• Title/Summary/Keyword: 재치

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Repair of Paravalvular Leak at Mitral Position after Redo DVR (승모판막 재치환술후 발생한 판막주위 누출 치험 1례)

  • 김경훈;정승혁
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.428-431
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    • 1997
  • We experienced a casts of prosthetic mitral paravalvular leak after redo DVR. As far as nonstructural dysfunction is concerned, the prosthetic paravalvular leak is not the result of prosthetic valve endocarditis, but is due to technical difficulties at the time of operation, either residual calcification or poor native tissue. Occasionally paravalvular leaks, particulary around mitral prostheses, may be silent. Paravalvular leaks are usually repaired when there is significant anemia or hemodynamic compromise. At reoperation, some of theses leaks can be repaired simply by patch losure around the paravalvular leak without placing additional suture or explanting the valve.

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The Clinical Aspects of Pulmonary Tuberculosis Patient Failed in Retreatment (재치료실패 폐결핵환자의 임상 양태)

  • Im, Young-Jae;Song, Ju-Young;Jeong, Jae-Man;Kim, Young-Jun;Kim, Moon-Shik
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.404-409
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    • 1993
  • Background: There are many retreatment failure patients admitted in National Kongju Tuberculosis Hospital. But there is not satisfactory treatment method for them at present. We think that more attentions and active measures for them are needed. Method: We reviewed sex and age, duration of illness, previously used antituberculosis drugs, drug resistance, extent of disease, reasons for early stopping or irregular medication and schooling of 50 retreatment failure patients admitted in National Kongju Tuberculosis Hospital from April 1992 to February 1993. Results: 1) The male to female ratio was 3:2 and 62% of the patients were between 21 and 40 years of age. 2) Twenty eight cases (56%) had the duration of illness over 10 years. 3) All cases had used most of the antituberculosis drugs. 4) Drug sensitivity test showed resistance to RMP in 46 cases (96%), INH in 40 cases (83%) and other drugs in 3-32 cases (6-67%). 5) Forty eight cases (96%) had far advanced disease on chest P-A film. 6) Twenty eight cases (56%) in primary chemotherapy and twenty one cases (42%) in retreatment had the histories of premature stopping or irregular ingestion of the drug. The reasons for premature stopping or irregular ingestion of the drug were as follows; in primary chemotherapy, 29 cases (75%) were due to 'having no symptoms', while in retreatment, 6 cases (29%) were due to 'having no symtoms', 6 cases (29%) were 'too, busy' and 3 cases (14%) were for 'financial problem'. 7) Twenty seven cases (54%) had at least graduated from high school. Conclusion: Greater efforts are needed to prevent tratment failure. More supports and admission treatment for retreatment failure patients are needed to prevent infection and to treat properly.

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The Clinical Characteristics and Outcomes of Short-term Treatment in Patients with Recurrent Pulmonary Tuberculosis (한 대학병원에서 반복성 폐결핵 환자의 임상적 특성과 6개월 단기요법의 치료 성적)

  • Yoo, Seung Soo;Kwon, Jee Suk;Kang, Yeh Rim;Lee, Jeong Woo;Cha, Seung Ick;Park, Jae Yong;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.341-346
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    • 2008
  • Background: Recurrent pulmonary tuberculosis (TB) can be due to relapse of the original infecting strain or due to reinfection with a new strain of Mycobacterium tuberculosis. We investigated the clinical characteristics and efficacy of short-term treatment (6 months) in patients with recurrent pulmonary TB. Methods: Twenty-nine patients with recurrent pulmonary TB were compared with control patients who received primary treatment for pulmonary TB with respect to drug sensitivity and outcomes of treatment. Results: Most patients with recurrent pulmonary TB (25 cases, 86.2%) recurred more than 2 years after the completion of previous treatment. Twenty-three patients (82.1%) with recurrent pulmonary TB were sensitive to all anti-tuberculous drugs and a ratio was similar to the drug sensitivities observed in control patients. The outcomes of short-term treatment in patients with drug-sensitive TB were not significantly different between the two groups. Conclusion: Recurrent pulmonary TB in the study area was likely due to reinfection with new strains. Thus the short-term treatment of patients with drug-sensitive recurrent pulmonary TB may be successful.

Intractable Hemoptysis due to Valvular Heart Disease Treated by Emergency Redo DVR: 1 case report (판막부전증에 의한 대량객혈의 응급 이중판막 재치환술: 1례 보고)

  • 이재훈;전양빈
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.423-427
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    • 1997
  • Hemoptysis occurs quite frequently as a consequence of mitral stenosis, but massive, lirE threatening pulmonary hemorrhage is distinctly unusual. We report a 30 year old female who underwent cmcrgcncy rcdo double valve replacement for intractable pulmonary hemorrhage. she underwent mitral valve replacement (lonescu Shirley 27 mm) due to rheumatic valvular heart disease in 1984 and tricuspid valve annuloplasty (Carpentier's rlng 30mm) two years later She was admitted for massive hcmoptysis and dyspnea on the 26th of December, 1995. Medical treatment including transarterial embolization was given but was not satisfactory. Emergency valve replacement (Mitral valve , 51. Judc 29mm and tricuspid valve ; 51. Jude 33mm) was performed and hemoptysis was controlled dramatically 24 hours after surgery.

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Reoperation for Dysfunction of Cardiac Valve Prosthesis (인공 심장판막 기능부전 환자에서의 심장판막 재치환술)

  • 윤정섭;김치경;조규도;이성호;곽문섭;김세화
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.242-246
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    • 1998
  • From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5$\pm$12.2 years. Seventeen(63.0%) patients had the mitral valve replacement, 8(29.6%) the aortic valve, 1(3.7%) the aortic composite graft, and 1(3.7%) the tricuspid valve. Mean follow-up period was 49.5$\pm$30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9$\pm$34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis(1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2$\pm$43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak(4/15, 26.7%), and valve thrombosis(3/15, 20.0%). Posto- perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.

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Efficacy of retreatment NiTi files for root canals filled with calcium silicate-based sealer (칼슘실리케이트 계열 실러로 충전한 근관에서 재치료용 NiTi 파일의 효율성)

  • Jae-Yun, Hyun;Kyung-Mo, Cho;Se-Hee, Park;Yoon, Lee;Yoon-Joo, Lee;Jin-Woo, Kim
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.4
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    • pp.213-221
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    • 2022
  • Purpose: The efficacy of the amount of sealer in the root canal and two retreatment NiTi file systems in removing filling materials. Materials and Methods: Extracted premolars with a single root canal were selected for this study. After access opening and root canal preparation up to size #40/.06, the specimens were randomly divided into four groups. Gutta percha (GP) tapers of .06 or .04 were used for each group and filled using a single-cone filling technique with CeraSeal, a calcium silicate-based sealer. Each group was retreated either using the ProTaper Universal Retreatment System (PTUR) or the Hyflex Remover (HR). The time taken to remove the filling material, the amounts of apically extruded debris, and canal cleanliness were measured and compared. Results: The amount of sealer did not affect the efficiency when removing the filling materials. However, the filling material was removed faster in the HR group than in the PTUR group. Two types of NiTi files showed similar retreatment effects in the amounts of apically extruded debris and in the degree of canal cleanliness. Conclusion: The amount of sealer in canal filling had no significant effect on retreatability. Retreatment with HR removed filling materials is faster than PTUR. There was no difference in other removal efficiencies according to the type of retreatment NiTi file.

The Comparison of Interferon-${\alpha}$ Treatment by Dosages and Retreatment for Chronic Hepatitis B in Children (소아 만성 B형 간염 환아에서 Interferon-${\alpha}$의 용량 차이 및 재치료에 따른 치료 효과 비교)

  • Jang, Chang-Hwan;Lee, Kyung-Hee;Hwang, Wi-Kyung;Oh, Ki-Won;Park, Woo-Saeng;Lee, Jun-Hwa;Ko, Cheol-Woo;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.152-160
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    • 2003
  • Purpose: We compared the therapeutic efficacy of low dose with that of standard dose of interferon (IFN) treatment and also compared the first IFN treatment with retreatment. Methods: We have studied 51 children (age, 2~14) treated for chronic hepatitis B from March 1990 to August 1999. Twenty seven children had been treated with $3\;MU/m^2$ ($2.66{\pm}0.66\;MU/m^2$) of IFN-${\alpha}$ three times a week for 6 months (range, 6~12 months), whereas 24 children with $6\;MU/m^2$ ($4.45{\pm}0.94\;MU/m^2$). There was no significant difference in gender, age, initial ALT and HBV DNA levels between each comparative group. Results: Among the 27 children treated with $3\;MU/m^2$ of IFN, ALT level had normalized in 11 children (41%) and anti-HBe seroconversion occurred in 9 children (33%) one year after the initiation of treatment. In comparison, among the 24 children treated with $6\;MU/m^2$ of IFN, ALT normalized in 12 children (50%) and anti-HBe seroconversion occurred in 7 children (29%). In comparing the first treatment group to retreatment group, ALT level had normalized in 23 children (45%) and anti-HBe seroconversion occurred in 16 children (31%) among the 51 children treated with the first course of IFN treatment. In comparison, ALT normalized and anti-HBe seroconversion occurred in 3 children (25%) among the retreated 12 children. Conclusion: There was no significant difference in the therapeutic efficacies between $3\;MU/m^2$ and $6\;MU/m^2$ dose of IFN treated groups in ALT normalization and anti-HBe seroconversion. The retreatment efficacy of IFN-${\alpha}$ was as effective as the first treatment.

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