• Title/Summary/Keyword: 수술실 내 검사

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Papillary Fibroelastoma of the Aortic Valve: Discovered by Chance with Intraoperative Transesophageal Echocardiography - A case report - (수술실 내 경식도 심장초음파검사에서 우연히 발견된 유두상 섬유탄력종 - 1예 보고 -)

  • Kim, Jeong-Won;Jung, Jong-Pil;Park, Soon-Eun;Kim, Young-Min;Park, Chang-Ryul;Shin, Je-Kyoun
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.637-640
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    • 2007
  • Papillary fibroelastoma is a rare benign cardiac tumor with an elevated risk for embolization and most papillary fibroelastomas do not cause symptoms. In this report, we describe a case of previous undiagnosed masses of the aortic valve that were incidentally found on intraoperative transesophageal echocardiography during coronary artery bypass surgery. Upon surgery, masses were found on the left and right aortic cusps and the pathological findings were consistent with a papillary fibroelastoma.

A Case of Recurred Pseudomyxoma Peritonei Identified by Serially Elevated Serum CEA Levels after Cytoreductive Surgery and Intraperitoneal Chemotherapy (수술과 항암치료 후 종양표지자 검사의 상승으로 복막 가성점액종의 재발을 확인한 1례)

  • In Sub Han;Geun Am Song;Kwang Ha Kim;Bong Eun Lee;Dong Hoon Baek;Seong Jun Lee;Moon Won Lee;Sung Yong Han
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.32-35
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    • 2016
  • Pseudomyxoma peritonei (PMP) is a rare clinical syndrome characterized by profuse jelatinous materials in the abdominal cavity and pelvis with mucinous implants on the peritoneal surface. There are some studies for serum tumor markers, including carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125), to assess the risk of recurrence following cytoreductive surgery and intraperitoneal chemotherapy. However, rare cases were reported about recurrence with increasing serum CEA levels. Herein, we report a case of recurrence of PMP according to serially elevated serum CEA.

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Endophthalmitis after Removal of an Intralenticular Foreign Body in Place without Symptoms for 20 Years (20년 동안 증상없이 잔존한 수정체 내 이물제거 후 발생한 안내염)

  • Choi, Young;Eom, Youngsub;Choi, Soo Youn;Lee, Bo Young;Kim, Eun Jee;Kang, Su-Yeon;Song, Jong Suk;Kim, Hyo Myung
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.5
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    • pp.480-485
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    • 2019
  • Purpose: We report a case of postoperative endophthalmitis in the cataract patient, associated with removal of an intralenticular foreign body that had remained in place without symptoms for 20 years. Case summary: A 45-year-old male visited our outpatient clinic complaining of gradual visual loss in his right eye over the past 3 months. In slit-lamp examinations, anterior capsular opacification, nuclear sclerosis, and posterior subcapsular opacity were observed in the right eye. Twenty years before, a tiny metallic projectile had hit his right eye, but slit-lamp examination at the time of injury did not reveal any intraocular foreign body. We decided to undergo cataract surgery. During phacoemulsification, a metallic foreign body was found in the lens and safely removed; then an intraocular lens was implanted. As hypopyon was evident 3 days later, we injected intravitreal antibiotics and applied fortified antibiotic eye drops to the right eye. The anterior chamber inflammation improved and the best-corrected visual acuity recovered to 1.0. Conclusions: Surgeon should be aware of that endophthalmitis could develop after cataract surgery with removal of an intralenticular foreign body that had been in place for 20 years. But did not trigger inflammation or cause any symptoms as the cataract progressed.

Case of Anterior Segment Ischemia after Two Vertical Rectus Muscles Surgery (두 개의 수직근수술 후 발생한 전안부허혈 1예)

  • Ahn, Jayoung;Kim, Gyu Nam;Kim, Seong Jae;Chung, In Young;Seo, Seong Wook;Yoo, Ji Myong
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1195-1200
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    • 2018
  • Purpose: To report a case of anterior segment ischemia after superior and inferior rectus muscle surgery in a patient with superior rectus muscle enlargement. This is the first report in the Republic of Korea of anterior segment ischemia after two rectus muscles surgery. Case summary: An 80-year-old male was referred to our clinic with a 3 years history of diplopia. The patient had 30 prism diopters right eye hypertropia in the primary position and downgaze limitation. The orbital computed tomography scan revealed enlargement of the right superior rectus muscle. He underwent right superior rectus recession and inferior rectus resection. On postoperative day 2, slit lamp examination revealed diffuse corneal edema, Descemet's membrane folding, an aqueous flare and a dilated pupil. Treatment with 45 mg oral steroid was initiated, and 1% prednisolone acetate and 0.5% Levofloxacin eye drops were administered. At postoperative 1 month, the patient was orthophoric in the primary position, and there was no corneal edema, pupil abnormality or aqueous flare. Conclusions: Base on the present case, the possibility of anterior segment ischemia should be considered after even two muscles surgery, and older patients with vertical muscle surgery should be considered more carefully.

Thoracic Actinomycosis - A Case Report - (흉부 방선균증-1례 보고-)

  • 박찬범;최시영;조덕곤;문석환;조규도;조건현;왕영필;이선희
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.914-916
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    • 2002
  • Actinomycosis of the lung is a chronic, suppurative granulomatous infection which is caused by Actinomyces israelii. It is believed to enter the thorax by way of the bronchial tree, by aspiration of contaminated aerosol particles in the upper digestive tract. Symptoms of chronic cough, sputum, hemoptysis, low grade fever, chest pain, and weight loss are common. Chest X-ray shows mass like lesion, pulmonary infiltration, abscess, and tuberculosis like lesion, which makes differential diagnosis from lung cancer very difficult. Surgical intervention is needed for the diagnosis and treatment, and diagnosis of actinomycosis is achieved when histologic examination reveals sulfur granules containing filamentous organisms. Penicillin is the drug of choice. Two or three months of penicillin treatment is recommended to treat the oropharyngeal or dental abscess to avoid recurrences. We present a case of actinomycosis which is suspected to malignant with review of literatures.

Spatial Dose Distribution for C-arm Examination within Operation Room Using Monte Carlo Method (몬테카를로 방법을 이용한 이동형 X선 투시검사 시 수술실 내 공간선량평가)

  • Kim, Jung-Hoon;Shin, Eom-Hyeon
    • Journal of radiological science and technology
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    • v.44 no.3
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    • pp.205-210
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    • 2021
  • The purpose of this study was to analyze the spatial dose according to the distance by location of medical workers when using a mobile X-ray fluoroscopy device in the operating room through a simulation experiment. The MCNPX program was used for the simulation, and the location of medical workers was set around the operating table, and the spatial dose distribution according to the distance and changes in imaging conditions was evaluated. As a result, The highest score was 2.74×10-4 mGy, 2.72×10-4 mGy, and 1.18×10-4 mGy based on the 10 cm distance from the operating table. Spatial dose depending on the distance 100cm, A point 5.15×10-5 mGy is decreased 19% of 10cm, D point 5.12×10-5 mGy, 19 % of 10cm, and G pint, 1.73×10-5 mGy is reduced by 15% of 10cm. Based on this study, medical-related workers directly or indirectly participating in surgery carry potential risks of radiation exposure during surgery, but there are difficulties in radiation protection due to the nature of their work. Therefore, efforts to reduce exposure suitable for the operating room environment will be required.

Surgical Experience of Diffuse Esophageal Spasm - A report of 2 cases - (광범위 식도경련 -수술치험 2례-)

  • 이창민;박성달;조성래
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.427-431
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    • 1998
  • Diffuse esophageal spasm(DES) is a rare disease seen in 4% of all patients studied in an esophageal motility laboratory, and its diagnosis and surgical management is still controversial. Recently, we treated two patients by extended esophageal myotomy for diffuse esophageal spasm which was diagnosed by the clinical symptoms of patients, esophagoscopy, esophagography, and esophageal manometry. The successful result of treatments was proved with subsidence of previous clinical symptoms(dysphagia and chest pain), postoperative esophagography and esophageal manometry. We present the results together with the review of literatures.

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Operative Treatment for Cardiac Tamponade with Ventricular Rupture of Post Myocardial Infarction without Cardiopulmonary Bypass - A case report - (급성심근경색 후 발생한 양심실파열로 인한 심장압전에서 체외순환의 사용없이 시행한 수술적 치료 - 1예 보고 -)

  • Choi, Chang-Seock;Kim, Han-Yong;Park, Jae-Hong
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.95-97
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    • 2008
  • Ischemic ventricular rupture is one of the most fatal complications following myocardial infarction, and this requires prompt diagnosis and operation. A 75-year-old female was admitted to the ER in a semicomatous mentality with cyanotic extremities. Cardiac echography was carried out in the ER, and a $1.5{\sim}2\;cm$ thickness of effusion in the pericardium was seen. Because the patient's heart had declined to 35 times per min, an emergency operation was started while giving cardiac massage. After observing a 1 cm rupture on the right ventricular wall and a necrotic hemorrhagic scar with a rupture on the left ventricular apical wall, repair of the ruptured areas with a large Satinsky clamp was carried out to control bleeding without cardiopulmonary bypass. On the 28th day after surgery, she was discharged home with a minimal degree of dyspnea.

Significance of tibial intra-tunnel fixation at Arthroscopic ACL Reconstruction with hamstring tendon (Second-look Arthroscopic Evalution) (자가 슬괵건을 이용한 전방 십자인대 재건술시 경골측 골 터널내 고정의 의의 (이차관절경 검사의 평가))

  • Kim, Young-Chang ;Seo, Seung-Suk;Jung, Kyung-Chil;Gwak, Hey-Chul;Kim, Yoon-Jun;Kim, Jin-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.165-172
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    • 2006
  • Purpose: The purpose of this study is to evaluate the effects of intratunnel fixation in the tibial side on the arthroscopic ACL reconstruction with quadruple hamstring tendon at the second look arthroscopy. Materials and Method: From Dec 1999 to May 2005, we arthroscopically reexamined 32 cases who had been done arthroscopic ACL reconstruction with quadruple hamstring tendons. Hamstring tendons of all cases were fixed at femoral side with RigidfixTM. At the tibial side hamstring tendons were fixed only Post-tie (Group I) or Post-tie combined with IntrafixTM (Group II). At the time of second look arthroscopy mean age of cases was 30 years and mean duration for second look arthroscopy was 21.3 months. We analyzed the results with IKDC score, KT-1000 arthrometer under anesthesia, Telos stress radiography, tibial tunnel widening on the radiography and second look arthroscopic findings. Results: Group II had more superior than group I at side to side differences with KT-1000 and Telos stress radiograph, IKDC score, but the differences were insignificant. At arthroscopic evaluation, Group ll also had more superior than group I at graft tension and graft appearance, graft synovialization, but the differences were insignificant. Tibial tunnel widening in the knee AP radiograph was 2.3 mm in Group I and 1.7 mm in Group II and the difference was significant. (P=0.042) Conclusions: Additional procedure of tibial intratunnel fixation in arthroscopic ACL reconstruction with autogenous hamstring tendon significantly prohibited from tibial tunnel widening but clinical results, radiologic joint stability, findings in second look arthroscopy were insignificantly different. We concluded that Post-tie itself induced satisfactory clinical results, joint stability and graft maturation and that tibial tunnel widening did not affect the results.

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Evaluation of Enzyme-linked Immunosorbent Assay in Serological Diagnosis of Human Neurocysticercosis using paired Samples of Serum and Cerebrospinal Fluid (면역효소측정법을 이용한 뇌낭미충증의 혈청학적 진단의 평가)

  • 조승열;김석일
    • Parasites, Hosts and Diseases
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    • v.24 no.1
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    • pp.25-41
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    • 1986
  • The applicability of micro-ELISA was evaluated in human neuro-cysticercosis using paired samples of serum and CSF. A total of 355 cases who were mostly neurologic patients was subjected. Cystic fluid of C. cellulosae was used as antigen in protein concentration of $2.5{\;}{\mu}g/ml$. Serum was diluted to 1 : 100 and CSF was undiluted in the assay for the specific IgG antibody level. The differential criterion of the positive reaction was the abs. of o. 18 in both samples. The results were summarized as follows: 1. The overall sensitivity of the micro-ELISA in 71 confirmed neurocysticercosis was 90.1% ; the sensitivity by serum was 77.5% and that by CSF was 83.1%. CSF was a more sensitive and valuable material. Most of the false negative cases of neuro-cysticercosis showed far lower level of abs. rather than marginal. 2. The overall specificity of the micro-ELISA in 52 confirmed other neurologic diseases was 88.5%; the specificities by serum and by CSF were 94.2% respectively. Cases of other neurologic diseases did not show false positive reactions in both samples. 3. When serum was assayed, taeniasis(2/18), sparganosis(2/20), paragonimiasis(1/56), clonorchiasis(1/15) and fascioliasis(1/1) cases showed cross reactions. When CSF was assayed, 2 ot 10 neuro-sparganosis showed cross reactions while none of 9 neuro-paragonimiasis showed it. Out of 71 confirmed neuro-cysticercosis cases, 6 and 11 showed cross reactions by serum and CSF to crude extract antigen of sparganum; but no case did show it to crude extract antigen of Paragonimus westermani. 4. Ventricular CSF showed low or negative levels of IgG antibody than lumbar CSF unless the lesion was at the lateral ventricle itself. 5. Out of 4 racemose cysticercosis cases, 3 showed positive reaction in serum while all of 3 examined CSF were positive. The above results indicated that the serological test for detecting the specific IgG antibody by micro-ELISA using paired samples of serum and CSF was very helpful for clinical differentiation of neuro-cysticercosis from neurologic diseases of other causes.

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