• Title/Summary/Keyword: 수술 후 감염

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Recurrent Brain Abscess In Chronic Sinusitis : A Case Report (만성부비동염을 가진 환자에서 재발된 뇌농양 : 증례보고)

  • Yi, SangHak;Hwang, Yong;Lee, Hak Seung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.275-279
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    • 2018
  • A brain abscess is caused by an infection in the central nervous system and leads to significant neurological sequelae. Despite advances in neurocritical care, high morbidity and mortality rates are still associated with brain abscess, especially in certain high-risk patients. Thus, a brain abscess is a medical emergency requiring prompt diagnosis and treatment with antibacterial therapy. However, the recurrence of brain abscess is rare. A 59-year-old man presented at our neurology clinic with a headache and was found to have chronic otitis media. Serial brain magnetic resonance imaging (MRI) scans of the patient demonstrated a brain abscess in the right frontal lobe. Following stereotactic aspiration of the brain abscess and proper antimicrobial treatment, the patient recovered completely. Five months after discharge, the patient revisited our clinic with a headache and seizure symptoms, and recurrence of the brain abscess was confirmed by brain MRI. Recurrent brain abscess has been documented in patients with predisposing conditions such as retained foreign bodies, chronic sinusitis, arteriovenous fistula, and right-to-left shunt.

Surgical Treatment of Traumatic Pulmonary Cyst -A case report- (외상성 폐낭종의 외과적 치료)

  • O, Seong-Cheol;Lee, Seong-Ju;Kim, Chang-Hui;Chae, Seong-Su
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.577-580
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    • 1996
  • Traumatic pulmonary cysts are rare cavitary pulmonary lesions following nonpenetrating thoracic trauma. The pathogenesis of this lesion Is a tear in the pulmonary parenchyma with leakage of air and fluid into this tear. The diagnosis is one of exclusion, based on an awareness that lung cyst can develop after trauma. Once traumatic lung cyst is diagnosed, the principle of the treatment is in-hospital obser- vation with respirato y support. However, if a cyst is complicated by infection unresponsive to a trial of appropriate antibiotic therapy and does not progressively become smaller, surgical intervention is indicated. Authors recently experienced a case of traumatic lung cyst in a 19 year-old man. Case presentation and review of articles on traumatic pulmonary cyst follows.

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Acromio-Clavicular joint Cyst Associated with Rotator Cuff Re-tear Followed by Ultrasonography (초음파검사로 추시한 회전근 개 재파열에 동반된 견봉 쇄골 관절의 낭종)

  • Oh, Chung Hee;Kim, Joon Yub;Kim, Sae Hoon;Kim, Je Kyun;Oh, Joo Han
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.65-68
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    • 2010
  • Acromio-clavicular (AC) joint cyst have been reported in small series of the orthopedics literature in association with extensive rotator cuff tear, pseudotumor, infection of the shoulder or chondrocalcinosis. Authors experienced one case of AC joint cyst with rotator cuff re-tear after arthroscopic rotator cuff repair, clinicians may need pay attention to AC joint bulging or mass lesion after arthroscopic rotator cuff repair as an important sign to check follow-up imaging study for the cuff integrity. Especially, ultrasonography is recommended for this follow up study, because it is simple to be operated, economic, easily accessible.

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Etiology and Treatment of Revision Shoulder Arthroplasty (견관절 인공관절 재치환술의 원인과 치료)

  • Kim, Young-Kyu;Jung, Kyu-Hak
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.100-109
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    • 2019
  • The rapidly increasing rate of shoulder arthroplasty is certain to increase the number of revision arthroplasties because of parallel increases in complication numbers. It has been widely reported that the causes of revision shoulder arthroplasty include rotator cuff deficiency, instability, glenoid or humeral component loosening, implant failure, periprosthetic fracture, and infection. Revision arthroplasty can be technically challenging, and surgical options available for failed shoulder arthroplasty are limited, especially in patients with glenoid bone loss or an irreparable rotator cuff tear. Furthermore, the outcomes of revision arthroplasty are consistently inferior to those of primary arthroplasty. Accordingly, surgical decision making requires a good understanding of the etiology of failure. Here, we provide a review of indications of revision arthroplasty and of the surgical techniques used by failure etiology.

Fabrication of implant-associated obturator after extraction of abutment teeth: a case report (지대치 발거 후 임플란트 연관 상악 폐색장치 제작 증례보고)

  • Ki-Yeol Jang;Gyeong-Je Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.4
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    • pp.229-236
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    • 2023
  • Maxillary bone defects may follow surgical treatment of benign and malignant tumors, trauma, and infection. Palatal defects often lead to problems with swallowing and pronunciation from the leakage of air into the nasal cavity and sinus. Obturators have been commonly used to solve these problems, but long-term use of the device may cause irritation of the oral mucosa or damage to the abutment teeth. Utilizing implants in the edentulous area for the fabrication of the obturators has gained attention. This case report describes a patient, who had undergone partial resection of the maxilla due to adenocarcinoma, in need of a new obturator after losing abutment teeth after long-term use of the previous obturator. Implants were placed in strategic locations, and an implant-retained maxillary obturator was fabricated, showing satisfactory results in the rehabilitation of multiple aspects, including palatal defect, masticatory function, swallowing, pronunciation, and aesthetics.

A Study on Restriction of Access to Medical Institutions and Discrimination on Human Rights of Persons with Disabilities Not Wearing Masks to Prevent Healthcare-Associated Infections (의료관련감염 예방을 위한 마스크 미착용 장애인의 의료기관 출입제한과 인권차별 결정에 대한 검토)

  • Moon, Sang Hyuk;Kim, Je Sun
    • The Korean Society of Law and Medicine
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    • v.24 no.1
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    • pp.67-98
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    • 2023
  • In the early stages of the COVID-19 pandemic, Korea took the lead in implementing "social distancing" policies more strongly than other countries. In addition to making it mandatory to wear a mask according to the policy, all patients using medical institutions are tested for COVID-19 to prevent Healthcare-Associated Infections, and only those patients who test negative have been regulated to receive face-to-face medical treatment. In this process, situations such as the disabled, who have difficulty wearing masks, were not taken into account, and emergency patients did not receive timely treatment or surgery from medical personnel. In response, the National Human Rights Commission of Korea has decided that forcing everyone to wear a mask and restricting access to medical institutions constitutes discrimination against the disabled. Therefore, the purposes this study has that, the first is to review cases of human rights discrimination against persons with disabilities due to measures to prevent the transmission of infectious diseases that did not consider the characteristics of persons with disabilities in the COVID-19 situation and issues regarding the decisions of the National Human Rights Commission of Korea, the second is to find a reasonable plan and the need for measures to prevent refusal of treatment by medical institutions for the disabled who have difficulty wearing masks.

Arthroscopic Treatment of Septic Knee Arthritis in Old Aged Group: Prognostic Factor (50세 이상에서 발생된 화농성 슬관절염의 관절경적 치료: 예후 인자)

  • Lee, Dong-Chul;Shon, Oog-Jin;Kong, Byung-Sic
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.114-119
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    • 2010
  • Purpose: The purpose of this study was to assess the result of arthroscopic treatment in septic knee arthritis and evaluate the prognostic factor over 50 years old. Materials and Methods: Fifty-two patients were treated by arthroscope for septic knee arthritis from January, 2002 to August, 2005. The mean follow-up period was 27.5months. We assessed Lysholm score as functional result, CRP normalized period as laboratory result, and knee range of motion as clinical result. We evaluated patient's age, underlying disease, causative organism, previous knee status (Kellgren stage), clinical status of septic arthritis (G$\ddot{a}$chter stage) and history of intra-articular injection as prognostic factor. Results: Mean Lysholm score was improved from 40.7 to 67.1. And the mean CRP normalized period was 38.7days. At last follow-up, almost patient (92%) were recovered to prior knee full range of motion and 45 patient (74%) were completely cured by one stage operation. The microorganism isolated were MSSA (n=13), MSSE (n=3), MRSA/MRSE (n=4),no microorganism (n=27) and others (n=5). In Lysholm score, young age (42.8(preop.)$\rightarrow$83.5(postop.)), Kellgren stage 0 ($45.5{\rightarrow}84.2$), G$\ddot{a}$chter stage I ($39.3{\rightarrow}73.1$) and no microorganism (442.1{\rightarrow}72.6$) were more increased than old age (439.3{\rightarrow}61.7$), Kellgren IV ($28.3{\rightarrow}43.7$), G$\ddot{a}$chter stage IV ($40.2{\rightarrow}67.1$) and MRSA/MRSE ($40{\rightarrow}58.75$). In case of old age (42.3days), G$\ddot{a}$chter stage IV (55.5), Kellgren stage IV(43.7), DM patient (42.1) and intra-articular injection history (52.1), the CRP titer normalized period was longer than mean period. MRSA/MRSE(n=3,75%) were not normalized in CRP titer at last follow-up. Conclusion: Arthroscopic treatment of septic knee would be an effective and satisfactory procedure. Age, previous knee status (Kellgren stage), underlying disease (DM), intra-articular injection history, microorganism and Ga¨chter stage effect end result outcome.

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Early Results of Coronary Artery Bypass Graft with Purely Bilateral Internal Thoracic Arteries Using Y-anastomosis in Multiple Coronary Artery Disease Patients: Coronary Angiographic Analysis (다중혈관 관상동맥 환자에서 Y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적: 관상동맥 조영술 분석)

  • 성기익;이영탁;박계현;전태국;박표원;한일용;장윤희
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.142-149
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    • 2003
  • To know the feasibility of the coronary artery bypass graft (CABG) for multivessel coronary artery disease with purely bilateral internal thoracic arteries (ITAs), we analyzed the short-term clinical results and the coronary angiography of the patients. Material and Method: From March 2001 to June 2002, four hundred and five patients underwent CABG. Purely bilateral ITAs were used in 159 patients (39.3%). We analyzed these patients retrospectively The mean age of these patients was $61.2{\pm}8.5$ (range: 30 ~80) years and there were 123 male patients. The preoperative risk factors were as follows: diabetes in 54 patients (34.0%), history of acute myocardiac infarction within 4 weeks in 29 (18.2%), and emergency operation in 6 (3.8%). Off-pump CABG was carried out in 128 patients (80.5%). Associated procedures were mitral valvuloplasty (5), aortic valve replacement (3), Dor procedure (1), and so on. Result: The mean number of distal anastomoses was $3.1{\pm}0.9$ (range: 2~6), the mean duration of hospital stay was $8.4{\pm}4.5$ days. There was one (0.6%) operative death. Except for one early death, no other patients suffered from low cardiac output. The other postoperative complications were occurred as follows: reoperation due to bleeding in 3 patients, perioperative myocardiac infarction in 1, transient cardiac arrest in 2, transient cognitive dysfunction in 7, and transient ischemic attack in 1, and deep sternal wound infection in 1 patient. Recently, early postoperative angiography was performed in 19 patients who had triple vessel disease. The total number of distal anastomosis was 78 (mean $4.1{\pm}0.8$/patient). All distal anastomosis sites were patent, but competition flow was observed at the bypass sites where the native coronary artery stenosis was not significant. Conclusion: The CABG with purely bilateral ITAs for triple vessel disease was performed safely. The early patency rate was relatively good in small number of patients. However the long-term patency rate and the functional study to evaluate the sites where competition flow was observed should be followed.

Bronchoscopy and Surgical Lung Biopsy for the Diagnosis and Management of Pulmonary Infiltrates in Immunocompromised Hosts (면역저하환자에서 발생한 폐침윤에서 기관지내시경과 수술적 폐생검의 유용성)

  • Park, Sang-Joon;Kang, Soo-Jung;Koh, Young-Min;Suh, Gee-Young;Kim, Ho-Joong;Kwon, O-Jung;Lee, Hong-Ghi;Rhee, Chong-H.;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.195-208
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    • 1999
  • Background: Pulmonary infiltrate in immunocompromised hosts has many infectious and non-infectios etiologies. To evaluate the diagnostic yield and therapeutic implication of two invasive diagnostic methods, such as bronchoscopy and surgical lung biopsy, we performed retrospective analysis of these patients. Methods: All immunocompromised patients admitted to Samsung Medical Center from October 1995 to August 1998 who underwent bronchoscopy and/or surgical lung biopsy for the diagnosis of pulmonary infiltrates were included in this study. Confirmative diagnostic yield, the rate of changed therapeutic plan and patients' survival were investigated. Results: Seventy-five episodes of pulmonary infiltrates developed in 70 patients(M : F=46 : 24, median age 51). Underlying diseases of patients were hematologic malignancy(n=30), organ transplantation(n=11), solid tumor(n= 12), connective tissue disease(n=6) and others. Confirmative diagnosis was made in total 53 cases (70.7%), of which 70.2% had infectious etiology. Diagnostic yields of bronchoscopy, bronchoalveolar lavage(BAL), transbronchiallung biopsy(TBLB) and surgical lung biopsy were 35.0%(21/60), 31.4%(16/51), 25.0%(9/36) and 80.0%(20/25). Therapeutic plan was changed in 40%(24/60) of patients after bronchoscopy and in 36%(9/25) of patients after surgical lung biopsy. More patients survived (84.4% vs 60.5%, p=0.024) when therapeutic plan was changed after invasive diagnostic study. Conclusion: Bronchoscopy and surgical lung biopsy are helpful for the therapeutic implication of pulmonary infiltrates in immunocompromised hosts. Large-scale prospective case-control study may further clarify their limitation and usefulness.

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Detection of Hepatitis B Virus DNA in Liver Grafts Obtained from HBsAb and HBcAb Positive Organ Donors (HBsAb와 HBcAb가 양성인 장기 공여자의 간조직에서 Hepatitis B Virus DNA의 발현)

  • Jung, Chang-Woo;Jang, Joo-Young;Kim, Kyung-Mo;Lee, Sung-Gyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.166-172
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    • 2007
  • Purpose: It has recently been reported that de novo HBV infection following liver transplantation is caused by grafts from HBcAb positive donors, and this phenomenon has been observed in one third of the liver transplant patients in our center. Therefore, we investigated the presence of HBV virus DNA in liver tissues obtained from HBcAb positive donors to determine the mechanism by which de novo HBV infection occurs. Methods: This study was conducted on 6 patients that were HBsAg negative, HBsAb positive, and HBcAb positive who were donors for liver transplantation between November 1997 and November 1998 at Asan Medical Center. We isolated DNA from a portion of liver biopsy tissues that were obtained during the operation, and then identified the surface and core region of HBV DNA using nested PCR. In addition, four children who received liver grafts from these donors were monitored to determine if they became afflicted with non-HBV related diseases while receiving prophylaxis consisting of short-term HBIG treatment and long-term treatment with an antiviral agent. Results: The surface antigen region was identified in all 6 donors and the core antigen region was observed in 4 of the 6 donors. However, no episodes of de novo HBV infection with prophylaxis were observed. Conclusion: The results of this study support the results of previous studies, which indicated that HBV infection may be the main cause of de novo HBV infection in patients that receive HBsAb positive and HBcAb positive donor grafts.

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