• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권6호
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• pp.528-534
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• 2021

Purpose: Living-donor liver transplant emerged as an alternative treatment for end stage liver disease due to the lack of cadaveric organs availability that met the demand. In Portugal, pediatric living-donor liver transplant (P-LDLT) was initiated in 2001 in Portugal in order to compensate for the scarcity of cadaveric organs for such cases. The aim of this study was to retrospectively analyze the morbi-mortality of the 28 donors included in P-LDLT program performed at Coimbra's Pediatric Hospital (CHUC), a Portuguese reference center. Methods: We retrospectively collected pertinent donor data and stratified complications according to Clavien's scoring system. Results: In total, 28.6% (n=8) of the donors had surgical complications. According to Clavien-Dindo's classification, two donors had major complications (Clavien grade ≥3), four donors had grade 2 complications, and two donors had grade 1 complications. There were no P-LDLT-related mortalities in the present case series. The most common verified complications were biliary tract injuries and superficial incisional infections, which are consistent with the complications reported in worldwide series. Conclusion: These patients from CHUC shows that donor hepatectomy in P-LDLT is a safe procedure, with low morbidity and without mortality.

• Journal of Chest Surgery
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• 제33권3호
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• pp.231-239
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• 2000

Background: This retrospective study tries to identify specific risk factors that may increase complication rates after the surgical treatment of tuberculous destroyed lung. Material and method: A retrospective study was performed on forty-seven patients, who received surgical treatment for tuberculous destroyed lung in the Department of Thoracic and Cardiovascular Surgery at Hanyang University Hospital from 1988 to 1998, to identify specific preoperative risk factors related to postoperative complications. Fisher's exact test was used to identify the correlations between the complications and right pneumonectomy, preoperative FEV1, predicted postoperative FEV1, massive hemoptysis, postoperative persistent empyema. Result: Hospital mortality and morbidity rates of the patients who received surgical treatment for tuberculous destroyed lung were 6.4% and 29.7%, respectively. In view of the hospital mortality and morbidity rates as a whole, predicted postoperative FEV1 less than 0.8L(p<0.005), preoperative FEV1 less than 1.8L(p=0.01), massive hemoptysis(p<0.005), postoperative persistent positive sputum cultures(p<0.0005), and the presence of multi drug resistant tuberculosis(p<0.05) presented statistically significant correlations. Among the postoperative complications, bronchopleural fistula, the most common complication, was found to have statistically significant corrleations with the preoperative empyema(p<0.05) and postoperative persistent positive sputum cultures(p<0.05). Conclusion: Although mortality and morbidity rates after surgical treatment of tuberculous destroyed lung were relatively low, when predicted postoperative FEV1 was less than 0.8L, when preoperative FEV1 was less than 1.8L, when massive hemoptysis was present, when postoperative sputum cultures were persistently positive, and when multi drug resistant tuberculosis was present, the rates were significantly higher.

• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.8-12
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• 2015

Background: Enlargement of subdural hematomas is relatively rapid in subacute stage of hematoma with clinical deterioration, which eventually necessitates surgery. The purpose of this study is to investigate the feasibility and safety of burr hole drainage using urokinase for management of patients with subacute subdural hematoma (SASDH). Methods: Nine patients with SASDH were treated by burr hole drainage using urokinase. Under local anesthesia a catheter was inserted into the hematoma through a burr hole. Burr hole drainage was followed by hematoma thrombolysis with instillation of urokinase (10,000 units) every 12 hours. Drainage was discontinued when a significant decrease of hematoma was observed on cranial computed tomography. Results: The patients' median age was 70 years (range, 62-87). The median Glasgow Coma Scale score before surgery was 15 (range, 11-15). Drainage was successfully performed in all patients. All patients had Glasgow Outcome Scale scores of 5 at discharge. There was no surgery-related morbidity or mortality. Conclusion: A burr hole drainage using urokinase could be a safe, feasible and effective minimally invasive method with low morbidity in treatment of selected patients with SASDHs.

• 한국건강관리협회지
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• 제2권2호
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• pp.154-159
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• 2004

Rheumatoid arthritis(RA) is the most common inflammatory joint disease and a major cause of disability, morbidity, and mortality. It occurs worldwide, affecting approximately one percent of adults. Inflammation of the synovial membrane surrounding a joint leads to swollen, tender, and stiff joints RA has no known cure and the diagnosis is made based on clinical criteria and many different options exist for treatment. All of these factors magnify the importance of the patient-physician interaction and place a premium on the art rather than the science of medicine. The major goals of therapy for RA are to relive pain, swelling, and fatigue; improve joint function; stop joint daage, and prevent disability and disease-related morbidity. Some combination of nonsteroidal anti-inflammatory drugs(NSAIDs), steroids, and DMARDs is necessary in almost patients. In many combinations of different DMARDs or DMARDs plus biologicals are necessary for optimal control. Additionaly, all patients with RA should be educated about their disease and the therapies that will be used. Patient education is essentially early in the disease course and on going basis Much research is focused on the further development of biological agent for treatment of RA. Elucidation of the trigger or trigers for RA may allow us to begin to think about prevention of RA.

• 대한간호학회지
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• 제38권1호
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• pp.19-28
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• 2008

Purpose: The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions. Method: A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified. Result: Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment. Conclusion: There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.

• Journal of Chest Surgery
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• 제28권3호
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• pp.324-327
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• 1995

Extracranial carotid artery disease is rare and closely related to cardiovascular morbidity and mortality.We experienced one case of surgical treatment of left common carotid artery stenosis using internal shunt.The patient was 54-year-old female presented as headache and dizziness for about 2 years.On Doppler ultrasound, an atheromatous plaque was noted along the posteromedial wall of left common carotid artery resulting in luminal narrowing in about 75s of cross section area.The atheroma was resected through carotid endarterectomy, measured about 5.2cm in length. Postoperative course was uneventful and she was discharged in good condition.

• Journal of Chest Surgery
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• 제26권10호
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• pp.812-814
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• 1993

Six patients with flail chest were performed operative stabilization with Judet`s Struts.The indications of opertive stabilization were exploratory thoracotomy or laparotomy in 4 patients, and severe chest pain due to displaced ribs which deteriorated respiratory pattern and gas exchange in 2 patients. After operation, all patients became comfortable and complained less pain.Two patients restored spontaneous breathing without ventilator therapy and 2 patients were ventilated during 4 days and 5 days, respectively.There were no morbidity and mortality related to operative stabilization.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2383-2391
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• 2014

Tobacco use is described as the single most preventable cause of morbidity and mortality globally, with the World Bank predicting over 450 million tobacco-related deaths in the next fifty years. In India, the proportion of all deaths that can be attributed to tobacco use is expected to rise from 1.4% in 1990 to 13.3% in 2020 of which smoking alone will cause about 930,000 adult deaths by 2010. Many studies have shown that counseling from a health professional is an effective method of helping patients quit the tobacco habit. Tobacco cessation needs to be urgently expanded by training health professionals in providing routine clinical interventions, increasing availability and subsidies of pharmacotherapy, developing wide-reaching strategies such as quitlines, and costeffective strategies, including group interventions. The WHO Framework Convention on Tobacco Control (FCTC) emphasizes the vital contribution of participation of health professional bodies, as well as training and healthcare institutions in tobacco control efforts. Dentists can play an important role in helping patients quit using tobacco. One of the key strategies to reduce tobacco-related morbidity and mortality is to encourage the involvement of health professionals in tobacco-use prevention and cessation counselling. The dental office is an ideal setting for tobacco cessation services since preventive treatment services, oral screening, and patient education have always been a large part of the dental practice.

• Journal of Chest Surgery
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• 제46권4호
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• pp.256-264
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• 2013

Background: Surgical treatment of infective endocarditis (IE) remains a challenge, especially in cases of multiple valve surgery. We evaluated the clinical outcomes of native valve IE and compared the outcomes of single valve surgery with those of multiple valve surgery. Materials and Methods: From 1997 to 2011, 90 patients underwent surgery for native valve IE; 67 patients with single valve surgery (single valve group) and 23 patients with multiple valve surgery (multiple valve group). The mean follow-up duration was $73.1{\pm}47.4$ months. Results: The surgical mortality in the total cohort was 4.4%. The overall survival (p=0.913) and valve-related event-free survival (p=0.204) did not differ between the two groups. The independent predictor of postoperative complications was New York Heart Association class (p=0.001). Multiple valve surgery was not a significant predictor of surgical mortality (p=0.225) or late mortality (p=0.936). Uncontrolled infection, urgent or emergency surgery, and postoperative complications were identified as independent predictors of valve-related morbidity, excluding multiple valve surgery (p=0.072). Conclusion: In native valve IE, multiple valve surgery as a factor was not an independent predictor of mortality and morbidity. The number of surgically corrected valves in native IE seems to be unrelated to perioperative and long-term outcomes.

• Journal of Korean Neurosurgical Society
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• 제44권4호
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• pp.228-233
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• 2008

Objective : The standard treatment strategy of intracranial aneurysms includes either endovascular coiling or microsurgical clipping. In certain situations such as in giant or dissecting aneurysms, bypass surgery followed by proximal occlusion or trapping of parent artery is required. Methods : The authors assessed the result of extracranial-intracranial (EC-IC) bypass surgery in the treatment of complex intracranial aneurysms in one institute between 2003 and 2007 retrospectively to propose its role as treatment modality. The outcomes of 15 patients with complex aneurysms treated during the last 5 years were reviewed. Six male and 9 female patients, aged 14 to 76 years, presented with symptoms related to hemorrhage in 6 cases, transient ischemic attack (TIA) in 2 un ruptured cases, and permanent infarction in one, and compressive symptoms in 3 cases. Aneurysms were mainly in the internal carotid artery (ICA) in 11 cases, middle cerebral artery (MCA) in 2, posterior cerebral artery (PCA) in one and posterior inferior cerebellar artery (PICA) in one case. Results : The types of aneurysms were 8 cases of large to giant size aneurysms, 5 cases of ICA blood blister-like aneurysms, one dissecting aneurysm, and one pseudoaneurysm related to trauma. High-flow bypass surgery was done in 6 cases with radial artery graft (RAG) in five and saphenous vein graft (SVG) in one. Low-flow bypass was done in nine cases using superficial temporal artery (STA) in eight and occipital artery (OA) in one case. Parent artery occlusion was performed with clipping in 9 patients, with coiling in 4, and with balloon plus coil in 1. Direct aneurysm clip was done in one case. The follow up period ranged from 2 to 48 months (mean 15.0 months). There was no mortality case. The long-term clinical outcome measured by Glasgow outcome scale (GOS) showed good or excellent outcome in 13/15. The overall surgery related morbidity was 20% (3/15) including 2 emergency bypass surgeries due to unexpected parent artery occlusion during direct clipping procedure. The short-term postoperative bypass graft patency rates were 100% but the long-term bypass patency rates were 86.7% (13/15). Nonetheless, there was no bypass surgery related morbidity due to occlusion of the graft. Conclusion : Revascularization technique is a pivotal armament in managing complex aneurysms and scrupulous prior planning is essential to successful outcomes.