• Title/Summary/Keyword: Perforation Rate

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Successful Management of Delayed Esophageal Rupture with T-Tube Drainage Using Video-Assisted Thoracoscopic Surgery

  • Do, Young Woo;Lee, Chang Young;Lee, Sungsoo;Kim, Ha Eun;Kim, Bong Jun;Lee, Jin Gu
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.478-480
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    • 2016
  • Spontaneous perforation of the esophagus after forceful vomiting is known as Boerhaave syndrome, a rare and life-threatening condition associated with a high rate of mortality. The management of Boerhaave syndrome is challenging, especially when diagnosed late. Herein, we report the successful management of late-diagnosed Boerhaave syndrome with T-tube drainage in a 55-year-old man. The patient was transferred to our institution 8 days after the onset of symptoms, successfully managed by placing a T-tube, and was discharged on postoperative day 46 without complications.

Mycological Features of Trichophyton verrucosum Isolated in Cattle

  • Kim, Su Jung
    • Biomedical Science Letters
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    • v.25 no.4
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    • pp.367-371
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    • 2019
  • In this study, the author observed the fungal characteristics of T. verrucosum which is commonly known as the cattle ringworm fungus in the farms of Hoengseong, Gangwon-do. After isolating 20 strains of T. verrucosum from cattle, they were cultured on SDA, PDA media and the fungal characteristics were concluded through visual observation of the colonies, microscopic findings, hair perforation test and urease test. The size of the colonies cultured on SDA media at 37 C was on an average 5 mm at 1 week, 33 mm at 2 weeks, 42 mm at 3 weeks and 58 mm after 4 weeks. Observing the characteristics of the colonies, 17 strains of T. album showing central bold radial folds, 2 strains of T. ochraceum having l throughout the colonies and 1 strain of T. discoides with rapid growth rate and gray-white cotton patterns were found. On microscopic observations of the cultured colonies on SDA, PDA media, macroconidia and microconidia were not found in T. verrucosum and hyphae and chlamydospore were only seen in T. album types. Out of 20 strains of T. verrucosum, hair perforation test was positive on only 3 strains and urease test was positive on all of the 20 strains.

Surgical Experiences of Boerhaave`s Syndrome -10 Cases analysis- (Boerhaave syndrome의 외과적 치험)

  • 최병철
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.1035-1039
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    • 1990
  • All 10 cases of spontaneous rupture of esophagus had violent vomiting as precursor. 9 patients were male, 1 case was female. Chief complaints were chest pain and dyspnea. Chest P \ulcornerA and esophagogram were mainly used as confirm diagnostic tool. Perforation sites of all cases were at distal esophagus near the G-E junction. 6 cases were received primary repair within 24 hrs, other cases were managed with surgical drainage after exclusion and diversion of esophagus. Empyema was the most frequent complication. Other complications were sepsis, pneumonia, leaking etc. Overall mortality rate was about 70.0%.

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Emergency preoperative angioembolization without computed tomography to treat unstable pelvic fractures with bowel perforation (장 천공을 동반한 혈역학적으로 불안정한 골반골 골절에서 전산화 단층촬영 전 시행한 혈관색전술의 지혈효과: 증례보고)

  • Park, Chan-Yong;Kang, Wu-Seong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.417-422
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    • 2019
  • Hemodynamically unstable pelvic fractures show a remarkably high mortality rate of 40% to 60%. However, their standard of care remains controversial. We report here a case of a 78-year-old woman who was admitted to the Emergency Department with pelvic pain following a fall. Based on pelvic radiography, she was diagnosed with an unstable pelvic fracture. Her blood pressure was 60/40 mmHg, and owing to her unstable vital signs, emergency angiography was performed without computed tomography (CT). Both internal iliac arteries were embolized without sub-branch selection for prompt control of pelvic bleeding. Following embolization, her vital signs were stabilized. Subsequent CT revealed free intra-abdominal air, suggesting bowel perforation had occurred and necessitating emergency laparotomy. An approximately 1 cm-sized free perforation of the small intestine was identified intraoperatively, and primary closure was performed. A retroperitoneal hematoma identified intraoperatively was not explored further because it was a non-expanding and non-pulsatile mass. The patient was admitted to the Intensive Care Unit and transferred to the general ward on postoperative day 3. In this case, the hemodynamically stable pelvic fracture with bowel perforation was successfully and safely treated by prompt angioembolization without conducting CT.

Clinical Outcomes of Gastrectomy after Incomplete EMR/ESD

  • Lee, Hye-Jeong;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seung-Heum;Park, Jong-Jae;Kim, Seung-Joo;Kim, Chong-Suk;Mok, Young-Jae
    • Journal of Gastric Cancer
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    • v.11 no.3
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    • pp.162-166
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    • 2011
  • Purpose: Endoscopic resection is widely accepted as standard treatment for early gastric cancer (EGC) without lymph node metastasis. The procedure is minimally invasive, safe, and convenient. However, surgery is sometimes needed after endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) due to perforation, bleeding, or incomplete resection. We evaluated the role of surgery after incomplete resection. Materials and Methods: We retrospectively studied 29 patients with gastric cancer who underwent a gastrectomy after incomplete EMR/ESD from 2006 to 2010 at Korea University Hospital. Results: There were 13 incomplete resection cases, seven bleeding cases, three metachronous lesion cases, three recurrence cases, two perforation cases, and one lymphatic invasion case. Among the incomplete resection cases, a positive vertical margin was found in 10, a positive lateral margin in two, and a positive vertical and lateral margin in one case. Most cases (9/13) were diagnosed as mucosal tumors by endoscopic ultrasonography, but only three cases were confirmed as mucosal tumors on final pathology. The positive residual tumor rate was two of 13. The lymph node metastasis rate was three of 13. All lymph node metastasis cases were submucosal tumors with positive lymphatic invasion and no residual tumor in the gastrectomy specimen. No cases of recurrence were observed after curative resection. Conclusions: A gastrectomy is required for patients with incomplete resection following EMR/ESD due to the risk of residual tumor and lymph node metastasis.

Evaluation of clinical outcomes of implants placed into the maxillary sinus with a perforated sinus membrane: a retrospective study

  • Kim, Gwang-Seok;Lee, Jae-Wang;Chong, Jong-Hyon;Han, Jeong Joon;Jung, Seunggon;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.50.1-50.6
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    • 2016
  • Background: The aim of this study was to evaluate the clinical outcomes of implants that were placed within the maxillary sinus that has a perforated sinus membrane by the lateral window approach. Methods: We examined the medical records of the patients who had implants placed within the maxillary sinus that has a perforated sinus membrane by the lateral approach at the Department of Oral and Maxillofacial Surgery of Chonnam National University Dental Hospital from January 2009 to December 2015. There were 41 patients (male:female = 28:13). The mean age of patients was $57.2{\pm}7.2years$ at the time of operation (range, 20-76 years). The mean follow-up duration was 2.1 years (range, 0.5-5 years) after implant placement. Regarding the method of sinus elevation, only the lateral approach was included in this study. Results: Ninety-nine implants were placed in 41 patients whose sinus membranes were perforated during lateral approach. The perforated sinus membranes were repaired with a resorbable collagen membrane. Simultaneous implant placements with sinus bone grafting were performed in 37 patients, whereas delayed placements were done in four patients. The average residual bone height was $3.4{\pm}2.0mm$ in cases of simultaneous implant placement and $0.6{\pm}0.9mm$ in cases of delayed placement. Maxillary bone graft with implant placement, performed on the patients with a perforated maxillary sinus membrane did not fail, and the cumulative implant survival rate was 100%. Conclusions: In patients with perforations of the sinus mucosa, sinus elevation and implant placement are possible regardless of the location and size of membrane perforation. Repair using resorbable collagen membrane is a predictable and reliable technique.

Statistical evaluation of ameloblastoma on the relationship between radiological and clinical characteristics (법랑모세포종의 방사선학적 소견에 따른 임상 통계학적 평가)

  • Park, Ji-Hoon;Kim, Jin-Wook;Kwon, Tae-Geon;Kim, Chin-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.176-183
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    • 2011
  • Introduction: Very high aggressiveness and recurrence are important clinical characteristics of ameloblastoma compared to the other benign tumors. Therefore, an accurate diagnosis and treatment plan is important. This study examined the association of the clinical findings and recurrence based on the radiological findings of ameloblastoma. In recurrent cases, these results are expected to help in the diagnosis and treatment of ameloblastoma to examine the relevance with the clinical characteristics and radiological features. Materials and Methods: For a clinical (gender, age) and radiological (location, internal pattern, size, perforation, border pattern, impacted tooth, root resorption) evaluation, this study examined 156 cases of 147 patients diagnosed with ameloblastoma, who had been treated and in most cases regularly checked at the department of oral and maxillofacial surgery, Kyungpook National University Hospital, between January 1993 and December 2009. For a recurrent rate evaluation, a more than 3 years follow-up period is needed. Accordingly, 116 patients diagnosed with ameloblastoma between January 1994 and December 2007 were investigated. Results: The recurrence rate in all cases was 6.1% but was 7.8% in cases with follow-up periods more than 3 years. The male-to-female ratio was 3:2, showing a slight male predilection. Ameloblastoma had a peak occurrence in the second decade of life followed by the fourth decade of life. The mandibular angle area is the most frequent site of ameloblastoma (50.8%) in the jaws. Six cases of unilocular (7.8%) and 3 cases of multilocular (7.7%) ameloblastomas recurred. Seven cases of smooth (10%) and 2 cases of irregular (4.3%) ameloblastomas recurred. No cases of ameloblastomas without perforation of the cortical bone (0%) and 9 cases with a perforation of cortical bone (11.1%) recurred. Four cases of the ameloblastomas with impacted teeth (11.4%) and 5 cases of ameloblastomas without impacted tooth (6.2%) recurred. Seven cases of ameloblastomas with root resorption (10.9%) and 2 cases of ameloblastomas without root resorption (3.8%) recurred. Conclusion: A multiple smooth margin, unilocular ameloblastoma with an impacted tooth, root resorption tends to recur more easily. Therefore, they need to be treated more carefully and require a a longer follow-up.

Effect of Condensation on Spray Characteristics of Simplex Swirl Nozzle (응축이 심플렉스 와류 노즐의 분무 특성에 미치는 영향)

  • Koh, Kwang-Uoong;Lee, Sang-Yong
    • Proceedings of the KSME Conference
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    • 2001.06e
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    • pp.107-112
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    • 2001
  • The effect of ambient gas (steam) condensation on swirl spray characteristics were studied experimentally for low subcooling condition of the liquid. The configuration of the liquid(water) sheet and the breakup modes were examined. Also variation of the discharge coefficient, breakup length, local and the cross-sectional area-averaged SMD of droplets with the liquid flow(injection) rate were obtained. The perforation breakup mode appears dominant with condensation while the aerodynamic wave breakup mode is dominant without condensation(in the air environment). The discharge coefficient, breakup length and the mean drop sizes decrease in a same manner with increasing of the liquid flow rate for both cases(with and without condensation). The condensation effects are insignificant with the discharge coefficient. However, the local and cross-sectional area-averaged SMD are larger and the breakup length becomes shorter in the steam environment. The spray angle predicted from the volumetric flux distribution along the radial direction of the sprays in the steam environment becomes larger with condensation.

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Myringoplasty Outcomes From a 5-Year Single Surgeon's Experience and Important Surgical Technical Aspects

  • Karunaratne, Dilhara;Violaris, Nick
    • Journal of Audiology & Otology
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    • v.25 no.4
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    • pp.224-229
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    • 2021
  • Background and Objectives: The United Kingdom (UK) national standard for the closure rate for myringoplasty is 89.5% (90.6% and 84.2% for primary and revision surgeries, respectively). The average hearing gains for primary and revision myringoplasty are 9.14 dB and 7.86 dB, respectively. This study compared the myringoplasty outcomes for a single surgeon over 5 years. Subjects and Methods: Data for 68 cases were analyzed retrospectively. The outcome measures were achievement of the tympanic membrane closure and the average hearing gain or loss. Results: The overall and primary closure rates were 97% and 98%, respectively and significantly higher than the UK national standard (p=0.0210 and p=0.0287, respectively). The revision closure rate was 93%; however, it was not significantly higher than the national standard (p=0.1872). The average hearing gain was 5.18 dB. The gains for primary and revision surgeries were 5.15 dB and 5.25 dB, respectively. Conclusions: We propose that these outcomes are a result of our surgical technique, including the simultaneous use of cortical mastoidectomy in ears with discharge.

Myringoplasty Outcomes From a 5-Year Single Surgeon's Experience and Important Surgical Technical Aspects

  • Karunaratne, Dilhara;Violaris, Nick
    • Korean Journal of Audiology
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    • v.25 no.4
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    • pp.224-229
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    • 2021
  • Background and Objectives: The United Kingdom (UK) national standard for the closure rate for myringoplasty is 89.5% (90.6% and 84.2% for primary and revision surgeries, respectively). The average hearing gains for primary and revision myringoplasty are 9.14 dB and 7.86 dB, respectively. This study compared the myringoplasty outcomes for a single surgeon over 5 years. Subjects and Methods: Data for 68 cases were analyzed retrospectively. The outcome measures were achievement of the tympanic membrane closure and the average hearing gain or loss. Results: The overall and primary closure rates were 97% and 98%, respectively and significantly higher than the UK national standard (p=0.0210 and p=0.0287, respectively). The revision closure rate was 93%; however, it was not significantly higher than the national standard (p=0.1872). The average hearing gain was 5.18 dB. The gains for primary and revision surgeries were 5.15 dB and 5.25 dB, respectively. Conclusions: We propose that these outcomes are a result of our surgical technique, including the simultaneous use of cortical mastoidectomy in ears with discharge.