• Title/Summary/Keyword: Heart treatment

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Surgical Outcomes for Native Valve Endocarditis

  • Park, Bong Suk;Lee, Won Yong;Ra, Yong Joon;Lee, Hong Kyu;Gu, Byung Mo;Yang, Jun Tae
    • Journal of Chest Surgery
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    • v.53 no.1
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    • pp.1-7
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    • 2020
  • Background: The aim of this study was to evaluate the short-term and long-term results of surgical treatment for native valve endocarditis (NVE) and to investigate the risk factors associated with mortality. Methods: Data including patients' characteristics, operative findings, postoperative results, and survival indices were retrospectively obtained from Hallym University Sacred Heart Hospital. Results: A total of 29 patients underwent surgery for NVE (affecting the mitral valve in 20 patients and the aortic valve in 9) between 2003 and 2017. During the follow-up period (median, 46.9 months; interquartile range, 19.1-107.0 months), the 5-year survival rate was 77.2%. In logistic regression analysis, body mass index (p=0.031; odds ratio [OR], 0.574; 95% confidence interval [CI], 0.346-0.951), end-stage renal disease (ESRD) (p=0.026; OR, 24.0; 95% CI, 1.459-394.8), and urgent surgery (p=0.010; OR, 34.5; 95% CI, 2.353-505.7) were significantly associated with in-hospital mortality. Based on Cox proportional hazard regression analysis, the statistically significant predictors of long-term outcomes were hypertension, ESRD, and urgent surgery. Conclusion: Surgical treatment for NVE is associated with considerable mortality. The in-hospital mortality and 5-year survival rates of this study were 13.8% and 77.2%, respectively. Underlying conditions, including hypertension and ESRD, and urgent surgery were independent risk factors for unfavorable outcomes.

Result of Surgical Treatment for Infective Endocarditis (심내막염의 수술적 치료 성적에 관한 보고)

  • Kim, S.H.;Ahn, H.;Kim, C.W.
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.370-376
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    • 1990
  • From April, 1981, through March, 1989, 30 patients had received valve replacements and 1 patient had received foreign body removal for infective endocarditis at Seoul National University Hospital. There were 22 male and 9 female patients, ranged in age from 22 to 59 [mean 34.9] years. Twenty-three had native valve endocarditis, 7 had prosthetic valve endocarditis and 1 had infected transvenous permanent pacemaker electrode in right heart. Twenty-four required operation during active phase of disease and 7 during inactive phase. The infecting organism was Streptococcus in 10 patients, Staphylococcus in 5 patients, both Staphylococcus and Streptococcus in 1 patient, E. coli in 2 patients, and Candida in 1 patient. Indications for Surgery were congestive heart failure in 20, systemic emboli in 5, combination of both in 3, congestive heart failure with uncontrolled sepsis in 2, and complete heart block in 1 patient. Hospital mortality was 9.7% [3/31], and all were the patients who received emergency operation. There were 2 late mortality [7.7 %] due to acute myocardial infarction and recurrent endocarditis. This report suggests that the surgical treatment can be achieved with acceptable low mortality and morbidity in medically intractable congestive heart failure, emboli and sepsis.

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Treatment of Failed Arthrodesis of First Metatarsophalangeal Joint with Tensor Fascia Lata Interposition Arthroplasty: A Case Report (실패한 제 1중족 족지관절 유합술 후 대퇴근막 장근 개재 관절 성형술을 이용한 치료: 증례 보고)

  • Sim, Jaewoo;Hyun, Yoonsuk;Park, Junsik;Kang, Saehyun;Kwon, Hwanjin;Kim, Gablae
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.1
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    • pp.39-42
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    • 2017
  • Surgical treatments for arthritis in the first metatarsophalangeal joint include arthrodesis, interposition arthroplasty using silicone or meniscus cartilage, and rarely arthroplasty. Although arthrodesis was performed successfully, pain can persist if the angle of fusion was inappropriate. Interposition arthroplasty can be tried for the treatment of persisting pain after the arthrodesis. Interposition arthroplasty using tensor fascia lata is known that has low risk of adhesions and easy to harvest. Compared to autologous grafts, grafting rates is high and low risk of rejection additionally. Herein, we report a successfully managed arthritis with severe pain with interposition arthroplasty using tensor fascia lata after a failed metatarsophalangeal joint arthrodesis.

Treatment for Severe Deformed Foot with Ilizarov Technique(2 cases) (Ilizarov 술식을 이용한 심한 족부 변형의 치료)

  • Park, Yong-Wook;Lee, Chang-Ju;Chung, Yung-Khee;Yoo, Jung-Han;Park, Ju-Hyuk
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.1
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    • pp.42-47
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    • 1998
  • The conventional surgical treatment for deformed foot has always consisted of massive soft tissue releases combined with varying methods of osteotomies and fusions to plantigrade functional foot. But, the resulting feet have often been foreshortened, stiff, and nothing more than a cosmetically acceptable but functionally poor foot. Now the techniques of distraction histogenesis has been given a new tool to apply to the complex foot deformity. We have recently experienced two cases of severe deformed feet and treated with Ilizarov technique. One patient had postcompartmental severe rigid equinocavovarus foot. And the other had traumatic severe rigid metatarsus abductus. The follow up periods were 14 and 28 months respectively. The feet were aesthetically pleasing. So, we believed that the Jlizarov technique is an excellent treating method for severe deformed foot.

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Pathophysiology and new treatment of itch (가려움증의 병태생리 및 최신치료)

  • Jung, Min Je;Choi, Yong Won;Chung, Bo Young;Park, Chun Wook;Kim, Hye One
    • Journal of the Korean Medical Association
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    • v.61 no.11
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    • pp.670-677
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    • 2018
  • Many of the patients visit the doctors because of itching sensation. Itching is an unpleasant sensation. In the epidermal keratinocytes, various neurotransmitters and receptors are related itching. The itch signal is mainly transmitted through the lateral spinal ganglion-derived nerve fibers extending to the lower epidermis. Many mediators such as histamine are involved in the itching pathway. It can be helpful in the treatment of patients having itching sensation with a lot of new therapies from the basic medication such as antihistamines. Also, many drugs are currently under study.

Pott's puffy tumor of the upper eyelid misdiagnosed as simple abscess: a case report and literature review

  • Kuylhee Kim;Donghyun Lee;Soyeon Jung;Chul Hoon Chung;Yongjoon Chang
    • Archives of Craniofacial Surgery
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    • v.25 no.3
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    • pp.141-144
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    • 2024
  • A 76-year-old woman, initially thought to have a simple abscess on her right upper eyelid, presented to our department of plastic and reconstructive surgery. Enhanced three-dimensional facial computed tomography (CT) revealed an abscess on the right upper lid, with a pyomucocele present in the right frontal sinus, accompanied by bone erosion in the superior wall of the right orbit. Based on the results of the CT scan, we diagnosed an atypical Pott's puffy tumor (PPT) with an abscess on the upper lid originating from the frontal sinusitis. First, surgical incision and drainage were performed in our department, and a percutaneous vacuum drain was placed. To provide a more definitive treatment, endoscopic sinus surgery (ESS) was subsequently performed by otorhinolaryngologists. The patient was discharged without any complications 5 days after ESS. At a 1-year follow-up, no recurrence or notable neurological symptoms were observed. In the case we observed, the patient presented with an upper eyelid abscess and cellulitis, indicating possible orbital involvement. For such patients, a CT scan is necessary. Given the possibility of PPT, it is critical to perform a comprehensive differential diagnosis rather than defaulting to a straightforward approach involving abscess treatment.

Schedule-Dependent Effect of Epigallocatechin-3-Gallate (EGCG) with Paclitaxel on H460 Cells

  • Park, Sunghoon;Kim, Joo-Hee;Hwang, Yong Il;Jung, Ki-Suck;Jang, Young Sook;Jang, Seung Hun
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.3
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    • pp.114-119
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    • 2014
  • Background: Epigallocatechin-3-gallate (EGCG), a major biologically active component of green tea, has anti-cancer activity in human and animal models. We investigated the schedule-dependent effect of EGCG and paclitaxel on growth of NCI-H460 non-small cell lung cancer cells. Methods: To investigate the combined effect of EGCG (E) and paclitaxel (P), combination indices (CIs) were calculated, and cell cycle analysis was performed. For the effect on cell apoptosis, western blot analysis was also performed. Results: CI analysis demonstrated that both concurrent and sequential E ${\rightarrow}$ P treatments had antagonistic effects (CIs >1.0), but sequential P ${\rightarrow}$ E had synergistic effects (CIs <1.0), on the growth inhibition of NCI-H460 cells. In the cell cycle analysis, although paclitaxel induced $G_2/M$ cell cycle arrest and increased the sub-G1 fraction, concurrent EGCG and paclitaxel treatments did not have any additive or synergistic effects compared with the paclitaxel treatment alone. However, western blot analysis demonstrated that sequential P ${\rightarrow}$ E treatment decreased the expression of Bcl-2 and procaspase-3 and increased poly(ADP-ribose) polymerase (PARP) cleavage; while minimal effects were seen with concurrent or sequential E ${\rightarrow}$ P treatments. Conclusion: Concurrent or sequential E ${\rightarrow}$ P treatment had opposite effects to P ${\rightarrow}$ E treatment, where P ${\rightarrow}$ E treatment showed a synergistic effect on growth inhibition of NCI-H460 cells by inducing apoptosis. Thus, the efficacy of EGCG and paclitaxel combination treatment seems to be schedule-dependent.

Treatment of Heterotopic Calcification with Ulceration in Burn Scar (화상 반흔에서 생긴 궤양을 동반한 이소성 석회화의 치료)

  • Kang, Sang-Gu;Lee, Jong-Wook;Ko, Jang-Hyu;Seo, Dong-Kook;Choi, Jai-Koo;Jang, Young-Chul
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.415-420
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    • 2010
  • Purpose: Heterotopic calcification is a pathological event in which deposits of calcium salts build up, usually in the joint area or soft tissues. It can occur under many conditions and in some rare cases may develop in burn scars. In particular, ulcerations in burn scars accompanied by heterotopic calcification are difficult to treat through conservative treatment. This study reports methods for accurate diagnosis and adequate treatment of ulceration in burn scars accompanied by heterotopic calcification. Methods: Fourteen patients who visited our hospital from March 2008 to January 2010 were subjected to this study. Their sex, age, modes of burn, degree, TBSA (%), ulcerated area, the time of occurrence of the ulcerations in the burn scars were investigated. In addition, radiological examination and biopsy was performed to diagnose heterotopic calcification. Results: Among the 14 cases, 6 were male and 8 were female. The average age of the patients was 48.2 (27 - 69 yrs). As for the mode of burn, 11 were flame burns and 3 were scalding burns. The average time of occurrence of the ulcerations in the burn scars was 4.5 months. The ulcerated areas were situated in the legs in 12 cases, arms in 1 case, and torso in 1 case. The diagnosis was confirmed through X-ray and biopsy, and skin graft was performed after wide excision. Conclusion: Diagnosis of the ulceration in burn scars accompanied by heterotopic calcification is possible through radiological and pathologic studies. Surgical treatment is the most reliable method of treatment, and we chose to perform skin graft after wide excision. Also, we learned that the complete removal of the calcified tissue and the inflammatory fibrotic tissues is crucial in preventing recurrence. Also, in contrast to Marjolin's ulcer, heterotopic calcification had a small size, little or no granulation tissue, and lacked fungating type ulceration. Therefore, favorable prognosis could be achieved through adequate treatment.

Effect of Banhasasim-tang on the Cardiac Toxicity and clinical symptom induced by Doxorubicin (반하사심탕(半夏瀉心湯)이 Doxorubicin에 의해 유발(誘發)된 심장독성(心臟毒性) 및 임상증상(臨床症狀)에 미치는 영향(影響))

  • Shin Min-Kyu;Hwang Hui-Jeung;Kim Sang-Chan;Byun Joon-Seok
    • Herbal Formula Science
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    • v.10 no.1
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    • pp.131-142
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    • 2002
  • The effect of Banhasasim-tang extracts on the cardiac toxicity and general symptom induced by Doxorubicin administration(Three injection protocol) were monitored using male ICR mice. The changes of body weight, clinical signs, necropsy findings and organ weights of heart were observed. The results were as followed. 1. Decrease of body weight after Doxorubicin treatment were dose-dependently inhibited by Banhasasim-tang extracts. 2. The degrees of anorexia, ataxia and dehydration that were observed in Doxorubicin treatment group were dose-dependently inhibited by Banhasasim-tang extracts. 3. Increase of absolute and relative heart weight observed in Doxorubicin treatment group were dose-dependently inhibited by Banhasasim-tang extracts. In addition. the degrees of heart congestion and enlargement were significantly and dose-dependently decreased after Banhasasim-tang extracts dosing groups compared to that of Doxorubicin treatment group. In conclusion, the toxicity of Doxorubicin treatment(decrease of body weights, clinical signs such as anorexia, ataxia and dehydration, changes of organ weights of heart) was inhibited and/or prevented by Banhasasim-tang extracts. According to these results. it is considered that Banhasasim-tang has some preventive effect against to toxicity induced by Doxorubicin.

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Minimally Invasive Reduction and Pin Fixation Treatment for Displaced Intraarticular Calcaneal Fracture (최소 침습적 정복술 및 금속강선 고정술을 이용한 전위된 관절내 종골 골절의 치료)

  • Lee, Jin-Young;Park, In-Heon;Kim, Gab-Lae;Kim, Tae-Hwa;Oh, Bum-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.66-72
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    • 2010
  • Purpose: To evaluate the clinical efficacy of the minimally invasive posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2006 to October 2008, we studied retrospectively 45 patients, 56 cases who were treated with minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and AOFAS score, circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 1 was 81, type 2 was 75, type 3 was 69, type 4 was 61. By AOFAS score, Sanders type 1 was 88, type 2 was 82, type 3 was 78, type 4 was 63. And by circle draw test, type 1 was 8.8 cm, type 2 was 8.5 cm, type 3 was 8 cm, type 4 was 6.6 cm. Preoperative Bohler angle and Gissane angle were $7.2^{\circ}$, $98^{\circ}$, and it increased to $21.2^{\circ}$, $116^{\circ}$ after postoperative 1 year. Conclusion: Minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture was considered to be an effective treatment modality.