• 제목/요약/키워드: delayed mortality

검색결과 218건 처리시간 0.028초

교정형 대혈관전위증의 외과적 치험 4 (Congenitally Corrected Transposition of the Great Arteries Surgical Experience, 4 cases)

  • 이승구
    • Journal of Chest Surgery
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    • 제20권3호
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    • pp.603-609
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    • 1987
  • The clinical, investigative, and surgical experiences were reviewed in four patients with congenitally corrected transposition of the great arteries who presented to the National Medical Center between August 1983 and August 1985. This condition is very rare congenital anomaly defined as the combination of atrioventricular discordance and transposition of the great arteries. Examples of primitive [single] ventricle inverted [that is, left sided in situs solitus] with outflow chamber were excluded in this paper. According to the sequential arrangement of the hearts there were two cases of [S,L,L] and two cases of [I,D,D]. The surgical approach should be focused on minimizing the risk of heart block and increasing the degree of relief of pulmonary outflow tract obstruction [POTO]. We experienced complete heart block in two cases of [S,L,L] and significant residual POTO in one case of [S,L,L] and one case of [I,D,D] postoperatively. There were one hospital mortality caused by complete heart block and residual POTO and two delayed mortalities caused by congestive heart failure and sepsis respectively.

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Angiographically Progressive Change of Traumatic Pseudoaneurysm Arising from the Middle Meningeal Artery

  • Lee, Jae-Yoon;Lee, Cheol-Young;Kim, Hyun-Woo
    • Journal of Korean Neurosurgical Society
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    • 제56권5호
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    • pp.423-427
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    • 2014
  • Traumatic pseudoaneurysms of the middle meningeal artery (MMA) are rare phenomenon, which are usually associated with head trauma such as an underlying skull fracture. They were usually known to cause acute or delayed epidural hematomas but can be associated with subdural, subarachnoid, or even intracerebral hemorrhage. Sometimes, a high mortality rate was reported in these circumferences. But the natural course of these pseudoaneurysms is not well recognized. The indication and guideline of treatment for pseudoaneurysm are also unclear. This report describes a rare case of angiographically progressive change of traumatic pseudoaneurysm of the middle meningeal artery for one week, which was treated with endovascular embolization.

Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management

  • Lee, Jae-Young
    • Clinical and Experimental Pediatrics
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    • 제53권6호
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    • pp.669-679
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    • 2010
  • The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis and stabilization and timely referral to a tertiary cardiac center are crucial to improve the outcomes in neonates with CHDs. In this review, the clinical presentation of critical and potentially life-threatening CHDs is discussed along with brief case reviews to help understand the hemodynamics of these defects and ensure proper decision-making in critically ill patients.

뇌량주위동맥에 발생한 외상성 뇌동맥류 - 증례보고 - (Traumatic Aneurysm of the Pericallosal artery - A Case Report -)

  • 서의교;주진양
    • Journal of Korean Neurosurgical Society
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    • 제30권12호
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    • pp.1427-1429
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    • 2001
  • Traumatic intracranial aneurysms are rare, compromising less than 1% of intracranial aneurysms. The case of 20-year-old man suffered from delayed frontal intracerebral hematoma, subarachnoid hemorrhage and intraventricular hemorrhage from traumatic pericallosal aneurysm 12 days after head injury is presented. Traumatic pericallosal artery aneurysm is always near the falcine edge, is unrelated to arterial branching point. Sudden movement of brain and artery causes vessel wall injury against the stationary edge of the falx. Because of high mortality rate of ruptured traumatic aneurysm, clinical suspicion must be focused on the prompt diagnostic work-up and early treatment.

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Effect of Starvation on Growth and Hepatocyte Nuclear Size of Larval Haddock, Melanogrammus aeglefinus

  • Kim, Bong-Seok;Park, In-Seok;Kim, Hyung-Soo
    • 한국발생생물학회지:발생과생식
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    • 제16권2호
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    • pp.107-112
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    • 2012
  • Early growth, the rate of yolk sac absorption, and nucleus size in liver parenchymal cells were correlated with the nutritional status of first feeding larval haddock, Melanogrammus aeglefinus. Larvae that successfully began exogenous feeding maintained high growth rates, delayed yolk sac resorption, and had larger hepatocyte nuclear sizes than starved larvae. At 10 days post hatch (DPH) the cumulative mortality in the starved larval haddock group was 100%. The area of the hepatocyte nuclei in starved larvae gradually decreased, reaching its lowest value by 9 DPH. Our results support the current practice of providing the first food supply at 3 DPH. Hepatocyte nuclear size can be used to assess larval haddock nutrition status, and may be a good criterion for assessing the success of transition from endogenous to exogenous feeding.

비 직렬 시스템의 신뢰도 최적화를 위한 시스템 번인 (Optimal System Burn-in for Maximizing Reliability of Non-series Systems)

  • 김경미
    • 대한산업공학회지
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    • 제33권2호
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    • pp.273-281
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    • 2007
  • The decision of how long performing system burn-in must be answered with a probabilistic model of a system lifetime at which infant mortality failures created during assembly processes are quantified. In this paper, we propose such a model which is modified from previous results. Using the system model, we derived system reliability in terms of component and system burn-in times for the two cases of minimal repair at system failure and of component replacement and connection repair at their failure times. The procedure is illustrated with a bridge system and the optimal system burn-in times are obtained for maximizing system reliability. The result suggests that an assumption of minimal repair at system failure may underestimate the optimal burn-in time in practice.

소아에서 발병한 간농양 1예 (A Case of Liver Abscess in A Child)

  • 오승택;최광해
    • Journal of Yeungnam Medical Science
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    • 제25권1호
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    • pp.72-77
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    • 2008
  • Liver abscess in children is rare in developed countries; the incidence is 25 per 100,000 admissions in USA. Common complications are pleural effusion, empyema, pneumonitis, hepatopleural or hepatobronchial fistula, intraperitoneal or intrapericardiac rupture, septic shock, cerebral amebiasis, etc. These complications may lead to death if the management is delayed. However, recent management results in a mortality of less than 15%. We report a case of liver abscess in a child. He manifested with fever and abdominal pain in the right upper quadrant. On computerized tomography scans, multiple cystic lesions were seen in both lobes of the liver and were 5 to 55 mm in size. In laboratory findings, neutrophilic leukocytosis, peripheral eosinophila, elevated values of ESR, C-reactive protein, and elevated serum AST, ALT, ALP and GGT were detected. Furthermore, we determined the organisms in the blood culture and serum. Blood culture was positive for Streptococcus spp., and amebic indirect hemagglutination antibody titer was increased to 1:512.

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외상성 대동맥 파열: 4례 보고 (Traumatic Aortic Rupture - Report of 4 Case -)

  • 윤태진
    • Journal of Chest Surgery
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    • 제24권7호
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    • pp.725-731
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    • 1991
  • Four patients with traumatic rupture of aorta underwent operative repair at Seoul national university hospital. All cases were confirmed by preoperative aortography. Rupture site was aortic isthmus or just distal to it. Operations were somewhat delayed due to the low degree of suspicion and difficulties in diagnosis: ranging from 5 hours to 8 days. Operation was performed as same manners in all cases: resection of the ruptured portion and tubular woven dacron graft interposition in conjunction with shunt or bypass procedures, TDMAC-Heparin shunt between ascending and descending aorta was used in 3 cases, and LA-femoral centrifugal pump was used in one case. There were no intraoperative or postoperative mortality. Hoarseness was developed in all patients but paraplegia or other significant complications were not found in any of patients. We concluded that 1] high degree of suspicion is essential in the early diagnosis and treatment of traumatic aortic rupture and 2] any kind of shunt or bypass procedure is necessary in operative repair of traumatic aortic rupture and use of centrifugal pump without systemic heparinization is easier and safer procedure than others for the maintenance of adequate distal flow.

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객혈환자의 임상적 고찰 (Clinical Evaluation of Hemoptysis)

  • 김호경
    • Journal of Chest Surgery
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    • 제27권1호
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    • pp.36-42
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    • 1994
  • Between January 1990 and June 1993, the retrospective analysis was done in 48 consecutive patients with hemoptysis. According to clinical condition of patients, managements were divided into 3 subgroups; group 1[percutaneous bronchial artery embolization, group 2[operation after percutaneous bronchial artery embolization],group 3[delayed and emergency operation]. It was characterized that recurrence of hemoptysis was very frequent and most frequent underlying cause was pulmonary tuberculosis. In 40 patients[83%] urgent examination with flexible broncoscope was done and localization of the bleeding source was possible only in 24[60%] patients. The amount of hemoptysis was variable but there are no difference between groups and 22 patients[45%] had a prior episode of hemoptysis usually within 3 months of their admission. The recurrence was limited only in group 1[3/22] and the mortality rate was 6%[3/48]. We suggest that percutaneus bronchial artery embolization may be effective in recurrent massive hemoptysis but definitive management was operation.

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Drosophila melanogaster Is Susceptible to Vibrio cholerae Infection

  • Park, Shin-Young;Heo, Yun-Jeong;Kim, Kun-Soo;Cho, You-Hee
    • Molecules and Cells
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    • 제20권3호
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    • pp.409-415
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    • 2005
  • Infection of Drosophila melanogaster adults with 6 Vibrio species revealed that V. cholerae was lethal (100% mortality) within 20 h as a result of systemic infection. Avirulent infection by V. vulnificus restricted the subsequent virulent infection by V. cholerae. The immediate transcription of antimicrobial peptides (AMPs), most notably Attacin A, was delayed in V. cholerae infection compared to V. vulnificus infection. Ectopic expression of Attacin A and Metchnikowin enhanced the survival of D. melanogaster upon V. cholerae infection. These results suggest that AMPs are important in the response to infections by Vibrio species and that the signaling pathways governing their expression may be targeted by V. cholerae virulence factors to elude the innate immunity of Drosophila.