• Title/Summary/Keyword: Treatment-related morbidity

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Brain Imaging Provides Insight into the Neurobiology of Panic Disorder (공황장애의 뇌영상 및 신경생물학적 식견)

  • Park, Joo-Eon;Kang, Eun-Ho;Lee, In-Soo;Yu, Bum-Hee
    • Anxiety and mood
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    • v.3 no.2
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    • pp.91-96
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    • 2007
  • Panic disorder is a common psychiatric illness that causes considerable morbidity. However, the biological basis of panic disorder remains unclear. In this report, we present and summarize the current literature on functional neuroimaging studies related to the neurobiology of panic disorder. The findings were summarized and divided into six groups : (1) known brain structures related to anxiety, especially panic disorder ; (2) structural results ; (3) functional imaging studies at rest ; (4) functional imaging studies with challenge testing ; (5) neuroreceptor studies ; and (6) changes in the treatment of panic disorder. Based on the findings of these neuroimaging studies, it seems as though panic disorder involves the hippocampal and parahippocampal areas, including the amygdala, as well as some cortical regions, such as the temporal and prefrontal cortices. Panic disorder is known to be associated with an imbalance between the right and left hemispheres of the brain at rest or during panic attacks. During a panic attack, patients with panic disorder are likely to experience an increase in local activity in the cingulate, insula, midbrain, and so on. On the other hand, a widespread reduction in the cortical areas has also been reported in most provocation studies. Thus, panic disorder may be related to the excess activation of the fear networks in response to subtle environmental cues and insufficient inhibition from higher cortical control areas ; however ; further studies are recommended in order to fully understand the neurobiology of panic disorder.

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Prenatally Diagnosed Extrapulmonary Sequestration - 2 cases - (산전 진단된 폐외분리증 2예)

  • Kim, Hyun-Young;Son, Dong-Woo;Kim, Seok-Yong;Kim, Jee-Eun;Ha, Seung-Yeon
    • Advances in pediatric surgery
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    • v.15 no.2
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    • pp.173-179
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    • 2009
  • Congenital thoracic malformations such as intra- and extra-pulmonary sequestration, cystic adenomatoid malformation, congenital pulmonary airway malformation, malinosculation, bronchogenic cyst, reduplication cyst, and foregut cyst are frequently detected on routine prenatal ultrasound. There are some controversies about treatment for postnatally persistent pulmonary sequestration. Some authors recommend expectant long term follow up but most authors advocate elective surgical excision because of complication such as respiratory distress, infection, intrathoracic bleeding, haemoptysis, cardiac failure, and potential risk of malignancy. We experienced 2 cases of prenatally diagnosed extrapulmonary sequestration which were located in the subdiaphragmatic retroperitoneum. Resections were performed at 2 months and 4 months of age using intraabdominal approach. There were no complications. In conclusion, if the prenatally diagnosed extrapulmonary sequestration remained postnatally, early operation might reduce morbidity related to extrapulmonary sequestration and parental anxiety without any postoperative complication.

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Hypotension during Percutaneous Vertebroplasty with PMMA (Polymethylmethacrylate) -A case report- (경피적 추체 성형술 중 발생한 저혈압 -증례 보고-)

  • Park, Jin-Woo;Kim, Haa-Soo;Lim, Se-Hun;Kim, Jeong-Hun;Jeong, Soon-Ho;Choe, Young-Kyun;Kim, Young-Jae;Shin, Chee-Mahn;Park, Ju-Yuel
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.126-129
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    • 2000
  • Age-related osteoporotic compression fractures occur frequently in old aged group recently. Percutaneous vertebroplasty has recently been introduced as a therapeutic method for the treatment of pain associated with osteoporotic vertebral compression fracture. Percutaneous intravertebral injection of PMMA (polymethylmethacrylate) results in marked reduction in pain and morbidity. Among complications during vertebroplasty with PMMA, pulmonary embolism is repotred occasionally but the reports about hypotension are not common. This case is a report of a patient whom significant hypotension occured during percutaneous vertebroplasty.

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Unruptured Supraclinoid Internal Carotid Artery Aneurysm Surgery : Superciliary Keyhole Approach versus Pterional Approach

  • Shin, Donguk;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.306-311
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    • 2012
  • Objective : A superciliary keyhole approach is an attractive, minimally invasive surgical technique, yet the procedure is limited due to a small cranial opening. Nonetheless, an unruptured supraclinoid internal carotid artery (ICA) aneurysm can be an optimal surgical target of a superciliary approach as it is located in the center of the surgical view and field. Therefore, this study evaluated the feasibility and surgical outcomes of a superciliary keyhole approach for unruptured ICA aneurysms. Methods : The authors report on a consecutive series of patients who underwent a superciliary approach for clipping unruptured ICA aneurysms between January 2007 and February 2012. The data were compared with a historical control group who underwent a pterional approach between January 2003 and December 2006. Results : In the superciliary group, a total of 71 aneurysms were successfully clipped without a residual sac in 70 patients with a mean age of 57 years (range, 37-75 years). The maximum diameter of the aneurysms ranged from 4 mm to 14 mm (mean${\pm}$standard deviation, $6.6{\pm}2.3$ mm). No direct mortality or permanent morbidity was related to the surgery. The superciliary approach demonstrated statistically significant advantages over the pterional approach, including a shorter operative duration (mean, 100 min), no intraoperative blood transfusions, and no postoperative epidural hemorrhages. Conclusion : A superciliary keyhole approach provides a sufficient surgical corridor to clip most unruptured supraclinoid ICA aneurysms in a minimally invasive manner.

Practical stepwise approach to rhythm disturbances in congenital heart diseases

  • Huh, June
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.680-687
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    • 2010
  • Patients with congenital heart diseases (CHD) are confronted with early- and late-onset complications, such as conduction disorders, arrhythmias, myocardial dysfunction, altered coronary flow, and ischemia, throughout their lifetime despite successful hemodynamic and/or anatomical correction. Rhythm disturbance is a well-known and increasingly frequent cause of morbidity and mortality in patients with CHD. Predisposing factors to rhythm disturbances include underlying cardiac defects, hemodynamic changes as part of the natural history, surgical repair and related scarring, and residual hemodynamic abnormalities. Acquired factors such as aging, hypertension, diabetes, obesity, and others may also contribute to arrhythmogenesis in CHD. The first step in evaluating arrhythmias in CHD is to understand the complex anatomy and to find predisposing factors and hemodynamic abnormalities. A practical stepwise approach can lead to diagnosis and prompt appropriate interventions. Electrophysiological assessment and management should be done with integrated care of the underlying heart defects and hemodynamic abnormalities. Catheter ablation and arrhythmia surgery have been increasingly applied, showing increasing success rates with technological advancement despite complicated arrhythmia circuits in complex anatomy and the difficulty of access. Correction of residual hemodynamic abnormalities may be critical in the treatment of arrhythmia in patients with CHD.

Arthroscopic Cannulated Screw Fixation of Avulsion Fracture of the Intercondylar Eminence of the Tibia in a Child -A Case Report- (소아에서 발생한 전방 십자인대 견열 골절에서 유관 나사못을 이용한 관절경적 정복술 -증례보고-)

  • Moon, Kyu Pill;Kim, Kyung Taek;Kang, Min Soo;Park, Won Ro
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.62-65
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    • 2012
  • Avulsion fractures of the intercondylar eminence of the tibia are uncommon. This kind of fracture is most commonly found in adolescents, with an increasing incidence for those involved in competitive athletics. Recently, an arthroscopic procedure is preferred to reduce the operation-related morbidity. Screws, K-wires, Suture anchor have been described as fixation devices. Cannulated screw fixation is a simple method, but this instrument has the risk of causing damage to the growth plate. The authors report good results using cannulated screw in arthroscopic treatment for pediatric anterior cruciate ligament avulsion fracture.

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Treatment of Vasodilatory Shock after Cardiac Surgery : Low Dose Arginine Vasopressin Therapy - Three cases report - (개심술후 발생한 Vasodilatory Shock의 치료 : Arginine Vasopressin의 소량투여요법 - 3례 보고 -)

  • 이교준;김해균;정은규;김도형;강두영;이응석
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.227-230
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    • 2002
  • The vasodilatory shock after cardiopulmonary bypass is defined as the condition involving severe and persistent form of hypotension, tachycardia, normal or increased cardiac output and decreased systemic vascular resistance. Because of the unsuccessful response to infusion of fluids or catecholamine vasopressors, a sustained systemic shock state occurs and results in a high morbidity and mortality. We successfully treated this syndrome of 3 patients after open heart surgery with low dose of arginine vasopressin(AVP). Therefore, we report these cases with a review of related articles.

Vaginal Removal of Mature Cystic Teratoma in Postmenopausal Woman (성숙 난소 기형종의 질식 적출술 1예)

  • Jung, Ki-Mog;Lee, Hyun-Woo;Kim, Ki-Wan;Koh, Min-Whan
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.293-296
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    • 2001
  • Mature cystic teratomas, commonly called dermoid cysts, are the most common benign germ cell tumors of ovary in women of reproductive age. Mature cystic teratoma that constitutes 10-25% of ovarian tumors and 95% of teratoma, is germ cell tumor of the ovary. This occurs frequently in women less than 20 years old, but it can be found upto 10-20% in postmenopausal women. And in women over the age of 50, a mature cystic teratoma is likely to change into malignant form. Traditional surgical methods of mature cystic teratoma treatment include transabdominal cystectomy, oophorectomy, hysterectomy and(or) bilateral salphingooophorectomy. Recently laparoscopic approach replaces transabdominal surgeries in many cases. Vaginal removal of mature cystic teratoma is unique and rare. Compared with laparotomy, transvaginal approach is characterized by shorter hospital stay and lower morbidity rate. Compared with laparoscopic operation, transvaginal approach has advantages of no visible operative scar and lower intra-operative tumor spillage. The decision for surgical methods is related with patients' situations and surgeon's preference. We report 1 case of vaginal removal of mature cystic teratoma as a part of vaginal hysterectomy in old age patient.

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Multidisciplinary Approach to Breast Cancer Care

  • Juon, Hee-Soon
    • Perspectives in Nursing Science
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    • v.4 no.1
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    • pp.1-8
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    • 2007
  • Aim: The purpose of this paper is to present the importance of multidisciplinary strategies in cancer prevention and control, especially comprehensive breast cancer care. Background: Worldwide, breast cancer is the most common cancer diagnosed among women and is the leading cause of cancer deaths. Although the incidence of breast cancer in Asian countries is still lower than in Western countries, the rate of increase for the last two decades is striking. Methods: Data on cancer mortality, incidence, and risk factors were summarized by using the most recent data available from population-based cancer registries affiliated with the International Union Against Cancer, the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the CDC's National Program of Cancer Registries (NPCR). Results: Global differences in breast cancer incidence and fluctuations in rates within a country still exist. The incidence of breast cancer in Asian countries was lower than in Western countries. Breast cancer incidence in the United States decreased each year during 1999-2003. On the other hand, morbidity and mortality related to breast cancer in Asia has increased significantly. Conclusion: Multidisciplinary strategies to reduce breast cancer mortality and promote breast cancer awareness are addressed. Lessons learned from multidisciplinary approaches to cancer treatment and control will be valuable in implementing future breast cancer research in the fields of basic, clinical, and population research in Asia.

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Deep sternal wound infections: Evidence for prevention, treatment, and reconstructive surgery

  • Schiraldi, Luigi;Jabbour, Gaby;Centofanti, Paolo;Giordano, Salvatore;Abdelnour, Etienne;Gonzalez, Michel;Raffoul, Wassim;di Summa, Pietro Giovanni
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.291-302
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    • 2019
  • Median sternotomy is the most popular approach in cardiac surgery. Post-sternotomy wound complications are rare, but the occurrence of a deep sternal wound infection (DSWI) is a catastrophic event associated with higher morbidity and mortality, longer hospital stays, and increased costs. A literature review was performed by searching PubMed from January 1996 to August 2017 according to the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The following keywords were used in various combinations: DSWI, post-sternotomy complication, and sternal reconstruction. Thirty-nine papers were included in our qualitative analysis, in which each aspect of the DSWI-related care process was analyzed and compared to the actual standard of care. Plastic surgeons are often involved too late in such clinical scenarios, when previous empirical treatments have failed and a definitive reconstruction is needed. The aim of this comprehensive review was to create an up-to-date operative flowchart to prevent and properly treat sternal wound infection complications after median sternotomy.