• Title/Summary/Keyword: preoperative

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Preoperative Gadolinium-enhanced Magnetic Resonance Images on Infectious Spondylitis

  • Kim, Seok-Won;Lee, Seung-Myoung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.355-358
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    • 2005
  • Objective : The purpose of this study is to analyze the patterns of intervertebral disc enhancement seen in infectious spondylitis, differentiate between two groups[tuberculous vs pyogenic spondylitis]. Methods : Between January 1994 and December 2002, 83patients underwent operative procedure with confirmed to histopathologic evaluation. Magnetic resonance[MR] images were obtained in all patients and were analyzed retrospectively. 57patients had tuberculosis and 26patients were infected by pyogens. The patterns of gadolinium enhancement of disc were classified into 4 types[post's classification] : Type I, non-enhancing; Type II, enhancement of the peripheral rim; Type III, Type II with central area and partial endplate; Type IV, general enhancement. Results : The enhancement patterns observed were as follows : Common pattern of tuberculous spondylitis was Type II, and pyogenic spondylitis was Type III. [p < 0.01] This difference may result from pathophysiologic varieties of organisms. Conclusion : Careful preoperative MR analysis of the patterns of disc enhancement occuring in infectious spondylitis can be useful for differentiating between the tuberculous and pyogenic spondylitis.

Tricuspid Valve Replacement: A Report of 8 Cases (삼첨 판막이식 8례 보고)

  • 김용진
    • Journal of Chest Surgery
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    • v.11 no.2
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    • pp.185-193
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    • 1978
  • Between April 1976 and March 1978, six cases of tricuspid valve replacement were done in the Department of Thoracic Surgery, Seoul National University Hospital. There were 4 men and 2 women and the age of the patients ranged from 17 years of the youngest to 48 years of the oldest. Most of them had characteristic symptoms of tricuspid valve disease, such as a systolic murmur audible over the lower sternum and varying with respiration, pulsatile and distended neck vein, and an enlarged and pulsatile liver. Preoperative functional levels according to NYHA Calcification were class III in 4 cases, and class IV in 2 eases. Most of the cases showed moderate to severe cardiomegaly in chest films and elevated right atrial pressure on preoperative right heart catheterization. Five of them underwent concomittent mitral valve replacement and one pulmonary valvotomy. All of them showed tricuspid insufficiency resulted from massive dilatation of annulus, destructive lesions of valve structure, or both anomalies. One postoperative hospital death was encountered and the cause of death was low out-put syndrome. All survivors showed clinical improvement and cardiomegaly regressed and left hospital in a good condition . *Attendum; Recently 2 more cases of tricuspid valve replacement with mitral valve replacement were done after this review.

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Corelation between pulmonary function tests and pulmonary complications following pulmonary resection (폐기능과 폐절제술 합병증과의 상관)

  • Lee, Jong-Tae;Lee, Seong-Haeng;Song, Won-Yeong
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.465-469
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    • 1984
  • Preoperative evaluation of pulmonary function with spirometry can identify those at increased risk of morbidity and mortality owing to pulmonary complications following pulmonary resections. To assess the correlation between FVC, FEV1.0/FVC, EFE25-57% and MVV, measured preoperatively, and the incidence of pulmonary complications following pulmonary resections, a hundred patients who had pulmonary resections were selected. Patients were divided into two groups postoperatively. In group A, there was no postoperative pulmonary complication, and in group b, there were one or more complications. We compared the results of the preoperative pulmonary function tests of the two groups. The difference of FVC between the two groups was statically significant [p<0.01] and FEV1.0/ FVC [p<0.O01]. The differences of the FEF25-75% and MVV were not significant.

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Surgical Treatment of Thoracic Outlet Syndrome (Report of A Case) (흉곽출구 증후군 수술 치험 1례)

  • Ryu, Ji-Yun;Gang, In-Deuk;Jo, Gwang-Hyeon
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.563-566
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    • 1988
  • Thoracic outlet syndrome refers to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. it was previously designated according to presumable etiologies such as scalenus anticus, costoclavicular, hyperabduction, cervical rib and first thoracic rib syndromes. We experienced a case of thoracic outlet syndrome[costoclavicular syndrome] which was caused by posttraumatic left clavicular fracture. Patient had suffered from swelling and cyanosis of left forearm and hand. preoperative vascular doppler test, angiography and venography were performed. First rib resection was done with transaxillary approach. After operation preoperative cyanosis and swelling of left forearm and hand were disappeared. Postoperative course was uneventful.

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Accuracy of Preoperative Computed Tomography in Comparison with Histopathologic Findings in Staging of Lung Cancer (폐암의 병기결정시 임파절의 조직학적 소견과 전산화단층활영의 정확도에 관한 고찰)

  • 박기진;김대영
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.52-58
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    • 1996
  • Sixty six patients who were operated as lung cancer during the period from Mar. 1991 to Sep. 1993 at the department of Thoracic and cardiovascular surgery, were reviewed retrospectively and the accuracy of regional lymph node in preoperative CT were compared with histopathologlc report obtained from operation. The age ranged from 30 to 72 years old (mean age : 56.5), and 51 patients were male and 15 patients were female. The author analysed the true positive, true negative, false positive and false negative and sensitivity, specificity, positive predictive index, negative predictive index and accuracy of each nodes. The result is that there were differences between seven nodal groups in specificity, sensitivity, positive predictive Index, negative predictive index and accuracy. The range of each nodal group is from 81.7 to 98.3% The nodes of the most poor accuracy are aortopulmonary area and hilar area.

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Aortopulmonary Fistula Presenting without an Endoleak after Thoracic Endovascular Aortic Repair

  • Sica, Giacomo;Rea, Gaetano;Bocchini, Giorgio;Lombardi, Romilda;Muto, Massimo;Valente, Tullio
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.287-290
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    • 2017
  • Herein, we report the case of a 60-year-old man, a smoker with a history of arterial hypertension and diabetes mellitus. After computed tomography (CT) for an episode of hemoptysis, the patient underwent elective thoracic endovascular aortic repair (TEVAR) because of a degenerative aneurysm of the descending thoracic aorta. The area of perianeurysmal pulmonary atelectasis reported on the CT scan was not considered. Three months later, he developed an aortopulmonary fistula without endoleaks. Although TEVAR is a relatively safe procedure, no detail should be overlooked in the preoperative evaluation in order to avoid life-threatening complications. Further, the effectiveness and modality of prolonged antibiotic prophylaxis and/or preoperative respiratory physiotherapy should be assessed in such cases.

Indentation in the Right Ventricle by an Incomplete Pericardium on 3-Dimensional Reconstructed Computed Tomography

  • Kim, Hak Ju;Kwak, Jae Gun
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.298-299
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    • 2017
  • We report the case of a 17-year-old girl who presented with an indentation in the right ventricle caused by an incomplete pericardium on preoperative 3-dimensional reconstructed computed tomography. She was to undergo surgery for a partial atrioventricular septal defect and secundum atrial septal defect. Preoperative electrocardiography revealed occasional premature ventricular beats. We found the absence of the left side of the pericardium intraoperatively, and this absence caused strangulation of the diaphragmatic surface of the right ventricle. After correcting the lesion, the patient's rhythm disturbances improved.

Left Atrial Myxoma: Report of 2 Cases (좌심방내 점액종 치험 2예)

  • 김삼현
    • Journal of Chest Surgery
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    • v.11 no.1
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    • pp.58-64
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    • 1978
  • Left atrial myxoma, an unusual clinical entity, may cause severe and progressive cardiac disease mimicking mitral valvular disease. In recent years, increased clinical awareness and improved diagnostic techniques has led to a higher incidence of correct preoperative diagnosis. Recently we experienced 2 cases of left atrial myxoma, which were removed successfully under the cardiopulmonary by pass. The first case was 45 years old woman and the second was 23 years old female. Preoperative definite diagnosis was entertained by angiocardiography and echocardiography in both cases. In the first case, tumor was removed with left atriotomy and atrial septectomy was done with additional right atriotomy. In the second case, tumor and atrial septum were removed en bloc through the right atrium. Both patients were discharged with good results 2 weeks postoperatively.

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Transposition of the Great Arteries (TGA) -Report of An Autopsy Case- (대혈관전위증 부검 1례 보고)

  • 김학제
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.106-112
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    • 1977
  • Transposition of the great arteries is one of the commonest forms of severe congenital heart disease and produces severe cyanosis threatening survival from the day of birth. Anatomical anomalies which the aorta arises from the infundibulum of the right ventricle and the pulmonary artery arises from the outflow tract of the left ventricle make the deranged circulation. Survival is possible only if additional anomalies are present which allow mixing of the pulmonary and systemic circulations. Preoperative diagnosis as TGA was taken on the 15 day old female via the preoperative examination and the right cordioangiography. As palliative treatment for cyanosis, Blalock-Hanlon operation was performed in this patient. The results were good as 54 mmHg changed from 27 mmHg of $PO_2$ in aorta, but sudden cardiac arrest was developed in postoperative 12 hours. In order to confirm the cause of death and the cardiac anomalies, autopsy was performed on the date of death. The diagnosis of the autopsy showed; [1] Transposition of the Great Arteries. [2] Patent Ductus Arteriosus. [3] Patent Foramen Ovale. [4] Ventricular Septal Defect, 2 Muscular Type. [5] Double Ureter, Right. [6] Artificial Atrial Septal Defect. [7] Total Collapse of the left lung and Intraparenchymal hemorrhage of right lung.

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Surgical Management of Pancoast Tumor -2 Cases Report- (상구암종의 외과적 치료 -2례 보고-)

  • 안정태
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.426-430
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    • 1995
  • Pancoast tumor was specific lung carcinoma that has been symptoms and signs according to locations. It was located in peripheral,and involved the extrathoracic structures more than parenchyme of the lung. At 1838, Hare reported it, and at 1932 Pancoast was first described it. Prior to 1950,superior sulcus tumor was considered uniformly fatal, but at 1961 Paulson and Shaw advocated the use of preoperative irradiation therapy and followed by an extended en bloc resection. Recently we were experienced 2 cases of pancoast tumor managed with same method. One was 60-years old man that has been recommended preoperative radiation therapy with dose of 3000 cGy to 20 fractions and followed resection after 4 weeks, the other was 53-years old man that has been recommended a dose of 4000 cGy to 20 fractions and followed resection after 4 weeks. On tumor histology first case was large cell carcinoma and second case was squamous cell carcinoma. all patients was complicated atelectasis. First patient was expired with brain metastasis after 17 months, second was expired after 6 months.

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