• Title/Summary/Keyword: Brain Dead

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Clinical Evaluation of Lung Cancer Confirmed to be Dead in the Post-operative Follow-up Periods (사망이 확인되었던 폐암환지의 임상적 고찰)

  • 이두연
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.86-95
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    • 1992
  • We have performed surgical operations for 184 primary lung carcinomas over a 10 year period from December, 1979 to December, 1990 at the department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea. We have reviewed 77 cases confirmed to be dead in the post-operative follow-up period among 184 cases. There were 68 males and 9 females [M: F=7.56: 1], with 76.62% ranging between 50 to 70 years old There were 50 cases[64.94%] of squamous cell carcinoma, 15[19.48%] of adenocarcinoma, 4[5.19%] of large cell carcinoma, 4[5.19%] of mixed cell carcinoma 3 [3.90%] of small cell carcinoma % 1 case of bronchoalveolar cell carcinoma. There were 25 cases[32.47%] in stage I, 12 [15.58%] in stage II 32 [41.56%] in stage IIIa and 8 [10.39%] in stage IIIb according to the new international staging system for lung cancer. The operative methods were left pneumonectomy in 38 cases, right pneumonectomy in 21, bilobectomy in 5, lobectomy in 12, and wedge resection in one case.ase. There were 9 operative mortalities; one case by bleeding, 5 cases by respiratory failure, one case by bleeding & renal failure, one case by empyema thoracis with BPF and one case by brain metastases. The actuarial mean survival length was 14.636$\pm$18.188months overall and 16.441$\pm$18. 627months in 68 cases excluding 9 operative deaths. The actuarial mean survival length was 18.568$\pm$11.057 months in 43 squamous cell carcinomas, 14.385$\pm$11.057 months in 14 adenocarcinomas, 10.250$\pm$8.884months in 4 large cell carcinomas and 12.250$\pm$17.193months in 4 mixed cell carcinomas. The actuarial mean survival length was 14.051$\pm$16.963months in 59 pneumonectomy cases, 15.200$\pm$12.478 months in 5 bilobectomy cases, 18.417$\pm$26.026months in 12 lobectomy cases. The actuarial mean survival length was 28.952$\pm$25.738months in 22 stage I cases, 19. 455$\pm$16.723months in ll stage II cases, 8.633$\pm$6.584months in 29 stage IIIa cases and 6. 167$\pm$4.355months in 6 stage IIIb cases. The differences of actuarial mean survival length according to the stages were statistically significant [a=0.003]

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The First Successful Heart-Lung Transplantation in Korea (심장-폐이식 1례보고)

  • 박국양;김주이;박철현;김상익;김정철;현성열;심현자;정미진;권진형
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.610-614
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    • 1998
  • The first heart-lung transplantation in Korea was successfully performed. The recipient was a 11 year old girl with pulmonary atresia with intact ventricular septum. She had been catheterized at the ages of 4 months, 3 years, 7 years and 10 years, which revealed that neither Fontan nor biventricular repair was feasible. The donor was a traffic accident victim, a 9 year-old boy with the same blood type. The donor was pronounced dead according to the guidelines of the Korean Medical Association's Brain Death Committee. The operation was performed on April 20, 1997. The native heart-lung block was explanted segmentally and donor one was placed above the phrenic nerve using the Arizona technique. After the tracheal anastomosis with single continuous 4-0 prolene, both vena cavae were anastomosed, followed by aortic anastomosis. The graft ischemic time was 145 minutes. The postoperative course was complicated by fever and tracheal stenosis at the anastomosis site. The fever was controlled by anti-tuberculous medications and the tracheal stenosis was relieved by stent(Palmaz 8 mm, 30 mm in length) placement on POD #71. The patient is doing well and is very active in her 7th postoperative month.

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Toxoplasmic meningoencephalitis in a stray cat in Korea

  • Kim, Ha-Young;Bae, You-Chan;Woo, Gye-Hyeong;Byun, Jae-Won;Jung, Byeong-Yeal;Park, Jung-Won;Chae, Hee-Sun;Choi, Jae-Yong;Nakayama, Hiroyuki;Hwang, Eui Kyung;Joo, Yi-Seok;Lee, O-Soo
    • Korean Journal of Veterinary Research
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    • v.49 no.4
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    • pp.291-295
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    • 2009
  • A dead stray cat was necropsied for zoonotic feline disease monitoring. Grossly, there were no specific lesions. Major microscopic lesions included lymphocytic meningoencephalitis, malacia, and tissue cysts in the cerebral and cerebellar cortex. The size and shape of tissue cysts were identical to those of Apicomplexa including Toxoplasma (T.) gondii. Bradyzoites in the tissue cyst were strongly positive for T. gondii by immunohistochemistry. Electron microscopy revealed that bradyzoites within the tissue cyst were similar to the morphological features of T. gondii. Fresh tissue samples were examined by a polymerase chain reaction assay and resulted in a specific band of T. gondii only in the brain. Based on the results, this case was diagnosed as toxoplasmosis. This is the first case of toxoplasmic meningoencephalitis in a cat in Korea.

Role of Muscle Free Flap in the Salvage of Complicated Scalp Wounds and Infected Prosthetic Dura

  • Han, Dae Hee;Park, Myong Chul;Park, Dong Ha;Song, Hyunsuk;Lee, Il Jae
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.735-741
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    • 2013
  • Background The prosthetic dura is an essential element in the protection of the cranial parenchyma and prevention of cerebrospinal fluid leakage. Although prosthetic dura are widely used in neurosurgery, they occasionally provoke infection, which can be a major concern after neurosurgical treatment. However, removal of the prosthetic dura carries a risk of brain parenchyma injury and cerebrospinal fluid leakage. The salvage of infected prosthetic dural material has not been adequately addressed in the literature. In this study, we demonstrate the value of the combination of a meticulous surgical debridement of necrotic tissue and simultaneous muscle free flap for intractable postoperative epidural abscess without removal of the infected prosthetic dura. Methods Between 2010 and 2012, we reviewed the data of 11 patients with persistent infection on the prosthetic dura. The epidural infections each occurred after a neurosurgical procedure, and there was soft tissue necrosis with the disclosure of the underlying prosthetic dura and dead bone around the scalp wound. To salvage the infected prosthetic dura, meticulous debridement and a muscle free flap were performed. Results All 11 patients experienced complete recovery from the complicated wound problem without the need for further surgical intervention. No signs of prosthetic dural infection were observed during the mean follow-up period of 11 months. Conclusions The combination of a meticulous surgical debridement and coverage with a muscle free flap is an effective treatment for salvage of infected prosthetic dura.

Reproductive Toxicity Evaluation of Pestban Insecticide Exposure in Male and Female Rats

  • Morgan, Ashraf M.;El-Aty, A.M. Abd
    • Toxicological Research
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    • v.24 no.2
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    • pp.137-150
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    • 2008
  • Sexually mature male and female rats were orally intubated with the organophosphorus insecticide, Pestban at a daily dosage of 7.45 or 3.72 mg/kg bwt, equivalent to 1/20 and 1/40 $LD_{50}$, respectively. Male rats were exposed for 70 days, while the female rats were exposed for 14 days, premating, during mating and throughout the whole length of gestation and lactation periods till weaning. The results showed depressed acetylcholinesterase(AChE) activity in the brain of parents, fetuses and their placentae in a dose-dependent manner. The fertility was significantly reduced with increasing the dose in both treated groups, with more pronounced suppressive effects in the male treated group. The number of implantation sites and viable fetuses were significantly reduced in pregnant females of both treated groups. However, the number of resorptions, dead fetuses, and pre-and postimplantation losses were significantly increased. The incidence of resorptions was more pronounced in treated female compared to male group and was dose dependant. The behavioral responses as well as fetal survival and viability indices were altered in both treated groups during the lactation period. The incidence of these effects was more pronounced in the treated female group and occurred in a dose-related manner. The recorded morphological, visceral, and skeletal anomalies were significantly increased with increasing the dose in fetuses of both treated groups, with more pronounced effects on fetuses of treated females. In conclusion, the exposure of adult male and female rats to Pestban would cause adverse effects on fertility and reproduction.

Isolation and cultivation of swine encephalomyocarditis virus (돼지 뇌심근염 바이러스의 분리 배양)

  • Ha, Yong-kong;Yoon, Seok-min;Jung, Byung-tack;Park, Nam-yong;Lee, Bong-ju;Chung, Chi-young;Kee, Hye-young;Bae, Seong-yeol
    • Korean Journal of Veterinary Research
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    • v.31 no.4
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    • pp.479-484
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    • 1991
  • Encephalomyocarditis(EMC) virus was isolated from the mummified and stillborn pigs at a swine farm in Chonnam Province, experienced with EMC infection over the period Oct.~Dec. of 1989. In addition some cultural, serological properties of the isolates and experimental infections in the piglets were studied. The results obtained were as follows; 1. Two EMC virus strains with HA titers and CPE similar to EMC-ATCC were established in a baby hamster kidney (BHK)-21 cell line by inoculating homogenates of brain and heart of the 19 mummified or stillborn pigs and designated $K_3$ and $K_{11}$. 2. At the second BHK-21 cell line passage of the initial isolates CPE appeared after incubation for 16~18 hours, while at the fourth and fifth passage the highest titer of HA was recorded, titer of HA using rat and guinea pig erythrocytes. 3. One pig inoculated with the isolate $K_3$ showed dyspnea as clinical signs and died at the 10 days after inoculation at necropsy white necrotic foci were observed from the dead animal heart. 4. Although all the rest surviving pigs showed increases in antibody titer and body temperature of $40^{\circ}C$ above for the initial 2~4 days followed by the return to normal, there were no gross lesions when the animals were sacrificed at the 2 weeks after inoculation.

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Staged reconstruction of a chronically infected large skull defect using free tissue transfer and a patient-specific polyetheretherketone implant

  • Moon, Seung Jin;Jeon, Hong Bae;Kim, Eui Hyun;Lew, Dae Hyun;Kim, Yong Oock;Hong, Jong Won
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.309-314
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    • 2020
  • Reconstructions of extensive composite scalp and cranial defects are challenging due to high incidence of postoperative infection and reconstruction failure. In such cases, cranial reconstruction and vascularized soft tissue coverage are required. However, optimal reconstruction timing and material for cranioplasty are not yet determined. Herein, we present a large skull defect with a chronically infected wound that was not improved by repeated debridement and antibiotic treatment for 3 months. It was successfully treated with anterolateral thigh (ALT) free flap transfer for wound salvage and delayed cranioplasty with a patient-specific polyetheretherketone implant. To reduce infection risk, we performed the cranioplasty 1 year after the infection had resolved. In the meantime, depression of ALT flap at the skull defect site was observed, and the midline shift to the contralateral side was reported in a brain computed tomography (CT) scan, but no evidence of neurologic deterioration was found. After the surgery, sufficient cerebral expansion without noticeable dead-space was confirmed in a follow-up CT scan, and there was no complication over the 1-year follow-up period.

Vibro ordalii, the causative agent of massive mortality in cultured rockfish(Sebastes schlegeli) larvae (양식 조피볼락(Sebastes schlegeli) 치어의 대량폐사 원인인 비브리오병에 관하여)

  • Park, Sung-Woo;Kim, Young-Gill;Choi, Dong-Lim
    • Journal of fish pathology
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    • v.9 no.2
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    • pp.137-145
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    • 1996
  • A specific disease syndrome, which led to massive mortality on larve of rockfish(Sebastes schlegeli) in marine hatcheries at Chungnam area during the period 1995~1996 was studied. The causative agent isolated from the diseased or dead larvae was identified as Vibrio ordalii on the basis of biochemical and biological characteristics. In the experimental challenges aganist 0 and 1 summer fish conducted at two different temperatures as $18^{\circ}C$ and $25^{\circ}C$, Vibrio ordalii showed higher virulence to no summer fish at $18^{\circ}C$ than 1-summer fish at $25^{\circ}C$. These results were consistent to field data obtained during epizootic outbreaks in the farms. Moribund and died larvae presented telangiectasis of secondary gill lamella and brain, dissecting of respiratory epithelium, atrophy of hepatic cells and necrosis of kidney associated with the presence of the bacteria. But the digestive tissue of these fish showed no significant change.

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Risk Acceptance and Expectations of Scalp Allotransplantation

  • Choi, Jun Ho;Kim, Kwang Seog;Shin, Jun Ho;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.17 no.2
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    • pp.68-76
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    • 2016
  • Background: In scalp allotransplantation, the scalp from a brain-dead donor, including hair, is transferred to a recipient with scalp defects. Opinions differ on the appropriateness of scalp allotransplantation. In order to maintain graft function and cosmetic outcomes, scalp transplantation recipients would need to receive lifelong immunosuppression treatments. The risks of this immunosuppression have to be balanced against the fact that receiving a scalp allotransplant does not extend lifespan or restore a physical function. Therefore, the present study aimed to investigate risk acceptance and expectations regarding scalp allotransplantation in different populations. Methods: A questionnaire survey study was conducted. A total of 300 subjects participated; survey was conducted amongst the general public (n=100), kidney transplantation recipients (n=50), a group of patient who required scalp reconstruction due to tumor or trauma (n=50), and physicians (n=100). The survey was modified by using the Korean version of the Louisville instrument for transplantation questionnaire. Results: Risk acceptance and expectations for scalp transplantation varied widely across the groups. Kidney transplantation recipients revealed the highest risk acceptance and expectations, whereas the physicians were most resistant to the risks of scalp transplantation. Conclusion: Our study demonstrates that, in specific groups, scalp allotransplantation and the need for immunosuppression carries an acceptable risk despite the lack of lifeextending benefits. Our results suggest that scalp allotransplantation can be an acceptable alternative to existing scalp reconstruction surgeries in patients with pre-existing need for immunosuppression.

Molecular characterization of a pigeon paramyxovirus type 1 virus isolated from Eurasian collared doves in Iran, 2017

  • Esmaeelzadeh-Dizaji, Reza;Molouki, Aidin;Hosseini, Hossein;Fallah-Mehrabadi, Mohammad Hossein;Ziafati-Kafi, Zahra;Takalou, Azin;Eram, Nava;Kumar, Niloufar;Ashuri, Alireza;Sadri, Naser;Ghalyanchi-Langeroudi, Arash
    • Journal of Veterinary Science
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    • v.23 no.3
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    • pp.29.1-29.6
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    • 2022
  • In September 2017, an outbreak with high mortality, which showed the typical signs of ND, occurred among a flock of more than 2000 Eurasian collared doves in Konarak, southeast of Iran. A confirmed pigeon paramyxovirus type 1 strain was isolated from the brain tissues of the dead doves. The isolate, which was called Pigeon/Iran/Konarak/Barin/2017, was classified as a highly velogenic NDV. Complete genome sequencing and phylogenetic analysis showed that the isolate belonged to subgenotype XXI.2, which has never been reported from Iran before. The isolate had the highest homology (96.15%) with early 2010s Italian isolates. Further studies will be required to understand the diversity better.