• Title/Summary/Keyword: Incision & drainage

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Clinical Evaluation of Instrumental Esophageal Perforation (기구에 의한 식도천공에 대한 임상적 고찰)

  • Sa Young-Jo;Kang Chul-Ung;Cho Kyu-Do;Park Kuhn;Wang Young-Pil;Park Jae-Kil
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.387-393
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    • 2006
  • Background: Esophageal perforation is an uncommon problem, but it is associated with high mortality. We performed a retrospective review of patients with instrumental esophageal perforation to assess the outcome of current management techniques. Material and Method: We retrospectively analyzed all cases of instrumental esophageal perforation diagnosed at our hospital from January 1999 through to March 2005. The study group consisted of 12 patients (8 women and 4 men) with a mean age of 48.8 years (range, $21{\sim}83$ years). We reviewed the effects of the surgical or medical treatments in various conditions of patients, such as of various sites of perforation and time delayed after injury. Result: Perforations were due to diagnostic endoscopy (50.0%, 6/12), esophageal bougination for benign stricture (33.3%, 4/12), endoscopic port insertion (8.3%, 1/12), and tracheal intubation (8.3%, 1/12). The perforated sites were thoracic in 7 patients and cervical in 5. The treatment included resection and reconstruction (5 cases), incision and drainage (4 cases), medical treatment (2 cases), and closed thoracostomy drainage only (1 case). Post-operative complications of transient pneumonia and wound infection were developed in 1 patient respectively. Both occurred in two patients with diffuse mediastinal abscess formation. The overall mortality was 8.3% (1/12) in one old patient who was managed medically for cervical esophageal perforation. Conclusion: We concluded that surgical treatment for esophageal perforations was safe and effective whether diagnosed early or lately.

Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava

  • Lee, Sub;Kim, Han-Woong;Kang, Hyoung-Seok;Bae, Chi-Hoon;Jheon, Sang-Hoon;Kwon, Oh-Choon;Ahn, Wook-Su
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.672-679
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    • 2001
  • Background: Surgical correction of partial anomalous pulmonary venous connection to the superior vena cava has been associated with postoperative venous obstruction and sinus node dysfunction. In this paper we describe our current approach and its short-term results. Material and Method: Between April 1999 and January 2000, 5 consecutive patients, ranging from 2 months to 66 years old, underwent corrective operation for partial anomalous pulmonary venous connection to the superior vena cava at Sejong General Hospital and Daegu Catholic University Medical Center. Surgical correction involved diversion of the pulmonary venous drainage to the left atrium using a right atrial flap(2 patients) or prosthetic patch(3 patients) with division of the superior vena cava superior to the restore site of the pulmonary veins and reimplantation on the right atrial appendage to restore systemic venous drainage. Result: All patients were discharged between postoperative day 9 and 15 without complications. One Russian boy returned to his country, therefore, he was lost to follow-up after discharge. Remaining 4 patients were asymptomatic and in normal regular sinus rhythm at a mean follow-up of 17.75$\pm$4.27 months. Follow-up echocardiographic study (range, 12 to 24 months) revealed no incidence of narrowing of the venous pathways or of residual shunt. Conclusion: Our current approach is relatively simple and reproducible in achieving unobstructive pulmonay venous and SVC pathways. By avoiding incision across the cavoatrial junction, surgical injury to the sinus node and its artery may be minimized. The presented surgical technique can be safely and effectively applied to the selected patients.

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Geology of Athabasca Oil Sands in Canada (캐나다 아사바스카 오일샌드 지질특성)

  • Kwon, Yi-Kwon
    • The Korean Journal of Petroleum Geology
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    • v.14 no.1
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    • pp.1-11
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    • 2008
  • As conventional oil and gas reservoirs become depleted, interests for oil sands has rapidly increased in the last decade. Oil sands are mixture of bitumen, water, and host sediments of sand and clay. Most oil sand is unconsolidated sand that is held together by bitumen. Bitumen has hydrocarbon in situ viscosity of >10,000 centipoises (cP) at reservoir condition and has API gravity between $8-14^{\circ}$. The largest oil sand deposits are in Alberta and Saskatchewan, Canada. The reverves are approximated at 1.7 trillion barrels of initial oil-in-place and 173 billion barrels of remaining established reserves. Alberta has a number of oil sands deposits which are grouped into three oil sand development areas - the Athabasca, Cold Lake, and Peace River, with the largest current bitumen production from Athabasca. Principal oil sands deposits consist of the McMurray Fm and Wabiskaw Mbr in Athabasca area, the Gething and Bluesky formations in Peace River area, and relatively thin multi-reservoir deposits of McMurray, Clearwater, and Grand Rapid formations in Cold Lake area. The reservoir sediments were deposited in the foreland basin (Western Canada Sedimentary Basin) formed by collision between the Pacific and North America plates and the subsequent thrusting movements in the Mesozoic. The deposits are underlain by basement rocks of Paleozoic carbonates with highly variable topography. The oil sands deposits were formed during the Early Cretaceous transgression which occurred along the Cretaceous Interior Seaway in North America. The oil-sands-hosting McMurray and Wabiskaw deposits in the Athabasca area consist of the lower fluvial and the upper estuarine-offshore sediments, reflecting the broad and overall transgression. The deposits are characterized by facies heterogeneity of channelized reservoir sands and non-reservoir muds. Main reservoir bodies of the McMurray Formation are fluvial and estuarine channel-point bar complexes which are interbedded with fine-grained deposits formed in floodplain, tidal flat, and estuarine bay. The Wabiskaw deposits (basal member of the Clearwater Formation) commonly comprise sheet-shaped offshore muds and sands, but occasionally show deep-incision into the McMurray deposits, forming channelized reservoir sand bodies of oil sands. In Canada, bitumen of oil sands deposits is produced by surface mining or in-situ thermal recovery processes. Bitumen sands recovered by surface mining are changed into synthetic crude oil through extraction and upgrading processes. On the other hand, bitumen produced by in-situ thermal recovery is transported to refinery only through bitumen blending process. The in-situ thermal recovery technology is represented by Steam-Assisted Gravity Drainage and Cyclic Steam Stimulation. These technologies are based on steam injection into bitumen sand reservoirs for increase in reservoir in-situ temperature and in bitumen mobility. In oil sands reservoirs, efficiency for steam propagation is controlled mainly by reservoir geology. Accordingly, understanding of geological factors and characteristics of oil sands reservoir deposits is prerequisite for well-designed development planning and effective bitumen production. As significant geological factors and characteristics in oil sands reservoir deposits, this study suggests (1) pay of bitumen sands and connectivity, (2) bitumen content and saturation, (3) geologic structure, (4) distribution of mud baffles and plugs, (5) thickness and lateral continuity of mud interbeds, (6) distribution of water-saturated sands, (7) distribution of gas-saturated sands, (8) direction of lateral accretion of point bar, (9) distribution of diagenetic layers and nodules, and (10) texture and fabric change within reservoir sand body.

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Orbital and Periorbital Cellulitis in Children: A Recent 7-Year Clinical Review (소아에서 안와와 안와주위 봉와직염에 관한 최근 7년간의 임상적 고찰)

  • Choi, Jeong Ho;Hon, Sun Yeong;Park, Sung Sin;Cha, Sung Ho;Kim, Eun Jin;Lee, Jin;Chang, Jin Keun
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.36-44
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    • 2008
  • Purpose : Orbital cellulitis is rare, but it could be from the serious complication of sinusitis in children. It is often difficult to distinguish periorbital cellulitis from orbital cellulitis. The purpose of this study is to describe the clinical features of orbital and periorbital cellulitis in a pediatric population and to assess the predisposing factors and their complications. Methods : Forty-one patients aged 18 years and younger who were admitted between January 2000 and December 2006 to Hanil General Hospital and Kyunghee University Hospital with orbital or periorbital cellulitis. The retrospective analyses included clinical characteristics of orbital and periorbital cellulitis, dermographics, past history, predisposing factors, clinical presentations, treatments, and complications. Results : Among 41 patients, 34 patients had periorbital cellulitis, 7 patients had orbital cellulitis. While paranasal sinus disease was the most common predisposing cause in orbital cases, skin lesion, insect bite, dacrocystitis and conjunctivitis were the common causes in periorbital cases. In comparison with periorbital cases, orbital cases had higher level of white blood cell count, erythrocyte sedimentation rate, and C-reactive protein. Blood cultures were taken in 23 patients, but only one had Staphylococcus aureus from blood. Only one case had surgical incision and drainage and recovered without complications. Conclusion : From the results of our data, when patient shows erythematous swelling of periorbital area with opthalmoplegia, chemosis and proptosis, orbital CT scan is required to make diagnosis of orbital cellulitis. Most cases of orbital cellulitis can be treated successfully without surgical intervention. If there is no clinical improvement, repeated CT scan and/or surgical intervention should be considered.

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