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Acute Limb Ischemia and Coronary Artery Disease in a Case of Kimura's Disease

  • Heo, Woon;Jun, Hee Jae;Kang, Do Kyun;Min, Ho-Ki;Hwang, Youn-Ho;Kim, Ji Yong;Nam, Kyung Han
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.114-118
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    • 2017
  • Kimura disease (KD) is an immune-mediated chronic inflammatory disease of unknown etiology. KD has many complications associated with hypereosinophilia, including various forms of allergic reactions and eosinophilic lung disease. Additionally, hypereosinophilia is associated with hypercoagulability, which may lead to thromboembolic events. A 36-year-old man with KD presented with acute limb ischemia and coronary artery occlusion. He underwent thrombectomy, partial endarterectomy of both popliteal arteries, and coronary artery stent insertion. KD is a systemic disease that affects many organs and presents with thromboembolism and vasculitis. In a patient with KD, physicians should evaluate the vascular system, including the coronary arteries.

A Case of Bronchial Obstruction Due to Bronchial Angulation after Upper Lobectomy (엽절제술 후 기관지 꺾임에 의하여 발생한 기관지 폐쇄 1예)

  • Lee, Ho-Su;Yim, Ji-Hye;Kim, Woo-Jin;Shin, Ji-Hoon;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.3
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    • pp.216-219
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    • 2009
  • A bronchial obstruction of the remaining lung is a rare complication of thoracic surgery. We report a case of this rare complication after a right upper lobectomy due to a giant bulla. Post-resectional angulation of the bronchus intermedius caused the bronchial obstruction. An intrabronchial stent was inserted into the bronchus intermedius, which relieved the obstruction.

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.

A Case of Renovascular Hypertension Controlled by Renal Artery Embolization (신동맥 색전술로 치료한 신혈관 고혈압증 1례)

  • Yew, Jung Hun;Kim, Young Deuk;Shin, Byung Seok;Gil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.212-215
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    • 2005
  • Renal artery stenosis is a major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. There are several methods to treat renal artery stenosis, including surgery, percutaneous transluminal renal angioplasty(PTRA), and renal artery stenting(RAS). But, renal artery embolization can be tried in atherosclerotic stenosis, multiple stenosis, microaneurysm, and stenosis difficult to try PTRA or RAS. We report a case of renovascular hypertension in a 14-year-old female who had multiple segmental renal artery stenosis. Hypertension was controlled by renal ablation therapy with renal artery embolization.

Aortic Valve Replacement in a Patient with Aortic Arch Syndrome Secondary to Takayasu's Arteritis -One case - (Takayasu씨 동맥염에 의한 대동맥궁 증후군 환자에서 대동맥판막 치환술 - 1예 보고 -)

  • 최종범;양현웅;이삼윤
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.88-91
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    • 2004
  • Aortic regurgitation is not a rare complication of Takayasu's disease. Aortic regurgitation may aggravate cerebral ischemic syndrome like syncope in patients with stenotic or occlusive lesions in cerebral branches of aorta secondary to acute or progressive inflammation. In a 34-yrs-old male patient who complained of syncope and exertional dyspnea with occlusion of both carotid arteries and severe stenoses of both subclavian arteries, occlusion of right coronary artery, and aortic regurgitation, his symptom was improved with perioperative aggressive steroid therapy, stent insertion in both subclavian arteries, and aortic valve replacement.

Left Common Iliac Artery Rupture due to Hidden Blunt Trauma (Suspected Dildo-Masturbation Injury via Endovagina): A Case Report (내재된 둔상으로 인한 좌측 총 장골동맥 파열에 따른 출혈성 심정지 (질 내 경로를 통한 자위 행위로 인한 손상 의심): 증례보고)

  • Kyoung, Kyu Hyouck;Kim, Mi Jin;Choi, Byung Ho;Hong, Jung Seok;Hong, Eun Seog
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.211-214
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    • 2014
  • A 34-year-old woman experienced a sudden cardiac arrest after complaining of abdominal pain. The cause of that serious event was a hidden hemorrhagic shock. On computed tomography of her pelvic area, we found that her left common iliac artery had been ruptured. No bone fractures were observed. Her angiography showed neither atherosclerosis nor an aneurysm of the artery. Because spontaneous ruptures of the common iliac artery are rare, we suspected, based on her husband's statement, that a hidden blunt trauma to the artery had occurred via an endo-vaginal route due to dildo masturbation. Unfortunately, she died without recovery, in spite of our having controlled the bleeding by using an angiographic endovascular stent-graft.

A study on the rainfall runoff from paddy fields in the small watershed during Irrigation period (관개기관중 답유역에서의 강우유출량 추정에 관한 연구)

  • 김채수
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.24 no.4
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    • pp.99-108
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    • 1982
  • This thesis aims to estimate the rainfall runoff from paddy field in a small watershed during irrigation period. When the data observed at the proposed site are not available, the Monthly Runoff Equation of Korean Rivers which was derived from data observed under the following assumptions is used to study the water balance. a. Monthly base flow was assumed as 10. 2mm even if these is no mouthly rainmfall. b. Monthly comsumption of rainfall was ranged from 100 to 2OOmm without relation to the rainfall depth. However, the small watershed which consists mainly of paddy fields encounters severe droughts and accordingly the baseflow is negligible. Under the circumstances the author has developed the following equation called "Flood Irrigation Method for Rainfall Runoff "taking account of the evapotranspiration, precipitation, seepage, less of transportation, etc. R= __ A 7000(1 +F) -5n(n+1)+ (n+1)(Pr-S-Et)] where: R: runoff (ha-m) A: catchment area (ha) F: coefficient of loss (o.o-0. 20) Pr: rainfall (mm) S: seepage Er: evapotranspiration (mm) To verify the above equation, the annual runoff ratio for 28 years was estimated using the Monthly Runoff Equation of Korean Rivers the Flood Irrigation Method and the Complex Hydrograph Method based on meteorological data observed in the Dae Eyeog project area, and comparison was made with data observed in the Han River basin. Consequently, the auther has concluded that the Flood Irrigation Method is more consi- stent with the Complex Hydrograph Method and data observed than the Monthly Runoff Equation of Korean Rivers.

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A CLINICAL STUDY ON TRACHEAL STENOSIS (기관협착증에 관한 임상적 고찰)

  • 정무권;조진생;안회영;차창일;유세영;박주철
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.13.1-13
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    • 1987
  • 저자들은 1984년 12월 17일부터 1987년 2월 26일까지 경희대학교 의과대학 부속병원 이비인후과 및 흉부외과에서 경험한 9례의 기관협착증환자를 대상으로 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 연령 및 성별분포는 여자 3례, 남자 6례이었고, 10세이하 3례, 10대 2례, 20대 2례, 40대 이상이 2례 이었다. 2) 원인은 지속적 기관내삽입관에 의한 경우가 4례이었고 1례는 선천성 혈관기형인 double aortic arch에 의해 기관이 눌리어 기도협착증상이 있었던 경우이었다. 상기관절개술에 의한 경우가 2례, 경부외상 1례, 기관내 종양 2례이었다. 3) 협착부위의 길이는 1.5cm에서 2cm까지가 4례로 가장 많았고 3cm이내가 2례, 4cm이내 1례, 6cm이내 1례이었다. 4) 치료는 보존적인 방법으로 내시경하에서 육아조직 및 반흔조직을 laser를 이용하여 제거한 후 silastic stent 혹은 Montgomery T-tube 삽입후 4주에서 6주후 제거하여 치료한 경우가 2례이었고 협착부위절제 및 단단문합술을 시행한 경우가 6례이었다. 1례에서는 aortic arch division을 시행하였다. 5) 예후는 9례중 단단문합술을 시행한 6례 그리고 보존적 방법으로 laser를 이용한 육아조직의 제거 및 지지물삽입을 시행한 3례에서 모두 현재까지 재발은 보이지 않고 있다. 6) 기관협착의 길이가 1.5cm에서 4cm까지의 경우에는 supralaryngeal release procedure없이 단단문합술을 시행하였고 협착길이가 6cm인 1례에서는 supralaryngeal release를 하여 tension없이 문합술을 시행할 수 있었다.

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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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Intratracheal Stenting Under the Aid of Transcutaneous Cardiac Pacing in a Dog with Severe Bradycardic Conduction Defect (중증 서맥성 전도장애 개에서 피부경유 심박 조절 하에 기관내 스텐트 장착)

  • Lee, Seung-Keun;Hyun, Chang-Baig;Jang, Kwang-Ho
    • Journal of Veterinary Clinics
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    • v.25 no.5
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    • pp.400-404
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    • 2008
  • A 10-year-old intact female Yorkshire terrier dog (weighing 3 kg) was referred with the primary complaint of severe dyspnea, cyanosis and occasional syncopal episode. Physical examination revealed irregularly irregular bradycardia with persistent pulse deficits. The 12-lead surface ECG showed high grade atrioventricular blocks. Thoracic radiography revealed severe intrathoracic collapse. The dog was successfully treated with an intraluminal self-expanding stent ($COOK^{(R)}$) under the aid of transcutaneous cardiac pacing.