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Surgical Correction of Anomalous Right Superior Vena Cava[RSVC] into the Left Artium as an Isolated Anomaly - Report of a case - (우측 상대정맥의 좌심방으로 이상환류의 수술치험)

  • 백희종
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1455-1460
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    • 1992
  • Anomalous drainage of the right superior vena cava into the left atrium is a very rare congenital cardiac anomaly. Recently a patient with this venous anomaly was surgically corrected and forms the basis of this report. Patient findings were as follows: The patient has no other symptom but cyanosis which prompted cardiac evaluation Chest PA and electrocariogram were usual. Cross-sectional echocardiogram showed normally connected heart without intracardiac defect, Inferior vena cava drained normally into right atrium and coronary sinus was not dilated. Contrast, given into the right atrium, appeared in the left atrium This rare venous anomaly was confirmed by surgery. Surgical correction consisted of division of superior vena cava above the junction of left atrium and reanastomosis into right atrial appendage. Postoperative digital subtracion angiography confirmed the successful repair. She has doing well for 6months since operation. Systemic venous anomalies without intracardiac defect are very rare. However this anomalies should be considered in the differential diagnosis of cyanosis. The successfully corrected case is reported and literature is reviewed.

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Percutaneous OxyRVAD in a Patient with Severe Respiratory Failure and Right Heart Failure: A Case Report

  • Ga Young Yoo;June Lee;Seok Beom Hong;Do Yeon Kim
    • Journal of Chest Surgery
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    • v.57 no.3
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    • pp.319-322
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    • 2024
  • Venovenous extracorporeal membrane oxygenation (VV ECMO) is often used in cases of severe respiratory failure, especially in patients considered for lung transplantation. However, because many lung diseases can ultimately result in right heart failure, the treatment of secondary right heart failure can present a challenge when the patient is already under VV ECMO support. In such cases, an oxygenated-right ventricular assist device (OxyRVAD) can be used. OxyRVAD is designed to maintain anterograde blood flow and prevent right ventricular distension. Moreover, the pulmonary arterial cannula can be inserted percutaneously. We report a case in which percutaneous OxyRVAD was successfully implemented to manage right heart failure in a patient with respiratory failure who was on VV ECMO.

Intrapulmonary Teratoma - A Case Report - (폐기형종;1례 보고)

  • 유웅철
    • Journal of Chest Surgery
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    • v.25 no.2
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    • pp.205-209
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    • 1992
  • The intrapulmonary teratoma is an extremely tumor. This paper reports a case of int-rapulmonary teratoma located in the right upper and middle lobes of the lung in a 16-years-old male patient. The initial symptoms were right chest pain and coughing. Chest X-ray revealed huge soft tissue mass density in the right lower lung field. Right upper and middle lobectomy with resection of invaded pericardium was done. The gross and microscopic findings of res-ected specimen revealed characteristic findings of the intrapulmonary teratoma. The patient was recovered uneventually. We would like to describe this case of rare tumor with the review of literatures.

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Current Practices of the Ceasing Medical Treatment for Euthanasia and its Solutions (연명치료 중단의 현황과 대책 - 안락사, 보라매병원 사건을 중심으로 -)

  • Jung, Hyo-Sung
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.461-503
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    • 2008
  • The right to live is the most valuable benefit and protection of the law. And Medical science is the study considering value of life as the top priority. As modern medical science has progressed and expanding lifespan skills have developed, the number of symptom, called a human vegetable, has been also increased. As a result, people concerns whether euthanasia should be permitted. (1) Active euthanasia is prohibited and a doctor who conduct it is punished. (2) Indirect euthanasia can be permitted unless it is against a patient's intention. (3) Permission of passive euthanasia depends on intention of a patient. In other words, when a patient accepts, a doctor respects the right of self determination of patient and irreversible situation such as brain death happens, treatment stop is permitted. Even a patient who is in the last stage of cancer has a right to die in the dignity and elegance. Solutions for ceasing medical treatment are as follows; First, establishment of 'Bioethics Committee'. Second, setting procedures to empower a court a right to decide whether medical treatment is ceased. Third, setting procedure a government to assist treatment fees. In this paper, direction for social agreement of legal policy regarding the ceasing treatment is provided.

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Concurrent Intracranial and Extracranial Arterial Aneurysms: Report of Three Cases

  • Shin, Seung-Ryeol;Kim, Tae-Sun;Lee, Jung-Kil;Lee, Je-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.223-227
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    • 2005
  • Systemic multiple aneurysms are rare, and an association between intracranial and visceral arterial or abdominal aortic aneurysm in the same patient is a very rare occurrence. We report herein three such cases. In one case, aneurysms of the right internal carotid artery(ICA) and the right middle cerebral arterial bifurcation(MCAB) coexisted with the inferior pancreaticoduodenal arterial pseudoaneurysm and two ileal arterial aneurysms. In another case, the patient had the A-com arterial aneurysm and the right renal arterial aneurysm. And in the other patient, he had the right vertebral artery dissecting aneurysm with the abdominal aortic aneurym. Initially, all patients were referred to our hospital with subarachnoid hemorrhage(SAH), and thereafter first two patients developed visceral arterial aneurysm rupture in the course of hospital stay and in the last patient, the abdominal aortic aneurysm was detected incidentally during carotid angiogram for Guglielmi detachable coil(GDC) embolization of vertebral dissecting aneurym. After thorough review of our cases together with pertinent literatures, we emphasize the possibility of underlying extracranial aneurysms in ruptured intracranial arterial aneurysm patient and it's uncommon but fatal complication.

Factors Associated with the Exercise of Right to Self-determination about non-benefit Medical Services (의료소비자의 비급여 진료에 대한 자기결정권 행사와 관련 요인)

  • Kim, Ji Eun;Hahm, Myung-il;Lee, Hyewon;Kim, Sun Jung
    • Korea Journal of Hospital Management
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    • v.27 no.1
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    • pp.11-19
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    • 2022
  • Purposes: This study was to investigate intention to exercise the patient's right of self-determination on adopting the non-benefit medical services and was to identify factors associated with intention to self-determined decision. Methodology: A total of 1,000 adult respondents aged 20 to 65 years were recruited using stratified random sampling and surveyed by online. Multivariate logistic regression analysis was performed to identify factors associated with intention to self-determined decision using SAS 9.4(SAS Institute Inc. Cary, NC, USA). Findings: 61.9% of total participants(n=592) had intention to exercise patient's right of self-determination on adopting the non-benefit medical services. Significant differences were observed in the exercise of self-determination in relation to prior explanation and opportunity for self-determination. Practical Implications: This study suggested that explanation duty of provider might influence on increasing intention to exercise the patient's right of self-determination. Considering appropriate use of non-benefit services, it is important to enhance explanation duty of provider.

Solitary Papilloma of the Right Upper Lobe Bronchus: Report of a Case and Review of the Literature (우측 폐상엽 기관지에 발생한 고립성 유두종: 1례 치험 및 문헌 고찰)

  • 배수동
    • Journal of Chest Surgery
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    • v.5 no.2
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    • pp.135-140
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    • 1972
  • Papilloma of the upper respiratory tract, particularly larynx and vocal cords are relatively common disease. However, solitary papilloma of the bronchus is extremely rare condition and only a handful cases were reported in the literature. The patient is a 39 year old housewife who has been suffering from productive cough and occasional hemoptysis in the past one year. X-ray of the chest showed complete atelectasis of the right upper lobe. Bronchography revealed a hemispherical protruding mass in the right main bronchus with complete occlusion of the upper lobe bronchus. Bronchoscopy showed a whitish friable mass in the lumen of the right main bronchus biopsy of which was reported as benign papilloma. Right upper lobectomy together with wedge resection of the portion of right main bronchus to include the tumor was done. Cut-edges of the bronchus were stitched together with interrupted fine dacron sutures. During this procedure, right main bronchus was gently clamped with non-crushing Satinsky type clamp. Patient has had uneventful recovery from surgery and was discharged without symptom. Patientis doing well three months following the operation.

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Anomalous Origin of the Right Subclavian Artery in a Patient with D-transposition of the Great Arteries

  • Park, Hyojung;Song, Jinyoung;Huh, June;Kang, I-Seok;Jun, Tae-Gook;Yang, Ji-Hyuk
    • Journal of Chest Surgery
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    • v.51 no.6
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    • pp.403-405
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    • 2018
  • This case report concerns a young patient with an extremely rare combination of d-transposition of the great arteries (d-TGA) and anomalous origin of the right subclavian artery. In our patient, the right subclavian artery originated from the pulmonary artery, which is why he did not show reversed differential cyanosis. We conclude that the presence of an aortic arch anomaly should be considered in patients with d-TGA who do not present with reversed differential cyanosis. A further imaging work-up, including computed tomography or magnetic resonance imaging, might be helpful.

Azygos and right superior intercostal vein injury secondary to blunt trauma: a case report

  • Nima Yaftian;Benjamin Dunne;Phillip Antippa
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.53-55
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    • 2023
  • Azygos vein injuries are rare consequences of blunt trauma. When there is high drainage output from a right-sided intercostal catheter, an azygos injury must be considered in the differential diagnosis. We report the case of a 38-year-old male patient involved in a fall from a height during a motorcycle accident. Computed tomography demonstrated a large right-sided hemothorax and left-sided pneumothorax. The patient was transferred to the operating theatre and underwent a clamshell thoracotomy. A laceration in the azygos vein at the confluence of the arch of the azygos and the right superior intercostal vein was identified. Bleeding was controlled at the trifurcation. The patient survived and was discharged home on postoperative day 15.

Death with Dignity and the Right to Decide (생명권과 자기결정권, 그리고 의사의 진료의무)

  • Yoo, Seung-Ryong
    • The Korean Society of Law and Medicine
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    • v.9 no.2
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    • pp.11-52
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    • 2008
  • Based on foreign examples and past debates, the minimal conditions for passive euthanasia can be suggested as following; (1) The patient is incurable by modem medical practice and his death is impending (less than 6 months), (2) Euthanasia is practiced solely to relieve physical pain of the patient, (3) If the patient can express his will, there should be a clear and sincere request or consent, (4) More than 2 doctors including doctor in charge should consent, (5) Euthanasia should be practiced in ethical way, (6) Patient family should agree(when the patient will is assumed.) It is hard to resolve issues regarding euthanasia based on past rulings and cases without concrete law. As in United States and Germany, clear and objective provisions of euthanasia and definitive method for patient's advanced directive should be legislated to resolve medical conflict and to relieve patient and family from agony. And death with dignity debate will not be able to proceed if it is only substantively approached because of unclear definition of euthanasia and benefit comparison way of thinking. Thus it is important to establish definitive process to decided legislation of euthanasia act and resolving conflicts arising from each step of the process among interested parties exchanging medical/ethical opinions.

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