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Surgical treatment of unstable angina -Experience in 6 patients- (불안정형 협심증의 외과적 치료 -6예 경험-)

  • 조형곤
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.595-605
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    • 1986
  • From February 1986 through September 1986, the authors have experienced 6 cases of coronary artery bypass graft for patients with unstable angina. There were five males and one female who ranged from 39 to 65 years [mean, 53.3 years]. The extent of coronary disease was as follows: one-, two- and three-vessel diseases, all 2 cases respectively, and among them, 1 case had left main disease. Distal anastomoses were performed first with using saphenous vein grafts as conduits in all cases and sequential bypass methods were employed in 5 cases. Numbers of vein grafts were two in 2 cases and one in 4 cases. The mean time wasted for one distal anastomosis was 36 minutes. Post operative complications were leg-wound disruption [2 cases], transient psychosis [1 case] and perioperative myocardial infarction [MI] [1 case]. Sixty three year-old male patient associated with cardiomegaly, prior MI, ventricular arrhythmia, cardiac dysfunction and endocrinologic diseases preoperatively was expired in the operating room due to perioperative Ml. All survivors were asymptomatic and on discontinuing medical therapy on follow-up varying from 1 to 8 months.

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Giant Bulla with Pulmonary Fibrosis Caused by Gramoxon Toxicity -A case report- (그라목손 중독에 의한 폐섬유화와 동반된 거대 폐기포 - 1례 보고 -)

  • 정진악;금동윤;이재원
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.773-776
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    • 2000
  • Accidental or suicidal fatalities of paraquat(Gramoxon) poisong are occasionally seen in the emergency room or intensive care unit in this country. In most cases, respiratory symptoms and eventual death by respiratory distress occur within several days. The most striking pathologic change is fibrosis of the lung due to widespread proliferation of fibroblastic cell. We experience a 21-year-old woman with huge bulla on left lung and diffuse fibrosis in other site, who ingested paraquat 10 months ago. After thoracoscopic removal of bulla, the patient survive without progression of pulmonary complication till now.

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A case of fatal hyperinfective strongyloidiasis with discovery of autoinfective filariform larvae in sputum

  • KIM Jin;JOO Hyun-Soo;KO Hyang-Mi;NA Min-Sik;HWANG Sun-Ho;IM Jong-Cheol
    • Parasites, Hosts and Diseases
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    • v.43 no.2 s.134
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    • pp.51-55
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    • 2005
  • The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured $269\pm21.2{\mu}m$ in length and $11\pm0.6{\mu}m$ in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.

Penetrating Wound of the Heart: A Report of Three Cases (심장관통자상의 응급수술 치험 3례)

  • 김공수;지행옥;김근호
    • Journal of Chest Surgery
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    • v.4 no.1
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    • pp.43-50
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    • 1971
  • Three patients who sustained penetrating stab wound of the heart have been treated successfully by emergency thoracotomy in the Department of Thoracic Surgery, Chonnam University Hospital. There were two knife and one glass wound. The location of the injury were all on the right ventricle, but in one patient, it was penetrated to ventricular septum. All patients were in shock with a systolic pressure under 60 mmHg when admitted to the emergency room. In one of the three patients, blood pressure was not detectable and subsequently cardiac arrest. Two patients required immediate thoracotomy because of intrathoracic hemorrhage and increased pericardial tamponade and the other one required prompt thoracotomy because of sudden onset of cardiac arrest. There were no death postoperatively. Two patients are living without any complication in 4 years and 4 weeks after operation. One who had penetrating wound to ventricular septum, turned to cardiac decompensation, but he is living now in 4$\frac{1}{2}$ years after operation. Exploratory thoracotomy should be performed immediately in all the patients in whom a penetrating wound of the heart or pericardial tamponade following a penetrating wound of the chest wall is suspected.

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Neurologic Complication Following Spinal Epidural Anesthesia in a Patient with Spinal Intradural Extramedullary Tumor

  • Kim, Sung-Hoon;Song, Geun-Sung;Son, Dong-Wuk;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.544-546
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    • 2010
  • Paraplegia following spinal epidural anesthesia is extremely rare. Various lesions for neurologic complications have been documented in the literature. We report a 66-year-old female who developed paraplegia after left knee surgery for osteoarthritis under spinal epidural anesthesia. In the recovery room, paraplegia and numbness below T4 vertebra was checked. A magnetic resonance image (MRI) scan showed a spinal thoracic intradural extramedullary (IDEM) tumor. After extirpation of the tumor, the motor weakness improved to the grade of 3/5. If a neurologic deficit following spinal epidural anesthesia does not resolve, a MRI should be performed without delay to accurately diagnose the cause of the deficit and optimal treatment should be rendered for the causative lesion.

A Case of Benign Paroxysmal Positional Vertigo Treated with Stellate Ganglion Block (성상신경절 차단으로 치료했던 양성 발작성 현기증 1예)

  • Choe, Huhn;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.328-330
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    • 1995
  • A fourty-year-old housewife was admitted to the Department of Ear, Nose, and Throat from the emergency room, because of severe vertigo associated with positional changes of the head. Hallpike maneuver produced typical patterns of bilateral nystagmus consistent with benign paroxysmal positional vertigo(BPPV), and further geotropic rotatory nystagmus with positional change of the head in each direction. Direction of nystagmus reversed when the patients was repositioned upright. Particle repositioning maneuver was administered to her left ear but failed to relieve the severe dizziness associated with the head turning to the right. She was then referred to the patient received 27 SGB treatments and the patients was almost completely healed. It is unusual for the BPPV to occur bilaterally therefore reference concerning the effectiveness of SGB for the treatment of BPPV was difficult to obtain. In conclusion we would like to report the successful treatment of BPPV with SGB.

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A Case of Successful Treatment in Paraquat Intoxication Casued by Subcutaneous Injection (피하주사에 의한 파라콰트 중독환자의 성공적 치료 1예)

  • GiI Hyo Wook;Yang Jong Oh;Lee Eun Young;Hong Sae Yong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.107-109
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    • 2005
  • Paraqaut, a widely used herbicide, is extremely toxic, causing multiple organ failure in human. Most of paraquat intoxications happen through oral administration. But there is no clinical data for parenteral paraquat intoxication. A 35-year-old male injected paraquat solution on his forearm. He visited emergency room within 10 minutes and was treated with tourniquet, incision, washing and suction. After eight days, the patient was discharged without respiratory symptoms and complications. In treatment of parenteral paraquat intoxication, first aid was very important and the treatment should include tourniquet, incision, washing and suction in order to delay absorptions.

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A Study on the Isodose Distribution in a Vascular Characterization Room

  • Choi, Young;Kang, Byung-Sam;Min, Jung-Whan
    • Korean Journal of Digital Imaging in Medicine
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    • v.13 no.1
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    • pp.7-11
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    • 2011
  • As applications of radiation grow wider from use in the early detection of lesions and preventive diagnosis purposes to the treatment of diseases, the possibilities for patients and working professionals to be exposed to radiation are becoming greater than ever. This can not only directly bring about an increase in patient's individual radiation exposure, but also brings about an increase in the annual radiation dose of working professionals. Therefore, research and countermeasures to reduce radiation dosage are required. In this study, space dosimetry has been divided into two separate measuments with an understanding of the increasing number of angiography procedures: front perspective and side perspective. According to the results of the isodose curve, a way to minimize radiation exposure in working professionals has been suggested. This was made possible by workers through awareness of suitable working positions.

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Impaction of a continuous glucose monitoring sensor

  • Park, Kyong Chan;Choi, Hwan Jun
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.392-394
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    • 2021
  • A 33-year-old man presented to the plastic surgery department for foreign body removal 1 month after the insertion of a continuous glucose monitoring (CGM) sensor (Dexcom G5) in the left upper arm. The patient had used the CGM system for 5 years, and the insertion was done in the usual manner. The entire sensor wire was visible on simple radiography and ultrasonography. In the operating room, and the sensor wire was identified in the intermuscular septum and removed. No foreign body reaction or inflammatory signs were found around the CGM, and the extracted wire measured 2.5 cm. Thus, it was assumed that the whole sensor wire was detached from the transmitter, not fractured. No remnant foreign body was observed on follow-up simple radiography.

Hybrid Approach for Treatment of Multiple Traumatic Injuries of the Heart, Aorta, and Abdominal Organs

  • Kim, Seon Hee;Song, Seunghwan;Cho, Ho Seong;Park, Chan Yong
    • Journal of Chest Surgery
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    • v.52 no.5
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    • pp.372-375
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    • 2019
  • A 55-year-old man was admitted to the trauma center after a car accident. Cardiac tamponade, traumatic aortic injury, and hemoperitoneum were diagnosed by ultrasonography. The trauma surgeon, cardiac surgeon, and interventional radiologist discussed the prioritization of interventions. Multi-detector computed tomography was carried out first to determine the severity and extent of the injuries, followed by exploratory sternotomy to repair a left auricle rupture. A damage control laparotomy was then performed to control mesenteric bleeding. Lastly, a descending thoracic aorta injury was treated by endovascular stenting. These procedures were performed in the hybrid-angio room. The patient was discharged on postoperative day 135, without complications.