• Title/Summary/Keyword: Urgent surgery

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Innominate Artery Ruplure Caused by Blunt Chest Trauma -A Case Report (흉부둔상에 의한 무명동맥 파열 -치험 1례-)

  • Lee, Gun;Kim, Yong-In
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.1028-1031
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    • 1997
  • Rupture of an innominate artery caused by blunt chest trauma is extremel rare because this artery is short and relatively well protected by the bony cage. This report describes a 37-year-old male who sustained a blunt chest injury that resulted in an innominate artery rupture, detected by chest CT and thoracic aortography. The patient underwent an urgent operation through median sternotomy. A 3 by 3 m sized pseudoaneurysm of proximal innominate artery was found with a complete intimal tear. After the origin of the innominate artery was closed, the injured segment of artery was excised and an aorto-innominate artery bypass with a 10 mm Gore-tex graft was performed without use of a shunt. The patient was discharged 20 days later without neurologic complications and had equal blood pressure in both arms.

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The Study of Distribution of Upper Extremity Surgery for Korean Baseball Player (한국 프로야구 선수의 상지 수술 분포 연구)

  • Park, Jun-hyuck;Seo, Hyun-kyu
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.22 no.1
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    • pp.71-76
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    • 2016
  • Background: The objective of this research is to provide base line data on Korea Baseball rehabilitation treatment by presenting the distribution of upper extremity surgeries according the surgical sites of Korean professional baseball players. Methods: The targets of this research are 561 players from nine Korean baseball clubs. The number of players that have undergone surgery was investigated. In other words, the frequency of shoulder joint surgeries, elbow joint surgeries, and wrist and hand surgeries per each baseball club was investigated. Results: The number of the players who have had surgeries was 151, but among the players, there were some who have had repeated surgeries for which the total number of surgery experience was 162. The result showed that elbow joint surgeries were the most frequently enacted, followed by shoulder joint surgeries, and wrist and hand surgeries. From the nine clubs, Samsung was the club with the highest frequency of surgeries. Conclusions: This research shows that Korean professional baseball players need special training centers with systematic rehabilitation programs. Another conclusion suggests that urgent need for rehabilitation program of upper arm which particularly focused on elbow joint is existing. On the basis of this research, we expect more studies on the specific rehabilitation programs which is categorized by injury areas.

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A Case of Bilateral Vocal Fold Paralysis Induced by Concurrent Rheumatoid Arthritis Involvement of Laryngeal Nerve and Cricoarytenoid Joint (윤상피열관절과 후두신경을 동시에 침범하여 양측성대마비를 유발한 류마티스 관절염 1예)

  • Park, Yun Hwi;Kim, Han Su;Jung, Sung Min;Jung, Soo Yeon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.130-133
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    • 2016
  • Rheumatoid arthritis (RA) is a connective tissue disease involving the larynx in 30 % of the patients. Foreign body sensation, hoarseness, and cough are common symptoms in laryngeal involvement. An urgent tracheostomy is required when acute airway obstruction occurs in case of bilateral vocal fold paralysis. The most common cause of bilateral vocal fold paralysis in RA patients is a cricoarytenoid joint arthritis. Laryngeal nerve degeneration is rare cause of bilateral vocal fold paralysis in RA patients. In this case report, an emergent tracheostomy was performed on a 64-years-old male patient with acute dyspnea, and concurrent involvement of RA on laryngeal nerve and cricoarytenoid joint was revealed by laryngeal electromyography and histopathology. The vocal fold mobility was restored after 3-months medical treatment.

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Opinion on the legalization of the actual duties of clinical dental hygienists (임상치과위생사의 실제적 업무의 법제화에 대한 견해)

  • Ryu, Hae-Gyum
    • Journal of Korean Clinical Health Science
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    • v.6 no.2
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    • pp.1115-1125
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    • 2018
  • purpose : The purpose of the study is to investigate opinion on the legalization of the actual work of clinical dental hygienists. Methods : A self-reported questionnaire was completed by 171 dental hygienists in Busan and Gyeongnam from December 1, 2017 to January 31, 2018. Structured questionnaires were uesd for analysis. The collected data was analyzed using IBM SPSS. Statistic 20.0. Results : The first, assist of dental treatment, Second, dental health care education and consulting duties, and third priority preventive duties were found to be the most important duties in the dental office. Currently, it was investigated perform in a lot of workplace. Preventive treatment tasks include scaling, teeth polishing, applying fluoride and assist of dental treatment include preparation for medical care, preparation for implant surgery, preparation for oral surgery, implant surgery assistant and patient care training, and preparation for periodontal surgery. Conclusion : As a result, the dental hygienist performing a lot of dental assist tasks, oral health education counseling and preventive duties. Nonetheless, clinical dental hygienists are outlaws due to the disparity between practical and legal duties. Therefore, it is urgent to legislate actual duties of dental hygienist so that experts can fully exercise the competency of the public in promoting dental health. Relevant governments and related organizations should take reasonable measures to solve this problem.

Taussig-Bing Anomaly with Coarctation of Aorta (대동맥 축착을 동반한 Taussig-Bing 기형의 수술 치험 1예)

  • Kim, Hyuck;Lim, Hyoun-Soo;Kim, Young-Hak;Chung, Won-Sang;Kang, Jung-Ho;Lee, Chul-Beom;Jee, Heng-Ok;Kim, Nam-Su
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.189-193
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    • 2003
  • The patient was a 30-day-old female infant with symptoms of severe dyspnea and cyanosis, when she was admitted to the ER. The echocardiography revealed DORV with subpulmonary VSD, and the diagnosis of Taussig-Bing anomaly was made. Two days after admission, an urgent operation was performed. The operation consisted of intraventricular tunnel repair and arterial switch operation. She was discharged, and after checking her chest X-ray through OPD, there was no interval change of cardiomegaly. She was then re-admitted, and the angiography revealed coactation of aorta. We performed a resection and end-to-end anastomosis of aorta. She is currently in good condition 11 months postoperatively.

Results of Protocol-based Perioperative Management in Off-Pump Coronary Artery Bypass Grafting for Patients with Non-dialysis-dependent Chronic Kidney Disease

  • Kim, Jeong-Won;Sim, Hyung Tae;Yoo, Jae Suk;Kim, Dong Jin;Cho, Kwang Ree
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.427-434
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    • 2016
  • Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.

In Vitro Biological Characterization of DCUN1D5 in DNA Damage Response

  • Guo, Wei;Li, Guo-Jun;Xu, Hong-Bo;Xie, Jie-Shi;Shi, Tai-Ping;Zhang, Sheng-Zhong;Chen, Xiao-Hong;Huang, Zhi-Gang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4157-4162
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    • 2012
  • Background: Novel prognostic biomarkers or therapeutic molecular targets for laryngeal squamous cell carcinoma (LSCC) are an urgent priority. We here sought to identify multiple novel LSCC-associated genes. Methods: Using high-density microarray expression profiling, we identified multiple genes that were significantly altered between human LSCCs and paired normal tissues. Potential oncogenic functions of one such gene, DCUN1D5, were further characterized in vitro. Results: Our results demonstrated that DCUN1D5 was highly expressed in LSCCs. Overexpression of DCUN1D5 in vitro resulted in 2.7-fold increased cellular migration, 67.5% increased invasive capacity, and 2.6-fold increased proliferation. Endogenous DCUN1D5 expression was decreased in a time-dependent manner after genotoxic stress, and silencing of DCUN1D5 by siRNA decreased the number of cells in the S phase by 10.2% and increased apoptosis by 11.7%. Conclusion: Our data suggest that DCUN1D5 in vitro might have vital roles in DNA damage response, but further studies are warranted to assess its significance in vivo.

Simultaneous Off-pump Coronary Artery Bypass Surgery and Total Gastrectomy (동시에 시행한 체외순환 없이 시행하는 관상동맥우회수술과 위전절제술)

  • Park, Jeong-Ok;Ryu, Jae-Wook;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.56-59
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    • 2007
  • A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.

Surgical Angioplasty of Isolated Left Coronary Ostial Stenosis (좌관상동맥 입구협착의 외과적 확장술)

  • 서필원
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.247-252
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    • 1995
  • The isolated coronary ostial stenosis is rare and a critical lesion which requires urgent surgical intervention. Recently direct angioplasty is assumed as a preferable approach to conventional bypass grafting. From Mar. 1990 to Aug. 1993, six patients underwent direct angioplasty in Sejong Heart Institute. The mean age of 6 patients was 48 years [range 37 to 63 and they consisted with 5 females and one male. All had severe angina [class III or IV of short duration [mean 5.3 months and a low incidence of risk factors. Despite the crucial location of the lesion, most patients had well preserved left ventricular function and normal wall motion. We performed direct angioplasty with autologous pericardium via anterior approach except one patient who underwent direct angioplasty and CABG. One patient died 4 hours after angioplasty probably due to acute coronary dissection. The survived 5 patients maintain normal life without symptoms during 26.2 months follow up [range 5 to 47 months .Our preliminary results suggest that angioplasty of isolated coronary ostial stenosis in highly selected patient can be carried out with good results and relatively low operative risks.

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Acute Myocardial Infarction after Embolic Occlusion of Left Anterior Descending Artery by Prosthetic Valve Thrombosis - Report of 1 case - (인공판막 혈전에 의한 좌전하행지 폐쇄 후 급성심근경색 -1예 보고-)

  • 김재현;임달수;오삼세;백만종;김종환;나찬영
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.369-372
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    • 2004
  • Acute myocardial infarction due to coronary occlusion by emboli originating from the prosthetic valve thrombosis is very rare but fatal disease which needs immediate diagnosis and urgent treatment. We report a case of acute myocardial infarction after left anterior descending embolic occlusion in whom had previous mitral valve replacement. Redo valve replacement following the interventional catheterization and anti platelet therapy lead to successful results.