• Journal of Chest Surgery
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• v.36 no.5
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• pp.321-328
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• 2003

Background: The St. Jude Medical prosthesis is one of the popularly used artificial prosthesis, therefore the National Medical Center reports the long-term clinical results of patients who underwent prosthetic valve replacement with St. Jude medical valve for 18 years. Material and Method: Between January, 1984 and June, 2002, a series of 163 consecutive patients who had Implanted St. Jude prosthesis at the National Medical Center were reviewed. Mean age was 42.9$\pm$15.1 years and male to female ratio was 69:94. The operative procedure comprised of 87 MVR, 30 AVR, 45 DVR, and 1 TVR. The reoperative procedure comprised of 21 MVR, 2 AVR, and 14 DVR. Follow-up rate was 96.9%, and cumulative follow-up was 823.8 patient-years. Result: Early mortality rate was 7.9% (13 patients), late mortality rate was 8.7% (13 patients) and late mortality due to valve related complication was 47% (7 patients). Actual survival rate at 10 and 18 years were 91.7$\pm$2.1% and 91.0$\pm$1.9%. Linearized Incidence was as follows: thromboembolism, 1.09%/ patient-year; anticoagulant related hemorrhage, 0.36%/patient-year; valve thrombosis, 0.24%/patient-year; paravalvular leakage, 0.12%/patient-year; and prosthetic bacterial endocarditis, 0.12%/patient-year linearized incidence of over all valve related complication was 1.94%/patient-year. Freedom from valve related complication at 10 and 18 years were 89.1$\pm$3.3% and 88.4$\pm$3.9%. Freedom from valve related death at 10 and 18 years were 95.1$\pm$1.2% and 95.1$\pm$1.0%. Valve related complication was related the age of patient, especially anticoagulant related hemorrhage was more common in patients over 60 years of age. Valve related complication, death were higher in DVR than AVR or MVR, and valve related death was higher in reoperation. There was no relationship between valve related complication or death and implant valve of size. Conclusion: The long-term clinical results of patients implanted with St. Jude Mechanical prosthesis was quite satisfactory with a low incidence of valve related complication and mortality.

• Journal of Chest Surgery
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• v.12 no.3
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• pp.259-262
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• 1979

Alopecia is a minor complication following open heart surgery, but it is a cosmetic and psychotic problem to the patient. Especially the extensive long period of operation, prolonged mechanical ventilation and no change of patient head position during operative and recovery period may serve the localized scalp pressure effect, which causes postoperative alopecia. So, for prevention of the postoperative alopecia, adequate blood flow and pressure must be maintained with alternative change of head position during operative and recovery period. The author experienced one case of occipital alopecia following open heart surgery and reports with literature.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.116-120
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• 1988

From July 1986 to June 1987, five patients were underwent IABP [intra aortic balloon pulsation] because of sever left heart failure in spite of maximum medication. These patients were reviewed as prophylactic IABP [1 patient], During operation [3 patients] and postoperative IABP [1 patients]. All patients were showed stable hemodynamic status with improved LV function during and after IABP. there was no IABP related complication or mortality. Advanced disease needs more effective methods of mechanical circulatory assistance and heart replacement.

• Journal of Chest Surgery
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• v.33 no.5
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• pp.385-390
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• 2000

Background: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. Material and Method: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5$\pm$3.5 years). Result: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0$\pm$23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time. Conclusion: The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.54-57
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• 2016

Percutaneous dilatational tracheostomy (PDT) has become an increasingly popular method of establishing an airway for patients in need of chronic ventilator assistance. We report a rare case of a 42-year-old female who developed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum after percutaneous dilatational tracheostomy. The patient suffered from amyotrophic lateral sclerosis, and underwent PDT after a period of mechanical ventilation. During PDT, tracheostomy tube was inserted into the paratracheal space. Follow-up chest radiography and computed tomography of chest and abdomen revealed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and pneumoperitoneum. The patient was treated successfully with insertion of the thoracostomy tube and conservative care.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.237-241
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• 2000

Vertebral compression fractures commonly afflict the elderly. Some patients suffer from severe mechanical pain in spite of treatments with strong analgesics and bracing. Vertebroplasty, which was originally used for vertebral hemangioma, is effective for patients who do not respond to these more conservative treatments. However, the procedure has some risk. Leaks of bone cement into perineural tissues can be a serious complication. In contrast to the lumbar vertebrae, the outer margin of the pedicle of the thoracic vertebrae is almost in line with the outer margin of the body. This, combined with the thinner pedicle of the thoracic vertebrae, makes proper needle placement difficult. The posterolateral approach is preferred to the transpedicular approach in order to avoid the danger of destroying the inner cortex of the pedicle. But there can be a problems with the standard posterolateral approach. The rib can be broken, the pleura can be punctured. A new and safer approach is possible. Before penetrating the bone, the needle is positioned at the upper margin of the transverse process, 5 mm away from the pedicle. To achieve this positioning, the needle must puncture the skin 1~1.5 cm laterally and 3~5 mm cranially to the target point on the bone. This approach was used for 10 patients and we achieved good results with no serious complication.

• Korean Journal of Digital Imaging in Medicine
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• v.10 no.2
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• pp.39-49
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• 2008

Extravasation of contrast material is a not infrequent complication of enhanced imaging studies and large volume extravasation may result in severe damage. Subcutaneous extravasation of the radiographic contrast medium is one of the complications of the contrast medium-enhanced procedures. Automated power injectors enable the contrast material to be delivered at a uniform high-flow-rate and as a nonfragmented bolus, and this is essential for many contrast material enhanced CT(computed tomography) applications. The major risk associated with the use of automated power injectors is the well known complication of contrast material extravasation at the injection site. Automated injection of CT contrast material can produce the compartment syndrome. Selection of the nonionic contrast material after careful evaluation of the intravenous administration site and monitoring of the patient during the use of a mechanical power injector may help minimize or prevent extravasation injuries. Early identification is important and conservative management is effective in most cases. Prevention of these injuries with the education of radiological technologist remains the ultimate aim.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.1
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• pp.5-9
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• 2003

Introduction : Laryngomicrosurgery(LMS) is frequent procedure applying to benign and early malignant larygeal disease such as vocal cord polyp, nodule and early glottic cancer. LMS has been known as safe procedure and short time consuming treatment. So few reports about complications in LMS was done. In this study, complications and problems from LMS were investigated and reported. Method : From 2000, January to 2001, December, 180 patients who were treated with LMS in Asan medical center were studied by retrograde chart review. Results : In these patients, total 9 patients(5%) were suffered from complication. 4 patients (2%) had teeth injury and 4(2%) were suffered from foreign body sensation in tongue and 1(1%) had hypoglossal nerve injury. Main mechanism of complications is thought by pressure injury by laryngoscope blade. No definite correlation between procedure and complication was observed. Conclusion : There are few neural complications with LMS such as lingual and hypoglossal nerve injury. Before operation of LMS, warning and informing of complications by mechanical stress must be done. Gentle procedure and short operation time are necessary to avoid these problems. And patients who have risk factors of oral complications such as dental disease or dental prosthesis must have dental evaluation and treatment before LMS procedure.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.5
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• pp.417-421
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• 2007

Post-intubation granuloma of the larynx is a rare complication of general inhalation anesthesia, which is associated with direct mechanical irritation of laryngeal mucosa from trauma, prolonged period of endotracheal intubation, multiple intubations and endotracheal movement. This study was performed retrospectively to evaluate symptoms, incidence, duration and site for prevention of the intubation granuloma. The authors investigated 16 patients of intubation granuloma among 719 patients during 1 year period from August, 2005 to July, 2006 at the Department of Oral & Maxillofacial Surgery, Pusan National University Hospital. The results were as follows. 1. The incidence was 16/719 cases(2.2%) 2. The female to male ratio was 7:1 3. Hoarseness was the main symptom 4. Most cases occurred after 2-jaw orthognathic surgery.

• Neonatal Medicine
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• v.25 no.4
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• pp.196-201
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• 2018

Umbilical venous catheterization (UVC) is a common practice in intensive neonatal care. However, a malpositioned UVC and its prolonged use may lead to various problems, including mechanical, infectious, and thrombotic complications in various organs such as the liver, lungs, and heart. Congenital chylous ascites is characterized by abnormally high levels of triglycerides in the peritoneal fluid of newborns, which originate from refluxed lymph within the abdominal cavity. Herein, we report a case of an UVC complication presenting as chyloperitoneum simulating congenital chylous ascites in a preterm neonate that resulted from total parenteral nutrition (TPN) extravasation from a malpositioned UVC. Biochemical analysis of intraperitoneal chylous fluid and TPN infusate could help confirm the origin of chyloperitoneum. This case suggests that TPN extravasation from UVC should be considered when chyloperitoneum develops in newborns with an indwelling catheter. UVC positions must also be carefully monitored at regular intervals to recognize associated complications early, particularly in cases with an inevitably malpositioned catheter related to the anatomy of the vessel course.