• 제목/요약/키워드: external heart

검색결과 185건 처리시간 0.021초

Is Robot-Assisted Surgery Really Scarless Surgery? Immediate Reconstruction with a Jejunal Free Flap for Esophageal Rupture after Robot-Assisted Thyroidectomy

  • Park, Seong Hoon;Kim, Joo Hyun;Lee, Jun Won;Jeong, Hii Sun;Lee, Dong Jin;Kim, Byung Chun;Suh, In Suck
    • Archives of Plastic Surgery
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    • 제44권6호
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    • pp.550-553
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    • 2017
  • Esophageal perforation is a rare but potentially fatal complication of robot-assisted thyroidectomy (RAT). Herein, we report the long-term outcome of an esophageal reconstruction with a jejunal free flap for esophageal rupture after RAT. A 33-year-old woman developed subcutaneous emphysema and hoarseness on postoperative day1 following RAT. Esophageal rupture was diagnosed by computed tomography and endoscopy, and immediate surgical exploration confirmed esophageal rupture, as well as recurrent laryngeal nerve injury. We performed a jejunal free flap repair of the 8-cm defect in the esophagus. End-to-side microvascular anastomoses were created between the right external carotid artery and the jejunal branches of the superior mesenteric artery, and end-to-end anastomosis was performed between the external jugular vein and the jejunal vein. The right recurrent laryngeal nerve injury was repaired with a 4-cm nerve graft from the right ansa cervicalis. Esophagography at 1 year after surgery confirmed that there were no leaks or structures, endoscopy at 1 year confirmed the resolution of vocal cord paralysis, and there were no residual problems with swallowing or speech at a 5-year follow-up examination. RAT requires experienced surgeons with a thorough knowledge of anatomy, as well as adequate resources to quickly and competently address potentially severe complications such as esophageal rupture.

Outcome Analysis of External Neurolysis in Posture-Induced Compressive Peroneal Neuropathy and the Utility of Magnetic Resonance Imaging in the Treatment Process

  • Junmo Kim;Jinseo Yang;Yongjun Cho;Sukhyung Kang;Hyukjai Choi;Jinpyeong Jeon
    • Journal of Korean Neurosurgical Society
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    • 제66권3호
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    • pp.324-331
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    • 2023
  • Objective : We aimed to analyze the effectiveness of external neurolysis on the common peroneal nerve (CPN) in patients with posture-induced compressive peroneal neuropathy (PICPNe). Further, we aimed to examine the utility of magnetic resonance imaging (MRI) in assessing the severity of denervation status and predicting the postoperative prognosis. Methods : We included 13 patients (eight males and five females) with foot drop who underwent CPN decompression between 2018 and 2020. We designed a grading system for assessing the postoperative functional outcome. Additionally, we performed MRI to evaluate the denervation status of the affected musculature and its effect on postoperative recovery. Results : The median time to surgery was 3 months. The median preoperative ankle dorsiflexion and eversion grades were both 3, while the average functional grade was 1. Posterior crural intermuscular septum was the most common cause of nerve compression, followed by deep tendinous fascia and anterior crural intermuscular septum. There was a significant postoperative improvement in the median postoperative ankle dorsiflexion and eversion grades and average postoperative functional (4, 5, and 2.38, respectively). Preoperative ankle eversion was significantly correlated with denervation status. Additionally, the devernation status on MRI was positively correlated with the outcome favorability. However, denervation atrophy led to a less favorable outcome. Conclusion : Among patients with intractable PICPNe despite conservative management, surgical intervention could clinically improve motor function and functional ability. Additionally, MRI examination of the affected muscle could help diagnose CPNe and assess the postoperative prognosis.

뇌(腦)와 심(心)의 한의학적 상관성에 대한 연구 (Study on the Relationship of Brain and Heart Based on Oriental Medicine)

  • 조학준
    • 동의생리병리학회지
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    • 제19권6호
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    • pp.1496-1503
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    • 2005
  • This study aims to define the relationship between brain and heart through several literatures about oriental medicine and the conclusions are as follows. Heart in oriental medicine is called as Sinmyeongjishim(神明之心) which has a close connection with Mind, Consciousness, Emotion, and Physiological instinct of Drain in modern medicine. According to Oriental medicine, Brain stores Wonsin(元神) as Heart stores mind(神). Heart is where mind rests whereas Brain is where mind reveals. The external evidences that prove the relationship of Heart and Mind are as follows: First, with ears, eyes, mouth, and nose the subject of cognition is recognized as Sinmyeongjishim(神明之心). Second, Bulin(不仁), which means decreased movement power and sensibility of limbs, proves that Sinmyeongjishim(神明之心) is involved with movement power and sensibility of limbs. The physiological evidences that prove the relationship of Heart and Mind are as follows; First, Heart as the operation of Sinmyeongjishim(神明之心) manages language. Second, Heart is related with Tongue. Third, Heart is linked to Ears through the ear hole. Fourth, Heart is a store of Mind. Fifth, the five viscera control emotional and psychological activities. The pathological evidence of the relationship of Heart and Mind is that the symptoms of heart disease which are related to Sinmyeongjishim(神明之心) are also related to the functions of Brain. Though Brain has a close connection with Heart in oriental medicine, it is recognized that there are distinctive symptoms of disease of Brain and Hyeolyookjishim(血肉之心) respectively. The relationship of Heart and Brain has been researched in this study, even though there are not enough written materials about oriental medicine. But the fact that the majority of Heart operation is deeply connected with Brain activities cannot be denied. Therefore the research of Heart should be done as well as Brain in the clinical study of Brain.

전기-기계식 이식형 좌심실 보조 시스템의 개발 및 평가 (Development and Evaluation of a Novel Electro-mechanical Implantable Ventricular Assist System)

  • 조한상;김원곤;이원용;곽승민;김삼성;김재기;김준택;류문호;류은숙
    • 대한의용생체공학회:의공학회지
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    • 제22권4호
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    • pp.349-358
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    • 2001
  • A novel electro-mechanical implantable ventricular assist system is developed as a bridge to transplantation or recovery for patients with end-stage heart failure. The developed system is composed of an implanted blood pump, an external monitoring system which stores data, and a wearable system including a portable external driver and a portable power supply system. The blood pump is designed to be implanted into the left upper abdominal space and provides blood flow from the left ventricular apex to the aorta. The pulsatile blood flow is generated by a double cylindrical cam. There was mo excessive heat emission from the blood pump into the temperature-controlled chamber in the heat test and no stagnated flow within the blood sac by the observation in the flow visualization test. Animal experiments were performed using sheep and calves. The maximum assist flow rate reached 7.85L/min in the animal experiment. The evaluation results showed that the developed system was feasible for the implantable ventricular assist system. The long-term in vitro durability test and mid-term in vivo experiments are in progress and mow the modified next model is under development.

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반복 들기 작업에 따른 허리주변 근육의 근활성도와 근피로도에 대한 근전도 분석 (Electromyographic Analysis of Muscle Activity and Fatigue of the Paraspinal Muscles During a Repetitive Lifting Task)

  • 김원호
    • 한국전문물리치료학회지
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    • 제16권3호
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    • pp.16-23
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    • 2009
  • The purpose of this study was to investigate the effects of a repetitive lifting task on the level of activation and median frequency of the paraspinal muscles, and to provide basic data of the maximal acceptable duration of the lifting task to avoid muscle fatigue. Ten healthy male subjects were recruited as participants and they repetitively (12 lifts/min) lifted a box ($46cm{\times}30cm{\times}30cm$, 15 kg) for 10 minutes. Electromyographic data (muscle activation and median frequency), heart rate, and Borg CR10 score were recorded at 1, 3, 5, 7, and 9 minutes after the lifting task. Electromyographic data was recorded from the elector spinalis, mutifidus, external oblique abdominis, and rectus abdominis for 1 minute. The results showed that as the repetitive lifting task progressed, the heart rate and Borg CR10 score significantly increased. In addition, activation of the muscles increased. The median frequency significantly decreased over time in the elector spinalis, mutifidus, and external oblique abdominis (right side), except for the external oblique abdominis (left side) and rectus abdominis. It is suggested that the median frequency recorded from a dynamic task is used to monitor muscle fatigue. Furthermore, the repetitive lifting task (15 kg, 12 lifts/min) should not continue for more than 3 minutes in order to avoid muscle fatigue.

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한의학(韓醫學)과 유학(儒學)에 나타난 심(心)에 대한 고찰(심경(心經)을 중심으로) (Study about heart by oriental medicine and confucianism(center point by simkyung(心經)))

  • 구병수
    • 동의신경정신과학회지
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    • 제9궈1호
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    • pp.101-122
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    • 1998
  • As a result I get the fallowing conclusions;1. Oriental medicine and confucianism have similar point about heart because oriental medicine and confucianism have same philosophical backing 2. Oriental physitian read the books complated by confucianism by confuncianism physitian because racial characterristics are based on confucian thoughts, and my race make much of the heart. So to use confucian thought to phychotheraphy need to study confucian In(仁) thought.3. Thought that oriental medicine refers man as small university and thought that man and heaven are same based on the ethical doctrine that man's inborn nature is good are same connection. but oriental medical aim is agreement external features of man with university, confucian aim is agreement heart of man with university4. Confucianism will be used in phychotheraphy because phychotheraphy require close relationship between psychiatrist and patient and confucianism gives importance to man's relationship5. Oriental medical phychotheraphy deal prevention and cure at same time, but, confucianism deal prevention entirely. so confucianist target a saint by training at ordinary times.

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Endovascular Treatment of Traumatic Arteriovenous Fistula in Young Adults with Pulsatile Tinnitus

  • Kim, Hyun Sik;Song, Joon Ho;Oh, Jae Keun;Ahn, Jun Hyong;Kim, Ji Hee;Chang, In Bok
    • Journal of Korean Neurosurgical Society
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    • 제63권4호
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    • pp.532-538
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    • 2020
  • Traumatic arteriovenous fistulas (AVFs) involving the external carotid artery are exceedingly rare in young adults. Since an AVF is the most common life-threatening cause for pulsatile tinnitus (PT), meticulous evaluation and treatment of patients with PT is crucial. Here, we present two traumatic AVF cases treated with coil embolization leading to no residual fistulous connections followed by an immediate and complete resolution of PT. A 20-year-old man developed left ear tinnitus three months after a traumatic brain injury involving the right temporal bone fracture. Cerebral angiography demonstrated an enlarged left middle meningeal artery (MMA) and a fistular point at the posterior branch of the MMA draining to the middle meningeal vein (MMV) and the left pterygoid plexus, suggesting an AVF. Another 18-year-old girl developed left tinnitus, left exophthalmos, and conjunctival injection 6 months after a traffic accident involving no demonstrable abnormal findings in the radiologic exam. Magnetic resonance angiography demonstrated a markedly dilated left MMA draining to the MMV, left cavernous sinus, and left superior ophthalmic vein. In both cases, coil embolization was performed with total obliteration of the fistular point.

성문하 기관 협착증의 수술 치험 2예 (Surgical Treatment of Subglottic Stenosis -2 Cases-)

  • 김종만
    • Journal of Chest Surgery
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    • 제23권3호
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    • pp.577-583
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    • 1990
  • Subglottic stenosis is a disorder characterized by narrowing of the airway below the glottis. In children, the stenosis is usually due to scar formation secondary to prolonged airway intubation, rather than to external trauma. The location and extent of the stenosis are highly variable, consequently, corrective measures need to be selected to suit the individual problem. Conservative treatment is adequate for lesser degrees of stenosis but those with more severe scarring require external laryngeal surgery. We managed 2 children with subglottic stenosis due to prolonged intubation after open heart surgery who needed a resectional surgery of the stenotic upper airway. The preoperative evaluation and surgical technique for subglottic stenosis were reviewed.

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COVID-19 후각 이상에 대한 한의학적 고찰 (Olfactory Dysfunction in COVID-19 from a Korean Medical Perspective)

  • 김상현;김종현
    • 대한한의학원전학회지
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    • 제35권2호
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    • pp.99-120
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    • 2022
  • Objectives : To analyze symptoms of olfactory dysfunction caused by COVID-19 from a Korean Medical Perspective. Methods : Previous studies dealing with olfactory dysfunction accompanying COVID-19 were studied and analyzed for general characterization. Physiology and pathology of olfactory functions within the classical texts of Korean Medicine were collected and analyzed, through which symptoms of olfactory dysfunction in COVID-19 were examined. Results : Olfactory dysfunction manifested in high ratios in the early stages of confirmed COVID-19 cases, at times independent of other nasal symptoms such as blockage or discharge. There was a high chance of loss of taste being accompanied, while mental problems such as a tendency to have difficulty concentrating were present as well. In most cases, recovery took one to two weeks. From a Korean Medical perspective, physiology of olfactory function is closely linked to the Lungs, Ancetral Qi[宗氣], and the Heart, while its dysfunction could be explained by pathological factors such as Wind-Cold, Fire stagnation, Qi deficiency, Wind stroke, etc. Conclusions : In the context of external contraction disease[外感病], olfactory dysfunction could be caused by problems in the Lungs and Stomach that are responsible for breathing, or the Heart which is involved in recognizing and differentiating scent. General characteristics of COVID-19 imply it to be closely related to the Heart. In clinical application, overall symptoms need to be considered in diagnosis and treatment planning, after which further approaches could made to determine the problem to be of the Lung and Stomach, or of the Heart.