• Title/Summary/Keyword: Left-sided

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Successful nonoperative management of a simultaneous high-grade splenic injury and devascularized kidney in Australia: a case report

  • Peter Thanh Tam Nguyen;Jeremy M. Hsu
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.431-434
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    • 2023
  • Severe blunt injuries to isolated solid abdominal viscera have been previously managed nonoperatively; however, management algorithms for simultaneous visceral injuries are less well defined. We report a polytrauma case of a 33-year-old man involved in a motorbike collision who presented with left-sided chest and abdominal pain. Initial imaging demonstrated multiple solid organ injuries with American Association for the Surgery of Trauma (AAST) grade V splenic injury and complete devascularization of the left kidney. The patient underwent urgent angioembolic coiling of the distal splenic artery with successful nonoperative management of simultaneous grade V solid organ injuries.

Double-outlet Right Ventricle with Pulmonary Stenosis [DORV: S.D.D.,subaortic VSD with ps]: One Operative case Report (양대혈관 우심실 기시증: 폐동맥협착 동반례의 수술 치험)

  • Kim, Hyeong-Muk;Lee, Nam-Su;Song, Yo-Jun
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.148-155
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    • 1977
  • The clinical findings with cardioangiography and successful surgical treatment of a 10 year old girl with double-outlet right ventricle is reported at The Dept. of Thoracic and Cardiovascular Surgery, Korea University Hospital, College of Medicine. The patient has been suffered from intermittent cyanosis, palpitation, and exertional dyspnea since 1 year after NFSD, and a holosystolic ejection murmur of grade 4 at the left 3rd intercostal space with mild cyanosis of the lips was the only physical findings at the time of this admission. Cardiac catheterization revealed ventricular septal defect with left to right shunt of 43% and right to left shunt of 10.2%. On cardioangiography from the left ventricle revealed all of the left ventricular outflow shunted into the right ventricle through the large ventricular septal defect, and the aorta originated from the infundibular chamber of the right ventricle with left, anterior sided pulmonary artery. The atria, viscera, and ventricles were normally located, and right ventricular out-flow was narrowed with infundibular hypertrophy and pulmonary valvular stenosis. Surgical correction was accomplished by closure of the ventricular septal defect in such a way that left ventricular outflow was routed via a Teflon felt prosthetic tunnel to the aorta, and pulmonary valvulotomy with infundibulectomy Was done to pass Hegar`s dilator No. 15 for reconstruction of the right ventricular outflow tract. The patient tolerated complete repair and has continued to improve over a period of three months after operation with normal school life. Details of the disease and method of repair are presented with related references.

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A study on the origination and Transmission of Yu in Northeast Asia. -from the 4th Century to the 8th Century- (동북(東北)아시아 유의 기원(起源)과 그 교류(交流)에 관(關)한 연구(硏究) -$4{\sim}8$세기(世紀)를 중심(中心)으로-)

  • Cho, Sun-Hee;Park, Kyung-Ja
    • Journal of the Korean Society of Costume
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    • v.17
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    • pp.29-43
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    • 1991
  • Yu was a type of dress worn on the upper part of the body which was commonly used in Northeast Asia. It was originally used by the Northern race for the need of courtesy as well as protecting cold. It was believed that Yu in Northeast Asia, which was called Kaftan, was came from Scythai lived in North Eurasian land around the Black sea. Scythians were the first-formed horse-riding race in the world and their civilization influenced those of far Asiatic sector along the steppe route. As their power expanded, their costume culture transmitted to the East(China, Korea, Japan). The upper garment, Yu, was characterized by the left-sided collars, narrow sleeves belted at the waist to the length of the hip line and the tight trouser on the lower part, which we commonly called HoBok(胡服) style. 1. Yu in Northeast Asia was originated from the Eurasians, Scythian Culture. Being exchanged, active style costumes were widely used among Chinese, Koreans and Japanese throughout centuries' including $4{\sim}8$ century. 2. Chinese Yu had a style of wide-sleeves and right-sided collars. The traditional costumes of Han race are consisted of wide-sleeved Yu on the upper and long-skirt on the lower part of the body. Before the adoptation of HoBok during reign of King Jo Mooryung in 307. B.C., HoBok style had already found in the remains since the Sang period. There were various names among Yu during the Han period. Seup, Sean Eui, Kye, Kyu were one of the styles and several names were meant for collar and sleeves. During $4{\sim}8$ centuries, clothes of right-sided collar were found, superior to that of left-sided and narrow sleeves were widely used both the royal and the humble. Various styles of decoration were seen in Yu around neck, back and sleeves comparing other nations. 3. Yu, in Korea, was typical style of Northern-bound HoBok. Both men and women had similarity in Yu style, narrow sleeves, left-sided collar, belted at the waist and to the length of hip line. Influenced by Han race, in the $4th{\sim}8th$ centuries, dual system of collar was found. But we cannot see major change in Yu and finally was connected to the present. 4. The original design of the Japanese costumes was not similar to that of Northern nomadic hunting race, which was suitable for horse-riding activities. Owing to the climates along the island, we could see various conditions ranging from the cold and to the warm. Influenced by the climates, pulling over the neck(Pancho style) were major design in Japan. As Korea was advanced earlier than Japan, Korean landed Japanese territory showing clothes. So primitive costumes had changes in style. During the $4th{\sim}8th$ period. The Korean mode was found in Haniwa (which was built to make sacrifices to the dead King) and costumes in Jeong Chang Won. Among the costumes in Jeong Chang Won, we put 3 or more costumes to the category of Yu characterizing elements of Korea and Tang period. From the $4th{\sim}8th$ century, China, Korea, Japan fell into the same cultural category, Scythai. Styles in Yu among three nations, we saw little differences, basically along times. Originated from the West Asia, Yu was transmitted to the far East changing Chinese costumes, Koreans melted it into the traditional elements and then influenced Japan.

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Changes in Brain Glioma Incidence and Laterality Correlates with Use of Mobile Phones - a Nationwide Population Based Study in Israel

  • Barchana, Micha;Margaliot, Menahem;Liphshitz, Irena
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5857-5863
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    • 2012
  • Introduction: Mobile phones are in extensive use worldwide and concerns regarding their role in tumor formation were raised. Over the years multiple studies were published in order to investigate this issue using several approaches. The current study looks at secular trends of brain gliomas (low and high grade) incidence and changes in tumor's laterality over 30 years in a population extensively using this technology with a possible correlation to the spread of use of mobile phones. Materials and Methods: All brain gliomas that were diagnosed from 1980-2009 were included and subdivided into two groups - low and high grade. Secular and periodic time trend analyses of incidence rates and changes in laterality were performed. Preferred side of head using mobile phones was assessed with a questionnaire in a sample of adult individuals. Results: A decrease in incidence of low grade giomas (LGG) that correlated with introduction of mobile technology was found from 2.57, 2.34 and 2.79 for every 100,000 in the period 1980 to the end of 1994 to 1.72, 1.82 and 1.57, respectively, over the last three 5-years periods (1995-2009). High-grade glioma incidences increased significantly from 1980-2009 but in the period after mobile phones were introduced (1994-2009) a lower, non significant, rate of increase was observed in males and a lower one (significant) in females. A shift towards left sided tumor location for all adult gliomas combined and separately for LGG and HGG was noted from 1995 onward. The shift was more marked for those who were diagnosed in ages 20-49 (p=0.03). Conclusions: We found a statistically significant decrease in LGG's over 30-years period that correlates with introducing of mobile phones technology and a shift in laterality towards left-sided tumors, the latter occurred in both low and high-grade gliomas.

Continuous "Over and Over" Suture for Tricuspid Ring Annuloplasty

  • Park, Kwon-Jae;Woo, Jong-Soo;Jeong, Sang-Seok;Yi, Jung-Hoon
    • Journal of Chest Surgery
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    • v.45 no.1
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    • pp.19-23
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    • 2012
  • Background: A ring implantation in the tricuspid annulus requires many interrupted mattress sutures for correction of tricuspid regurgitation (TR). In this study, tricuspid ring annuloplasty was performed by 2-0 polypropylene continuous suture instead of multiple interrupted 2-0 polyester mattress sutures, and the efficacy of the method was evaluated. Materials and Methods: This study included 20 patients who underwent tricuspid ring annuloplasty by continuous suture between May 2009 and July 2010. Four of the patients had an isolated TR, and the rest had a left-sided cardiac lesion. The concomitant tricuspid annuloplasty was performed after the left-sided heart surgery was completed and a Duran flexible ring prosthesis was used. Results: There was no perioperative mortality or conduction problem. More than a moderate degree of TR was improved to less than a mild degree after the procedure. After the ring annuloplasty, the right atrial volume decreased from $123.7{\pm}69.2mL$ to $74.5{\pm}37.4mL$, and the mean right atrial pressure was lowered from $18.7{\pm}12.2mmHg$ to $8.9{\pm}5.5mmHg$. Conclusion: The continuous "over and over" suture may be a useful procedure for fixing the ring to the annulus and making an intentional annular placation in performing tricuspid ring annuloplasty.

Analysis of Radiofrequency Ablation of Small Renal Tumors in Patients at High Anesthetic and Surgical Risk: Urologist Experience with Follow-up Results in the Initial Six Months

  • Yuksel, Mehmet Bilgehan;Karakose, Ayhan;Gumus, Bilal;Tarhan, Serdar;Atesci, Yusuf Ziya;Akan, Zafer
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6637-6641
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    • 2013
  • Background: To evaluate the results of various types of radiofrequency ablation (RFA) treatment of renal tumors in patients with excessive anesthetic and surgical risk. Materials and Methods: Data for RFA performed in in high risk patients were retrospectively evaluated. Other RFA applications in patients with no anesthetic and/or surgical risk were excluded. RFA was by ultrasound or CT guided percutaneous (USG/CT-PRFA) and retroperitoneally or transperitoneally laparoscopic (R/T-LRFA) techniques under general or local anethesia. Follow-up data of enhanced CT or MRI after 1, 3 and 6 months were analysed for twelve RFA applications. Results: The RFA applications included 4 (40%) left-sided, 5 (50%) right-sided and 1 (10%) bilaterally RFA (simultaneously 1 right and 2 left). The localizations of tumors were 2 (16.6%) upper, 5 (41.6%) mid and 5 (41.6%) lower pole. The RFA applications included 9 (75%) USG-PRFA, 1 (8.3%) CT-PRFA, 1 (8.3%) T-LRFA and 1 (8.3%) R-LRFA. The mean age was $65.3{\pm}8.5$ (52-76) years. The mean tumor size was $29.6{\pm}6.08$ (15-40) mm. No complications related to the RFA were encountered in any of the cases. Failure (residual tumour) was determined in 8.3% (1/12) of USG-RFA application. The success rate was thus 91.7% (11/12). Other 1st, 3rd and 6th months follow-up data revealed no residua and recurrence. Conclusions: RFA application appears to be safe as a less invasive and effective treatment modality in selected cases of small renal tumors in individuals with excessive anesthetic and also surgical risk.

A Case Report of Osuyubujaijung-tang on the Recurrence of Breast Cancer in a Patient Complaining of Coldness and Dizziness (유방암 재발 환자의 장궐 및 현훈이 오수유부자이중탕으로 호전된 치험 1례)

  • U-ryeong Chung;Soo-hwa Hong;Han-sol Jang;Seung-hyun Jung
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.555-561
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    • 2023
  • A 63-year-old female patient was admitted to the hospital with complaints of coldness in the head and right femur, persistent vertigo, dry mouth, vexation, general weakness, anorexia, and hot flashes. After being diagnosed with left-sided ductal carcinoma in 2017 and undergoing partial resection, she was recommended radiotherapy, chemotherapy, and hormone therapy, but she refused and did not receive any treatment. At a checkup in November 2022, the left-sided invasive ductal carcinoma recurred. She underwent partial resection and was scheduled to receive radiotherapy two months later. During hospitalization, the patient received traditional Korean medicine treatment, including Korean herbal medicine (Osuyubujaijung-tang), acupuncture, moxibustion, and cupping. Subjective symptom changes were evaluated daily. At discharge, the patient's symptoms improved, and her condition varied with the presence of Aconitum carmichaelii. This study suggests that "Osuyubujaijung-tang" cared the coldness and vertigo caused by "Han-dam (寒痰)" in patients with Soeumin visceral syncope pattern (少陰人 臟厥症) and that A. carmichaelii played a major role in this outcome.

The Safety and Usefulness of Combined Video-Assisted Mediastinoscopic Lymph Adenectomy and Video-Assisted Thoracic Surgery Lobectomy for Left-sided Lung Cancer (좌측 폐암 환자에서 동반 시행한 비디오 종격동경 림프절 절제술과 흉강경 폐엽 절제술의 안정성과 유용성)

  • Jung, Hee Suk;Kim, Yong Hee;Park, Seung-Il;Kim, Dong-Kwan
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.33-38
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    • 2010
  • Background: The use of video-assisted thoracic surgery (VATS) to perform major pulmonary resection with systematic node dissection (SND) for lung cancer by is commonly used in clinics. However, the feasibility of SND by VATS remains controversial. Video-assisted mediastinal lymphadenectomy (VAMLA) increases the quality of mediastinal lymph node staging in lung cancer. The video-mediastinoscope allows systematic lymphadenectomy by bimanual preparation. This study was conducted to assess safety and usefulness and clinical feasibility of VAMLA expanding Linder-Dahan mediastinoscope with VATS lobectomy for left sided lung cancer. Material and Method: Between February 2004 to April 2008, a total 50 patients who underwent VATS lobectomy for left sided lung cancer were analyzed retrospectively. Thirty patients (group A) underwent VAMLA followed by VATS lymphadenectomy and 20 patients (group B) underwent VATS lymphadenectomy for SND. Result: There were no statistical differences in operation times, chest tube indwelling times, or hospital days between the 2 groups. The number of dissected total nodes (p=0.001) and N2 nodes (p=0.013) were higher in group A than in group B, but there was no difference in N1 nodes. Postoperative complications included 2 prolonged air leakages (${\geq}$10 days) in each group, one pneumonia in group A, and one vocal cord palsy in group B. There were no early operative mortalities. Conclusion: Mediastinal staging of resectable lung cancer is performed by VAMLA. This new technique is the basis for VATS lobectomy particularly for left-sided lung cancer, because a higher percentage of mediastinal lymph nodes undergo complete resection using VAMLA.

Evaluation of Dose Reduction of Cardiac Exposure Using Deep-inspiration Breath Hold Technique in Left-sided Breast Radiotherapy (좌측 유방암 방사선 치료에서 깊은 들숨 호흡법을 이용한 심장 선량 감소 평가)

  • Jung, Joo-Young;Kim, Min-Joo;Jung, Jae-Hong;Lee, Seu-Ran;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.278-283
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    • 2013
  • Breast cancer is the leading cause of cancer death in women worldwide and the number of women breast cancer patient was increased continuously. Most of breast cancer patient has suffered from unnecessary radiation exposure to heart, lung. Low radiation dose to the heart could lead to the worsening of preexisting cardiovascular lesions caused by radiation induced pneumonitis. Also, several statistical reports demonstrated that left-sided breast cancer patient showed higher mortality than right-sided breast cancer patient because of heart disease. In radiation therapy, Deep Inspiration Breath Hold (DIBH) technique which the patient takes a deep inspiration and holds during treatment and could move the heart away from the chest wall and lung, has showed to lead to reduction in cardiac volume and to minimize the unnecessary radiation exposure to heart during treatment. In this study, we investigated the displacement of heart using DIBH CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Treatment planning was performed on the computed tomography (CT) datasets of 10 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ${\geq}95%$ of the prescribed dose and that the volume inside the CTV receiving >107% of the prescribed dose should be minimized. Scar boost irradiation was not performed in this study. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. The present study demonstrates that cardiac dose during left-sided breast radiotherapy can be reduced by applying DIBH breathing control technique.

Double Outlet Left Atrium: A rare form of the atrioventricular septal defect with malposition of the atrial septum (좌심방 양심실 연결증 [DOLA])

  • Lee, Jae-Won;Seo, Gyeong-Pil
    • Journal of Chest Surgery
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    • v.18 no.2
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    • pp.273-278
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    • 1985
  • The case of a patient with abnormal position of the atrial septum resulting in a left atrium with two atrioventricular valves and a disconnected right atrium is presented with review of related articles. Anatomic details showed atrial situs solitus and a left sided cardiac apex. The right atrium received both venae cavae and a coronary sinus. No AV valve was found in the right atrium, and the floor of this chamber was placed above the posterior wall of right ventricular chamber. The atrial septum with secundum ASD was displaced to right anteriorly at its lower portion and inserted to right of tricuspid annulus. The tricuspid and mitral valve configuration was that of so-called partial ECD, i.e. mitral cleft with large anterior mitral leaflets. The ventricular septum was intact and both ventricular chambers were equally well developed with normal relationships. Surgical repair of this anomaly was performed by resecting the abnormally positioned lower part of the atrial septum, repairing the cleft of the anterior mitral leaflet, and septating the atrium for diverting the systemic and pulmonary venous blood to RV and LV, respectively.

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