• Title/Summary/Keyword: Pulmonary embolism

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Periareolar Augmentation Mastopexy with Interlocking Gore-Tex Suture, Retrospective Review of 50 Consecutive Patients

  • Franco, Johnny;Kelly, Emma;Kelly, Michael
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.728-733
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    • 2014
  • Background Periareolar Augmentation Mastopexy is one of the most challenging operations in plastic surgery. Problems with scar quality, areolar widening, and distortion are frequent problems that interfere with a predictable result. Methods A retrospective review was performed on fifty consecutive patients who underwent a periareolar augmentation mastopexy with the interlocking approach. Of the 50 patients, 30 had both preoperative and postoperative photographs and were the basis of the study. Results The age of the patients ranged from 19 to 56 years with the average age being 39 years. The postoperative follow-up averaged 9.5 months and the implants averaged 316 mL. There were no deaths, pulmonary embolism, deep vein thrombosis, or infected implants. Four patients had complications following surgery for an overall complication rate of 13%. Two patients developed an infected Gore-Tex suture. Two of these complications were treated with revision surgery. Five patients required reoperation for an overall reoperative rate of 16% (one patient was converted to a full mastopexy). Conclusions As a result of this retrospective study, we have found the interlocking approach to periareolar augmentation/mastopexy to be a safe and reliable operation.

Hypotension during Percutaneous Vertebroplasty with PMMA (Polymethylmethacrylate) -A case report- (경피적 추체 성형술 중 발생한 저혈압 -증례 보고-)

  • Park, Jin-Woo;Kim, Haa-Soo;Lim, Se-Hun;Kim, Jeong-Hun;Jeong, Soon-Ho;Choe, Young-Kyun;Kim, Young-Jae;Shin, Chee-Mahn;Park, Ju-Yuel
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.126-129
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    • 2000
  • Age-related osteoporotic compression fractures occur frequently in old aged group recently. Percutaneous vertebroplasty has recently been introduced as a therapeutic method for the treatment of pain associated with osteoporotic vertebral compression fracture. Percutaneous intravertebral injection of PMMA (polymethylmethacrylate) results in marked reduction in pain and morbidity. Among complications during vertebroplasty with PMMA, pulmonary embolism is repotred occasionally but the reports about hypotension are not common. This case is a report of a patient whom significant hypotension occured during percutaneous vertebroplasty.

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The Beau's Line Secondary to Acute Hand Injury (급성 수부 손상 후 발생한 보우선)

  • Kim, Tak Ho;Chung, Sung Mo;Lee, Nae Ho;Yang, Kyung Moo
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.652-654
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    • 2006
  • Beau first described transverse depressions of the fingernails after an acute febrile illness in 1846. It was the result of the temporary arrest of nail matrix formation. The transient interference of nail growth rate is usually induced by disability caused by severe systemic disease. Such as Raynaud disease, myocardial infarction, pulmonary embolism, acute renal failure, psoriasis and dysmenorrhea were reported to be the cause of Beau's line. The trauma caused either in a hand or in a forearm was also reported to be the cause of Beau's line. We experienced patients with Beau's line, two cases secondary to fingertip injury and one case due to fracture in radius. They had Beau's lines in all fingers of traumatized hand and nails of opposite hand were normal. During the follow-up, the growth rate of traumatized fingernails were normal and there was no complication.

Extravascular Migration of a Fractured Inferior Vena Cava Filter Strut

  • Lim, Jung Hyeon;Lee, Weon Yong;Ra, Yong Joon;Jeong, Jae Han;Park, Bong Suk;Ko, Ho Hyun
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.224-227
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    • 2017
  • A 20-year-old man presented with a femur fracture and epidural hemorrhage (EDH) following a fall. One month after fracture surgery, swelling developed in both legs, and he was diagnosed as having a deep-vein thrombosis and pulmonary embolism. A retrievable inferior vena cava filter (IVCF) was inserted, because EDH is a contraindication to anticoagulants. Four months later, he complained of abdominal pain, and a computed tomography scan showed a fractured IVCF strut. After percutaneous removal failed 3 times, the IVCF was surgically removed by orthopedists using a portable image intensifier without cardiopulmonary bypass.

Surgical Treatment of Infective Endocarditis (감염성 심내막염에 대한 외과적치료)

  • Wang, Ok-Bo;Park, Ju-Cheol
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1055-1060
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    • 1992
  • Clinical experience of 21 patients with infective endocarditis was reviewed. Endocarditis involved the left-sided valve in 16 cases, the right-sided valve in 2, and PDA in the remaining 3 patients. Valve abnormalities included leaflet perforation in 9 patients, chordal rupture in 2,; annular abscess in 6; and aorticoleft atnal perforation in 2. Sixteen patients underwent valve replacement[aortic valve replacement in 7 patients, mitral replacement in 4 and double valve replacement in 5], two had VSD closure with pulmonary valve excision, three had ductus arteriousus closure. The patients were classified into two groups. I ] Healed endocarditis group: including the patients who had completed a planned cou-rseof antibiotic therapy[N=10], II ] Active endocarditis group: patients in which operations were performed prior to completetion of antibiotic treatment course[N=11]. The indications for operation included congestive heart failure, embolism, and persistent sepsis. Organisms were predominantly streptococcus[N=5] and staphylococcus [N=4] followed by candida, moraxella, and E-coli. By NYHA functional classification, all patients were in Class III or IV preoperatively. There was only one operative mortality in patient from group II. All patients substantially, improved postoperatively with NYHA classification in class I or II. This study shows that early surgical intervention in patients with active endocarditis has desirable outcome.

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Complications of nephrotic syndrome

  • Park, Se-Jin;Shin, Jae-Il
    • Clinical and Experimental Pediatrics
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    • v.54 no.8
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    • pp.322-328
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    • 2011
  • Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

Lemierre Syndrome in Adolescent with Active Ulcerative Colitis

  • Unic, Josipa;Kovacic, Matea;Jakovljevic, Gordana;Batos, Ana Tripalo;Grmoja, Tonci;Hojsak, Iva
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.214-217
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    • 2018
  • Inflammatory bowel disease (IBD) is a well-recognized risk factor for thrombotic events in adults but data on children are scarce. In the great majority of adult patients, thrombotic events are usually deep vein thrombosis and pulmonary embolism. Other sites such as jugular veins are extremely rare. We present a case of Lemierre syndrome in an adolescent girl with active ulcerative colitis and discuss possible risk factors. This is the first reported case of severe Lemierre syndrome with thrombus extension to cranial veins in a patient with ulcerative colitis. Early recognition of Lemierre syndrome in patients who present with rapidly worsening symptoms of neck pain, fever and signs of pharyngitis is imperative because it increases a chance of favorable prognosis. It is important for pediatricians treating IBD patients not to underestimate possible thrombotic events in children with IBD. Recognition of additional risk factors is crucial for prompt diagnosis and adequate treatment.

The Experimental Studies on Antithrombotic Effects of Hyunhosaiksan (현호색산의 항혈전작용에 대한 연구)

  • Lim Min Cheul;Kim Dong Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.4
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    • pp.930-938
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    • 2003
  • The purpose of the present study was to investigate the effects of Hyunhosaiksan (HHS) on antithrombotic actions which include blood activation, thrombus removal, warming of circulating blood, and the control of pain on abdomen and lower and upper burning spaces. HHS significantly inhibited platelet aggregation induced by ADP and epinephrine in a HHS dose-dependent manner when analyzed by the Sigmoid Emax model in WinNonlin. EC50 values of HHS were 1.71 ㎍/ml and 0.004 ㎍/ml for ADP and epinephrine respectively. In the vivo study, HHS inhibited pulmonary embolism induced by collagen and epinephrine, which was however statistically insignificant. HHS increased number of platelets, APTT and volume of fibrinogen significantly as compared with the control group in dextran-induced thrombus model. Furthermore, HHS stimulated levels of blood flow in vivo though its effect was not observed in vitro. These results suggest that Hyunhosaiksan (HHS) can be used for treating numerous diseases related with blood aggregation and circulation problems. Further systematic investigations on the synergic effects among drugs used in the oriental medicine as well as in the western medicine in relation to thrombosis therapy would provide an important insight into the potential therapeutic applications.

Sphingomonas Paucimobilis : A Rare Infectious Agent Found in Cerebrospinal Fluid

  • Goker, Tuncer;Asik, Rahile Zulal;Yilmaz, Muhammet Bahadir;Celik, Ilhami;Tekiner, Ayhan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.481-483
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    • 2017
  • Sphingomonas paucimobilis (S. paucimobilis) is a gram negative bacillus. It has existed in soil, drinking water and plants. It has been isolated from distilled water tanks, respirators, and hemodialysis devices at the hospital setting. Patients with chronic disorders or immune suppression may be susceptible to infections with it. This microorganism has also been reported to infect healthy persons. Both nosocomial and community-acquired infections have been reported. So far, a variety of infections have been reported, including sepsis, septic pulmonary embolism, septic arthritis, peritonitis, and endophthalmitis. Only 2 cases of meningitis have been reported so far in the literature. So far, no previous reports of culture proliferation have been reported in patients with external ventricular drains, as was the case in our patient. Therefore, our case is the first to have S. paucimobilis proliferation in cerebrospinal fluid culture during intensive care unit stay for an external ventricular drain.

Multilevel Percutaneous Vertebroplasty (More than Three Levels) in the Management of Osteoporotic Fractures

  • Zidan, Ihab;Fayed, Ahmed Abdelaziz;Elwany, Amr
    • Journal of Korean Neurosurgical Society
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    • v.61 no.6
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    • pp.700-706
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    • 2018
  • Objective : Percutaneous vertebroplasty (PV) is a minimally invasive procedure designed to treat various spinal pathologies. The maximum number of levels to be injected at one setting is still debatable. This study was done to evaluate the usefulness and safety of multilevel PV (more than three vertebrae) in management of osteoporotic fractures. Methods : This prospective study was carried out on consecutive 40 patients with osteoporotic fractures who had been operated for multilevel PV (more than three levels). There were 28 females and 12 males and their ages ranged from 60 to 85 years with mean age of 72.5 years. We had injected 194 vertebrae in those 40 patients (four levels in 16 patients, five levels in 14 patients, and six levels in 10 patients). Visual analogue scale (VAS) was used for pain intensity measurement and plain X-ray films and computed tomography scan were used for radiological assessment. The mean follow-up period was 21.7 months (range, 12-40). Results : Asymptomatic bone cement leakage has occurred in 12 patients (30%) in the present study. Symptomatic pulmonary embolism was observed in one patient. Significant improvement of pain was recorded immediate postoperative in 36 patients (90%). Conclusion : Multilevel PV for the treatment of osteoporotic fractures is a safe and successful procedure that can significantly reduce pain and improve patient's condition without a significant morbidity. It is considered a cost effective procedure allowing a rapid restoration of patient mobility.