• 제목/요약/키워드: delayed bleeding

검색결과 117건 처리시간 0.029초

소아에서 뇌수두증의 단락술 이후 발생한 석회화된 만성 경막하 혈종 - 증례보고 - (Calcified Chronic Subdural Hematoma : Late Sequele of Shunt Operation in a Child with Hydrocephalus - Case Report -)

  • 박준오;권택현;박윤관;정흥섭;이훈갑;서중근
    • Journal of Korean Neurosurgical Society
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    • 제29권7호
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    • pp.968-972
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    • 2000
  • Post-shunting subdural hemorrhages are usually small and self-limited, and they can be recognized on the routine post-operative CT examinations. However, delayed subdural bleeding may occur without any clinical symptoms or signs. Thus the hematoma remains undetected, and it can be increased in size and sometimes become calcified with time. We experienced a case of 15-year-old male with a large calcified subdural hematoma who had undergone shunt operation 10 years previously. With pertinent review of the literatures, we discuss the possible mechanism of calcification and the proper way of treatment in calcified chronic subdural hematoma.

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위 사구종양 1예 (A Case of Gastric Glomus Tumor)

  • 이진성;최선택;이현욱;권병진;이지은;이시형
    • Journal of Yeungnam Medical Science
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    • 제28권2호
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    • pp.165-172
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    • 2011
  • Gastric glomus tumor is a rare mesenchymal tumor that originates from modified smooth muscle cells of the glomus body. Glomus tumors are commonly observed in peripheral soft tissue, such as dennis or subungal region, but rarely in the gastrointestinal tract. A 39-year-old woman was admitted due to epigastric soreness. Upper gastrointestinal endoscopy revealed a subepithelial mass measuring 3.5 cm with central ulceration at the lesser curvature-posterior wall of the antrum. Characteristically, contrast enhanced abdominal computed tomography scan demonstrated high enhancement of the submucosal mass up to the same level of the abdominal aorta in the arterial phase; this enhancement persisted to delayed phase. Due to the risk of bleeding and malignancy, wedge resection of the submucosal tumor was performed. Histologic findings were compatible with a glomus tumor.

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복부 둔상을 입은 소아에서의 비수술적 치료 (Nonoperative Management of Children with Blunt Abdominal Trauma)

  • 김경재;이두선
    • Advances in pediatric surgery
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    • 제2권2호
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    • pp.94-99
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    • 1996
  • The management of twenty-two children with blunt abdominal trauma was analyzed. Nineteen cases had intraabdominal injuries; involving the spleen in 7 cases, the liver in 5, the pancreas in one and the bladder in one. There were five case multiple intraabdominal organ injuries. Seventeen out of 19 patients were treated non-operatively, but one was operated upon later because of delayed bleeding. Thirteen patients required transfusion in the non operated group, the mean values of the Pediatric Trauma Score (PTS) was 11.3. The mean lowest hemoglobulin(LHb) was 9.1 g/dL. The mean value of three cases with extraabdominal injuries were 9.0 and 8.3 g/dL respectively. The average amount of transfusion was 17.3 ml/kg. In the operated group, 2 cases were transfused an average of 139.8 ml/kg and their mean PTS was 5 and LHb was 6.6 g/dL. In one out of 16 non-operated cases, intrahepatic hematoma developed and but resolved conservatively. However, two out of 3 operated cases suffer complications such as an intubation granuloma and an intraabdominal abscess with wound dehescence. In conclusion, non-operative management in child with blunt abdominal trauma was safe in Grade I and II solid organ injuries. The decision for operation should be based on the hemodynamic stability after initial resuscitation including transfusion.

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정신지체와 주의력결핍 과잉행동장애를 보이는 Noonan 증후군 1예 (A Case Report of Noonan Syndrome with Mental Retardation and Attention-Deficit Hyperactivity Disorder)

  • 김원우;심세훈
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제23권1호
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    • pp.31-35
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    • 2012
  • Noonan syndrome is characterized by short stature, typical facial dysmorphology, and congenital heart defects. The main facial features of Noonan syndrome are hypertelorism with down-slanting palpebral fissures, ptosis, and low-set posteriorly-rotated ears with a thickened helix. The cardiovascular defects most commonly associated with this condition are pulmonary stenosis and hypertrophic cardiomyopathy. Other associated features are webbed neck, chest deformity, mild intellectual deficit, cryptorchidism, poor feeding in infancy, bleeding tendency, and lymphatic dysplasias. The patient is a 10-year-old boy. He had experienced repeated febrile convulsions. He had typical facial features, a short stature, chest deformity, cryptorchidism, vesicoureteral reflux, and mental retardation. His language and motor development were delayed. When he went to school, it was difficult for him to pay attention, follow directions, and organize tasks. He also displayed behavior such as squirming, leaving his seat in class, and running around inappropriately. Clinical observation is important for the diagnosis, so we report a patient who was diagnosed with Noonan syndrome, mental retardation, and attention-deficit hyperactivity disorder.

경동맥 화학색전요법 후 절대안정중인 환자의 요통완화를 위한 운동의 효과 (Effects of Exercise on Relief of tow Back Pain in Patients on Absolute Bed Rest after Trans-Arterial Chemoembolization (TAE))

  • 고은주;채영란;이동숙
    • 기본간호학회지
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    • 제15권2호
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    • pp.171-177
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    • 2008
  • Purpose: The aim of study was to identify the effects of exercise on the relief of low back pain in patients on absolute bed rest after TAE. Method: A nonequivalent control group pretest-posttest design research design was used. The participants were 43 patients who had received TAE in a university hospital; patients in the experimental group (21) received both exercise therapy and general post-op nursing care and in the control group (22) only the latter. The exercise program used in this study was modified from exercise for post CABG to exercise for post TAE, which deflect the movement of thigh in which the catheter was inserted, the lumbar region of the back and pelvis. Results: First, Low back pain scores in the experimental group were lower than the control group. Second, The first dose of analgesics in the experimental group was delayed compared to the control group. Third, There was no significant difference in bleeding complications between the experimental group control groups. Conclusion: The results suggest that the exercise program used in this study is effective for relief of low back pain in patients on absolute bed rest after TAE.

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Delayed Diagnosis of Probable Radiation Induced Spinal Cord Vascular Disorders

  • Won, Young Il;Kim, Chi Heon;Chung, Chun Kee;Yun, Tae Jin
    • Journal of Korean Neurosurgical Society
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    • 제57권3호
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    • pp.215-218
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    • 2015
  • Occasionally, unexpected neurological deficits occur after lumbar spinal surgery. We report a case of monoparesis after lumbar decompressive surgery. A 63-year-old man, who had undergone decompression of L4-5 for spinal stenosis 4 days previously in the other hospital, visted the emergency department with progressive weakness in the left leg and hypoesthesia below sensory level T7 on the right side. He had been cured of lung cancer with chemotherapy and radiation therapy 10 years previously, but detailed information of radiotherapy was not available. Whole spine magnetic resonance (MR) imaging showed fatty marrow change from T1 to T8, most likely due to previous irradiation. The T2-weighted MR image showed a high-signal T4-5 spinal cord lesion surrounded by a low signal rim, and the T1-weighted MR image showed focal high signal intensity with focal enhancement. The radiological diagnosis was vascular disorders with suspicious bleeding. Surgical removal was refused by the patient. With rehabilitation, the patient could walk independently without assistance 2 months later. Considering radiation induced change at thoracic vertebrae, vascular disorders may be induced by irradiation. If the spinal cord was previously irradiated, radiation induced vascular disorders needs to be considered.

각혈 환자의 폐절제술 -29례 보고- (Pulmonary Resection of Hemoptysis Patients -29 case-)

  • 박병률
    • Journal of Chest Surgery
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    • 제28권12호
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    • pp.1139-1143
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    • 1995
  • We experienced 29 cases of patients with a chief complaint of hemoptysis who were performed pulmonary resection at the Department of Thoracic and Cardiovascular Surgery, Pusan Medical Center Hospital for 3 years from May 1990 to April 1993. The mean age of hemoptysis patients was 34.7 year old, and hemoptysis was most prevalent in third and fourth decades. The underlying lung diseases of hemoptysis patients were tuberculosis in 12[41.4% , bronchiectasis in 9[31.0% , lung cancer in 4[13.8% , aspergyllosis in 3[10.3% and pneumonia in 1[3.5% . Modes of hemoptysis were blood tinged in 7[24.1% , massive in 22[75.9% . Operation times were elective in 7[24.1% of all blood tinged hemoptysis, delayed in 20[69.0% , emergency in 2[6.9% out of massive hemoptysis. The cases of the definite bleeding focus found by bronchoscopy were 19 cases[65.5% . The operative procedures of hemoptysis were single lobectomy in 14[48.3% , pneumonectomy in 6[20.7% , lobectomy with segmentectomy in 5[17.2% , bilobectomy in 3[10.3% and segmentectomy in 1[3.5% . The postoperative results of hemoptysis were complete recovery in 27[93.0% , rehemoptysis in 1[3.5% which was treated by anti-Tbc medication completely, and hospital death in 1[3.5% which was brain metastasis of lung cancer. It was concluded that definitive diagnosis, preoperative control of hemoptysis and operation were important in the management of hemoptysis patients.

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부분 하흉골절개술을 이용한 심장수술 (Cardiac Surgery Via Lower Partial Sternotomy Lower Partial Sternotomy)

  • 권혁면;정태은;이정철;한승세;이동협
    • Journal of Chest Surgery
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    • 제33권9호
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    • pp.729-733
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    • 2000
  • Background: Recent trends suggest that minimally invasive cardiac surgery reduces postoperative morbidity and offers a cosmetic benefit. This study was performed to evaluate the CPB time, ACC time, OP time, ICU stay and postoperative hospital stay following a lower partial sternotomy and those of the median sternotomy. Material and Method: A group of 26 adult patients who underwent cardiac surgery through lower partial sternotomy from August 1997 to July 1999(A group) were compared to 45 adult patients who underwent cardiac surgery through median sternotomy from January 1996 to July 1997(B group). The mean ages(46.4$\pm$14.6 years, A group and 46.8$\pm$13.2 years, B group) were similar. Operations were performed with central cannula and antegrade/retrograde blood cardioplegia. Result: There was no death in each group. No differences were found in CPB time, ACC time, OP time, ICU stay and postoperative hospital stay. Postoperative complications were sternal splitting in a patient in group A and a patient with bleeding that required reoperation and a patient with delayed wound closure in group B. Conclusion: The lower partial sternotomy offered a cosmetic benefit, but does not significantly reduced the length of operative time and hospital stay. Minimally invasive cardiac surgery will be applied increasing because of the suggested advantage and choosing a proper operative technique will be helpful.

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특발성 치은증식증의 치험례 (IDIOPATHIC GINGIVAL HYPERPLASIA)

  • 유인아;김종철;한세현
    • 대한소아치과학회지
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    • 제25권3호
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    • pp.499-505
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    • 1998
  • Idiopathic gingival hyperplasia is a rare condition of undetermined etiology. The enlargement is usually associated with the emergence of the teeth into the oral cavity and may regress after extraction. The enlarged gingiva may be primarily attributed to hyperplasia of the subepithelial layer that is relatively avascular and consists of densely arranged collagen bundles and numerous fibroblasts. The recommended time for treatment is after completion of eruption of permanent teeth. But the most important thing is the patient's psychological and esthetic needs. Lately, Schluger has proposed modified gingivectomy procedure with horizontal, internal beveled incision for thinning of the flap resulting in less pain and bleeding after treatment, minimal opportunity of infection. The purpose of this report is to document a case of 8-year-old girl who had registered in Dept. of Pediatric Dentistry of Seoul National University dental hospital for treatment of her gingival hyperplasia and delayed tooth eruption

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폐암의 임상적 고찰 (A Clinical Study on Primary Lung Cancer)

  • 이정철;이종태;김규태
    • Journal of Chest Surgery
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    • 제19권1호
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    • pp.140-147
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    • 1986
  • A clinical study was made on 72 cases of primary lung cancer operated in the department of thoracic & cardiovascular surgery, Kyungpook national university hospital from January 1975 to May 1985. The ratio of male to female was 13.4: I and mean age was 53. Histologically, squamous cell carcinoma comprised 72.2% of 72 operated cases. Before admission to our hospital, the erroneous diagnoses were made at local clinics on the 43 cases[59.7%] and a large percentage of them was diagnosed as pulmonary tuberculosis. And then, total of 56 cases received inadequate treatment or delayed the operation. For the location of the tumor, right to left ratio is 1.2:1 and the right upper lobe was most often involved [23.6%]. Operation was performed on the 72 cases and resection on the 59 cases[8.2%]. Postsurgical staging showed that stage III was found most frequently [59.4%] and T,N,M, was 28% of total cases. Two common surgical complications were bleeding in 7 and acute respiratory failure in 6 cases, and these 6 cases of acute respiratory failure were all died. On the basis of these experiences, we conclude that aggressive effort is needed for the early accurate diagnosis and adequate treatment of lung cancer.

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