• Title/Summary/Keyword: Iatrogenic

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Iatrogenic Tracheal Posterior Wall Perforation Repaired with Bronchoscope-Guided Knotless Sutures Through Tracheostomy

  • Jung, Yong Chae;Sung, Kiick;Cho, Jong Ho
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.277-279
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    • 2018
  • A 68-year-old man presented with a posterior tracheal wall injury caused by percutaneous dilatational tracheostomy. The wound was immediately covered with an absorbable polyglycolic acid sheet. Ten days after the injury, the perforation was closed with knotless sutures using a Castroviejo needle-holder through the tracheostomy. The successful repair in this case indicates the feasibility of the knotless suture technique for perforations. The technique is described in detail in this report. The patient was weaned from the mechanical ventilator on postoperative day 25. In cases of posterior tracheal posterior wall perforation, every effort should be made to repair the perforation through an existing opening.

Sarcoptic Mange and latrogenic Hyperadrenocorticoidism in a Dog Undergoing Hyposensitisation for Atopy based on RAST Testing (방사선 알레르기 흡착 시험법(Radioallergosorbent testing, RAST)에 기반을 둔 아토피에 대한 저감작을 경험 중인 개에서의 천공개선충과 임상수의사에 의해 야기되는 고부신피질양증)

  • Burton Greg
    • Journal of the korean veterinary medical association
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    • v.38 no.6
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    • pp.549-558
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    • 2002
  • 3.5살짜리 래브라도 리트리버(Labrador Retriever)는 매일 처방되는 피질스테로이드제에 무반응으로 비계절적, 심한 소양증을 2년간 앓고 있는 병력을 갖고 있었다. 공기유래 알레르겐(알러젠; Allergens)들에 대한 시험관내 RAST1(Radioallergosorbent testing; 방사선 알레르기 흡착 시험법)에 양성으로 나타난 것을 기초로 한 면역요법(Immunotherapy)을 18개월 동안 시행했으나 성공적이지 않았다. 부신피질호르몬(Adrenocorticotropic Hormone, ACTH)자극 시험법은 이것이 본래 임상수의사에 의해 발생(Iatrogenic)된 것임을 예시하여준다. 피부 찰과물(Skin scrapings)을 검사한 결과 개 천공개선충(Sarcoptic mange)이라는 진단이 내려졌다. 이버맥틴(Ivermectin)치료효과와 피질스테로이드(Corticosteroid)의 투약중지에 대한 반응이 극적으로 나타났다. 10개월 추적기간(10-month follow-up period)동안에 이 질병은 재발되지 않았다. 이것은 비록 계절적인 알레르겐을 배제하기 위해 긴 기간동안 추적이 필요하였으나 개 천공개선충이 오히려 피질스테로이드요법에 대한 2차적인 것보다는 1차적인 질병이라는 것을 말해준다. 아토피의 진단을 위해 혈청학적 시험법의 이용이 논의되었다.

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Bilateral Chronic Subdural Hematoma Contaminated with Klebsiella Pneumoniae : An Unusual Case

  • Bakar, Bulent;Sungur, Cem;Tekkok, Ismail Hakki
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.397-400
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    • 2009
  • This article presents the case of a bilateral chronic subdural hematoma which was contaminated with Klebsiella pneumoniae and resulted in a life-threatening central nervous system infection. After repeated of bilateral burr-hole drainage, the patient became hyperpyrexic and drowsy. Suppuration within the subdural space was suspected and then the patient underwent bilateral fronto-temporo-parietal craniotomies, and pus was evacuated. Its cultures revealed Klebsiella pneumoniae. Intravenous meropenem was given for 6 weeks. He recovered completely. Microorganisms like Klebsiella pneumoniae may directly infect the subdural space with iatrogenic contamination.

OROFACIAL ODONTOGENIC INFECTIONS ASSOCIATED WITH MEDICAL DISEASES (내과적 질환을 수반한 치성감염)

  • Kim, Weon-Gyeom;Rhee, Gun-Joo;Ahn, Byoung-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.222-230
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    • 1991
  • Pyogenic orofacial infections are most commonly odontogenic in origin. Although such infections are usually self-limiting and spatially confined, purulent material may occasionally borrow deeply into contiguous fascial space or planes far from the initial site of involvement. The incidence of orofacial infection remains low in this modern era of preventive dental care and antibiotic therapy, but severe orofacial infections are most frequently observed in the medically compromised patients. We experienced 5 cases of severe orofacial odontogenic infection associated with medical diseases, and then concluded as follows : 1. The average hospitalized period was about 5 weeks, and the signs that indicated that the infections were controlled usually appeared in third week after incision and drainage. 2. The involved medical diseases were diabetes mellitus iatrogenic Cushing's syndrome, rheumatoid arthritis, malnutrition, etc. 3. The medical diseases should be treated coincidently with control of infection.

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Extraction of Impacted Supernumerary Teeth with Navigation System

  • Kim, Ji-Hyoung;Yoo, Byung-Woo;Moon, Seong-Yong
    • Journal of International Society for Simulation Surgery
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    • v.3 no.2
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    • pp.74-76
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    • 2016
  • Computer-aided navigation system is helpful in maxillofacial surgery with real time instrument positioning and clear anatomic identification. Generally, completely impacted tooth extraction surgery have e high risk by iatrogenic injury such as, adjacent tooth injury, normal anatomical structure injury. This case report describes performing extraction of impacted supernumerary teeth on anterior maxilla by using the navigation system in a 15 years old male patient.

Life-threatening airway obstruction after flapless implant placement in the anterior mandible

  • Kim, Jin-Hong;Park, Hee-Keun;Kim, Moon-Key;Kang, Sang-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.5
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    • pp.310-313
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    • 2012
  • This paper reports a patient who had an airway obstruction caused by a hemorrhage of the mouth floor that occurred after she underwent flapless implantation in the region of the mandibular anterior teeth. The hemorrhage may have been caused by iatrogenic malpositioned fixture and patient's hypertension. The lingual periosteum was not dissected during the flapless procedure. Therefore, when hemorrhage occurred, the blood did not drain easily into the oral cavity but instead drained into the deep neck region, which might have been the cause of the airway obstruction.

Removal of a broken needle using three-dimensional computed tomography: a case report

  • Kim, Jin-Ha;Moon, Seong-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.251-253
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    • 2013
  • Inferior alveolar nerve block obtained maximum anesthetic effect using a small dose of local anesthetic agent, which also has low a complication incidence. Complications of an inferior alveolar nerve block include direct nerve damage, bleeding, trismus, temporary facial nerve palsy, and etc. Among them, the major iatrogenic complication is dental needle fracture. A fragment that disappears into the soft tissue would be hard to remove, giving rise to a legal problem. A 31-year-old woman was referred for the removal of a broken needle, following an inferior alveolar nerve block. Management involved the removal of the needle under local anesthesia with pre- and peri-operative computed tomography scans.

Four Cases of Foreign Body in Lower Urinary Tract (하부 요로계 이물 : 4례 증례보고)

  • Yoo, Jin-Wook;Moon, Ki-Hak;Jung, Hee-Chang;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.391-396
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    • 1998
  • Foreign bodies in genitourinary tract are common and almost of them are within the bladder. These foreign bodies were inserted or applied for autoerotic, psychiatric, therapeutic, or no definite reasons by the patient. Foreign bodies(a thermometer and a piece of cloth) in the bladder were inserted as a mean of masturbation in two cases, and a cooper wire in the posterior urethra was introduced by iatrogenic causes in one case. In one case, four magnets were inserted into the bladder for the purpose of forceful penile erection. Clinical history, symptom, radiologic study, and endoscopic examination were required to diagnose foreign body. They were easily removed by endoscopic manipulation or open surgical procedure.

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Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain

  • Kim, Dongmin;Lim, Seong-Hoon;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.46 no.3
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    • pp.223-225
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    • 2013
  • Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

Management of Endodontic Perforation (End or And... 근관치료시 천공의 수복)

  • Jang, Ji-Hyun
    • The Journal of the Korean dental association
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    • v.55 no.8
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    • pp.565-573
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    • 2017
  • Root canal perforations are defined as the communication between the pulp cavity, the periodontal tissue and alveolar bone. The occurrence of perforations during endodontic treatment is reported to range from 2.3%~12%, which is not a complication rarely happens. Perforations have iatrogenic or pathological etiologies that involve caries or resorption. It leads to inflammation and the destruction of periodontal fibers and alveolar bone, followed by periodontal defects. Mineral trioxide aggregate (MTA) is currently the most indicated material for repair of root perforation, because of its favorable biocompatibility and sealing ability. Using magnification with dental operating microscope enhance the accessibility and visibility to manage the root perforation. It is important to diagnose and repair perforations immediately if possible.

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