• Title/Summary/Keyword: the right of patient

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Surgical Treatment of Lung Cancer with Bronchoplastic Procedures (기관지 성형술을 이용한 폐암의 수술적 치료)

  • Kim, Dong-Won;Park, Ju-Cheol
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.911-916
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    • 1995
  • Thirteen patients with lung cancer have undergone bronchoplastic procedures from January 1991 to July 1994 in Kyung Hee univ. Hospital.Among them,twelve patients were male and one patient was female from 33 to 76 years of age.[ mean 56.6 11.5 years of age The pathologic diagnoses were squamous cell carcinoma in twelve patients and adenoid cystic carcinoma in one patient.The bronchoplastic procedures consisted of seven right upper sleeve lobectomies, one right middle sleeve lobectomy, one left lower sleeve lobectomy and four sleeve pneumonectomies. In these sleeve pneumonectomies, right sleeve pneumonectomy was done in three patients and the other was left sleeve pneumonectomy. Including the four sleeve pneumonectomies, carinoplasty was performed in seven patients. Postoperatively, we carried out bronchoscopic suction of intrabronchial secretions in necessary for the prevention of postoperative complication. All except one were discharged without any complication and have been in good condition. Postoperative mortality was in one patient who expired 25days after right middle sleeve lobectomy with respiratory failure.

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Patient's Right of Self-determination and Informed Refusal: Case Comments (환자 자기결정권과 충분한 정보에 근거한 치료거부(informed refusal): 판례 연구)

  • Bae, Hyuna
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.105-138
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    • 2017
  • This is case comments of several representative legal cases regarding self- determination right of patient. In a case in which an intoxicated patient attempted suicide refusing treatment, the Supreme Court ruled that the medical team's respect for the patient's decision was an act of malpractice, and that in particular medical situations (medical emergencies) the physician's duty to preserve life supersedes the patient's rights to autonomy. Afterwards, at the request of the patient's family, and considering the patient's condition (irrecoverable death stage, etc.) consistent with a persistent vegetative state, the Supreme Court deduced the patient's intention and decide to withdraw life-sustaining treatment. More recently, regarding patients who refuse blood transfusions or other necessary treatment due to religious beliefs, the Supreme Court established a standard of judgment that can be seen as conferring equal value to the physician's duty to respect patient autonomy and to preserve life. An empirical study of legal precedent with regard to cases in which the physician's duty to preserve life conflicts with the patient's autonomy, grounded in respect for human dignity, can reveal how the Court's perspective has reflected the role of the patient as a decision-making subject and ways of respecting autonomy in Korean society, and how the Court's stance has changed alongside changing societal beliefs. The Court has shifted from judging the right to life as the foremost value and prioritizing this over the patient's autonomy, to beginning to at least consider the patient's formally stated or deducible wishes when withholding or withdrawing treatment, and to considering exercises of self determination right based on religious belief or certain other justifications with informed refusal. This will have a substantial impact on medical community going forward, and provide implicit and explicit guidance for physicians who are practicing medicine within this environment.

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Corrective surgery of double outlet right ventricle: an analysis of 27 cases (양대동맥 우심실 기시증 [Double Outlet Right Ventricle] 의 전교정술 -27례 분석-)

  • 조재일
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.349-355
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    • 1983
  • Twenty-seven patients with double-outlet right ventricle underwent complete intracardiac repair between 1978 and 1983, June, at Seoul National University Hospital . Although definite aorto-mitral discontinuity was discovered in 20 patients, both great arteries arose wholly or mostly from the right ventricle in all cases. There were 17 cases with subaortic VSD, 6 with subpulmonic, 2 with doubly-committed, and 2 with non-committed VSD. Pulmonary stenosis was present in 21 patients. Intraventricular baffle repair was applied in 23 patients. Three patients required extracardiac conduit to establish continuity between right ventricle and pulmonary artery, and modified Fontan operation was performed in one patient. Over-all mortality rate was 37.0%, but recently 4 of 15 died [26.7%]. One late death occurred from infective endocarditis. Incremental risk factors were small patient size, subpulmonic or non-committed VSD, presence of PS, coronary artery anomalies, associated valvular lesion and other complicated anomalies. However, great artery relationship, restrictive VSD and transannular patch were not risk factors. No instances of complete heart block occurred. Of the survivors, all showed complete or in complete right bundle branch block and in one patient intermittent ventricular tachycardia had developed. The important cause of death was low cardiac output syndrome.

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Total Correction of Double-Outlet Right Ventricle [DORV]: Report of 45 cases (양대동맥 우심실기시증의 전교정술 - 45예 보고 -)

  • 서울의대
    • Journal of Chest Surgery
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    • v.23 no.6
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    • pp.1174-1179
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    • 1990
  • Forty-five patients with double-outlet right ventricle[DORV] underwent complete intracardiac repair between July, 1983 and June, 1989. Patients with complete atrioventricular canal, atrioventricular discordance and uni-ventricular heart were excluded. The 32 male and 13 female patients ranged in age from 3 months to 15 years[mean 4 years]. Thirty-two patients had pulmonary stenosis. The early mortality was 11.ltd[5 /45] None of 27 died after a completely intraventricular repair. The mortality was 20%[1/5] for repair using transannular patch, 20% [1/5] for REV operation, 33.3%[1/3] for repair including extracardiac valved conduit, and 50% [1/2] for Jatene operation, respectively. Two modified Fontan procedures were performed without mortality. One died after Senning operation. Causes of early deaths included high residual right ventricular pressure[one patient] small left atrial and left ventricular volume[one patient], persisting severe pulmonary hypertension [one patient] and low cardiac output of unknown cause [two patients]. Complete heart block developed in one patient. Two late deaths occurred among the 40 operative survivors [5.0Po] from persisting severe pulmonary hypertension and bleeding at reoperation. Our results indicate that significant defects can be repaired with low mortality and morbidity.

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Anomalous Variations of the Origin and Course of Vertebral Arteries in Patients with Retroesophageal Right Subclavian Artery

  • Kim, Young-Don;Yeo, Hyung-Tae;Cho, Young-Dae
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.297-299
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    • 2009
  • We present two rare cases of anomalous vertebral artery (VA) with retroesophaqeal right subclavian artery. One patient had a right VA arising from the right common carotid artery (CCA), and a left VA originating from the third branch off the aorta. Both VAs ascended anteriorly to the transverse foramen of C5 to C6 vertebra and entered the transverse foramen of C4. The other patient had a right VA arising from the right CCA and entering the transverse foramen of C5. The presence of anomalous variations of the oriqin and course of vertebral artery might have serious implications in anqioqraphic and surgical procedures, and it is of great importance to be aware of such a possibility.

Intrapulmonary teratoma -Report of a case- (폐실질내 기형종 -1례 보고-)

  • 박도웅
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.158-162
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    • 1989
  • This paper reports a case in a 16-year-old female of intrapulmonary teratoma located in the right upper and middle lobes of the lung. The initial symptoms were high spiking fever, cough and chest pain. Initial chest X-ray revealed large homogenous mass in the right upper and middle lung fields. So intercostal tube drainage was done under the impression of the lung abscess. But mass density was remained on the follow-up chest X-ray, the patient had resection of the right upper and middle lobes of the lung. The gross and microscopic findings of the resected specimen revealed characteristic findings of the intrapulmonary teratoma. The patient is asymtomatic at present and living a normal life.

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Clinical Experience of a Complex Regional Pain Syndrome Type II Patient -A case report- (복합부위통증 증후군 II형(CRPS Type II) 환자의 치험 -증례 보고-)

  • Yoon, Keon-Jung;Kim, Jong-Lul
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.426-429
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    • 1996
  • Complex regional pain syndrome Type II(CRPS) can be diagnosed by new IASP criteria in 1994. Sympathetically maintained pain may or may not be present in a patient with complex regional pain syndrome. We experienced a CRPS Type II patient who has sympathetically maintained pain as a major painful nature developed after right multiple iliac bone fracture, right femoral artery thrombosis and lumbosacral plexus injury. Combination treatment with L2, L3, L4 sympathetic ganglion block and continuous lower thoracic epidural block for 30 days were tried to get long term effect. The patient had signs of successful. sympathetic denervation of the right foot. After that pain relief was sustained until three month later.

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One Case Report of Primary Choriocarcinoma of the Lung (폐에 발생한 원발성 융모막 상피종 치험 1례)

  • 김기만
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.366-369
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    • 1990
  • Primary choriocarcinoma of the lung is extremely rare. The patient was 28-year-old female and had no specific signs and symptoms except right chest pain for 5 years. On simple chest film, 8X8 cm sized, well demarcated, homogeneous ovoid mass was found on right lower lung field. The qualitative urine \ulcorner-HCG was 17140 mIU/ml. The result of percutaneous needle biopsy highly suggested choriocarcinoma. Under the impression of primary choriocarcinoma of the lung, right middle and lower lobectomy was done. On 33 postoperative days, serum \ulcorner-HCG level was within normal limit, the patient was discharged without complications after one-cycle chemotherapy.

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Superior Vena Cava Syndrome Bue to Thyroglossal Duct Cyst (갑상설관낭에 의한 상대정맥증후군 -1례 보고-)

  • 권오우
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.953-956
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    • 1994
  • This is a case report of superior vena cava syndrome due to thyroglossal duct cyst, which was surgically treated. The patient was 61 year old male who progressively complained exertional dyspnea for about 5 months and right ptosis, facial flushing, and nasal stuffiness for about 1 month before admission. The CT scan of the thorax revealed the right paratracheal cystic mass that compressed and displaced the trachea to leftward and SVC to rightward. The resection of the cystic mass was performed through the right posterolateral thoracotomy. The pathologic result was compatible with thyroglossal duct cyst. The postoperative status of the patient was uneventful.

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Traumatic Rupture of Lobar Bronchus - One case report - (외상으로 인한 엽성 기관지파열: 수술1 예)

  • Lee, Jin-Myeong;Sin, Je-Gyun;Kim, Sam-Hyeon
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.303-305
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    • 1991
  • The tracheobronchial rupture from blunt trauma is an uncommon injury with a variety of clinical presentations. Most of traumatic tracheobronchial tears occur within 2.5cm of the tracheal carina; lobar or segmental bronchi are rarely affected. Recently we experienced one case of traumatic rupture of right middle lobar bronchus in a patient who had fallen from a bicycle. Bronchoscopy showed linear disruption of the right middle lobe bronchus at its bifurcation site. Emergency right middle lobectomy was performed. The patient was recovered without any sequelae.

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