• Title/Summary/Keyword: Early rupture

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Surgical treatment of patent ductus arteriosus in adult (성인에 있어서 동맥관개존증의 외과적 치료)

  • Mun, Byeong-Tak;Kim, Sang-Hyeong;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.32-40
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    • 1984
  • During the past six years from July 1977 to June 1983, fifteen adult patients of patent ductus arteriosus were surgically treated. The results were as follows: 1. Of the 15 patients, their age range was 17 to 34 years with a mean of 24 years, and sexual predominance was women [9. cf. 6 men]. 2. The most common symptom showed exertional dyspnea, and 10 patients were classed in NYHA class II, the rest were all class III. 3. On physical examination, all patients were auscultated continuous murmur, but concomitantly diastolic murmur was noted apical region in 2 patients. 4. On roentgenogram of chest, normal finding was 3 patients, and the other patients were revealed the evidence of pulmonary congestion. 5. The electrocardiogram was normal in 6 patients, but LVH was seen in 5, and 2 patients were LVH+ LAH. 6. Cardiac catheterization was performed in 12, and mean value of SO2[LPA-RV] was 6.3%, Q/Q 2.09, peak systolic pulmonary arterial pressure 45.3 mmHg, and Rp/Rs 0.365. 7. All operations were carried out by posterolateral thoracotomy. In 6 patients, division and suture of ductus were possible, the other patients were treated by division and ligation with heavy silk or Dacron patch. 8. Postoperative complications were hoarseness, persistent murmur, reoperation for bleeding, and atelectasis. Early and late mortality was 20% [3 patients], and cause of death was mainly aneurysmal rupture of previous operative site.

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Traumatic diaphragmatic injuries: Report of 11 cases (외상성 횡격막 손상 치험 11례)

  • Lee, Young;Chang, Il Sung;Kim, In Koo;Bae, Jin Sun;Son, Ki Sub
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.323-327
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    • 1976
  • Eleven cases of traumatic diaphragmatic injuries were treated at the department of Surgery from Jan. 1972 to Nov. 1976 were reviewed in this study. 1. Sex ratio of the observed patients was 10 : 1 showing definitely high incidence male patients. 2. The age distribution in this series ranged from 4 to 49 years of age, and average age was 26 years age. 3. Seven cases were received blunt injury on lower chest and upper abdomen, three cases were stabbed by knife and gunshot injury case was on case 4. Six cases were diagnosed and treated early post-traumatic stage within 24 hours, three cases were repaired within I0 days, and the last case was repaired after 5 years post-trauma. 5. The operative mortality was 10% (1/10), the cause of death was liver failure, after right lobectomy of the liver for traumatic liver rupture.

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Surgical Treatment of Congenital Aneurysms of Sinus of Valsalva A report of 10 years` experience of 18 consecutive cases (선천성 Valsalva 동 동맥류의 수술요법)

  • Kim, Gi-Bong;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.265-272
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    • 1985
  • Congenital aneurysm of sinus of Valsalva is one of the rare congenital heart disease, which is usually asymptomatic until rupture. The aneurysm usually ruptures into a cardiac chamber and produces an aorto-intracardiac fistula. Ruptured aneurysm is a grave lesion in that it causes heart failure and subsequent death. If, however, it is discovered in its early stages and operated on properly, it can be corrected with considerable success. Form January 1975 through December 1984, 18 consecutive patients with congenital aneurysm of sinus of Valsalva underwent corrective surgery using total cardiopulmonary bypass in our department of Thoracic Surgery. 1. The incidence was about 0.9% of surgical cases of congenital heart disease during that period. 2. 13 were males and 5 females, with ages ranging 12 years to 52 years. 3. Associated anomalies were VSD in 14, infundibular PS in 1, aberrant muscle band in RVOT in 1, and secondary aortic insufficiency in 9. 4. 17 were suggested to arise from right coronary sinus and 1 from noncoronary sinus; Among 17, 12 ruptured into right ventricle, and one from noncoronary sinus into right atrium. 5. Surgical correction was performed by means of direct suture closure with combined pledget or patch graft after aneurysm resection, and associated lesions were also corrected simultaneously. 6. There was only one case of operative mortality, and all the other patients were relatively uneventful in their follow-up studies.

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Intraabdominal Complications after Cardiac Surgery (심장수술후 복부장기의 합병증)

  • 김양원;조용길
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.38-42
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    • 1996
  • Intraabdominal complications after cardiac surgery are infrequent, but often fatal. From 1985 to 1993, a total of 1241 cardiovascular operations requiring cardiopulmonary by pass were performed at Pusan Paik Hospital. A total of 16 intraabdominal complications occurred, represe ting a 1.3% incidence. Complications included enterocolitis in six, hepatitis in three, gastric bleeding in two, erosive gastritis in one, cholecystitis in one, spleen rupture in one, epididymitis in one, inguinal hernia in one patient. The overall mortality rate was 12.5% (2 of 16). Three of the 16 patients underwent surgical intervention, and one died. We concluded that intraabdominal complications after cardiac surgery are associated with a high mortality rate, so when evidence of an acute abdominal symptom is observed or conservativi medical treatment fails to improve symptoms, prompt early surgical intervention should be performed.

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Surgical Treatment of the Abdominal Aortic Aneurysm (복부 대동맥류의 외과적 치료)

  • 황석하
    • Journal of Chest Surgery
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    • v.26 no.5
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    • pp.355-359
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    • 1993
  • Ten consecutive patients with abdominal aortic aneurysm were treated in Chungnam National University Hospital from May of 1985 to June of 1993. Pulsating palable mass was the most common first sign [7 patients]. The ratio of male to female was 8:2. The age ranged from 53 to 73 years with mean age of 65 years. The etiology and location of the aneurysm was atherosclerosis and infrarenal aorta in all. Dacron graft interposition [straight graft-1, bifurcation graft-7] and wrapping with aneurysmal sac were performed in 8 patients. In one patient with infected abdominal aortic aneurysm, we performed aneurysmectomy and left axillo-bifemoral bypass with 8 mm PTFE graft. And in another patient with complete thrombotic obstruction of infrarenal aortic aneurysm, we performed the suturing of the proximal part of the abdominal aortic aneurysm and aorto-bifemoral bypass with 18 x 9 mm PTFE graft. There was one operative death with the mortality rate of 11 % and 8 complications in 4 patients; ARF[2], duodenal ulcer[1], mechanical ileus[1], genitourinary dysfunction[2] and wound infection with abdominal abscess[1]. Because of the high operative mortality after rupture of the aneurysm, we think it is better to operate on early at the diagnosis of abodominal aortic aneurysm is made.

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Mechanization of Pine Cone Harvest(II) -Shearing Characteristics of Shoots of Korean Pine Trees- (잣 수확의 기계화 연구(II) -잣나무 가지의 전단 특성-)

  • Kang, W.S.;Kim, S.H.;Lee, J.S.
    • Journal of Biosystems Engineering
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    • v.19 no.1
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    • pp.17-21
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    • 1994
  • This reasearch was performed to provide the fundamental intonation for the mechanization of Korean pine cone harvest when the shoot shearing method is adopted. Shear force and stress of pine cone shoots were measured and analyzed for this purpose. Samples are selected along their harvesting time and tested in 17 levels of shoot diameter from 10 to 26mm with 1mm increment. 1) Shear force-deformation characteristics showed that shoot reached its rupture point after 2 to 4 of bio-yield points. It was supposed that these multiple bio-yield points were caused by the discrete compression of wood parts which are composed of water, nutrient, resin, etc. 2) Required shear force to shear shoot was proportional to the square of shoot diamter, however, shear force for shoots of early harvesting time(Aug. 31) was proportional to the shoot diameter. Variance of shear force was increased as the harvesting time was delayed. Shear forces were distributed from 468N(Aug. 31, 12mm dia) to 4153N(Aug. 31, 26mm dia) disregarding the sampling date. 3) The average shear stresses by sampling dates were 744,822, and 883N/m2, respectively, and for the earlier shoot samples shear stress was quite smaller than the others. Shear stress was proportional to shoot diameter squared, and the effect of shoot diameter on the shear stress was decreased as harvesting time was delayed.

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Surgical Treatment of Infective Endocarditis (감염성 심내막염에 대한 외과적치료)

  • Wang, Ok-Bo;Park, Ju-Cheol
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1055-1060
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    • 1992
  • Clinical experience of 21 patients with infective endocarditis was reviewed. Endocarditis involved the left-sided valve in 16 cases, the right-sided valve in 2, and PDA in the remaining 3 patients. Valve abnormalities included leaflet perforation in 9 patients, chordal rupture in 2,; annular abscess in 6; and aorticoleft atnal perforation in 2. Sixteen patients underwent valve replacement[aortic valve replacement in 7 patients, mitral replacement in 4 and double valve replacement in 5], two had VSD closure with pulmonary valve excision, three had ductus arteriousus closure. The patients were classified into two groups. I ] Healed endocarditis group: including the patients who had completed a planned cou-rseof antibiotic therapy[N=10], II ] Active endocarditis group: patients in which operations were performed prior to completetion of antibiotic treatment course[N=11]. The indications for operation included congestive heart failure, embolism, and persistent sepsis. Organisms were predominantly streptococcus[N=5] and staphylococcus [N=4] followed by candida, moraxella, and E-coli. By NYHA functional classification, all patients were in Class III or IV preoperatively. There was only one operative mortality in patient from group II. All patients substantially, improved postoperatively with NYHA classification in class I or II. This study shows that early surgical intervention in patients with active endocarditis has desirable outcome.

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Estradiol Valerate Exerts Neuroprotective Effects in Ischemic Rat Brain when Administered after Middle Cerebral Artery Occlusion

  • Yoo, Seong-Jin;Yu, Jeong-Min;Youm, Mi-Young;Kim, Do-Rim;Kim, Jee-Yun;Kang, Sung-Goo
    • Proceedings of the Korean Society of Embryo Transfer Conference
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    • 2002.11a
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    • pp.111-111
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    • 2002
  • Stroke occurs when local thrombosis, embolic particle or the rupture of blood vessele interrupts the blood floe to the brain. $\beta$-estradiol 17-valerate has been reported to exert neuroprotective effects when administered before an ischemic insult. Recently, the pathophysiology of cerebral ischemia has been studied extensively in rat with various methods. In the present study, we investigates whether $\beta$-estrodiol 17-valerate can protect against brain injury. RNA sample were extracted from the hippocampus of female rat, reverse-transcription in the presence of [$\alpha$32p] dATP. Differential gene express-ion profiles were revealed (Bone morphogenetic protein type 1A receptor, Protein disulphide isomerase, Leukemia inhibitor factor receptor, cytochrome bc- 1 complex-x core P, thiol-specific antioxidant protein). RT-PCR was used to validate the relative expression pattern obtained by the cDNA array. The precise relationship between the early expression of recovery genes and stroke is a matter of luther investigation. This Study was supported by the Korea Science and Engineering Foundation(KOSEF) through the Biohealth Products Research Center(BPRC), Inje University, Korea.

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Analysis of Lethality in Echinococcal Disease

  • Khachatryan, Anna S.
    • Parasites, Hosts and Diseases
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    • v.55 no.5
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    • pp.549-553
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    • 2017
  • The information on mortality from echinococcosis is important not only for a better understanding of the severity of the disease, but also for evaluating the effectiveness of public health interventions. The aim of this research was to study the causes of mortality from echinococcosis. We have collected and analyzed the materials of 1,470 patients in 10 age - groups in the Republic of Armenia (from 2000 to 2016). To find out the causes of mortality from echinococcosis, we have analyzed the medical histories and protocols of postmortem examinations of 19 deaths from echinococcosis and 17 deaths due to other indirect causes not associated with the parasite. The average annual death rate from echinococcosis is 0.007 per 10,000 population, and the mortality is 1.29 (per 100 patients). The highest mortality occurs in people aged 70-79. Mortality from echinococcosis is also recorded among the unoperated children. The rupture of the parasitic cyst and hepatic insufficiency are major among the direct causes of mortality. Sometimes the hydatid cysts unrecognized during the life were first diagnosed at autopsy. Insufficient qualification of doctors in the field of helminthology, as well as the latent course of the disease or manifestation of minor symptoms in echinococcosis over a long period often led to medical errors. Further decline in mortality can be achieved by early diagnosis, timely hospitalization and treatment before the development of severe complications worsening the prognosis and outcomes of surgical intervention.

Delayed Bronchoplasty in Complete Transection of Left Main Bronchus after Blunt Trauma (외상성 좌측주기관지 절단환자의 지연수술 치험)

  • 김명천;이재영;조규식;박주철;유세영
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.182-185
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    • 1998
  • Recently, The non-penetrating injury of bronchus has been increased, especially by traffic accident. Early diagnosis and primary repair of bronchial injury not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. This report describes about a case of total collapse and consolidation of left lung with the complete transection of nearly bifurcated portion of left main bronchus , lasted for 2weeks after traffic accident. This was diagnosed by fiberbronchoscopy and 3-D chest computed tomography(CT). She underwent the sleeve resection and end to end anastomosis, and postoperative PEEP for 2 days, suctioning twice by fiberbronchoscopy, continue postural drainge and physiotherapy were applied. She had almost full expansion of the left lung at discharge.

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