• 제목/요약/키워드: bleeding site

검색결과 233건 처리시간 0.028초

역행성 뇌혈 관류를 이용한 상행대동맥류 수술 -4례 보고- (Retrograde Cerebral Perfusion in the Surgical Treatment of Ascending Aortic Aneurysm -Report of 4 Cases-)

  • 문승호
    • Journal of Chest Surgery
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    • 제28권8호
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    • pp.788-791
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    • 1995
  • Dissecting aortic aneurysm of ascending aorta is a life threatening condition which requires prompt surgical correction. With deep hypothermic circulatory arrest and retrograde cerebral perfusion via superior vena cava, we could replaced ascending aorta in 4 cases safely. All of 4 cases; femoral artery, right auricle were used as cannulation site. The duration of circulatory arrest were 28, 30, 45, 60 minute in each cases and rectal temperature was 2$0^{\circ}C$ at that time. At the time of retrograde cerebral perfusion, we maintained central venous pressure under 25mmHg. We resected all of dissecting portion and replaced it with Hemashield graft. There were no deaths but two of four reoperated because of bleeding.

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폐국균증에 대한 외과적치료;11례 보고 (Surgical Treatment of Pulmonary Aspergillosis; 11 Cases Report)

  • 조재호
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.380-383
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    • 1993
  • Aspergillosis is not only the problem increasing the freguency for recent decades but also a serious one. Coexistent pulmonary diseases are frequent and the most common antecedent disease is Tuberculosis with healed cavitary lesion. Interest of the surgeons is aroused because of it`s predilection to sudden life-threatening, exsanguinating pulmonary hemorrhage. 11 patients with pulmonary aspergillosis evaluated at this hospital in a 7-year period, and the results were as follows: 1.male to female ratio was 1:1.75. 2.The most common symptom was gross or microscopic hemoptysis[72.7%]and other symptoms were chest pain[9.1%] and chronic productive coughing[9.1%]. 3.The right upper lobe was most common involving site[81.8%] 4.Surgical interventions were 8 cases of lobectomy, 1 case of lobectomy with wedge resection, 2 cases of wedge resection. 5.Post-operative complications developed in 5 patients and were 4 cases of wound infections, 2 cases of empyemas, 1 case of bleeding, 1 case of atelectasis.

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종격동 종양의 외과적 고찰 (Surgical Analysis of Mediastinal Tumor)

  • 이석재
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.395-402
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    • 1993
  • For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumor, and to provide the guidelines of surgical management of mediastinal tumor,238 patients with mediastinal tumors treated during the period from January 1983 to December 1991 were reviewed at Seoul National University Hospital. There were 106 males & 132 females, and their ages ranged from 3 months to 73 years, with average 33.6 years. The most frequently encountered tumor site was anterosuperior mediastinum followed by posterior, and middle mediastinum. In the pathological viewpoint, thymoma was the most frequent type followed by neurogenic tumor. 81% of the tumor were benign and 19% were malignant. Half of the malignant tumors were neurogenic tumors. Malignancy rate was high in pediatric patients compared to adults as 40% and 19% respectively. 65% of patients were asymptomatic at diagnosis.There was no operative mortality. Post operative complications were occurred in 35 cases. Most frequent complications were adjacent peripheral nerve injuries. But other usual operative complications, such as bleeding, chylothorax, infection, were relatively rare.

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흉골 골절에 대한 임상적 고찰 (A Clinical Observation of the Traumatic Sternal Fracture)

  • 심재영
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.916-921
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    • 1990
  • Clinical observations were performed on 17 cases of the traumatic sternal fracture, those were admitted and treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the past 6 years 5months period from January 1983 to May 1989. Obtained results were as follows: 1. The frequency was about 4.8% of the nonpenetrating chest trauma. 2. The ratio of male to female was 16: 1 in male predominance and age distribution was from 24 to 62 years old. 3. The common cause were high decelerating injury [impact of the steering column] and falling down[more than 3 m in high]. 4. The most common fracture site was sternal body and next was sternomanubrial junction. 5. Associated intrathoracic organ injuries were cardiac contusion [6 cases], hemopneumothorax[1 Case], mediastinal bleeding[1 case], and thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture, and long bone fracture. 6. Abnormal EGG findings were sinus bradycardia[1 case], bundle branch block [2 cases], and sinus tachycardia[3 cases]. 7. The operative reduction and fixation was necessary in only one case and the others were treated with conservative treatment.

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기관 재건술후 발생한 협착증에 대한 Microwave 조직응고법을 이용한 치료 -1례 보고- (A Micorowave Tissue Coagulation Therapy in the Restenosis of the Tracheal Reconstruction -A Case of Report-)

  • 김남혁
    • Journal of Chest Surgery
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    • 제28권4호
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    • pp.416-418
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    • 1995
  • The microwave tissue coagulation therapy was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases.We experienced one case of the restenosis after the tracheal reconstruction. The patient, who was 42 year-old male, had severe dyspnea due to the tracheal stenosis for 4 years. The resection of tracheal stenosis and tracheal reconstruction was done. But the restenosis occurred at the tracheal anastomosis site because of the protrusive granulation at one month after operation. The patient was successfully treated by the microwave tissue coagulation therapy.

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Positioning of Resuscitative Endovascular Balloon Occlusion of the Aorta Catheter: A Case of an Elderly Patient with Concomitant Chest and Pelvic Injury after Blunt Trauma

  • Noh, Dongsub;Yun, Jeongseok;Chang, Ye Rim
    • Journal of Trauma and Injury
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    • 제33권3호
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    • pp.186-190
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been increasingly used in recent years as a resuscitative adjunct for trauma patients with life-threatening non-compressible torso hemorrhage. By blocking the aorta temporarily with an inflated balloon, REBOA preserves cerebral and coronary perfusion while diminishing exsanguination below the balloon, thereby providing time for resuscitation and definitive bleeding control. When determining the occlusion zone during the REBOA procedure, factors such tortuosity of the aorta, co-occurring minor chest injuries, and the severity of shock must be considered, as well as the main injury site. This paper describes a case of high Zone I REBOA in an elderly patient with a tortuous aorta who had concomitant injuries of the chest and pelvis.

혈우병 A의 발병에 관여하는 유전적 요인 (Genetic Risk Factors of Hemophilia A)

  • 심예지;이건수
    • Journal of Genetic Medicine
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    • 제7권1호
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    • pp.1-8
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    • 2010
  • Hemophilia A is a sex-linked recessive coagulation disorder associated with diverse mutations of the factor VIII gene and a variety of phenotypes. The type of mutation involved dictates the activity of factor VIII, and in turn the severity of bleeding episodes and development of alloantibodies against factor VIII (inhibitors). Missense mutations are the most common genetic risk factors for hemophilia A, especially mild to moderate cases, but carry the lowest risk for inhibitor development. On the other hand, intron 22 inversion is the most common mutation associated with severe hemophilia A and is associated with high risk of inhibitor formation. Large deletions and nonsense mutations are also associated with high risk of inhibitor development. Additional mutations associated with hemophilia A include frameshift and splice site mutations. It is therefore valuable to assess the mutational backgrounds of hemophilia A patients in order to to interpret their symptoms and manage their health problems.

심장상부 환류형 총폐정맥환류이상증의 수술치험 3례 보고 (Total anomalous pulmonary venous connection (supracardiac type: report of 3 cases))

  • 김은기
    • Journal of Chest Surgery
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    • 제16권3호
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    • pp.322-330
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    • 1983
  • TAPVC represents 1 to 4% of all congenital cardiac defects. Generally severe and refractory cardiac failure develops in the majority of patients in the early infancy. In a small minority of patient, they are relatively asymptomatic in infancy, but symptoms will develop of necessity In the later life. Our three cases had dyspnea on exertion and cyanosis and had a history of frequent respiratory infections. All 3 cases had the typical showman configuration on roentgenograms of the chest. Current surgical therapy has greatly altered the unfavorable course of these patients after institution of extra-corporeal circulation. We have experienced three cases from June, 1973 to May, 1983, the patients were undergone complete repair with extracorporeal circulation at the Department of Thoracic and Cardiovascular Surgery in the Yonsei University. The ages ranged from 12 years to 14 years, all cases were supracardiac type of TAPVC. Only one case died due to bleeding from anastomosis site between LA and pulmonary venous trunk. In the remaining two patients with complete corrections of TAPVC, there was excellent relief of symptoms such as dyspnea and cyanosis. Their postoperative course have been good during follow-up.

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대동맥절개를 퇘한 교정형 대혈관전위증의 심실중격결손 봉합 (Transaortic Closure of Ventricular Septal Defect in Congenitally Corrected Transposition of Great Arteries with Pulmonary Stenosis)

  • 안홍남;이종태;김규태
    • Journal of Chest Surgery
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    • 제21권4호
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    • pp.748-756
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    • 1988
  • Transaortic closure of ventricular septal defect, suturing a patch on the morphological right ventricular side in patients with congenitally corrected transposition of great arteries might help to avoid postoperative complete heart block if the aorta is large and the subaortic conus is not well developed. In two patients[aged 6 and 16 years] with congenitally corrected transposition of great arteries, ventricular septal defect, and pulmonary stenosis, transaortic closure of ventricular septal defect was performed. No postoperative complete heart block resulted. One hospital death occurred because of sepsis who had underwent reoperation due to bleeding from the aortotomy site. Minimal aortic regurgitation developed in another patient.

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자동봉합기를 이용한 전폐절제술후 발생한 좌심방 파열 (Left Atrium Rupture after Left Pneumonectiomy Using Autostapler -A Case Report-)

  • 배기만
    • Journal of Chest Surgery
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    • 제27권5호
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    • pp.418-421
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    • 1994
  • The usage of autosuture instruments and techniques in resection of bronchovascular structures gained increasing acceptance amongst surgeons in the recent years. The manipulation of these devices are simple, safe, and shortens operating time by avoiding numerous ties and sutures. We have been using autosuture instruments in most of pulmonary resections in Yongdong Severance hospital, and had a satisfactory results. However, we recently have experienced post-pneumonectomy rupture of left pulmonary vein on postoperative one day where the rupture site was in the border of left atrium and left pulmonary vein where the stapler was fired. The patient underwent emergency operation to control massive bleeding and successfully managed by left atrial suture.

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