• Title/Summary/Keyword: Incision and Drainage

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Geomorphological Processes and Changes of Waterfalls formed by Channel Avulsion (하도 변위에 의한 폭포의 형성과 변화)

  • Lee, Gwang-Ryul
    • Journal of the Korean Geographical Society
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    • v.48 no.5
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    • pp.615-628
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    • 2013
  • The waterfall can be formed by difference between the height of up and down part in new channel, is formed by channel avulsion that rapidly changing of river channel course. This study described types and processes of waterfalls by channel avulsion, and analyzed rates and factors of waterfall recession, on object to 7 waterfalls in South Korea. Bulyeong falls at Uljin-gun, Yongchu falls at Yeongdeok-gun, Jikyeon falls at Yanggu-gun and Gwangpum falls at Uljin-gun are formed by natural incised meander cutoff. Samhyeongje falls at Taebaek-si and Guryong falls are formed by river capture processes, and Palbong falls at Chungju-si is formed by artificial channel cutting for farm land secured. The locations of waterfalls gradually moved to upstream over time by head erosion. The recession rates were measured by 3~4m/ka on Bulyeong falls, Yongchu falls, Jikyeon falls and Samhyeongje falls, to estimate of formation age. Recession rates of these 4 waterfalls were analyzed that have clearly positive correlations with drainage area, precipitation, corrosion and weathering capability of bedrock, and initial height of waterfall.

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Use of Anti-TNF Alpha Blockers Can Reduce Operation Rate and Lead to Growth Gain in Pediatric Crohn's Disease

  • Woo, Min Hyung;Cho, Young Hoon;Sohn, Min Ji;Lee, Eun Joo;Kim, Ju Whi;Moon, Jin Soo;Ko, Jae Sung;Kim, Hyun-young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.4
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    • pp.358-368
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    • 2019
  • Purpose: Pediatric Crohn's disease (CD) is directly related to growth and has a high probability of requiring surgical intervention(s); therefore, more active treatment for CD is required for children. This study investigated the impact of biologics on growth and disease course associated with surgery. Methods: This was a retrospective cohort study involving patients diagnosed with CD at the Seoul National University Children's Hospital (Seoul, Korea) between January 2006 and October 2017. The aim was to determine the characteristics of pediatric patients with CD and whether biologics affected growth and the surgical disease course. Results: Among patients who underwent surgery for CD, the mean number of operations per patient was 1.89. The mean time from initial diagnosis to surgery was 19.3 months. The most common procedure was fistulectomy (34%), followed by incision and drainage (25%). In all patients, the use of biologics increased the height (p=0.002) and body mass index (BMI) (p=0.005). Among patients who underwent surgery, height (p=0.004) and BMI (p=0.048) were increased in the group using biologics. Patients who used biologics exhibited a low operation rate only within 2 years after diagnosis, with no differences thereafter (p=0.027). Conclusion: Although biologics could not mitigate the operation rate in pediatric patients who underwent surgery for CD, biological therapy delayed disease progression within 2 years of disease onset. Additionally, biologics conferred growth and BMI benefits in this window period. Therefore, it may be helpful to use biologics for optimal growth in pediatric patients with a high probability of undergoing future surgery.

Safe and time-saving treatment method for acute cerebellar infarction: Navigation-guided burr-hole aspiration - 6-years single center experience

  • Min-Woo Kim;Eun-Sung Park;Dae-Won Kim;Sung-Don Kang
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.403-410
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    • 2023
  • Objective: While patients with medically intractable acute cerebellar infarction typically undergo suboccipital craniectomy and removal of the infarcted tissue, this procedure is associated with long operating times and postoperative complications. This study aimed to investigate the effectiveness of minimally invasive navigation-guided burr hole aspiration surgery for the treatment of acute cerebellar infarction. Methods: Between January 2015 and December 2021, 14 patients with acute cerebellar infarction, who underwent navigation-guided burr hole aspiration surgery, were enrolled in this study. Results: The preoperative mean Glasgow Coma Scale (GCS) score was 12.7, and the postoperative mean GCS score was 14.3. The mean infarction volume was 34.3 cc at admission and 23.5 cc immediately following surgery. Seven days after surgery, the mean infarction volume was 15.6 cc. There were no surgery-related complications during the 6-month follow-up period and no evidence of clinical deterioration. The mean operation time from skin incision to catheter insertion was 28 min, with approximately an additional 13 min for extra-ventricular drainage. The mean Glasgow Outcome Scale score after 6 months was 4.8. Conclusions: Navigation-guided burr hole aspiration surgery is less time-consuming and invasive than conventional craniectomy, and is a safe and effective treatment option for acute cerebellar infarction in selected cases, with no surgery-related complication.

Treatment-failure tularemia in children

  • Karli, Arzu;Sensoy, Gulnar;Paksu, Sule;Korkmaz, Muhammet Furkan;Ertugrul, Omer;Karli, Rifat
    • Clinical and Experimental Pediatrics
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    • v.61 no.2
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    • pp.49-52
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    • 2018
  • Purpose: Tularemia is an infection caused by Francisella tularensis. Its diagnosis and treatment may be difficult in many cases. The aim of this study was to evaluate treatment modalities for pediatric tularemia patients who do not respond to medical treatment. Methods: A single-center, retrospective study was performed. A total of 19 children with oropharyngeal tularemia were included. Results: Before diagnosis, the duration of symptoms in patients was $32.15{\pm}17.8days$. The most common lymph node localization was the cervical chain. All patients received medical treatment (e.g., streptomycin, gentamicin, ciprofloxacin, and doxycycline). Patients who had been given streptomycin, gentamicin, or doxycycline as initial therapy for 10-14 days showed no response to treatment, and recovery was only achieved after administration of oral ciprofloxacin. Response to treatment was delayed in 5 patients who had been given ciprofloxacin as initial therapy. Surgical incision and drainage were performed in 9 patients (47.5%) who were unresponsive to medical treatment and were experiencing abcess formation and suppuration. Five patients (26.3%) underwent total mass excision, and 2 patients (10.5%) underwent fine-needle aspiration to reach a conclusive differential diagnosis and inform treatment. Conclusion: The causes of treatment failure in tularemia include delay in effective treatment and the development of suppurating lymph nodes.

Pyoderma Gangrenosum in a Patient with Ulcerative Colitis: A Case Report (궤양성 대장염에서 다발성으로 발생된 괴저농피증 1예)

  • Kang, Kyoung-In;You, Sun-Young;Oh, Sang-Ha;Kim, Jae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.240-245
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    • 2009
  • Pyoderma gangrenosum associated with ulcerative colitis is an unknown etiology of destructive skin disorder, characterized by progressive painful ulceration. It begins as a erythematous areola or pustule and rapidly progress into a deep ulceration with a discrete and violaceous edge. Early diagnosis followed with non-compressive moist dressing, topical application and systemic immunosuppressants are cornerstone in treating this disease. We report a case of pyoderma gangrenosum exacerbated with incision and drainage in a 15 year old girl with ulcerative colitis. This case emphasizes the importance of early consideration of pyoderma gangrenosum in patient with a background of related systemic disease and minimal traumatized wound care.

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A Surgical Treatment of the Esophageal Foreign Body (10 cases report) (수술적 처치가 필요했던 식도이물에 관한 임상적 고찰)

  • 황의두;황경환
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1117-1120
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    • 1997
  • Ten cases with esophageal foreign body were treated surgically from July 1980 to October 1995 at the Departme t of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The mean age was 45.3 years, with a range from 25 to 71. Out of ten cases, 6 were female and four were male. Common symptoms were dysphagia, fever, foreign body sensation and neck pain. Three cases of foreign bodies were of fish bones, two of bubble paclcage of drugs, one case of a Eeer bottle cap, one of a piece glass, one of a bathtub plug, one of chicken and one of a bean. The diagnosis was established by esophagography using a water soluble contrast material and esophagoscopy. Among of ten cases, two had esophageal stricture due to the ingestion of Aye at a young age. One case had experienced psychological problems. All foreign bodies were removed by surgical procedures. Five cases were treated by cervical esophagostomy, one case by right thoracotomy, one case by retrograde bougienation through gastrostomy and two cases by cervical incision and drainage for cervical abscess. Three cases developed pos operative esophageal leaks which healed spontaneously and transient hoarseness developed in one case. One case developed traumatic pneumothorax and subcutaneous emphysema which was treated by closed thoracostomy. There were no operative deaths. C(ocean J Thorac Cardiovasc Surg 1997;30:1117-20)

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Vacuum-assisted Closure for the Treatment of Lymphorrhea Following Surgery of the Femoral Artery (대퇴동맥 수술 후 발생한 임파루의 음압 요법 치료)

  • Chang, Won-Ho;Youm, Wook;Oh, Hong-Chul;Han, Jung-Wook;Kim, Hyun-Jo
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.562-564
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    • 2010
  • Lymphorrhea is a common complication after inguinal dissection for exposure of the femoral artery. Injury of the lymphatics occurs frequently because they are anatomically close to blood vessels. Uncontrolled lymph drainage increases postoperative morbidity, and wound infection may follow. Despite current treatment options, lymphorrhea after inguinal dissection is still difficult to manage and results in a prolonged hospital stay. A vacuum-assisted closure device was used in a 72-year-old woman who had lymphorrhea after vascular surgery by groin incision. Vacuum-assisted control for lymphorrhea resulted in earlier closure of the wound and reduced the length of hospital stay.

Endoscopic Removal of Traumatic Intracerebral Hematoma via Superolateral Keyhole (외상성 뇌실질내 혈종에 대한 상측방 키홀을 통한 내시경적 혈종 제거)

  • Park, Sung-Jin;Ha, Ho-Gyun;Jung, Ho;Lee, Sang-Keol;Park, Moon-Sun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.249-254
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    • 2000
  • Objective : As a minimally invasive strategy, endoscopic technique was introduced for removal of the traumatic intracerebral hematoma. Material and Method : A 54-year-old man with three-day history of seizure and progressive mental deterioration after traffic accident was presented. Computerized Tomography(CT) of the brain showed a huge intracerebral hematoma on the right frontal lobe and ventricle. The operation was performed via right frontal superolateral keyhole with 2cm eyebrow skin incision. Using 0-degree and 30-degree angled lens 4mm rigid endoscopes, nearly all of the hematoma was evacuated under the direct endoscopic visualization and a ventricular catheter was exactly placed into the frontal horn of the right lateral ventricle at the end of procedure. Results : The seizure was discontinued and neurological status had been improved during postoperative periods. Postoperative CT demonstrated that most of the hematoma was removed and the ventricular drainge tube was exactly placed in the right foramen of Monro. Conclusion : With endoscopic technique, the authors successfully evacuated traumatic intracerebral hematoma and exactly placed the ventricular drainage catheter under direct visualization. This technique may be considered as an another option for removal of traumatic intracerebral hematoma.

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A Clinical Evaluation of the Esophageal Perforation (식도 천공의 임상적 고찰)

  • 김재학;오덕진
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.759-762
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    • 1996
  • Fifteen patients with esophageal perforation were treated at the Department of Thoracic and Cardiovacular Surgery, Chungnam National University Hospital during the period from June, 1985 to September, 1995. The ratio between male and female patients was 9 : 6, their age ranged from 19 years to 71 years old(a erage : 49 years old). The causes of the perforation were various, spontaneous in 4 cases, foreign body in 4 cases, instrumental trauma in ) cases, chest trauma in 1 case, drug ingestion (chlorocalchi) induced in 1 case, tracheostomy induced in 1 case, unknown in 1 case. The perforation sites were intrathoracic esophagus in 9 cases and cervical in 6 cases. The Patients complained of chest or cervi- cal pain in 11 cases, fever in 9 cases, dysphagia in 8 cases and dyspnea in 5 cases. We have performed the following surgical procedures : incision and drainage, primary repair, gastrostomy for cervical esophageal perf'oration and primary repair, primary repair and pleural flap reinforcement, gastrostomy for thoracic esophageal perforation. A patient died of sepsis.

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Multiple Intramuscular Abscesses Caused by Nocardia abscessus in a Patient with Chronic Obstructive Lung Disease: Clinical Microbiology Considerations (만성 폐쇄성 폐질환으로 저용량 스테로이드 유지 중인 환자에게 발생한 Nocardia abscessus에 의한 다발성 근육 농양 1예)

  • Jung-Ah Kim;Hyunjoo Dong;Eunjung Lee;Jongtak Jung;Yae Jee Baek;Tae Hyong Kim;Tae Youn Choi
    • The Korean Journal of Medicine
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    • v.99 no.1
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    • pp.50-56
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    • 2024
  • Nocardiosis is uncommon. Immunocompromising conditions predispose individuals to pulmonary and disseminated nocardiosis of the brain, skin, and subcutaneous tissues. The most common pathogens are Nocardia cyriacigeorgica, Nocardia nova, and Nocardia farcinica. The speciation of Nocardia to determine antimicrobial susceptibility is difficult using traditional biochemical methods. Here, we report the case of a 73-year-old man with chronic obstructive lung disease who developed a rapidly progressing intramuscular abscess around the left hip and thigh. Within 3 days, the lesions progressed to an epidural abscess at the L4 to S1 level. Although he was treated with broad-spectrum antibiotics and extensive incision and drainage, he died of rapidly progressive respiratory failure. Nocardia abscessus (N. abscessus) was identified in pus samples using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). This case shows that the diagnosis of an intramuscular abscess caused by N. abscessus is challenging and that using MALDI-TOF MS may facilitate the diagnosis and ensure appropriate treatment.