• Title/Summary/Keyword: 치명적 합병증

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INFECTIVE ENDOCARDITIS IN ANTIBIOTICALLY PROTECTED PATIENT WITH VENTRICULAR SEPTAL DEFECT (심실 중격 결손에 의한 감염성 심내막염 환자의 치과치료)

  • Yang, Jung-Hyun;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Lee, Sang-Hoon;Hahn, Se-Hyun;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.3
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    • pp.461-467
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    • 2007
  • Infective endocarditis is a life-threatening disease, although it is relatively uncommon. Substantial morbidity and mortality result from this infection. Therefore, primary prevention of endocarditis whenever possible is very important. The American Heart Association updated recommendations for the prevention of infective endocarditis in individuals at risk for this disease in 1997. But, utilization of antibiotic prophylaxis for patients at risk does not provide absolute immunity from infection. This report presents the case of infective endocarditis that occurred in spite of appropriate antibiotic prophylaxis in the ventricular septal defect(VSD) patient.

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Chest Wall Implantation of Lung Cancer after Fine Needle Aspiration Biopsy - 2 cases - (세침 흡입생검 후 발생한 폐암의 흉벽전이 -2례 보고-)

  • 강정신;조현민;윤용한;이두연
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.629-633
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    • 1998
  • Implantation of malignant cells along the needle aspiration tract is an extremely rare potential complication following a percutaneous fine needle aspiration biopsy of a lung carcinoma. The dissemination of malignant cells by a needle aspiration biopsy may convert an operable and potentially curable lesion into a fatal disease. We report two cases of chest wall implantation of carcinoma of the lung after a thin needle aspiration biopsy. A fifty-five year old male was successfully treated by a radical full-thickness excision of the chest wall and immediate reconstruction with the latissimus dorsi musculocutaneous island flap. A sixty-eight year old female was treated with a partial-thickness excision of the chest wall and skin graft due to superimposed infection and ulceration of the metastatic chest wall carcinoma. One case lived for 31 months up to November 1994, and the other's condtion has been uneventful for 3 months up to now.

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Successful Management with Vincristine after Failure of Prednisolone Therapy for Diffuse Neonatal Hemangiomatosis (Vincristine 투여로 호전된 미만성 신생아 혈관종증)

  • Lee, Hak-Sung;Heo, Soon-Young;Kim, Won-Duck
    • Clinical and Experimental Pediatrics
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    • v.48 no.9
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    • pp.1004-1008
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    • 2005
  • Hemangiomas are the most common benign tumors of infancy. Fifteen to 30% of these patients have multiple hemangiomas. Diffuse neonatal hemangiomatosis (DNH) is a disease that often has a fatal outcome if left untreated, and is characterized by multiple cutaneous and visceral hemangiomas. Corticosteroids are the commonly accepted first line treatment, but if no effect is seen, further treatment is required such as interferon, surgical excision, embolization and radiotherapy. Interferon is effective, but the neurologic sequela including spastic diplegia can be a complication. We experienced a case of DHN in a neonate. In this case, the baby presented with multiple cutaneous and visceral hemangiomas with Kasabach-Merritt syndrome (KMS) that included thrombocytopenia and consumptive coagulophthy. The baby was successfully treated with vincristine after the failure of steroid therapy.

Five Cases of Shaken Baby Syndrome (흔들린 아이 증후군 5례)

  • Cho, Ok Yeon;Huh, Kwon Hoe;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang;Lee, Yul
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.404-408
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    • 2003
  • Shaken baby syndrome is a serious form of child abuse, mostly involving children younger than 2 years. It results from extreme rotational cranial acceleration induced by violent shaking. The characteristic injuries include subdural hemorrhage, retinal hemorrhage, and fracture of ribs or long bones. If physicians have no recognition of, or suspicion about, shaken baby syndrome, this syndome is difficult to diagnosis because of a lack of obvious external signs and failure of the abuser to admit his or her actions. In addition to the high mortality, 60% of survivors have significant long term neurologic and developmental abnormality. The authors experienced five cases of shaken baby syndrome presented with seizures or vomiting, without external signs of trauma. All of these cases had subdural hemorrhages, and four cases had retinal hemorrahges. In our follow up, two children were found to have sequelae such as quadriplegia, monoplegia, and developmental delay. We emphasize that early recognition and prompt treament are key to overall success of case management. The incidence of shaken baby syndrome can be reduced through public awareness and education of parents not to shake a babies.

Repair of Complex Cardiac Anomaly Associated with Congenital Tracheal Stenosis -1 Case Report- (선천성 기관 협착증을 동반한 복잡 심기형의 완전 교정술 -1예 보고-)

  • Park, Jeong-Jun;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.88-91
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    • 1997
  • Congenital long-segment tracheal stenosis with complex cardiac anomaly has generally been regarded as a fatal disease This report described the successful concomitant repair of unexpected congenital tracheal stenosis and complex cardiac anomaly with the use of edrdiopulmonary bypass. The patient was a 3-month-old girl with coarctation of aorta, V D, and PDA. The presence of tracheal stenosis was not discovered until when difficulty with endotracheal intubation was encountered at operating room. Thus, we decided concomitant repair of both lesions and performed anterior pericardial tracheoplasty combined with one stage repair of coarctation of aorta, VSD, and PDA under the cardiopulmonary bypass. The patient is doing well without any signs of complication at present, 2 years and 1 month after the operation.

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Management of Descending Necrotizing Mediastinitis with Thoracoscopy (흉강경을 이용한 하행 괴사성 종격동염의 치료)

  • Lee, Sung-Ho;Sun, Kyung;Kim, Kwang-Taik
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.161-165
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    • 2002
  • Descending necrotizing mediastinitis is a life-threatening infection originating in the head or the neck and descends into the mediastinum. Even in the era of antibiotics, mortality rate has been reported to be 25 ∼ 40%. Prompt diagnosis and treatment is mandatory for delayed diagnosis and inappropriate drainage of the mediastinum are the main causes of high mortality Surgical management ranges from cervical drainage to routin thoracotomy:however, the optimal management still needs to be defined particularly in respect to effective mediastinal drainage. Although posterolateral thoracotomy incision has been considered as a standard approach, potential disadvantages including postoperative pain, risk of wound complication and delayed recovery remain to be concerned. Thoracoscopic approach is an attractive treatment modality as it can provide an excellent exposure with minimal incision and can complete drainage from the mediastinum and the neck in one-staged manner We describe here two cases of descending necrotizing mediastinitis successfully managed by thoracoscopic drainage.

Chest Wall Implantation of Lung Cancer After Percutaneous Fine Needle Biopsy -A Case Report (경피적 폐생검술에 의한 폐암의 흉벽 전이 -1례 보고-)

  • 심성보;이성호
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.445-448
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    • 1997
  • Percutaneous transthoracic fine needle biopsy has been widely used In the diagnosis of pulmonary lesions especially lung cancer. Onc of the rarest complication's is that malignant cells are implanted within the needle tract and developed a chest wall mass subsequently. Wc expcrlenccd a case of chest wall implantatio of lung cancer after percutaneous transthoracic floe needle biopsy. A 65-ycar old man had undergone bilobectomy (right upper lobe and right middle lobe)for squamous cell (·4rcinoma (TINOMO) of the lung. 60 days after percutaneous biopsy (48 days after operation), a tiny nodule (1 mm sized) was notcd at the right anterior chcst wall where the diagnostic fine needle biopsy had been performed before operation. This tiny mass was rapidly growing to 1.5 cm sized mass for 20 days. We carried out wide excision of chest wall mass and skin grafting, and confirmed squamous cell carcinoma histopathologically as same as the lung cancer.

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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.

A Case of Massive Air Embolism after Contrast-enhanced Computed Tomography (조영증강 흉부전산화 단층촬영 후 발생한 대량의 공기 색전증 1예)

  • Park, Byeong Chool;Kil, Ho;Park, Chan Sun;Jeong, Jee In;Choi, Eun Young;Shin, Yoon Mi;Lee, Ki Man;Kim, Sung Jin;Choe, Kang Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.178-182
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    • 2007
  • A venous air embolism is a complication of various venous access procedures such as contrast-enhanced computed tomography (CECT). Although most cases of iatrogenic venous air embolisms during CECT involve a few milliliters of air and are asymptomatic, a massive venous air embolism can be fatal. We report a case of a massive intraventricular air embolism after CECT with a review of the literature regarding the pathophysiology and treatment of air embolisms.

A Case of Bacillus Cereus Infection with Pneumonia and Bacteremia (폐렴과 균혈증의 임상상을 보인 Bacillus cereus 감염 1예)

  • Park, Jae-Hong;Jang, An-Soo;Han, Sang-Woo;Kim, Young-Chul;Lee, Kyung-Rok;Park, Sang-Hoo;Choi, Soo-In;Shin, Myung-Geun;Kim, Soo-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.780-784
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    • 2000
  • Bacillus species are aerobic-gram-positive, spore forming rods that are widely distributed in soil, dust, stream, and other environmental sources and are regarded as natural organism. But certain species of the genus Bacillus, most notably B. cereus, which is associated with food-borne illness, occasionally have been implicated in the occurrence of fatal illness and complication in a compromised host. We roport a case of pneumonia and bacteremia caused by B. cereus in an 81 year-old man, who had no obvious immunologic compromise. The condition was treated with combination of roxithromycin and gentamicin.

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