• Title/Summary/Keyword: Treatment-related complication

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Six-year Experience of Endovascular Embolization for Intracranial Aneurysms

  • Jung, Yeun-Ho;Park, Seong-Hyun;Kim, Yong-Sun;Hamm, In-Suk
    • Journal of Korean Neurosurgical Society
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    • v.38 no.3
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    • pp.190-195
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    • 2005
  • Objective : This study is performed to evaluate the procedural complications, aneurysm occlusion rate, and mid-term outcome of endovascular treatments in intracranial aneurysms. Methods : We retrospectively investigated 135 patients with 161 cerebral aneurysms who were treated by endovascular means at our institute from March 1999 to December 2004. We statistically analyzed overall outcome, occlusion rate, and occurrence of complications according to the location, size, rupture history, and neck size of aneurysms. Results : Forty-nine patients [36.3%] had experienced acute intracranial or extracranial complications related to the procedure. Among these, there were 13cases of perforation of the aneurysm, 9 of local vasospasm, 8 of thromboembolism, 4 of coil migration, 3 of occlusion of parent vessels due to coil protrusion, and 1 of seizure. Extracranial complications occurred in 14cases including alopecia [9cases], femoral artery thrombosis [2cases], acute renal failure [2cases], and hypovolemic shock [1case]. One hundred twenty-six aneurysms [78.3%] had complete occlusion of the aneurysm and 35 [21.7%] incomplete occlusion at 6months angiographic follow-up. Postembolization clinical follow-up ranged from 1 to 60months [mean, 14.2months]. Seven of the 161 aneurysms underwent additional embolization and 2 incomplete embolized aneurysms required subsequent surgery. Conclusion : The procedural complications and incomplete occlusion rates are substantial. Therefore, endovascular treatment needs close and continued neurosurgical and neuroradiological concerns for the therapy of intracranial aneurysms.

Complications of reverse shoulder arthroplasty: a concise review

  • Kim, Su Cheol;Kim, Il Su;Jang, Min Chang;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.24 no.1
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    • pp.42-52
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    • 2021
  • Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%-24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

Medical adhesive related skin injury after dental surgery

  • Kim, Tae-Heung;Lee, Jun-Sang;Ahn, Ji-Hye;Kim, Cheul-Hong;Yoon, Ji-Uk;Kim, Eun-Jung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.5
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    • pp.305-308
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    • 2018
  • An 87-year-old woman was referred for the extraction of residual teeth and removal of tori prior to prosthetic treatment. After surgery under general anesthesia, the surgical tape was removed to detach the bispectral index sensor and the hair cover. After the surgical tape was removed, skin injury occurred on the left side of her face. After epidermis repositioning and ointment application, a dressing was placed over the injury. Her wound was found to have healed completely on follow-up examination. Medical adhesive related skin injury (MARSI) is a complication that can occur after surgery and subjects at the extremes of age with fragile skin are at a higher risk for such injuries. Careful assessment of the risk factors associated with MARSI is an absolute necessity.

The studies of east-western medicine on Rheumatoid arthritis (류머티스성 관절염(Rheumatoid arthritis)에 대한 동서의학적(東西醫學的) 고찰(考察))

  • Kwon, Young-Dal;Song, Yong-Sun
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.373-396
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    • 1994
  • The studies look at the causes, pathology, symptom, diagnosis, treatment of rheumatoid arthritis in the sight of east-western medicine. Following are the results : 1. Rheumatoid arthritis korean-medically belongs to symptom such as Bi(痺), Poung Bi(風痺), Tong Poung(痛風), Youk Jeol Poung(歷節風), Bak Hoe Poung(白虎風), Bak Hoe Youk Jeol Poung(白虎歷節風), etc. 2. The causes of Rheumatoid arthritis are endopathic and exopathic : endopathically it tis related to Chil Jeong(七情) and visceral imbalance, and exopathically it is related to Euk Eum (六淫) and environmental factors. 3. To figure out rheumatoid arthritis, we need to diagnose first the joint symptom and the general body condition, we need about 6 weeks to get the exact decision after the serologic test, the immune and inheritance test, the synovium test. 4. There are four kinds of treatments for rheumatoid arthritis : medicin, acupucture and moxibustion, suction cup and purging away the blood, physical therapy. Cheong Eol So Bi(淸熱消痺) can be used for the acute stage and Jang Bu Seong Shai(臟腑盛衰) is to be considered for the chronic stage. 5. Rheumatoid arthritis should be constantly treated to prevent the patient from the deformity of joint complication.

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Surgical Treatment of Patent Ductus Arteriosus in Preterm and Infants with Severe Heart Failure and Cardiac Cachexia (중증 심부전 또는 심인성 악액질을 동반한 미숙아및 영아기 동맥관개존증에 대한 수술요법)

  • 이석재
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.915-919
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    • 1993
  • The management of Patent Ductus Arteriosus[PDA] with heart failure and cardiac cachexia in premature infants have been a disturbing and controversial problem in the field of pediatric cardiovascular surgery.We analysed our experiences to determine the rationale of surgical closure of PDA in infants . During a period of 7 years from January 1986 to December 1992, 12 infants under 2 months of age underwent operations for "hemodynamically significant" PDA which had caused severe heart failure.There were 6 male and 6 female patients. Their mean gestational age was 33.8 weeks and their mean body weight was 1990 g. ranged from 710 g. to 2900 g. Mean age at operation was 28.5days. Seven patients had history of Indomethacin trial. All patients were operated with double ligation technique under general anesthesia.There was no mortality and blood transfusion was not necessary in any patient during the operation.In all cases, we could confirm the complete closure of PDA after operation by follow-up echocardiography.Two patients died during their hospital stay and 1 patient died at 6 months after operation. The causes of death were sepsis with congestive heart failure, necrotizing entero colitis and pneumonia respectively.We can not detect any operation related complication which resulted in permanent sequelae as well as delayed complications related to nerve damage. These results indicate that surgical ligation of PDA in infants with severe heart failure is relatively safe and effective.effective.

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Central Venous Access for Chemoterapy in Patients with Malignant Disease (항암 화학요법을 받는 환자들에서의 중심정맥삽관술)

  • Kim, Uk-Seong;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.483-487
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    • 1993
  • From July 1990 to August 1992,78 Hickman catheters and 22 chemoports were inserted in 98 patients for chemotherapy.We analyzed the clinical data of these patients. The results were as follows: 1]Mean age of patients was 42.8$\pm$1.6[SE] years 2]Male to female ratio was 1.09:1 3]The diseases of the cases were leukemia[66] ,lymphoma[8], stomach cancer[8],uterine cervix cancer[5],ovarian cancer[4],lung cancer[3],aplastic anemia[2],maxillary gland cancer[1],pancreas cancer[1],malignant mesothelioma[1] and multiple myeloma[1] 4]Mean values of preoperative WBC counts,platelet counts,PT and APTT were 31,500$\pm$ 8,132[SE]/mm,104,000$\pm$ 12,200 [SE]/mm,82$\pm$ 1.9[SE]% and 32$\pm$ 0.8[SE] sec,respectively. 5]The average duration of catheter uses was 121.7$\pm$ 17.3[SE]days. 6]The complications were subcutaneous tunnel bleeding or hematoma[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1]. 7]The causes of catheter removal were patient`s death or hopeless discharge[22],completion of treatment[6],subcutaneus hematoma or bleeding[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1].So,we concluded that Hickman catheter and chemoport were useful vascular access for chemotherapy in patients with malignant diseases, with low rate of complication and longterm duration.

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Bilateral optic neuropathy related to severe anemia in a patient with alcoholic cirrhosis: A case report and review of the literature

  • Humbertjean-Selton, Lisa;Selton, Jerome;Riou-Comte, Nolwenn;Lacour, Jean-Christophe;Mione, Gioia;Richard, Sebastien
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.417-423
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    • 2018
  • Anemia appears frequently in patients with alcoholic liver disease (ALD) but has never been linked to bilateral nonarteritic anterior ischemic optic neuropathy (NAION). A 65-year-old woman with a medical history of alcoholic cirrhosis was admitted for bilateral NAION. On admission, she was found to have a low arterial pressure and severe normocytic anemia (48 g/L). The anemia was related to chronic bleeding due to antral gastritis along with other factors associated with ALD. The applied treatment consisted of urgent transfusion followed by high doses of proton-pump inhibitors, iron and vitamin supplementation, and support in lifestyle measures. Her hemoglobin levels remained stable after 2 years but the patient still suffered from visual loss. This case highlights the link between anemia and bilateral NAION in ALD patients. The optic nerve head is prone to infarction in this context due to the vascularization characteristics of ALD. Hemoglobin levels should be monitored in ALD patients to avoid the severe complication of NAION.

Interstitial Lung Abnormality in Asian Population

  • Gong Yong Jin
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.2
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    • pp.134-144
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    • 2024
  • Interstitial lung abnormalities (ILAs) are radiologic abnormalities found incidentally on chest computed tomography (CT) that can be show a wide range of diseases, from subclinical lung fibrosis to early pulmonary fibrosis including definitive usual interstitial pneumonia. To clear up confusion about ILA, the Fleischner society published a position paper on the definition, clinical symptoms, increased mortality, radiologic progression, and management of ILAs based on several Western cohorts and articles. Recently, studies on long-term outcome, risk factors, and quantification of ILA to address the confusion have been published in Asia. The incidence of ILA was 7% to 10% for Westerners, while the prevalence of ILA was about 4% for Asians. ILA is closely related to various respiratory symptoms or increased rate of treatment-related complication in lung cancer. There is little difference between Westerners and Asians regarding the clinical importance of ILA. Although the role of quantitative CT as a screening tool for ILA requires further validation and standardized imaging protocols, using a threshold of 5% in at least one zone demonstrated 67.6% sensitivity, 93.3% specificity, and 90.5% accuracy, and a 1.8% area threshold showed 100% sensitivity and 99% specificity in South Korea. Based on the position paper released by the Fleischner society, I would like to report how much ILA occurs in the Asian population, what the prognosis is, and review what management strategies should be pursued in the future.

Multisystem Inflammatory Syndrome in Children (MIS-C) (소아 다기관 염증 증후군)

  • Lee, Joon Kee;Cho, Eun Young;Lee, Hyunju
    • Pediatric Infection and Vaccine
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    • v.28 no.2
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    • pp.66-81
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    • 2021
  • The coronavirus disease 2019 pandemic has been continuously spreading throughout the world. As of July 15, 2021, there have been more than 188 million confirmed cases and more than 4.06 million deaths. Although the incidence of severe infections is relatively low in children and adolescents compared to adults, a complication called multisystem inflammatory syndrome in children (MIS-C) may occur in some cases at approximately 2-6 weeks after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. MIS-C can be seen in patients of various ages, from young infants to adolescents, and may present with diverse clinical manifestations. While fever present in a great majority of patients, symptoms suggesting the involvement of the digestive or nervous system and the skin and mucous membranes (Kawasaki disease-like symptoms) also appear in many cases. Cardiac involvement may also be observed, including left ventricular dysfunction, myocarditis, coronary artery dilatation, and coronary aneurysm. In some cases, hypotension or shock can occur, and mechanical ventilation or treatment in the intensive care unit may be necessary. Fortunately, recovery is generally reported after appropriate treatment. MIS-C is a rare but important complication of SARS-CoV-2 infection in children and adolescents. As such, it is important to recognize the clinical symptoms and provide appropriate treatment at an early stage. In this review, the epidemiology, clinical symptoms, suggested pathophysiology, diagnostic approach, and treatment of MIS-C will be discussed.

Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma

  • Lee, Ji-Eun;Park, Young-Je;Yang, Dae-Sik;Yoon, Won-Sup;Lee, Jung-Ae;Rim, Chai-Hong;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.30 no.2
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    • pp.62-69
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    • 2012
  • Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.