• Title/Summary/Keyword: Delayed repair

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Massive Rhabdomyolysis Following Cardiopulmonary Bypass

  • Kim, Young Sam;Yoon, Yong Han;Kim, Joung Taek;Baek, Wan Ki
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.181-184
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    • 2014
  • Here, we report a case of massive rhabdomyolysis following an uncomplicated repair of a ventricular septal defect in a five-month-old baby. Postoperatively, the patient was hemodynamically stable but metabolic acidosis continued, accompanied by fever and delayed mental recovery. The next day, he became comatose and never regained consciousness thereafter. The computed tomography of the brain revealed a diffuse brain injury. The patient followed a downhill course and eventually died on postoperative day 33. An unusually high level of creatine phosphokinase was noticed, peaking (21,880 IU/L) on postoperative day 2, suggesting severe rhabdomyolysis. The relevant literature was reviewed, and the possibility of malignant hyperthermia obscured by cardiopulmonary bypass and hypothermia was addressed.

Radial Arteriovenous Fistula Developed Late after Coronary Angiography: A Case Report

  • Na, Kwon Joong;Kim, Myung A;Moon, Hyeon Jong;Lee, Jeong Sang;Choi, Jae-Sung
    • Journal of Chest Surgery
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    • v.45 no.6
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    • pp.421-423
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    • 2012
  • Transradial access is a widely accepted method for percutaneous coronary diagnostic and interventional procedures, and it has dramatically reduced access site vascular complications compared to transfemoral access. Arteriovenous fistula formation at the access site is an especially rare complication in transradial access. We report an extremely rare case of delayed radial arteriovenous fistula that developed one year after transradial coronary angiography, which was successfully treated by surgical repair.

Role of phospholipase D and osteopontin in reactive glial cells after transient forebrain ischemia

  • Kim, Seong-Yun
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 2000.04a
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    • pp.15-16
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    • 2000
  • Transient forebrain ischemia results in delayed neuronal death in the CA1 region of the hippocampus after injury, which is, at least in part, a consequence of excessive generation of reactive oxygen species. Previous in vitro studies using cell cultures or brain slices have demonstrated that phospholipase D (PLD) in the nervous system is involved in the signaling mechanism in response to a variety of agonists. Several recent studies have shown that reactive oxygen species stimulate phospholipase D (PLD) activity in several kinds of cells. Therefore, this raises the possibility that PLD activity is enhanced in the ischemic brain. Meanwhile, osteopontin (OPN) was initially identified as a sialoglycoprotein in bone, but has since been found in various tissues. Although not much is known about its function, OPN seems to play an important role in inflammation and tissue repair. Recently, it was reported that OPN was upregulated in the activated microglia after focal brain ischemia, suggesting that OPN might play a role in wound healing after a focal stroke.

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Delayed Left Atrial Perforation Associated with Erosion After Device Closure of an Atrial Septal Defect

  • Kim, Ji Seong;Yeom, Sang Yoon;Kim, Sue Hyun;Choi, Jae Woong;Kim, Kyung Hwan
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.110-113
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    • 2017
  • A 43-year-old man who had had a history of atrial septal defect (ASD) device closure 31 months previously presented with abrupt chest and back pain along with progressive cardiogenic shock and cardiac arrest. After resuscitation, he was diagnosed with cardiac tamponade. Diagnostic and therapeutic surgical exploration revealed left atrium (LA) perforation due to LA roof erosion from a deficient aortic rim. Device removal, primary repair of the LA perforation site, and ASD patch closure were performed successfully. The postoperative course was uneventful. The patient was discharged after 6 weeks of empirical antibiotic therapy without any other significant complications.

A Study on the Development of Interactive Electronic Technical Manual to Improve the Maintainability for Underwater Guided Weapon (수중유도무기의 정비성 향상을 위한 전자식 기술교범 개발에 관한 연구)

  • Shin, Ju-Hwan;Yun, Won-Young
    • IE interfaces
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    • v.18 no.3
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    • pp.308-316
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    • 2005
  • Delayed repair to the failure of weapon system can cause enormous damages to military operation. Various materials like diagnostic equipment, general and special tools, technical manuals(maintenance manual and illustrated parts breakdown) and drawing documents are required for maintenance. For existing weapon systems the distributed environment of these various materials reduces the maintenance effectiveness of maintenance crew. In this paper, to provide the information of maintenance procedures and supply to the maintenance crew we develope a digital interactive electronic technical manual of the technical documents which can be used easily in computer through question and answer method and improve maintenance effectiveness and minimized repairing time.

The Design and Development of a Web Based Information System for Military Expendable Maintenance Supply Chains (군 정비활동을 위한 웹 기반 소모성 수리부속품 보급체인 정보체계의 설계 및 구현)

  • Woo, Hoon-Shik
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.32 no.2
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    • pp.171-178
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    • 2009
  • Logistic support activities for weapon systems play an important role at maintenance activities in modern warfares. These activities are essential for keeping weapon systems ready at all time. However, maintenance supplies can be delayed without a proper information system. Further, increases of mean time to repair (MTTR) and unavailability of weapon systems can be occurred. In this study, a web based information system is developed for logistic chains of class 9 supplies. Utilizing web database technologies, the developed system can provide an environment for data exchange and sharing among various participants in the supply chain.

Traumatic diaphragmatic injuries (외상성 횡격막 손상)

  • 이형민
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.643-649
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    • 1994
  • We evaluated sixteen patients of traumatic diaphragmatic injuries that we have experienced from Jan. 1987 to Aug 1993. Age was ranged from 6 to 71 years, predominantly in the fourth and fifth decades. 13 were male and 3 were female, a ratio of 4.3: 1. Blunt trauma was develped in 11 [Lt 7, Rt 4], penetrating trauma in 5 [Lt 2, Rt 3]. Preoperative diagnosis of diaphragmatic injury was possible in 8 patients [72.2 %] in blunt trauma, and 1 patient [20 %] in penetrating trauma. 8 cases[54.5%] in blunt trauma, and 4 cases in penetrating trauma were treated within 24 hours,meanwhile, patients treated after 10 days were 3, all by blunt trauma.The repair of 16 cases were performed with thoracic approach in 4 cases, thoracoabdominal approach in 3 cases, and abdominal approach in 9 cases. The herniated organs in thorax were stomach [5], colon [3], liver [2], and pancreas [1]. Postoperative complication were developed in 9cases[56.3%] significantly related with delayed operation time [p < 0.01 ]. Hospital mortality was 12.5 % [2/16], and the causes of death were hypovolemic shock in one and hepatic failure due to portal vein rupture in another.

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A Knife Penetrating the Right Ventricle, Interventricular Septum, and 2 Valves: A Case Report

  • Megan Minji Chung;Stephanie Nguyen;Isao Anzai;Hiroo Takayama
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.456-459
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    • 2023
  • Penetrating chest trauma may result in significant intracardiac injury. A traumatic ventricular septal defect is a rare complication that requires surgical management, particularly if heart failure ensues. We report a case of delayed repair of an outlet-type ventricular septal defect and perforation of the aortic and pulmonary valve leaflets following a stab wound. This report highlights diagnostic and surgical considerations and also presents an opportunity to review the conotruncal anatomy, which may be relatively unfamiliar to many adult cardiac surgeons.

Evaluation of clinical outcomes of implants placed into the maxillary sinus with a perforated sinus membrane: a retrospective study

  • Kim, Gwang-Seok;Lee, Jae-Wang;Chong, Jong-Hyon;Han, Jeong Joon;Jung, Seunggon;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.50.1-50.6
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    • 2016
  • Background: The aim of this study was to evaluate the clinical outcomes of implants that were placed within the maxillary sinus that has a perforated sinus membrane by the lateral window approach. Methods: We examined the medical records of the patients who had implants placed within the maxillary sinus that has a perforated sinus membrane by the lateral approach at the Department of Oral and Maxillofacial Surgery of Chonnam National University Dental Hospital from January 2009 to December 2015. There were 41 patients (male:female = 28:13). The mean age of patients was $57.2{\pm}7.2years$ at the time of operation (range, 20-76 years). The mean follow-up duration was 2.1 years (range, 0.5-5 years) after implant placement. Regarding the method of sinus elevation, only the lateral approach was included in this study. Results: Ninety-nine implants were placed in 41 patients whose sinus membranes were perforated during lateral approach. The perforated sinus membranes were repaired with a resorbable collagen membrane. Simultaneous implant placements with sinus bone grafting were performed in 37 patients, whereas delayed placements were done in four patients. The average residual bone height was $3.4{\pm}2.0mm$ in cases of simultaneous implant placement and $0.6{\pm}0.9mm$ in cases of delayed placement. Maxillary bone graft with implant placement, performed on the patients with a perforated maxillary sinus membrane did not fail, and the cumulative implant survival rate was 100%. Conclusions: In patients with perforations of the sinus mucosa, sinus elevation and implant placement are possible regardless of the location and size of membrane perforation. Repair using resorbable collagen membrane is a predictable and reliable technique.

Postoperative Speech Outcomes and Complications in Submucous Cleft Palate Patients

  • Park, Tae Seo;Bae, Yong Chan;Nam, Su Bong;Kang, Kyung Dong;Sung, Ji Yoon
    • Archives of Plastic Surgery
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    • v.43 no.3
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    • pp.254-257
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    • 2016
  • Background The postoperative speech outcomes of submucous cleft palate (SMCP) surgery are known to be poorer than those of other types of cleft palate. We attempted to objectively characterize the postoperative complications and speech outcomes of the surgical treatment of SMCP through a comparison with the outcomes of incomplete cleft palate (ICP). Methods This study included 53 SMCP patients and 285 ICP patients who underwent surgical repair from 1998 to 2015. The average age of the patients at the time of surgery was $3.9{\pm}1.9years$ for the SMCP patients and $1.3{\pm}0.9years$ for the ICP patients. A retrospective analysis was performed of the complications, the frequency of subsequent surgical correction for velopharyngeal dysfunction (VPD), and speech outcomes. Results In both the SMCP and ICP patients, no cases of respiratory difficulty, bleeding, or wound disruption were noted. Delayed wound healing and fistula occurred in 18.9% and 5.7% of the SMCP patients and in 14% and 3.2% of the ICP patients, respectively. However, no statistically significant difference in either delayed wound healing or fistula occurrence was observed between the two groups. The rate of surgical correction for VPD in the SMCP group was higher than in the ICP group. In the subset of 26 SMCP patients and 62 ICP patients who underwent speech evaluation, the median speech score value was 58.8 in the SMCP group and 66 in the ICP group, which was a statistically significant difference. Conclusions SMCP and ICP were found to have similar complication rates, but SMCP had significantly worse speech outcomes.