• Title/Summary/Keyword: 수술후 유착

Search Result 123, Processing Time 0.027 seconds

Clinical Implication of Malignant Pleural Lavage Cytology (PLC) in Primary Lung Cancer (원발성 폐암에서 악성 흉강 세척액의 임상적 의미)

  • 김용희;박승일;김동관;공경엽
    • Journal of Chest Surgery
    • /
    • v.37 no.3
    • /
    • pp.252-260
    • /
    • 2004
  • The purpose of study is to evaluate the clinical implication of malignant Pleural Lavage Cytology (PLC) in primary lung cancer. 315 patients were examined with pleural lavage cytology in Asan Medical Center between November 1998 and August 2002. The patients were chosen from primary lung cancer patients with no pleural effusion according to preoperative radiologic examination; no tumor invasion into the chest wall and no diffuse pleural adhesion in intraoperative findings, The pleural cavity and lung were washed with 100 $m\ell$ of warm normal saline. The 315 patients consisted of 237 men and 78 women. The incidence of malignant PLC was found in 28 patients (8.9%). For patients in early stages (I & II), survival rate was 93.9% in positive malignant PLC and 85.7% in negative malignant PLC. 31 patients (13.6%) had local or distant recurrences; 2-year recurrence-free rate was 90.1% in negative PLC and 87.5% in positive PLC. The survival and recurrence-free rate in each stage were not statistically associated with the result of PLC. Median follow-up was 16.4 months from the surgery. To access implication of malignant PLC in primary lung cancer, a long-term follow-up and further study are required.

Right Thoracotomy for Reoperation of Mitral Valve (우측 개흉을 통한 승모판 재수술)

  • 조창욱;구본일
    • Journal of Chest Surgery
    • /
    • v.29 no.12
    • /
    • pp.1342-1346
    • /
    • 1996
  • A right thoracotomy was used for the reoperation or mitral valve of 15 patients who had previously undergone a cardiac operation through a median sternotomy. In our experience. this approach provided dn excellent exposure of the nlitral valve and easy cannulations of both cavie with minimal dissection, ilvoiding any damage of cardiac and major vessels during re-sternotomy Arterial cannulation was performed in the ascending aorta in 13 patients And in the femoral artery in 2 patients. In earlier cases, venous cannulation was done in the SVC And IVC through the right atrium and snared. In later cases, this could be done without snaginly of both cavae or by placing a silgle light-angled catheter into the right atrium. Crystalloid cardioplegic solution was infused for myocardial protection. Hypothermia was controlled at 20\ulcorner$25^{\circ}C$. For defibrillation, internal paddles were used In one patient while sterilized external paddles were used in 10 patients. In the remaining four patients. however. the heart beat spontaneously The respirator could be weaned within 48 hours alter the operation and no pulmonary complication was observed. One out of the 15 patients expired due to sudden attack of ventricular tarchycardid developed ten days after the operation, but the rest of the patients were discharged with good condition.

  • PDF

A Case of Meckel's Diverticulum Presented with Acute Abdomen in a Newborn (신생아에서 급성 복증으로 발현된 Meckel 게실 1예)

  • Lim, Jae Young;Jang, Sun Hwa;Cho, Jae Min;Ko, Gyung Hyuck;Park, Eun Sil;Seo, Ji Hyun;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.8 no.2
    • /
    • pp.222-225
    • /
    • 2005
  • Meckel's diverticulum is generally acknowledged to be the most prevalent congenital anomaly of the gastrointestinal tract. The preoperative diagnosis of Meckel's diverticulum is difficult, especially in neonates, because of the lesions ability to masquerade as one of a variety of much more common abdominal pathologies. Recently we experienced a case of perforated Meckel's diverticulum with mild inflammatory reaction, intestinal adhesion, and small bowel obstruction in a previous healthy 9-day-old neonate. The spontaneous perforation of Meckel's diverticulum in neonate is very rare but serious entity. The course was rapid and progressed to sepsis. So despite its varied presentation, Meckel's diverticulum should be kept in mind as a cause of acute abdomen in neonates.

  • PDF

Double Bypass of Esophagus and Descending Thoracic Aorta for the Treatment of Esophagapleural and Aortopleural Fistula (식도파열 후 발생한 식도 흉막루와 대동맥루의 수술적 치료: 식도 및 대동맥 이중 우회술)

  • Park, Sung-Joon;Kang, Chang-Hyun;Kim, Kyung-Hwan;Yao, Byung-Su;Kim, Young-Tae;Kim, Joo-Hyun
    • Journal of Chest Surgery
    • /
    • v.43 no.6
    • /
    • pp.753-757
    • /
    • 2010
  • We report hereon a case of double bypass of the esophagus and descending thoracic aorta for the treatment of esophagopleural fistula and aortopleural fistula due to an infected aortic aneurysm after esophageal rupture. A 48 year old man was diagnosed as having esophageal rupture after an accidental explosion. Although he had been treated by esophageal repair and drainage at another hospital, the esophageal leakage could not be controlled and subsequent empyema developed in the left pleura. Further, bleeding from the descending thoracic aorta had developed and he was managed with endovascular stent insertion to the descending thoracic aorta. He was transferred to our hospital for corrective surgery. We performed esophago - gastrostomy via the substernal route, without exploring posterior mediastinum and we let the empyema resolve spontaneously. While he was being managed postoperatively Without any signs and symptoms of infection, sudden bleeding developed from the left pleural cavity. After evaluation for the bleeding focus, we discovered an Infected aortic aneurysm and an aortospleural fistula at the stent insertion site. We performed a second bypass procedure for the infected descending thoracic aorta from the ascending aorta to the descending abdominal aorta via the right pleural cavity. We found leakage at the distalligation site during the immediate postoperative period, and we occluded the leakage using a vascular plug. He discharged without complications and he is currently doing well without any more bleeding or other complications.

Arthroscopic Treatment of Recurrent Prepatellar Bursitis (관절경을 이용한 재발성 슬개골전 점액낭염의 치료)

  • Kyung Hee-Soo;Kim Hee-Soo;Hwang Jun-Kyung;Ihn Joo-Chul
    • Journal of the Korean Arthroscopy Society
    • /
    • v.6 no.2
    • /
    • pp.183-187
    • /
    • 2002
  • Purpose : We report a result of arthroscopic treatment of the recurrent prepatellar bursitis. Materials and Methods : Between March 2001 and May 2002, we treated 4 patients with prepatellar bursitis, the average follow-up period was 14.5 months. The causes were acute trauma 3 cases and repeated minor trauma 1 case. All cases were recurred after previous history of the conservative therapy at other hospital but one was a recurred case after operative excision. Operative technique was as follows. Before inserting the arthroscope, the bursa was inflated with saline. The portals fur 4 mm diameter arthroscope were placed 1cm away from the bursal sac through small skin incision. Superficial layer of the bursa was resected first and then deep portion was the next. Several percutaneous mattress sutures were applied to the overlying skin with deep tissue, and compressive dressing was applied and maintained for 2 weeks. Results : All 4 cases were no recurrence, no pain, no tenderness. The results were considered satisfactory, Two cases of mild skin dimpling at suture site were observed. Conclusion : Arthroscopic treatment of the prepatellar bursitis is an another method of operation technique fur recurrent prepatellar bursitis, however long term follow-up will be needed about recurrence.

  • PDF

THE CARE OF DELAYED MALUNION AFTER MAXILLARY FRACTURE BY DIFFERENT METHODS:REPORT OF THREE CASES (치료법을 달리한 상악골절후 부정유합 2예)

  • Yoo, Jae-Ha;Lee, Won-Yoo;Rew, Soo-Jang
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.13 no.1
    • /
    • pp.117-127
    • /
    • 1991
  • When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

  • PDF

FIBRIN SEALANTS IN MAXILLOFACIAL SURGERY : A INTRODUCTORY REPORT (악안면 외과 영역에서의 FIBRIN SEALANTS 의 이용)

  • Kim, Myung-Jin;Park, Hyung-Kook
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.13 no.2
    • /
    • pp.129-136
    • /
    • 1991
  • The fibrin sealant was first designed as an alternative to surgical suture for the purpose of surface-to-surface union especially in parenchymal organs like the liver, spleen and kidney. The clinical application of currently used fibrin sealant was first introduced in 1972. The fibrin sealant consists of principal two components; lyophilized human fibrinogen and bovine thrombin. The fibrinogen component also contains coagulation factor XIII. A solution of aprotinin, an inhibitor of fibrinolysis is used to dissolve the fibrinogen and to provide the first component, and a solution of calcium chloride is also used to provide the second component. From July to December in 1990, during 6 months, we used fibrin sealant in the 28 patients of 33 various cases, in the following ways; supportive application of fibrin sealant after free autogenouse nerve graft for the repair of inferior alveolar nerve, facial nerve or accessory nerve, treament of hemangioma or lymphangioma to thrombosize and lead to the tumor shrinking, skin grafting to stimulate the adhesion and tissue repair, bone grafting in the patients of cleft alveolus, mandibular reconstruction or orthognathic surgery to facilitate the knitting of bone chips, tissue adhesion after tumor resection, radical neck dissection or flap reconstructions, and supportive adhesion of external auditory cannal after TMJ surgery via postauricular approach. No adverse effects were observed, none of the patients developed hepatitis or other blood transmitted disease, and the wound healing were acceptable.

  • PDF

A Prospective Clinical Trial on the Mg Oxidized Clinical Implants (마그네슘 양극산화 임플란트의 성공률에 관한 전향적 임상연구)

  • Im, So-Min;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra;Um, Heung-Sik;Lee, Jae-Kwan
    • Journal of Dental Rehabilitation and Applied Science
    • /
    • v.27 no.1
    • /
    • pp.25-39
    • /
    • 2011
  • In animal studies, Magnesium (Mg) - incorporated oxidized implants showed significant enhancement of the bone response. This prospective clinical trial was performed to investigate the success rate, implant stability and marginal bone loss of Mg oxidized clinical implant. The experimental protocol was approved by Institutional Review Board of the Gangneung-Wonju National University Dental Hospital. Fifty healthy patients had partial edentulism were included in this study. Mg oxidized clinical implants (Implant M, Shinhung, Korea) were installed and restored with conventional protocol. The patients were recalled at 1, 3, 6 months after functional loading. Implant stability quotient (ISQ) was measured and periapical radiographic images were obtained. Amount of marginal bone loss was calculated with calibrated images from periapical radiographs. Repeated measured analysis of variance and post hoc Tukey test were used to compare the mean ISQ and bone level. A total of 101 implants were analyzed. The mean ISQ values increased continuously with time lapse from 68.4 at fixture installation to 71.5 at 6 months after loading. Implant stability was correlated with gender, fixture diameter, bone quality and implant sites. The mean marginal bone loss during 6 months after loading was 0.26 mm. There was no failed implant and six-month success rate was 100%. Within the limitations of this study, the six-month success rate of Mg oxidized implant was satisfactory. The implant stability and marginal bone level were excellent. However, further longer clinical studies will be needed to confirm the success of Mg oxidized clinical implant.

Repeated Unplanned Excision of Malignant Fibrous Histiocytoma (Malignant Fibrous Histiocytoma Misdiagnosed as the Simple Cyst): A Case Report (악성 섬유성 조직구종의 반복된 무계획적 절제(단순 낭종으로 오인된 악성 섬유성 조직구종): 증례 보고)

  • Soh, Jae-Wan;Kim, Woo-Jong;Kim, Chang-Hyun;Kwon, Sei-Won;Kim, Han-Jo
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.18 no.2
    • /
    • pp.113-117
    • /
    • 2012
  • A 73-year-old male was admitted for unhealed wound. Eight months ago, the patient had been operated for excision of soft tissue mass on left distal thigh area in previous hospital and after 4 months from first operation, had been reoperated because of recurrence. The pathologic diagnosis of previous operation was simple cyst. In operating finding, the mass invaded the vastus lateralis fascia and had irregular margin and adhesion. We carried out simple excision with retaining 5 cm of free margin from the mass. The pathologic diagnosis of our hospital was malignant fibrous histiocytoma, and then the patient was performed radiation therapy. In 1 year follow-up, there was no significant finding either increasing mass size or metastasis. We misdiagnosed as simple cyst and then performed simple excision, however finally pathologic diagnosis confirmed as malignant fibrous histiocytoma. It is considered to operate a mass that preoperative proper evaluation and diagnosis are required.

Aprotinin Therapy for Cardiac Operation in Adult -Full dose regimen- (개심술에서 아프로티닌의 효과 (고용량 요법))

  • 장운하;오태윤;김미혜
    • Journal of Chest Surgery
    • /
    • v.32 no.4
    • /
    • pp.358-363
    • /
    • 1999
  • Background: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. Material and Method: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. Result: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186${\pm}$40cc, control group:409${\pm}$69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317${\pm}$53cc, control group: 671${\pm}$133cc, P=0.024). Conclusion: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.

  • PDF