• Title/Summary/Keyword: Surgical stent

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Refractory Vascular Spasm Associated with Coronary Bypass Grafting

  • Kim, Young Sam;Yoon, Yong Han;Kim, Jeoung Taek;Shinn, Helen Ki;Woo, Seong Ill;Baek, Wan Ki
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.468-472
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    • 2014
  • Diffuse refractory vascular spasms associated with coronary bypass artery grafting (CABG) are rare but devastating. A 42-year-old male patient with a past history of stent insertion was referred for the surgical treatment of a recurrent left main coronary artery disease. A hemodynamic derangement developed during graft harvesting, necessitating a hurried initiation of cardiopulmonary bypass (CPB). Although CABG was carried out as planned, the patient could not be weaned from the bypass. An emergency coronary angiography demonstrated a diffuse spasm of both native coronary arteries and grafts. CPB was switched to the femorofemoral extracorporeal membrane oxygenator (ECMO). Although he managed to recover from heart failure, his discharge was delayed due to the ischemic injury of the lower limb secondary to cannulation for ECMO. We reviewed the case and literature, placing emphasis on the predisposing factors and appropriate management.

Surgical Management of Tracheal and Bronchial Stenosis (기관및 기관지 협착증 환자의 외과적 치료)

  • 유정훈
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1299-1304
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    • 1992
  • We experienced 5 cases of tracheal stenosis and 7 cases bronchial stenosis treated surgically at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University during 5 years. The causes of tracheal stenosis were prolonged endotracheal intubation 1 case, tracheostomy 1 case, the sequela of endobronchial tuberculosis 2 cases and tracheomalacia 1 case. The causes of bronchial stenosis were all endobronchial tuberculosis. The managements of tracheal stenosis were tracheal resection and end to end anastomosis. The resected lengths of trachea were 1.5cm, 3cm and 7.5cm. One case of suglottic stenosis was underwent the resection of trachea, 8cm in length, and the laryngotracheal anastomosis was done, but the re-stenosis of trachea was developed after 4 weeks post-operatively. One case of tracheomalacia was done permanent tracheostomy only, because the entire trachea was adhered to the surrounding tissue. The managements of bronchial stenosis were resection of involved lobe or one lung, in the 5 case. One case with Lt. main bronchial stenosis and atelectasis of Lt. upper lobe was done the lobectomy of Lt. upper lobe only and then, the Lt. pneumonectomy was done re-operatively because the atelectasis of Lt. lower lobe had continued. The other one case with stenosis of Rt. main bronchus, failed the insertion of metalic stent, was underwent the Rt. upper lobe lobectomy, sleeve resection and side to end anastomosis

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Transcortical Endoscopic Surgery for Intraventricular Lesions

  • Kim, Myung-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.327-334
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    • 2017
  • To review recent advances in endoscopic techniques for treating intraventricular lesions via transcortical passage. Articles in PubMed published since 2000 were searched using the keywords 'endoscopy,' 'endoscopic,' and 'neuroendoscopic.' Of these articles, those describing intraventricular lesions were reviewed. Suprasellar arachnoid cysts (SACs) can be treated with ventriculo-cystostomy (VC) or ventriculo-cysto-cisternostomy (VCC). VCC showed better results compared to VC. Procedure type, fenestration size, stent placement, and aqueductal patency may affect SAC prognosis. Colloid cysts can be managed using a transforaminal approach (TA) or a transforaminal-transchoroidal approach (TTA). However, TTA may result in better exposure compared to TA. Intraventricular cysticercosis can be cured with an endoscopic procedure alone, but if pericystic inflammation and/or ependymal reaction are seen, third ventriculostomy may be recommended. Tumor biopsies have yielded successful diagnosis rates of up to 100%, but tumor location, total specimen size, endoscope type, and vigorous coagulation on the tumor surface may affect diagnostic accuracy. An ideal indication for tumor excision is a small tumor with friable consistency and little vascularity. Tumor size, composition, and vascularity may influence a complete resection. SACs and intraventricular cysticercosis can be treated successfully using endoscopic procedures. Endoscopic procedures may represent an alternative to surgical options for colloid cyst removal. Solid tumors can be safely biopsied using endoscopic techniques, but endoscopy for tumor resection still results in considerable challenges.

Superiorly Based Flap Tracheostomy (Superiorly based flap을 이용한 기관절개술)

  • 정필상;이정구;정필섭;김영훈
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.129-135
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    • 1995
  • The superiorly based flap tracheostomy(SBFT) has been advocated as an new technique of tracheostomy to manage a wide variety of causes of upper airway obstruction. This technique has particular applicability in patients who require long term tracheostomy such as in bilateral vocal cord paralysis and severe obstructive sleep apnea. SBFT has numerous advantages such as shortening of the gap between the skin and trachea : construction of a self-sustaining tract ; circumferential mucocutaneous junction to reduce infection, granulation tissue, bleeding, and stenosis of the tract : avoidance of the laryngotracheal damage : easy placement of a tracheostomal stent to promote speech, coughing and swallowing. Most of all, this technique can reduces the suprastomal buckling by the support of the superiorly based tracheal flap, and thus prevents the stenosis of suprastomal airway. The disadvantage of SBFT is more time-consuming procedure than the conventional tracheostomy, A retrospective analysis of 8 patients undergoing SBFT between June, 1994 and March, 1995 in Dankook University Hospital was performed to present the surgical technique and com-plication rates. The average duration of follow up was 11 months. The complications were consisted of a wound infection and a sternal granulation. The other complications including wound dehiscence, tracheitis, pneumonia, tracheal granulation, sternal narrowing and subglottic stenosis were not experienced.

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Maxillary anterior single implant prosthesis ; a clinical case

  • Kim Seung-June;Kwon Kung-Rock;Lee Sung-Bok;Woo Yi-Hyung;Choi Dae-Gyun;Choi Boo-Byung
    • The Journal of Korean Academy of Prosthodontics
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    • v.39 no.3
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    • pp.306-312
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    • 2001
  • Achieving an aesthetic implant-supported restoration in the single tooth missing case can be challenging when the implant site is in e anterior region. The objective of this report is to focus on presurgical evaluation of implant site and systematic development of related prosthetic modalities. An accurate diagnostic evaluation, a systematically developed pesurgical plan, and knowledge and clinical skill of the various related therapeutic modalities are indispensible. Collection of patient's information, appropriate abutment selection, soft tissue contour, implant axis, and occlusion need to be discussed for aesthetic clinical outcome. For aesthetic restoration, such as surgical guide stent for precise implant positioning customized provisional restoration for development of optimal periimplant soft tissue contours, and fabrication customized abutment (mesiostructure) for veriable emergence profile, are recommended.

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Bilateral Ureteral Obstruction Related to Pelvic Rhabdomyosarcoma Presenting with Acute Kidney Injury: A Case Report

  • Han, Sanghoon;Han, Kyoung Hee
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.116-120
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    • 2019
  • Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

A Case of Metastatic Ampulla of Vater Cancer Achieving Cure (고형물 삼킴장애로 내원한 환자 1례)

  • Weon Jin Ko;Won Young Park;Jun-Hyung Cho;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.82-84
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    • 2014
  • We report a case with dysphagia for solids. A 51-year-old man with benign esophageal stricture was transferred for endoscopic treatment. He had lye ingestion history at 9 years old and underwent esophagectomy with right colonic interposition for the treatment of the benign esophageal stricture. But his symptom was acting up 2 years ago and lasted afterward even though he had underwent endoscopic treatments for dysphagia several times, including balloon dilation and stent insertion. He had polypoid enhancing wall thickening around anastomosis site of stomach with perigastric soft tissue density and suspicious nodular extension to omentum on the small bowel computed tomography. So he had a surgical resection of small bowel and jejunojejunostomy, and the pathological result was adenocarcinoma, intestinal type with soft tissue infiltration. Later he underwent total gastrectomy with segmental resection of interpositional colon and segmental resection of duodenum and ileo-colic anastomosis revision. And recently he has been on chemotherapy.

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Intervention for Chest Trauma and Large Vessel Injury (흉부 및 대혈관 외상의 인터벤션)

  • Hojun Lee;Hoon Kwon;Chang Won Kim;Lee Hwangbo
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.809-823
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    • 2023
  • Trauma is an injury to the body that involves multiple anatomical and pathophysiological changes caused by forces acting from outside the body. The number of patients with trauma is increasing as our society becomes more sophisticated. The importance and demand of traumatology are growing due to the development and spread of treatment and diagnostic technologies. In particular, damage to the large blood vessels of the chest can be life-threatening, and the sequelae are often severe; therefore, diagnostic and therapeutic methods are becoming increasingly important. Trauma to nonaortic vessels of the thorax and aorta results in varying degrees of physical damage depending on the mechanism of the accident and anatomical damage involved. The main damage is hemorrhage from non-aortic vessels of the thorax and aorta, accompanied by hemodynamic instability and coagulation disorders, which can be life-threatening. Immediate diagnosis and rapid therapeutic access can often improve the prognosis. The treatment of trauma can be surgical or interventional, depending on the patient's condition. Among them, interventional procedures are increasingly gaining popularity owing to their convenience, rapidity, and high therapeutic effectiveness, with increasing use in more trauma centers worldwide. Typical interventional procedures for patients with thoracic trauma include embolization for non-aortic injuries and thoracic endovascular aortic repair for aortic injuries. These procedures have many advantages over surgical treatments, such as fewer internal or surgical side effects, and can be performed more quickly than surgical procedures, contributing to improved outcomes for patients with trauma.

Diagnosis and Cure Experience of Hepatolithiasis-Associated Intrahepatic Cholangiocarcinoma in 66 Patients

  • Li, Hong-Yang;Zhou, Shi-Ji;Li, Min;Xiong, Ding;Singh, Akanand;Guo, Qing-Xi;Liu, Chang-An;Gong, Jian-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.725-729
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    • 2012
  • Background: The management of hepatolithiasis combined with intrahepatic cholangicarcinoma (IHHCC) remains a challenge due to poor prognosis. The aim of this study was to summarize our diagnosis and cure experience of IHHCC over the recent 10 years. Methods: From January 1996 to January 2006, 66 patients with IHHCC were reviewed retrospectively. Results: Of the 66 patients, 52 underwent surgical resection (radical resection in 38 and palliative in 14) and 8 patients abdominal exploration, while the other 6 cases received endoscopic retrograde biliary internal drainage and stent implantation. In this series, correct diagnosis of advanced stage was made during operation in 8 cases (8/60, 13.3%) and all of them (underwent unnecessary abdominal exploration, among them the positive rate of CA19-9 was 100%, and the positive rate of CEA was 87.6% (7/8), incidence rate of ascites was 100% and short-term significant weight loss was 100%, with median overall survival of only 4 months. Conclusion: Radical resection is mandatory for IHHCC patient to achieve long-term survival, the CT and MR imaging features of IHHCC being concentric enhancement. Patients with IHHCC have significant higher CA199 and significant higher CEA and short-term significant weight loss and ascites should be considered with advanced stage of IHHCC and unnecessary non-therapeutic laparotomies should be avoided.

SHOCK-ABSORBING BEHAVIOR OF TEMPORARY SOFT DENTURE LINERS (임시 연성 의치상 이장재의 충격 흡수에 관한 연구)

  • Chun, Yong-Suk;Cho, In-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.34 no.1
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    • pp.151-167
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    • 1996
  • Temporary soft liners can be used to prevent chronic soreness from dentures or to aid in its treatment are as adjuncts in tissue conditioning, for temporary obturators, and to stabilize baseplate or surgical stent. The purpose of this study was to evaluate the shock absorption properties of several temporary soft denture liners using a free drop test with an accelerometer. The materials tested inclued Coe-comfort, Softone, Tissue conditioner and Viscogel. The specimens were fabricated with the thickness of 1, 2, 3mm and were stored in distilled water at $37^{\circ}C$ for a day, 1, 2, and 3 weeks. Six samples were made with each material for each test condition and the shock-absorbing behavior was evaluated according to material, thickness and duration. The results were as following : 1. Softone of 3mm thickness stored for a day showed the most excellent shock absorbability. 2. The shock absorbing behavior of duration according to materials and thickness showed a day to be the highest and decreased in 1 week, 2 weeks and 3 weeks in that order(p<0.05). And there was no significant difference between durations in Tissue conditioner. 3. The shock absorbability of thickness according to materials and duration showed 3mm to be highest and decreased in the order of 2mm, 1mm(p<0.05). 4. In comparison of the shock absorbability of temporary soft denture liners according to thickness, there was statistically significant difference between Softone and Visocgel, Tissue conditioner, Coe-comfort / Viscogel and Tissue conditioner, Coe-comfort in 1,2mm thickness, and between Softone, Viscogel and Tissue conditioner, Coe-comfort in 3mm thickness (p<0.05).

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