• Title/Summary/Keyword: Stenosis

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Status Epilepticus Caused by Nefopam

  • Park, Yong-Sook;Kim, Young-Baeg;Kim, Jeong-Min
    • Journal of Korean Neurosurgical Society
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    • v.56 no.5
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    • pp.448-450
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    • 2014
  • Nefopam, a centrally acting analgesic, has been used to control postoperative pain. Reported adverse effects are anticholinergic, cardiovascular or neuropsychiatric. Neurologic adverse reactions to nefopam are confusion, hallucinations, delirium and convulsions. There are several reports about fatal convulsive seizures, presumably related to nefopam. A 71-year-old man was admitted for surgery for a lumbar spinal stenosis. He was administered intravenous analgesics : ketorolac, tramadol, orphenadrine citrate and nefopam HCl. His back pain was so severe that he hardly slept for several days; he even needed morphine and pethidine. At 4 days of administration of intravenous analgesics, the patient suddenly started generalized tonic-clonic seizures for 15 seconds, and subsequently, status epilepticus; these were not responsive to phenytoin and midazolam. After 3 days of barbiturate coma therapy the seizures were controlled. Convulsive seizures related to nefopam appear as focal, generalized, myoclonic types, or status epilepticus, and are not dose-related manifestations. In our case, the possibility of convulsions caused by other drugs or the misuse of drugs was considered. However, we first identified the introduced drugs and excluded the possibility of an accidental misuse of other drugs. Physicians should be aware of the possible occurrence of unpredictable and serious convulsions when using nefopam.

A Case of a del(8p)/dup(8q) Recombinant Chromosome (8번 염색체 단완 결실과 장완 중복을 동반한 신생아 1례)

  • Kim, Jeong-Young;Im, Hyo-Bin;Son, Sang-Hee;Jeong, So-Young;Sung, Min-Jung;Seo, Son-Sang
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.76-80
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    • 2009
  • A male baby with intrauterine growth retardation had a short neck, small hands and feet, hypospadia, both grade I hydronephrosis, type II atrial septal defect, and moderate valvular pulmonary stenosis. The routine chromosome and banding analyses revealed a 46,XY,rec(8)del(8)(p21)dup(8) (q24.1)inv(8)(p21q24.1)pat chromosome constitution. His mother has normal chromosomes, but the father had 46,XY,inv(8)(p21q24.n Also his uncle had an inv(8) chromosome constitution. We used lymphocytes and examined 40 mitotic cells. All mitotic cells showed deletion of 8p21-->pter and duplication of 8q24.1 -->qter. Because Sp21 involves secretion of macrophage and lymphocyte against cancer cells, long-term follow-up for cancer will be needed.

The Effect of Yangganhwadam-tang(YHT) on Hypertension (양간화담탕(凉肝化痰湯)이 고혈압에 마치는 영향)

  • Oh, Yong-Sung;An, Joung-Jo;Jo, Hyun-Kyung;Yoo, Ho-Rhyong;Seol, In-Chan;Kim, Yoon-Sik
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.657-673
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    • 2009
  • This experiment was performed to determine the antihypertensive effect of Yangganhwadam-tang(YHT) on hypertension in spontaneously hypertensive rat. The results obtained were as follows : 1. YHT showed scavenging activity on DPPH free radical and SOD-like activity. 2. YHT significantly decreased heart weight. 3. YHT significantly decreased blood pressure and pulse. 4. YHT significantly decreased the level of plasma aldosterone. 5. YHT significantly decreased the level of norepinephrine. 6. YHT significantly decreased the levels of potassium and calcium. 7. YHT significantly decreased the level of BUN. 8. YHT decreased eosinophilic changes in the heart cells, and dilated renal arterioles stenosis. These results suggest that YHT might be effective in treatment and prevention of hypertension.

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Tracheomalacia Associated with Esophageal Atresia - A case report - (식도폐쇄증과 동반된 기관연화증 - 1예 보고 -)

  • Song Seung-Hwan;Chang Yun-Hee;Lee Chang-Hun;Shin Dong-Hoon;Sung Si-Chan
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.643-647
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    • 2006
  • Congenital tracheomalacia associated esophageal atresia is a rare foregut anomaly. We report a case of 40-day old male infant with tracheomalacia who has undergone repair of esophageal atresia at his age of 1 day. The patient had progressive dyspnea and stridor after repair of esophageal atresia. His 3-dimensional chest computed tomography showed severe stenosis at the middle of trachea. We underwent resection and end-to-end anastomosis under cardiopulmonary bypass. Histologic examination revealed esophageal tissues indicating congenital origin as well as no cartilage.

A successful Mustard operation for complete transposition of the great arteries combined with VSD, ASD, dextrocardia and PS: a report of one case (심실중격결손, 심방중격결손, 폐동맥협착과 우심증을 동반한 완전대혈관전위증의 치험)

  • 조중구
    • Journal of Chest Surgery
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    • v.15 no.3
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    • pp.346-354
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    • 1982
  • A Complete transposition of the great arteries combined with V.S.D, A.S.D, dextrocardia, and P.S is a rare congenital anomaly. The patient was a 10 year-old female whose complaints were frequent URI, exertional dyspnea, and cyanosis at rest since birth. Cheat X-ray films showed Dextrocardia ; situs inversus, moderate cardiomegaly, and Characteristic egg-shape heart shadow. E.K.G, Echocardiography, Cardiac Catheterization, and Angio-Cardiography were performed. Open heart Surgery was done under diagnosis of d-TGA, Dextrocardia, V.S.D, A.S.D, and P.S. At the time of Operation, Dextroeardia, T.G.A, Secndum type A.S.D, A.S.D, and P.S. At the time of Operation, Dextroeardia, T.G.A, Secndum type A.S.D. ($2.0{\times}2.0cm$. in diameter), V.S.D. type II ($1.5cm{\times}1.5cm$ in diameter), and pulmonary valvular stenosis were noted. Mustard operation using pericardial Baffle in the atrium for T.G.A. was perforsned. Teflon patch graft for closure of V.S.D. through tricuspid orifice and pulmonary Valvulotomy through pulmonary arteriotomy were performed. The post-op, low cardiac output Syndrome and dysrhythmicawere developed till Postoperative day #7, so that was controlled by inotropic and antiarrhythmic agents. After that, patient's conditions were Uneventful.

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Coexistent Atrial Septal Defect with Mitral Valve Disease: a report of 6 cases (승모판막질환을 합병한 심방중격결손증의 수술요법6례 보고)

  • Jo, Sung-Rae;Chae, Hurn;Rho, Joon-Rhyang
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.339-345
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    • 1979
  • Mitral valve disease is the most common disease of the acquired heart diseases, and atrial septal defect is also one of common congenital heart diseases. Coexistence of these two lesions is rare, but of great hemodynamic interest. Among 443 cases with mitral valve disease and 90 cases with atrial septal defect experienced in the Department of Thoracic Surgery, Seoul National University Hospital, there were 6 cases with atrial septal defect complicated by mitral valve disease. 1. Of the 6 patients, four were female and two were male. The age was ranged from 18 to 46. 2. Atrial septal defect was ostium secundum type in all cases, and the mitral valvular lesions were regurgitation in four and stenosis in two. Type II ventricular septal defect was also combined in one of the cases. 3. The atrial septal defect was corrected by, primary closure and the mitral valve was replaced with the prosthetic or bioprosthetic valve in all cases. The combined ventricular septal defect was closed using Teflon felt patch. 4. The operative result was good except in one who was expired of bacterial endocarditis 4 months after hospital discharge.

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Surgical Teatment of Congenital Cardiac Malformations in the Adult -A Report of 1389 Surical Cases- (성인에서의 서천성 심장기형의 외과적 치료)

  • Kyu
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.747-753
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    • 1995
  • Patients over 14 years of age who have undergone a surgical correction of a congenital cardiac malformations during period of August 1959 through December 1993 have been reviewed. During this period, there were 6894 cases of congenital cardiac lesions consisting of 4576 acyanotic and 2318 cyanotic cases. Among them, a total of 1389 adults [20.1%with various congenital cardiac malformations, 1126 acyanotic group and 263 cyanotic group were operated on. 677 patients were male and 712 patients were female. There were 444 patients under 20 years of age, 365 patients between 20-24 years, 220 patients between 25-29 years, 138 patients between 30-34 years and 222 patients over 34 years. The most common defects were atrial septal defect which accounted for 500 cases [36.0%and another common malformations were ventricular septal defect [276 cases, 19.9% , patent ductus arteriosus [207 cases, 14.9% , tetralogy of Fallot [185 cases, 13.3%and pulmonary stenosis [44 cases, 3.2%in order of incidence. Overall operative mortality for this series was 2.7% [1.5% of acyanotic group and 7.9% of cyanotic groupcompared with 4.6% of operative mortality of total cases of congenital cardiac malformations [2.9% of acyanotic group and 16.7% of cyanotic group . This reviewed series reveals the incidence of operable congenital heart defects appearing in any adult life and demonstrates that surgical repair can be accomplished with a satisfactory low mortality rate.

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Long-Term Result of Surgical Treatment for Renovascular Hypertension (신혈관성 고혈압의 외과적 치료 결과)

  • 우건화;김창호
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.393-396
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    • 1996
  • During the past eight years, we have encountered 9 patients, aged between 2 and 61 years, with renovascular hypertension. The renovascular hypertension In this series included Takayasu's disease with renal artery stenosis, arteriosclerosis of renal artery, fibromuscular dysplas a of renal artery Aortd-renal bypass was performed In 8 patients, iliac-to-renal bypass in 1 patient. 9 patients have been followed form 2 months to 5.1 years. Postoperatively, all patients'hypertension was improved. Only 2 patients need to take small dose of antihypertensive medication after discharge. These data indicated the good results of renovascular reconstruction for the patients with renovascular hypertension.

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A Systems Engineering Approach to Development of a Worker's Location Monitoring System in Ship and Offshore Plant (선박 및 해양플랜트 환경에서 작업자 위치 모니터링 시스템 개발을 위한 시스템엔지니어링 접근 방법)

  • Park, Jong Hee;Kim, Han June;Yoon, Jae Jun;Kim, Hyoung Min;Hong, Dae Geun
    • Journal of the Korean Society of Systems Engineering
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    • v.16 no.1
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    • pp.68-77
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    • 2020
  • The shipbuilding and offshore industry is a large and complex assembly industry, which causes many safety accidents. The major accidents in the shipbuilding and offshore industry workplaces are stenosis, falling objects, dust, fire, explosions, and gas poisoning. The accident by worker in this industry mainly has three factors: frequent movement, narrow work space, and increased use of subcontractors. To control these factors, it is necessary to monitor the worker's location and work status. In this paper, a worker location monitoring system using inaudible sound wave was designd that can be used in environments with many metal barriers. The process included deriving stakeholder requirements, transforming to system requirements, designing system architecture, and developing prototype. The prototype was validated by third-party testing agency. As a result, it satisfied the designed performance and verified its feasibility.

Right ventricular failure in congenital heart disease

  • Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.56 no.3
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    • pp.101-106
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    • 2013
  • Despite developments in surgical techniques and other interventions, right ventricular (RV) failure remains an important clinical problem in several congenital heart diseases (CHD). RV function is one of the most important predictors of mortality and morbidity in patients with CHD. RV failure is a progressive disorder that begins with myocardial injury or stress, neurohormonal activation, cytokine activation, altered gene expression, and ventricular remodeling. Pressure-overload RV failure caused by RV outflow tract obstruction after total correction of tetralogy of Fallot, pulmonary stenosis, atrial switch operation for transposition of the great arteries, congenitally corrected transposition of the great arteries, and systemic RV failure after the Fontan operation. Volume-overload RV failure may be caused by atrial septal defect, pulmonary regurgitation, or tricuspid regurgitation. Although the measurement of RV function is difficult because of many reasons, the right ventricle can be evaluated using both imaging and functional modalities. In clinical practice, echocardiography is the primary mode for the evaluation of RV structure and function. Cardiac magnetic resonance imaging is increasingly used for evaluating RV structure and function. A comprehensive evaluation of RV function may lead to early and optimal management of RV failure in patients with CHD.