• Title/Summary/Keyword: Surgical therapy

Search Result 1,537, Processing Time 0.044 seconds

A Clinical Review of Surgically Treated 115 Cases of Lung Abscess (외과적 치료를 가한 폐농양 115례에 대한 임상적 관찰)

  • 문한배;이호일
    • Journal of Chest Surgery
    • /
    • v.2 no.1
    • /
    • pp.3-12
    • /
    • 1969
  • Prior to availability of antibiotics, lung abscess has been recognized as one of the most serious pulmonary disease, and despite of diminished morbidity and mortality rate with the advent of antibiotics and development of better technique in the fields of surgery on pulmonary disease it continues to be a virulent form of pulmonary supuration. It is the purpose of this paper to present a clinical review of 115 lung abscess treated by surgically at "The National Medical Center" during past 9 years. 1. The most common age of occurrence is between the age of 30 and 50, and 105 cases were male and 31 cases occurred in female. 2. Numerous etiological factors may play a role in the formation of a pulmonary abscess; aspiration in 36 patients of which 2 patients had diabetes, 54 patients had preceding URI or pneumonia, and 5 patients followed liver abscess, one of which in hematogenous route. In 20 patients, no predisposing factor could be determined- 3. Clubbing digits were presented in 26 of 1315 patients suggesting chronicity of the disease, and gastric ulcer were combined in 3 of 136 patints. 4. Apparently the onset was insidious, and the progress was masked by indiscriminate administration of antibiotics for URI and TB remedies under impression of pul. tbc. Previous TB treatments were done in 56.%[76 cases] for one week to two years and administration of antibiotics in 51 cases. 5. 89 cases were on tbe right and 2t5 cascs were on the left side. 51 cases of pneumonectomy and 8 of open drainage, of which 4 of Monaldi procedure, were made and operative mortality rate was 5.2%. Numerous complications such as 8 of empyema, 4 of each bleeding and atelectasis, 2 of BPF, 1 of esophageal fistula and one of pneumothorax which were responded well to prolonged treatment with good results, were obtained. 6. The incidence of Klebsiella and Pseudomonas were increased recently. In these results, we submit the surgery should be performed if the conservative therapy had failed. The resection was most favorable operation for pulmonary abscess though drainage procedure may be of value in certain patients with grave systemic menifestations. In chronic long standing abscess, more complications and high mortality rate were assumable although the prognosis has been improved with the advent of antibiotics, the development of improved surgical technique and complete preoperative care.

  • PDF

Removal of an Infected Permanent Pacemaker through a Right Atriotomy without Cardiopulmonary Bypass Via a Right Thoracotomy (체외순환 없이 우측 개흉술을 통한 우심방 절개 만으로 감염된 영구심박동기의 제거 치험)

  • Choi, Kwang-Ho;Yoon, Young-Chul;Park, Kyung-Taek;Lee, Yang-Haeng;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
    • /
    • v.43 no.4
    • /
    • pp.421-423
    • /
    • 2010
  • A 52-year-old female presented with pain and swelling owing to recurrent inflammation on a generator pocket. She had undergone a permanent pacemaker implantation (DDD type) 7 years previously. We planned to insert a new pacemaker after removal of the previous generator and wires through a surgical approach. However, she had a history of the left modified radical mastectomy (MRM) with radiation therapy for breast cancer. For this patient, it would be difficult to care for the postoperative wound if we approached via the median sternotomy. Therefore, we decided to use a right atrial approach via a right thoracotomy. We removed the previous pacing wires through an atriotomy and inserted a new pacemaker using epicardial pacing leads without cardiopulmonary bypass.

Dissecting Intramural Hematoma of the Esophagus - A case report - (박리성 벽내성 식도 혈종 - 1예 보고 -)

  • Choi, Jin-Wook;Lee, Sung-Soo;Choi, Ho;Moon, Jong-Hwan;Chung, Sang-Ho
    • Journal of Chest Surgery
    • /
    • v.41 no.6
    • /
    • pp.782-786
    • /
    • 2008
  • Dissection intramural hematoma of the esophagus (DIHO) is a rare, but well-documented condition that is part of the spectrum of, acute esophageal injuries; these include the more common Mallory-Weiss tear and Boerhaave's syndrome. This disorder is predominantly seen in women during their sixth or seventh decade and the disease has various etiologies, but the pathogenesis has yet to be clarified. The triad of symptoms for this disorder includes retrosternal pain, hematemesis and odynophagia. It is important to differentiate esophageal submucosal dissection form other disorders that have a similar appearance, such as Mallory-Weiss syndrome and esophageal perforation because the prognosis of DIHO is excellent with conservative therapy and these other diseases require surgical treatment. We report here on a case of a dissecting intramural hematoma of the esophagus that was preoperatively misdiagnosed as the submucosal tumor of the esophagus preoperatively, and it was confirmed by Video-assisted thoracic surgery.

CERVICOFACIAL NECROTIZING FASCIITIS;CASE REPORT (경안면 괴사성 근막염;증례보고)

  • Park, Kwan-Soo;Jeong, Ki-Hoon;Kim, Hyo-Eon;Jeong, Jeong-Kwon;Yoon, Kyu-Ho;Jeon, In-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.23 no.1
    • /
    • pp.77-81
    • /
    • 2001
  • Necrotizing fasciitis is defined as infectious disease showing extensive necrosis of the superficial fascia with widespread involvement of the surrounding tissues and concurrent systemic toxicity. It is found commonly in the extremities, the trunk and the perineum, but shows extremely rare occurrence in the well vascularized area such as head and neck area. Occurred in the head and neck area, it is called "cervicofacial necrotizing fasciitis" (CFNF). It is a fatal disease which carries a mortality rate up to 60%. Early diagnosis, aggressive surgical debridement of necrotic tissues and massive antibiotics therapy are essential for achieving a favorable outcome. We present a case of cervicofacial necrotizing fasciitis in 35-year-old male patient with literature review.

  • PDF

HERPES ZOSTER OF ORAL AND MAXILLOFACIAL AREA : CASES REPORT (구강 악안면 영역에 발생한 대상 포진 환자의 치험례)

  • Kim, Il-Kyu;Choi, Jin-Ho;Jeong, Sung-Rok;Oh, Seong-Seob;Oh, Nam-Sik;Kim, Eui-Seong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.26 no.3
    • /
    • pp.313-317
    • /
    • 2000
  • Return of facial nerve function is important in patients with facial nerve paralysis by trauma. Sometimes, delay in diagnosis of facial nerve paralysis make recovery of facial nerve function difficult. Traumatic facial palsy mostly occur after temporal bone fracture in unilateral. Temporal bone fracture after head trauma are divided into the three group; longitudinal fracture, transverse fracture and mixed fracture. The most common symptoms are hearing impairment, bloody otorrhea, loss of consciousness and facial nerve paralysis. The early care of temporal bone fracture involves facial nerve paralysis. And there has been many discussion and study in the treatment of the immediate or delayed facial palsy ; examply, surgical approach, time and methods. We have managed a patient with unilateral facial nerve paralysis after longitudinal temporal bone fracture in mastoid process and conservative facial nerve decompression was performed. We have obtained good result and report this case with review of literatures.

  • PDF

Screening of MicroRNA in Patients with Esophageal Cancer at Same Tumor Node Metastasis Stage with Different Prognoses

  • Zhao, Bao-Sheng;Liu, Shang-Guo;Wang, Tian-Yun;Ji, Ying-Hua;Qi, Bo;Tao, Yi-Peng;Li, Han-Chen;Wu, Xiang-Nan
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.1
    • /
    • pp.139-143
    • /
    • 2013
  • Patients at the same pathological stage of esophageal cancer (EC) that received the same surgical therapy by the same surgeon may have distinct prognoses. The current study aimed to explore the possibility of differentially-expressed microRNAs (miRNAs) underlying this phenomenon. Samples were collected from EC patients at the same tumor node metastasis (TNM) stage but with different prognoses. Paracancerous normal tissues were taken as controls. The specimens were histopathologically analyzed. Differentially-expressed miRNAs were analyzed using real-time quantitative reverse transcription polymerase chain reaction. Compared with patients with poor prognosis, those with good prognosis exhibited 88 two-fold or more than two-fold increased miRNA fragments and 4 half-decreased miRNAs. The most noticeably up-regulated miRNAs included hsa-miR-31, hsa-miR-196b, hsa-miR-652, hsa-miR-125a-5p, hsa-miR-146b, hsa-miR-200c, hsa-miR-23b, hsa-miR-29a, hsa-miR-186, hsa-miR-205, hsa-miR-376a, hsa-miR-410, hsa-miR-532-3p, and hsa-miR-598, whereas the most significantly-downregulated miRNAs were hsa-let-7e, hsa-miR-130b, and hsa-miR-103. EC patients at same TNM stage but with different prognoses show differentially-expressed miRNAs.

The Unnecessity of Positron Emission Tomography Computed Tomography in the Etiologic Evaluation of Neurodevelopmental Delay in Craniosynostosis Patients

  • Yang, Chae Eun;Park, Eun Kyung;Lee, Myung Chul;Shim, Kyu Won;Kim, Yong Oock
    • Archives of Craniofacial Surgery
    • /
    • v.18 no.1
    • /
    • pp.21-24
    • /
    • 2017
  • Background: In evaluation of craniosynostosis patients in terms of neurodevelopmental delay, positron emission tomography computed tomography (PET-CT) scan can be used to assess brain abnormalities through glucose metabolism. We aimed to determine the unnecessity of PET-CT in this study. Methods: Thirty-eight patients diagnosed with craniosynostosis who underwent distraction osteogenesis from October, 2010 to November, 2013 were reviewed. Magnetic resonance imaging (MRI) and PET-CT scan were carried out for evaluation of the brain structure and function, whereas X-ray and CT scan were taken for evaluation of the skull. Results: Nine patients reported abnormal MRI findings which were not significant, and five patients showed local problem on brain on PET-CT scan. No correlation was found among them. Conclusion: PET-CT evaluation of possible abnormal brain findings do not affect surgical planning or require additional therapy. Preoperative PET-CT scan is not the essential study to get any etiologic information of the disease consequences or to establish the treatment plan.

Primary Melanoma of the Stomach at Cardia (위 분문부에 발생한 원발성 흑색종)

  • Park, Jong-Ik;Kang, Sung-Gu;Park, Sang-Su;Yoon, Jin;Kim, Il-Myung;Shin, Dong-Gue
    • Journal of Gastric Cancer
    • /
    • v.6 no.3
    • /
    • pp.193-197
    • /
    • 2006
  • Melanoma is a malignant neoplasm of melanocytes most frequently arising from the skin, but primary melanoma can also arise from the mucosa of the gastrointestinal tract. Gastrointestinal melanomas are most commonly metastases from a cutaneous melanoma. Primary melanoma of the stomach is rare and carries a poor prognosis. Reported here is the case of a 75-year-old man with a primary gastric melanoma who presented with a melena, abdominal pain, and weight loss. Most cases of melanoma are treated by excision of the primary tumor. Patients with melanoma have been treated with adjuvant chemotherapy, radiation therapy, and immunotherapy. None of these modalities has been demonstrated to prolong the survival rate. To improve long-term disease-free survival, early diagnosis and surgical intervention are very important.

  • PDF

Comparative Study on the Tooth Mobility after Modified Widman Flap (변형 Widman 판막술 후 치아 동요도 변화에 관한 연구)

  • Kim, Soo-Yong;Chung, Chin-Hyung;Lim, Sung-Bin
    • Journal of Periodontal and Implant Science
    • /
    • v.33 no.1
    • /
    • pp.103-111
    • /
    • 2003
  • Tooth mobility is an important part of a periodontal examination and represents a function of the persisting height of the alveolar bone and the width of the periodontal ligament. The purpose of this study was to evaluate the changes of the tooth mobility over 4 week-period following surgical therapy on the periodontal disease. Thirty five patients presenting with moderate periodontal pockets were selected and tooth mobility was measured at weekly intervals using Periotest (Siemens Co., Germany) beginning at the pre-operation examination and ending four weeks following the modified Widman Flap. All data were statistically analyzed using the one-way ANOVA test. The results were obtained as follows; 1. All teeth exhibited the greatest change in mobility at 1 week post-op, mobility generally decreasing with time. 2. Comparison of the weekly tooth mobility data regarding the 1st premolars showed significant differences only between weeks 1 (9.94) and 4 (6.14) (p<0.05). 3. Comparison of the weekly tooth mobility data regarding the 1st molar showed significant changes in the intervals between pre-op (6.49) and week 1 (11.22), pre-op and week 2 (9.37), weeks 1 and 3 (7.65), weeks 1 and 4 (5.62), and weeks 2 and 4 (p<0.05). 4. Comparison of the weekly tooth mobility data regarding the 2nd premolar and 2nd molar showed significant differences between pre-op (6.91, 8.60) and week 1 (11.02, 12.62), weeks 1 and 3 (8.00, 8.05), weeks 3 ad 4 (6.22, 6.71), and weeks 2 (9.34, 11.01) and 4 (p<0.05).

Bisphophonate-Related Osteonecrosis of the Jaw (BRONJ) (비스포스포네이트 연관 악골괴사증(BRONJ))

  • Kim, Hyeon-Mook;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
    • /
    • v.27 no.4
    • /
    • pp.449-454
    • /
    • 2011
  • Recently, jawbone osteonecrosis has been largely reported as a potential adverse effect of bisphosphonate (BP)administration. Currently available published incidence data for BRONJ are based on retrospective studies and estimates of cumulative incidence range from 0.8 to 12%. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60-70% of cases are preceded by a dental surgical procedure. The signs and symptoms that may occur before the appearance of clinical evident osteonecrosis include changes in the health of periodontal tissues, non-healing mucosal ulcers, loose teeth and unexplained soft-tissue infection. Tooth extraction as a precipitating event is a common observation. The significant benefits that bisphosphonates offer to patients clearly surpass the risk of potential side effects; however, any patient for whom prolonged bisphosphonate therapy is indicated, should be provided with preventive dental care in order to minimize the risk of developing this severe condition.