• Title/Summary/Keyword: bleeding site

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Sutureless Gastroduodenostomy (무봉합 위십이지장 문합술)

  • Lee, Jong-In;Kim, Jin-Young;Jeong, Jin-Ho
    • Journal of Gastric Cancer
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    • v.2 no.1
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    • pp.29-32
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    • 2002
  • A gastroduodenostomy is the most physiological reconstruction after a distal gastrectomy. However, a gastroduodenostomy with either sutures or staples has many complications. These include bleeding, leakage and stenosis. A sutureless gastroduodenostomy with a biofragmentable anastomosis ring (BAR) in was used adenocarcinoma patients to prevent these complications from 1999. A BAR is composed of polyglycolic acid and Barium sulfate to allow for X-ray visualization. Hardy in first introduced the BAR in 1985. Since then, it has been used in an anastomosis of the colon or small bowel surgery but its use in a gastroduodenostomy is the first trial in the world. A 70 year male patient, old who received a subtotal gastrectomy (Billroth I), underwent a A sutureless gastroduodenostomy with a BAR. The gastroduodenostomy with the BAR was watertight and maintained the initial burst strength in the gastrografin X-ray study performed at the postoperative 1 week. The BAR began to fragment 3 weeks after the operation and disappeared from the digestive tract completely. The diameter of the anastomosis site was sufficient for passed foods. No other secondary changes from remained foreign bodies were found in the endoscopic examination. In a second operation to treat a primary hepatoma, there was no adhesive changes around the gastroduodenostomy site. In conclusion, a sutureless gastroduodenostomy with BAR is a safe, easy and efficient reconstructive method after a distal gastrectomy.

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Fish Composition and Trophic Guild Analysis as a Collection of Basic Data for Ecosystem Health Assessments in Yeongsan Lake

  • Choi, Ji-Woong;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.40 no.4
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    • pp.546-552
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    • 2007
  • The objectives of this study were to analyze fish compositions, based on trophic guilds and tolerance guilds and determine community characteristics structure at five sampling sites of Yeongsan Lake during July 2006-May 2007. Total number of species sampled was 30 species and the number was 1350. Cyprinidae (77%) and Centrarchidae (15.7%) dominated the community and then followed by Cobitidae(2.7%), Gobiidae(2.4%), Mugilidae (0.5%), and others (0.1%). The relative abundance of tolerant and omnivore species at all sites was 63% and 77% of the total, respectively, suggesting an ecological degradations in the Lake. Exotics species such as large mouth bass (Micropterus salmoides), which is a top-carnivore in the water distributed at all sampling sites, implying that ecological disturbance was severe based on previous reference of US EPA (1991). Also, we found external anomalies such as external deformities, bleeding and tumors and not found migratory fish. Analysis of fish community structure showed that species diversity index and richness index was the highest in Site 1 and the dominance index was the highest in Site 2. In this study, high proportions of tolerant species and omnivore species, widespread exotic species, and frequent observations of abnormal fish. Such problems may be directly or indirectly associated with high nutrient enrichments and the reduced flow velocity by the dam construction. The ecosystem restoration by dam removal or removal of exotic top-carnivore fish may be one of the best strategies for better lak management.

Usefulness of Balloon-type Hemostatic Device After Transarterial Chemoembolization (간동맥 화학색전술 후 풍선형 지혈기구의 유용성)

  • Kim, Seung-Gi
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.181-186
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    • 2019
  • Transarterial chemoembolization is one of the most representative procedures for puncture of the femoral artery. In addition, the same procedure is often repeatedly performed many times, and Hepatocellular carcinoma patients due to cancer is significantly lowered blood tests, regardless of platelet counts are not good enough to stop bleeding. More importantly, hepatocellular carcinoma has a high degree of complication and disease severity, which makes it less likely that the condition of the body will be relatively inferior to other patients. In order to prevent delayed hemorrhage of the femoral artery puncture site after the procedure, it is advised to absolutely stabilize the limb so that it does not bend the limb for 3 hours after climbing in the ward. Therefore, I have been complaining about inconvenience. In addition, in order to prevent delayed hemorrhage after hemostasis, balloon type hemostatic device was used instead of sand bag which was placed on hemostatic site. The results of this study were compared with the results of actual application. The use of a balloon-type hemostatic device to increase the effectiveness of continuous hemostasis and to minimize the inconvenience during the time of patient's absolute bed rest, rather than raising the sandbag to prevent primary delayed hemorrhage by various methods in transarterial chemoembolization. It can be used as a substitute for existing sand bags because it can alleviate pain, increase satisfaction, and can be used as a disposable one.

A Study on the Influencing Factors on the Estimation of Compressive Strength by Small Size Core (소구경 코어에 의한 콘크리트 압축강도 추정에 미치는 실험인자의 영향에 관한 연구)

  • 한민철;김기정;백병훈;한천구;송성진
    • Proceedings of the Korea Concrete Institute Conference
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    • 2002.10a
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    • pp.361-364
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    • 2002
  • This paper discusses the influencing factors such as coring position, height to diameter ratio of core specimen(h/d) and coring torque on the strength estimation of concrete by small site coring method in order to verify the validities of small size core method. According to results, as for the influence of drilling position, when core specimens are obtained from the place parallel to placing direction, compressive strength of core specimens are higher than those perpendicular to placing direction. This is due to the loss of the area of core specimen perpendicular to plating direction by bleeding. And in case of $\phi$ 24mm core specimen, when vertical drilling against placing direction is taken. compressive strength of core specimen obtained at the bottom of the structure is higher than that at the top of the structure. As for the influence of height to depth ratio, as h/d ratio increases compressive strength shows to be decreased. As for the influences of rotation speed of drilling machine, as its speed goes up, compressive strength decreases, regardless of core diameter.

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Surgical Treatment of Benign Esophageal Stricture (양성 식도 협착의 외과적 치료)

  • 박창권
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.107-114
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    • 1990
  • During a ten-year period from August, 1978 to September, 1989 45 patients with benign esophageal stricture were surgically evaluated. The results are as follows; l. Out of 45 patients, there were 26 males and 19 females ranging from 2 to 70 years of age with a mean of 31.9 years. 2. The most common cause of benign esophageal stricture was corrosive burn due to caustic agents[40 cases, 88.9 %]. Corrosive agents were 15 cases of lye, 22 cases of acid and 3 cases of other agents. Other causes were two cases of esophageal web and each one case of previous surgical result, inflammation and idiopathic mediastinal fibrosis respectively. 3. The most frequent stricture site was whole esophagus as 21 cases[46.7 %] and the next was lower a third thoracic esophagus[10 cases, 25.0%]. 4. In 33 of total 45 cases, colon interposition with right colon was performed without resection of the strictured esophagus except one case which was complicated esophageal cancer. Other procedures were 4 cases esophagogastrostomy with segmental resection, 2 cases of plastic repair and so on. 5. Major postoperative complications which were needed for secondary operation were 5 cases[11.1 %]. [2 cases of stenosis, ileus and ulcer bleeding respectively] Overall mortality rate was 4.4 %.

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A Case Report of Pulmonary Atresia with Pulmonary Artery, PDA and Ventricular Septal Defect (동맥관개존증, 심실중격결손 및 폐동맥이 동반된 폐동맥 폐쇄증: 1예보고)

  • Yun, Yang-Gu;Hong, Seung-Rok
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.212-216
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    • 1991
  • A surgical correction was successfully performed in a adult female who had pulmonary atresia with almost non-confluent pulmonary artery, PDA and ventricular septal defect. Initially as a first stage of corrective surgery isolation of patent ductus arteriosus, ligation of aortopulmonary collaterals and identification of the pathologic anatomy of left pulmonary artery through left posterolateral approach were performed. At the second stage, a week after the initial operation, total correction was done making both pulmonary arteries confluent with albumin coated woven-dacron graft, external valved conduit and closure of large VSD of subarterial and perimembranous type. The PDA was ligated with previously encircled heavy stitch soon after partial bypass was started. Although massive bleeding from anastomotic site of dilated left pulmonary artery to the graft occurred preoperatively, postoperative functional improvement was excellent in terms of disappearance of cyanosis and normal exercise tolerance.

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An Experimental Study on High Strength Concrete for Concrete Filled Steel Tube Column for Field Application (CFT구조용 초고강도 콘크리트의 현장 적용을 위한 실험적 연구)

  • Lee Jang Hwan;Kim Young Joo;Joung Kwang Sik;Kang Tea Kyung;Jung Keun Ho;Jung Sang Jin
    • Proceedings of the Korea Concrete Institute Conference
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    • 2004.05a
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    • pp.454-457
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    • 2004
  • Due to social problems such as the increasing of land price and the expanding of city, buildings require more complex and bigger components and structure. However, the complex and massive building projects need new technology to solve effect of local buckling and the needs for more space. Hence, Concrete Filled Tube Steel (CFT), the tube steel to hold concrete during pouring and curing of concrete procedure, which helps to reduce local buckling and space, was developed. Most researches on CFT might not be focused on the characteristic of concrete 'filled in tube but structural analysis. However, it is the essential factor to increase the strength of concrete on CFT for having efficient results. Therefore, this paper will describe how to apply CFT into the construction site through examining High Strength Concrete $(800kg/cm^2)$, the strength of core, and bleeding during pouring strategy.

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An Experience of The Microwave Tissue Coagulation Therapy in The Restenosis of The Esophagogastrostomy (식도위 문합술후 재협착증에 대한 microwave 조직응고법적 치험 례)

  • Nam, Chung-Hui;An, Uk-Su;Lee, Gil-No
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.859-864
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    • 1987
  • The microwave tissue coagulator 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 the good result of the microwave tissue coagulation therapy in the patient with the restenosis of esophagogastrostomy. The patient was 67 year-old female, who was admitted due to the lye stricture of esophagus for 40 years. We made the lower esophagectomy and the esophagogastrostomy with the upper intact esophagus in the right thorax. But the restenosis occurred at the esophagogastrostomy site because of the polypoid mucosal protrusion at one month after operation. We applied the microwave tissue coagulator 3 times with 6 day interval under esophagoscopy and the good symptomatic and endoscopic relief was alleviated. We think that the microwave tissue coagulation is a very convenient and advisable method in the case of restenosis after esophageal surgery.

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Surgical correction of congenital aortic stenosis - Report of 14 cases - (선천성 대동맥협착증 수술치험 14례 보)

  • 조범구
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.710-714
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    • 1987
  • Over the past 6 years, from July, 1981. through June, 1987., 14 consecutive patient with congenital aortic stenosis underwent corrective surgery in our department of Thoracic and Cardiovascular Surgery. The patient ranged in age from 1 to 20 years. There were 8 male and 6 female patients. According to the operative findings, stenotic site was valvular stenosis [5 cases], subvalvular stenosis [5 cases], supravalvular stenosis [2 cases], valvular and supra valvular stenosis [1 case]. We have performed valvotomy and commissurotomy [5 cases]. Resection of subvalvular membrane [3 cases], patch enlargement of Ascending aorta [2 cases], LV myotomy [2 cases], valvotomy and excision of membrane [1 case], patch enlargement of ascending aorta and valve ring [1 case]. There was one hospital mortality [7.1%]. He died of C-I bleeding and sepsis on the 25th postoperative day. All survivors showed improvement in NYHA functional class in the 160 patient/month follow up period.

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

  • 문승호
    • Journal of Chest Surgery
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    • v.28 no.8
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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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