• Title/Summary/Keyword: Bilateral sequential

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Sequential Surgical Treatment of Hemoptysis Caused by Bilateral Aspergilloma -A case report- (양측 폐상엽 진균구에 의한 객혈의 순차적 수술 치험 1례)

  • Hur, Jin;Goo, Bon-Won
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.569-573
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    • 2001
  • We experienced a case of hemoptysis caused by bilateral upper lobe aspergilloma. He was 66 years old and had a history of old unclear pulmonary tuberculosis with irregular medication 20 years ago and intermittent hemoptysis for several years. In x-ray study, there was a bilateral upper lobe aspergilloma with cavity. He received bilateral wedge resection through thoracotomy with some interval to reduce postoperative complications. We selected the priorty of operation through the bronchoscope in the operation room. Both sides had the same pathology of aspergilloma and he was discharged after an uneventful postoperative course.

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Sequential Bilateral Lung Transplantation with Extracorporeal Membrane Oxygenation (ECMO) Support - A case report - (체외막 산소화 장치를 이용한 순차적 양측 폐이식 수술 치험 - 1예 보고 -)

  • Lee, Mina;Kim, Kwhanmien;Sung, Ki-Ick
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.96-99
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    • 2010
  • Artificial lung support may be necessary in various conditions during the performance of bilateral lung transplantation, and cardiopulmonary bypass (CPB) has usually been used. Yet using the conventional CPB techniques may increase risk of bleeding and early allograft dysfunction due to the large dosages of heparin and the complement activation. Extracorporeal membrane oxygenation (ECMO) is able to support gas exchange and maintain the hemodynamics without administering high-dose heparin for anticoagulation. We performed sequential bilateral lung transplantation with ECMO support. ECMO is a valuable tool when performing lung transplantation and it has the potential to replace CPB.

Animal Model for Sequential Bilateral Reimplantation of the Lung in Dog (순차적 자가 양측 폐재식을 위한 황견에서의 실험 model -2례 보고)

  • 이두연;김해균
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.733-738
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    • 1997
  • Sequential bilateral lung transplantation may result in a variety of perioperative and postoperative complications, showing high perioperative morbidity and mortality rates. This research was performed to investigate the hemodynamic changes in adult mongrel dogs after bilateral reimplantation, two methods preferred for avoiding or minimizing graft rejection. The anterior portion of the pulmonary artery and the left atrium proximal to the superior and the inferior pulmonary veins were resected out and then re-anastomosed one hour later to prevent torsion or stenosis of the anastomotic site and the formation of a thrombosis in the left atrium. An everted suture technique was employed for the left atrium; An hour after the division, however, the main bronchus was tightly anastomose by interrupted sutures of No. 4-0 prolene in a telescope method. A modified I-C solution mixed with PGEI was infused into the cut portion of the pulmonary artery at the rate of 15 mllkglmin and at a pressure of 40 cmH20 for a total dosage of 70 mlfkg in order to preserve the transected lung. Topical cooling using wet gauzes soaked with cold I-C solution was performed for one hour to prevent ischemic lung injury. The above procedures are considered to be beneficial for achieving a satisfactory outcome for bilateral lung reimplantation.

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Left Sleeve Pneumonectomy Via Sequential Bilateral Thoracotomy in Carinal Squamous Cell Carcinoma -One case report- (기관분기부 편평상피 세포암에서 순차적 양측 개흉술을 통한 좌측 소매 전폐 절제술 치험 1예)

  • 김도형;강두영;백효채
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.444-447
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    • 2003
  • Sleeve pneumonectomy can be a method of treatment in a selected patient with bronchogenic carcinoma involving carina. A 64 years old male with a history of mitral valve replacement via midsternotomy 13 years ago and resection of papilloma of the vocal cord 2 years ago. The patient was admitted due to blood-tinged sputum. Bronchoscopy and computerized tomogram of the chest revealed 3.5 cm mass at lower margin of the trachea and totally obstructing the left main bronchus. A biopsy revealed squamous cell carcinoma. He underwent left sleeve pneumonectomy through sequential bilateral thoracotomy without cardiopulmonary bypass, and the pathologic stage was T4N0M0 stage IIIB. The patient is being followed through the outpatient clinic in good general condition.

Optimal endoscopic drainage strategy for unresectable malignant hilar biliary obstruction

  • Itaru Naitoh;Tadahisa Inoue
    • Clinical Endoscopy
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    • v.56 no.2
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    • pp.135-142
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    • 2023
  • Endoscopic biliary drainage strategies for managing unresectable malignant hilar biliary obstruction differ in terms of stent type, drainage area, and deployment method. However, the optimal endoscopic drainage strategy remains unclear. Uncovered self-expandable metal stents (SEMS) are the preferred type because of their higher functional success rate, longer time to recurrent biliary obstruction (RBO), and fewer cases of reintervention than plastic stents (PS). Other PS subtypes and covered SEMS, which feature a longer time to RBO than PS, can be removed during reintervention for RBO. Bilateral SEMS placement is associated with a longer time to RBO and a longer survival time than unilateral SEMS placement. Unilateral drainage is acceptable if a drainage volume of greater than 50% of the total liver volume can be achieved. In terms of deployment method, no differences were observed in clinical outcomes between side-by-side (SBS) and stent-in-stent deployment. Simultaneous SBS boasts a shorter procedure time and higher technical success rate than sequential SBS. This review of previous studies aimed to clarify the optimal endoscopic biliary drainage strategy for unresectable malignant hilar biliary obstruction.

Successful Bilateral Lung Retransplantation in a Patient with Primary Graft Failure Following a Single Lung Transplantation (일측 폐 이식 후 발생한 이식편 부전으로 양측 폐 재이식을 시행한 1예 보고)

  • Hwang Jung-Joo;Joung Eun-Kyu;Kim Jae-Ho;Lee Doo-Yun;Paik Hyo-Chae
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.490-494
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    • 2006
  • Lung transplantation is the choice of treatment for selected patients with end-stage pulmonary disease. However, retransplantation of the lung due to primary graft failure carries a high risk of morbidity and mortality. This is a case of a 52 year old male with emphysema who continuously needed a ventilator care and a tracheostomy. He underwent a left single lung transplantation but were not able to wean from the ventilator due to primary graft failure, and therefore we decided to do a retransplantation. Bilateral sequential single lung transplantation was performed under the cardiopulmonary bypass. The patient recovered quite well and was discharged and fully active with his work. Retransplantation although it carries a high risk, is a very effective treatment in patients with primary graft failure.

Clinical Implications of the Premature Loss of the Mandibular Primary Canine (하악 유견치 조기탈락은 무엇을 의미할까?)

  • Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.1
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    • pp.87-101
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    • 2015
  • The premature loss of the mandibular primary canine is relatively frequent and a sign of the upcoming space problems in the transitional period. This situation is caused by the permanent lateral incisor resorbing the root of the primary canine during its eruption. Bilateral loss of primary canines in a crowded arch leads to the lingual tipping of the permanent incisors, with the consequent reduction in the arch perimeter and increase in overbite. When the loss of a primary canine is unilateral, tipping of the adjacent incisors occurs toward the space, resulting in midline deviation. In these situations, treatment possibilities, such as extraction of the antimeric tooth or placement of a passive lingual arch, can be applied; although there are some controversies concerning this. Most space problems with less than 4 mm can be resolved through preservation of the leeway space using sequential disking of the primary teeth and a passive lingual arch, regaining space or limited arch expansion in the late mixed dentition. In cases with 4~6 mm of space problems, arch expansion (A-P or transverse) can be applied. Space problems with more than 6 mm should be treated through diagnosis and treatment planning. Most of these cases will require extraction of permanent teeth including serial extraction (guidance of eruption).

Successful Lung Transplantation in a Patient with Myasthenia Gravis

  • Kim, Kangmin;Lee, Hyun Joo;Park, Samina;Hwang, Yoohwa;Kim, Young Whan;Kim, Young Tae
    • Journal of Chest Surgery
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    • v.50 no.5
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    • pp.382-385
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    • 2017
  • A 47-year-old man with myasthenia gravis (MG) was admitted for a lung transplant. He had bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation due to acute myeloid leukemia. MG developed after stem cell transplantation. Bilateral sequential lung transplantations and a total thymectomy were performed. The patient underwent right diaphragmatic plication simultaneously due to preoperatively diagnosed right diaphragmatic paralysis. A tracheostomy was performed and bilevel positive airway pressure (BiPAP) was applied on postoperative days 8 and 9, respectively. The patient was transferred to the general ward on postoperative day 12, successfully weaned off BiPAP on postoperative day 18, and finally discharged on postoperative day 62.

Comprehensive orthodontic treatment of a young girl with an odontogenic keratocyst and impacted teeth in the mandible

  • Baik, Won-Kyeong;Baik, Hyoung-Seon;Choi, Sung-Hwan
    • The korean journal of orthodontics
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    • v.50 no.1
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    • pp.63-71
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    • 2020
  • Odontogenic keratocysts (OKCs) are one of the most aggressive cysts in the oral and maxillofacial area because of their high recurrence rate and infiltrative behavior. In growing patients with OKCs, a radical treatment approach might cause numerous complications, including the disturbance of jaw growth and loss of the involved tooth. This case report describes successful comprehensive orthodontic treatment combined with marsupialization of the cyst in a young girl who exhibited an OKC with impacted teeth. The 10-year-old girl presented with an OKC extending from the mandibular symphysis through the left mandibular body, with ectopic impaction of the mandibular left canine and first premolar, as well as congenitally missing bilateral mandibular second premolars. Interestingly, spontaneous improvement of the positions of the ectopic impacted teeth, along with a reduction in the size of the cyst, occurred during marsupialization. The sequential use of removable and fixed appliances enabled orthodontic traction of the impacted teeth. The treatment outcome was stable at 2.5 years after the end of the treatment. We speculate that comprehensive orthodontic treatment combined with marsupialization can be an effective treatment strategy for patients with OKCs, especially when they are encountered in young, growing patients with impacted teeth.