침윤, 복부 선예도 감소, 경증의 간비대가 확인되었다. 복부 초음파 검사에서 경증의 복수, 간문 수준의 문정맥과 비장정맥에서 고에코성의 혈전이 확인되었다. 조영 증강 컴퓨터 단층촬영을 통해 문정맥 내강내 저밀도 영역과 혈관내 충진결손을 확인하였다. 환자는 항응고제와 혈전용해제로 치료를 받았으며, 42일 동안의 치료 후 혈전의 완전한 용해를 복부 초음파 검사를 통해 확인하였으며 임상 증상의 개선이 관찰되었다.

• 임상간호연구
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• 제20권3호
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• pp.337-347
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• 2014

Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.109-114
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• 2012

Purpose: Deep vein thrombosis and pulmonary thromboembolism are major causes of death after severe multiple trauma. Although various means of prevention have been presented and utilized, still, there are no standard guidelines for anticoagulation of multiple trauma because of some contraindications. Methods: A retrospective study of adult major trauma patients whose injury severity scores (ISSs) were over 16 and who had visited one university hospital in Daegu city was performed. We compared some features of patients diagnosed DVT or PTE with those of patients without DVT by computed tomography or ultra sonography. Those features included accompanying various kinds of intracranial hemorrhages, possibility of ambulation, emergent operation, early transfusion, and suspicious symptoms. Results: The mean age of the 58 subjects included in this study was $50.9{\pm}17.2years$, the mean ISS was $22.7{\pm}6.0$, and the mean hospital stay was $55.2{\pm}37.9days$. Ten(17.2%) patients had emergent surgery, and 44(75.9%) experienced delayed surgery. Early transfusion was needed in 34(58.6%) patients. Among the 18 patients diagnosed with DVT, accompanying intracranial hemorrhages were noted in 8(44.4%) patients; one of the 8 also had PTE. Among the same 18 patients, early transfusions were required in 11(61.1%) patients; one of the 11 also had PTE. Conclusion: The risk of DVT is increased in cases of severe multiple trauma, and many difficulties in applying anticoagulants are experienced. Though we need additional studies to decide proper prophylaxis for DVT and PTE, if the patient's general condition permits, a screening test for DVT as soon as possible could be an effective method to reduce the possibility of a bad outcome.

• Journal of Veterinary Science
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• 제24권4호
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• pp.46.1-46.12
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• 2023

Background: Heartworm infection in dogs is caused by Dirofilaria immitis and common in shelter animals and outdoors dogs. Caval syndrome can develop with severe infection and physical heartworm removal is essential with heartworm burdens. In this study, we used an improved transvenous heartworm extraction brush, which was expected to cause less cardiovascular damage and allow easier manipulation. Objectives: This study aims to evaluate efficacy of this improved transvenous heartworm extraction brush. Methods: The brush was designed to improve upon the limitations of the previous brush-type devices. The brush was made of a polyvinyl chloride tube and threads of polyamides or polyglyconates. Metal material was inserted at the front tip for easy visualization under fluoroscopy. The eight dogs diagnosed with caval syndrome with large numbers of heartworms and pulmonary hypertension were used in this study. The removal procedure began with the dissection of the subcutaneous tissue around the right jugular vein. The device was inserted through the jugular vein. After insertion, the tube was rotated to catch the heartworms and extracted with the heartworms hanging on the threads. The procedure was repeated several times. Lastly, jugular vein and skin sutures were made. Adulticidal therapy was administered after heartworm removal. Results: The mean number of removed heartworms was 10.5 ± 4.24 and mean number of remaining heartworms was 0.63 ± 1.06. Total procedure time was 72.63 ± 51.36. Except for three cases, heartworms were not detected on ultrasonography after the procedure. No procedure-related side effects were observed within the 1- to 2-mon. Conclusions: An improved transvenous heartworm extraction brush is efficient for heartworm removal in dogs with caval syndrome.

• Journal of Chest Surgery
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• 제39권1호
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• pp.12-17
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• 2006

배경: 초 저체온 하 순환 정지는 총 폐정맥 환류 이상을 수술하는데 있어 중요한 보조 수단이다. 그러나 초 저체온 하 순환 정지 하에 심장 수술을 하는 것은 순환 정지 후 신경계 이상의 위험을 동반하고 있다. 이에 완전 순환 정지 없이 총 폐정맥 환류 이상을 수술하여 그 결과를 평가하고자 한다. 대상 및 방법: 2000년 4월에서 2004년 10월까지 10명의 환자의 의무 기록을 후향적으로 분석하였다. 결과: 해부학적 연결 이상의 위치는 심장 상부형이 7예,심장형이 1예, 심장 하부형이 2예였다. 평균 심폐기 가동 시간과 대동맥 차단 시간은 각각 116.8 $\pm$40.7분, 69.5$\pm$24.1분이었다. 수술로 인한 사망 예는 없었고, 합병증은 술 후 폐정맥 협착이 1예, 폐렴, 기흉, 창상 감염, 횡격막 마비가 각각 1예씩 있었다. 평균 16.6개월의 추적 관찰 기간동안 페동맥 협착이 없었던 모든 환아는 NYHA class I으로 지내고 있다. 결론: 총 폐정맥 환류 이상을 완전 순환 정지 없이 수술하여 아주 만족할 만한 결과를 얻을 수 있었다.

• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.38-41
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• 2015

Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.

• 대한영상의학회지
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• 제84권4호
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• pp.934-940
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• 2023

뇌실-복강 단락술은 가장 널리 사용되고 있는 수두증의 수술적 치료 방법이다. 단락술과 관련된 합병증은 비교적 흔하게 발생하며, 높은 단락장치 교정술 시행률과 관련이 있다. 그러나 원위도관이 다른 장기 내로 전위되는 경우, 특히 심장 및 혈관 내 전위는 드물게 보고되었다. 드물지만 잠재적으로 위험한 합병증에 대해 알고 있는 것은 신속한 처치를 통해 위중한 상황을 예방할 수 있기 때문에 중요하다. 저자들은 뇌실-복강 단락술 시행 2개월 후 원위도관이 좌측 내경정맥을 통해 심장 및 양측 폐동맥 내로 전위되었던 23세 남자 환자의 증례를 보고하고, 발생 가능한 기전과 치료에 관해 논의해 보고자 한다.