• 제목/요약/키워드: surgical intervention

검색결과 911건 처리시간 0.02초

Progression of periapical cystic lesion after incomplete endodontic treatment

  • Huh, Jong-Ki;Yang, Dong-Kyu;Jeon, Kug-Jin;Shin, Su-Jung
    • Restorative Dentistry and Endodontics
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    • 제41권2호
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    • pp.137-142
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    • 2016
  • We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment.

우측 쇄골하 동맥 기시 이상에 의한 기형성 연하곤란 (Surgical Managemnet of Symptomatic Aberrant Right Subclavian Artery through Midsternotomy - A case report -)

  • 허동명
    • Journal of Chest Surgery
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    • 제23권4호
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    • pp.785-790
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    • 1990
  • A 30-year-old male with a symptomatic aberrant right subclavian artery underwent surgical intervention on January 17, 1990. An aberrant right subclavian artery is a rare congenital anomaly, but it is the most common one of the aortic arch anomalies. This anomalous vessel usually does not produce symptoms, but occasionally symptomatic patients require surgical intervention. Although ligation and division of the aberrant right subclavian artery through left thoracotomy has been advocated by many surgeons, the ischemic symptoms of the upper extremity or the brain can occur. In the procedure described here, ligation and division of the aberrant artery and its anastomosis to the ascending aorta with Gore \ulcornerTex vascular graft was performed simultaneously through midsternotomy. With this procedure, we relieved the esophageal obstruction and established normal blood flow to the right arm. Hoarseness developed postoperatively. We consider that above symptom has been attributed to the injury of the left recurrent laryngeal nerve during dissection.

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심내막염 환자의 수술적 치료 (Early Surgical Intervention of Active Infective Endocarditis)

  • 박국양
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.121-130
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    • 1988
  • During one year period from Sep. 1986 to Sep. 1987, we have experienced 6 cases of infective endocarditis requiring surgical interventions. All 6 patients had class IV or V cardiac disability at the time of surgery. The indication for surgery was rapidly progressive congestive heart failure in all cases. Four patients underwent aortic valve replacement including one double valve replacement. Two other patients required other surgical procedures, removal of large left atrial vegetation mass in one patient and excision of destroyed pulmonary valve and aortic vegetation in the other patient. Two patients died; one of mitral annulus rupture after release of aortic clamp and the other of mediastinal bleeding 3 months after replacement of aortic valve. Three out of 4 survivors are in NYHA Class I and the remaining patient is in Class II. We emphasize that early operative intervention is life-saving in patients with persistent or progressive congestive heart failure, irrespective of the activity of the infective process or the duration of antibiotic therapy.

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The Surgical and Cognitive Outcomes of Focal Cortical Dysplasia

  • Choi, Sun Ah;Kim, Ki Joong
    • Journal of Korean Neurosurgical Society
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    • 제62권3호
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    • pp.321-327
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    • 2019
  • Focal cortical dysplasia (FCD) is the major cause of intractable focal epilepsy in childhood leading to epilepsy surgery. The overall seizure freedom after surgery ranges between 50-75% at 2 years after surgery and the long-term seizure freedom remain relatively stable. Seizure outcome after surgery depends on a various factors such as pathologic etiologies, extent of lesion, and types of surgery. Therefore, seizure outcome after surgery for FCD should be analyzed carefully considering cohorts' characteristics. Studies of pediatric epilepsy surgery emphasize the early surgical intervention for a better cognition. Early surgical intervention and cessation of seizure activity are important for children with intractable epilepsy. However, there are limited data on the cognitive outcome after surgery in pediatric FCD, requiring further investigation. This paper reviews the seizure and cognitive outcomes of epilepsy surgery for FCD in children. Several prognostic factors influencing seizure outcome after surgery will be discussed in detail.

Sural nerve grafts in subacute facial nerve injuries: a report of two cases

  • Jiwon Jeong;Yongjoon Chang;Kuylhee Kim;Chul Hoon Chung;Soyeon Jung
    • 대한두개안면성형외과학회지
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    • 제25권2호
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    • pp.99-103
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    • 2024
  • Because facial nerve injuries affect the quality of life, leaving them untreated can have devastating effects. The number of patients with traumatic and iatrogenic facial nerve paralysis is considerably high. Early detection and prompt treatment during the acute injury phase are crucial, and immediate surgical treatment should be considered when complete facial nerve injury is suspected. Symptom underestimation by patients and clinical misdiagnosis may delay surgical intervention, which may negatively affect outcomes and in some cases, impair the recovery of the injured facial nerve. Here, we report two cases of facial nerve injury that were treated with nerve grafts during the subacute phase. In both cases, subacute facial nerve grafting achieved significant improvements. These cases highlight surgical intervention in the subacute phase using nerve grafts as an appropriate treatment for facial nerve injuries.

경피적 관상동맥 확장 성형술 도중 우관상동맥 뒤가쪽가지에서 발생한 유도철사 부러짐 (Guide wire fracture during percutaneous coronary intervention)

  • 김학로;임태훈;김병철;이호준;오홍근;주현식;김태진;김용복
    • Journal of Yeungnam Medical Science
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    • 제33권1호
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    • pp.52-55
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    • 2016
  • Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.

A decade of treating traumatic sternal fractures in a single-center experience in Korea: a retrospective cohort study

  • Na Hyeon Lee;Seon Hee Kim;Jae Hun Kim;Ho Hyun Kim;Sang Bong Lee;Chan Ik Park;Gil Hwan Kim;Dong Yeon Ryu;Sun Hyun Kim
    • Journal of Trauma and Injury
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    • 제36권4호
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    • pp.362-368
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    • 2023
  • Purpose: Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution. Methods: A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encompassed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain. Results: Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5-18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3-23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3-48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention. Conclusions: Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with offset-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications.

심근 경색후 심실중격결손: 1례 보고 (Surgical Management of Postinfarction VSD - Report of 1 case -)

  • 윤태진
    • Journal of Chest Surgery
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    • 제24권9호
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    • pp.913-917
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    • 1991
  • Ventricular septal defect complicating myocardial infarction is rare but fatal condition which requires early surgical intervention before end-organ failure ensues from cardiogenic shock. Since the first successful repair by Cooley et al in 1956, surgical skills and strategies were developed and modified to a great extent, and we adopted the new repair technique in our case which stresses that minimal or no part of the infarcted septum and left ventricular wall be resected. This technique obviates the need to resect the infarcted part of the septum and prevents recurrence of an even larger VSD, and provides adequate size and shape of the left ventricle after of transinfarction left ventriculotomy.

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식도기관지루를 합병한 식도게실 1례 보고 (Esophageal diverticulum complicated with esophagobronchial fistula-Report of one case-)

  • 문병탁;김상형;이동준
    • Journal of Chest Surgery
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    • 제16권3호
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    • pp.405-410
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    • 1983
  • Acquired communicated diverticula between the esophagus and respiratory system are infrequent, and they are caused by carcinoma, trauma, infection, and traction. This report reviews the feature of benign esophagobronchial fistula due to midesophageal diverticulum. Patient is twenty year old man with excellent result by surgical intervention . The surgical procedures consist of divertuculectomy and superior segmentectomy of lower lobe of right lung. Clinically and radiologically, the patient is free from substernal distress, regurgitation, esophagorespiratory fistula, and esophageal stricture after surgical treatment.

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일 종합병원 중환자실의 섬망 발생 및 중재 현황과 의료진의 섬망 인식 조사 (Investigation of Delirium Occurrence and Intervention Status in Intensive Care Unit at a Hospital and Perception of Delirium by Medical Staff)

  • 강이슬;김순희;이민정;이효진;임옥분;홍상범;최혜란
    • 중환자간호학회지
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    • 제16권1호
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    • pp.71-86
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    • 2023
  • Purpose : This study aims to investigate the status of delirium intervention in adult intensive care unit (ICU) patients and the perception of this delirium by medical staff. Methods : This retrospective study involves 185 patients, whereas, a descriptive survey is conducted with 197 medical staff members. Results : The delirium group includes 100 patients (54.1%). The incidence of delirium is 64.9% in the medical ICU, 65.9% in the surgical ICU, 42.4% in the neuro ICU, and 46.5% in the cardiac ICU. The percentages of delirium prevention intervention differs between the two groups: 65.0% in the delirium group and 95.3% in the non-delirium group. The medical staff recognize that delirium is a common problem in the ICU (100.0%) and requires active medical intervention (98.5%). Conclusion : The length of stay at the ICU is longer in the delirium group than in the non-delirium group. It is necessary to standardize delirium prevention and treatment protocols to be equally applicable to all ICU patients.