• 제목/요약/키워드: Surgical delay

검색결과 99건 처리시간 0.026초

Changes of Clinical Practice in Gastrointestinal Perforation with the Increasing Use of Computed Tomography

  • Park, Ji-Min;Yoon, Young-Hoon;Horeczko, Timothy;Kaji, Amy Hideko;Lewis, Roger J
    • Journal of Trauma and Injury
    • /
    • 제30권2호
    • /
    • pp.25-32
    • /
    • 2017
  • Purpose: The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED). Methods: We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003-2004 and 2013-2014. Results: In patients with gastrointestinal perforation, time from ED arrival to CT was shorter ($111.4{\pm}66.2min$ vs. $199.0{\pm}97.5min$, p=0.001) but time to surgical consultation was longer ($135.1{\pm}78.8$ vs. $77.9{\pm}123.7$, p=0.006) in 2013-2014 than in 2003-2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups. Conclusion: With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.

Suppression of Cellular Apoptosis Susceptibility (CSE1L) Inhibits Proliferation and Induces Apoptosis in Colorectal Cancer Cells

  • Zhu, Jin-Hui;Hong, De-Fei;Song, Yong-Mao;Sun, Li-Feng;Wang, Zhi-Fei;Wang, Jian-Wei
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권2호
    • /
    • pp.1017-1021
    • /
    • 2013
  • The cellular apoptosis susceptibility (CSE1L) gene has been demonstrated to regulate multiple cellular mechanisms including the mitotic spindle check point as well as proliferation and apoptosis. However, the importance of CSE1L in human colon cancer is largely unknown. In the present study, we examined expression levels of CSE1L mRNA by semiquantitative RT-PCR. A lentivirus-mediated small interfering RNA (siRNA) was used to knock down CSE1L expression in the human colon cancer cell line RKO. Changes in CSE1L target gene expression were determined by RT-PCR. Cell proliferation was examined by a high content screening assay. In vitro tumorigenesis was measured by colony-formation assay. Cell cycle distribution and apoptosis were detected by flow cytometric analysis. We found CSE1L mRNA to be expressed in human colon cancer cells. Using a lentivirus based RNAi approach, CSE1L expression was significantly inhibited in RKO cells, causing cell cycle arrest in the G2/M and S phases and a delay in cell proliferation, as well as induction of apoptosis and an inhibition of colony growth capacity. Collectively, the results suggest that silencing of CSE1L may be a potential therapeutic approach for colon cancer.

광범위한 두개안면부 섬유성골이형성증의 치험 2례 (TWO CASES OF MASSIVE CRANIOFACIAL FIBROUS DYSPLASIA)

  • 김종렬;정기돈;김홍식;김기원
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제18권1호
    • /
    • pp.61-68
    • /
    • 1996
  • 1. 첫 번째 증례에서 관상 절개를 이용한 부분골 절제술과 Le Fort씨 1급 골절단술을 시행한 결과, 골절단술을 시행한 부위에 원활한 골 치유가 일어났다. 2. 두 번째 증례에서 관상 절개를 이용하여 두개안면부에 광범위한 부분골 절제술을 시행하여 만족할만한 결과를 얻었으며, 병소 부위 말초 혈관 과다는 병소의 성장에 따른 생리적 변화로 추정된다.

  • PDF

슬근 좌골 결절 견열 손상의 지연 수술후 발생한 좌골신경 손상 - 증례 보고 - (Sciatic Nerve Injury Following a Delayed Surgical Procedure for the Hamstring Muscle Avulsion from the Ischial Tuberosity - A Case Report -)

  • 김휘택;류총일;윤평주;이종서
    • 대한정형외과스포츠의학회지
    • /
    • 제1권1호
    • /
    • pp.75-78
    • /
    • 2002
  • 슬근의좌골결절부착부 견열손상은스포츠인구의증가와군대훈련을받고있는 젊은 남자에게 간혹볼수있는손상이며 대부분은젊은성인 특히 운동선수에게주로발생한다. 이는 슬관절이신전된상태에서고관절이 과도히굴곡되면슬근에강력한 긴장을 일으켜야기된다. 조기에진단하여 견열된 근육을 좌골에 부착시키는 수술적 치료로 기능을 회복시키고 기형을 교정할수있으나진단과치료가지연되면기능적으로나임상적으로양호한결과를얻기어렵다. 좌골결절에서슬근견열골절의수술적치료후생길수있는합병증은이소성골형성과고정실패외에크게알려진것이없으며, 특히좌골신경손상은보고된적이없다. 저자들은수상후3개월된슬근의좌골결절부착부파열을수술적치료한후좌골신경손상을경험하여보고하는바이다.

  • PDF

하지와 족부의 급성 구획 증후군 (Acute Compartment Syndrome of the Lower Leg and Foot)

  • 채수욱
    • 대한족부족관절학회지
    • /
    • 제17권3호
    • /
    • pp.165-173
    • /
    • 2013
  • Acute compartment syndrome of the lower leg and foot is a surgical emergency. The clinical symptoms is an important clue to diagnose compartment syndrome. In cases of ambiguous diagnosis, unconscious patients and children additionally need a intracompartmental pressure measuring. Immediate fasciotomy should be performed when clinical signs are obvious or when delta pressure is less than 30 mmHg or intracompartmental pressure is greater than 30 mmHg. Fasciotomy of the lower leg can be performed either by one lateral single incision or double incision, which of the foot mainly has a dorsal or medial incision. A delayed in diagnosis that leads to a delay in treatment can result in devastating disability. Acute compartment syndrome of the lower leg and foot is a relative rare but serious complication of which a surgeon should be aware.

발달성 고관절 이형성증 또는 탈구 환자의 수술후 물리치료 (A Case Study of Physical Therapy for Developmental Dysplasia or Dislocation of the Hip After Operation)

  • 박소연
    • 한국전문물리치료학회지
    • /
    • 제6권2호
    • /
    • pp.77-86
    • /
    • 1999
  • Developmental dysplasia or dislocation of the hip is the most pronounced form of a condition in which the femoral heads tends progressively to leave the acetabulum. In the young child the variability of findings and course suggest a spectrum of conditions in which there are a number of common features: restriction of movement, particularly of abduction in flexion; shortening; and abnormal radiology, including a sloping or dysplastic acetabulum and delay in the appearance of the upper femoral epiphysis. It is vital to make the diagnosis of a congenital dislocation as soon after birth as possible. Conservative treatment with an abduction brace before the child run begins to walk is completely adequate, but after the age of 4 even surgical repositioning is difficult and after the age of 7 it is almost impossible. The aim of the study was to gain insight into the value of physical therapy of developmental dysplasia or dislocation after operation.

  • PDF

응급실에서 디클로페낙 근주 후 발생한 니콜라우 증후군 1례 (Nicolau Syndrome following Diclofenac Injection in an Emergency Department)

  • 정상원;강지훈;여준모;고재욱
    • 대한임상독성학회지
    • /
    • 제9권2호
    • /
    • pp.101-104
    • /
    • 2011
  • Nicolau syndrome is a rare adverse reaction at the site of an intramuscular injection, and is characterized by severe pain immediately after the injection and rapid development of distinct skin lesions. As this syndrome is rare, it may be overlooked at the early clinical phase and subsequently, clinical outcomes may be worse due to delay in treatment. We report on a female who developed Nicolau syndrome following intramuscular diclofenac injection, which required surgical reconstruction. Understanding the characteristics of Nicolau syndrome and careful surveillance for relevant clinical features may help physicians to more quickly diagnose and treat this condition.

  • PDF

콜라겐제제 봉합제 사용으로 인한 우측 대퇴동맥, 우측 슬와동맥 혈전증의 수술적 치료 (Surgical Treatment of Femoral & Popliteal Arteries Thrombosis Caused by Collagen Material Closure Device - A case report -)

  • 조태준
    • Journal of Chest Surgery
    • /
    • 제38권5호
    • /
    • pp.396-399
    • /
    • 2005
  • Manual or mechanical compression followed by 4 to 8 hours of bed rest is still the standard technique for accessing site management of the femoral arterial puncture site. But these methods are often uncomfortable and delay hospital discharge. Recently, a number of new devices to achieve hemostasis have been developed. These devices uses collagen to facilitate local hemostasis. But many complications associated with the use these devices have been reported internationally. We present a case of successful treatment of Rt. femoral and Rt. popliteal arteries thrombosis caused by Angioseal.

Alexander씨 병 환아의 마취 관리 (Anesthetic Management of a Patient with Alexander's Disease -Case Report-)

  • 김범수;지대림;송선옥
    • Journal of Yeungnam Medical Science
    • /
    • 제27권1호
    • /
    • pp.47-51
    • /
    • 2010
  • We present here the case of a 13-year-old male patient with Alexander's disease who underwent surgical correction of a femur fracture. Alexander's disease is a rare and fatal disorder that affects the white matter in the brain and it causes developmental delay, psychomotor regression, spasticity, megaloencephaly and seizure. The patient had the possibility of a seizure attack during the perioperative period. We discuss the anesthetic management of a patient with Alexander's disease and we review the relevant literature.

  • PDF

Isolated Traumatic Injury of the Pancreatic Head: A Case Report

  • Kim, Dong Hun
    • Journal of Trauma and Injury
    • /
    • 제29권2호
    • /
    • pp.51-55
    • /
    • 2016
  • Isolated injury to the pancreas after abdominal trauma is uncommon, and a delay in diagnosis and treatment can increase the morbidity and mortality. Therapeutic decisions with respect to pancreatic trauma are usually made based on the site of injury and the status of the pancreatic ductal system. In this report, we describe the surgical management of pancreatic head transection as an isolated injury following blunt abdominal trauma. A 55-year-old man presented with epigastric pain that radiated to the back. Abdominal computed tomography revealed a hematoma in the pancreatic head and upstream dilatation of the main pancreatic duct. Endoscopic retrograde cholangiopancreatography showed complete disruption of and contrast leakage from the main pancreatic duct in the pancreatic head region with a nonenhanced upstream duct. Emergency pancreaticoduodenectomy was successfully performed, and the patient was discharged on postoperative day 9 without any complications.