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Hybrid Procedure for Pulmonary Atresia with Ventricular Septal Defect in a Low Birth Weight Neonate

  • Park, Ji Young;Seo, Dong-Man;Shin, Hong Ju;Kim, Soo-Jin;Son, Jae Sung
    • Journal of Chest Surgery
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    • v.46 no.1
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    • pp.56-59
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    • 2013
  • Cardiac surgery in neonates with congenital heart disease has progressed dramatically in the past three decades. However, low-birth-weight neonates with congenital heart disease continue to challenge the intellectual and technical skills of healthcare professionals. We present a case of a low-birth-weight neonate with pulmonary atresia and a ventricular septal defect, in whom palliation was achieved with a right ventricular outflow tract stent using a hybrid procedure.

A Case of Epstein-Barr Virus Infection with Gall Bladder and Common Bile Duct Stones in an Otherwise Healthy Child

  • Park, Jong-Hyun;Noh, Jin-Chul;Park, Hyang-Mi;Jung, Yu-Soek;Park, Sei-Hyeog;Hong, H. Christian;Shin, Hye-Jung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.1
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    • pp.57-61
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    • 2012
  • Cholelithiasis and choledocholithiasis are uncommon pediatric diseases, although clinicians have seen them with increasing frequency in children in recent years. Moreover, no case of Epstein-Barr virus (EBV) infection with cholelithiasis and choledocholithiasis has been previously reported in the English literature. We report a pediatric patient with EBV infection, a gall bladder stone, and a common bile duct stone, may have had GB and CBD stones prior to her EBV infection, whom we successfully treated with antibiotics and laparoscopic cholecystectomy for cholecystitis.

Incidentally Discovered Solitary Gastrointestinal Polyp with Pathological Significance in Children: Four Case Reports

  • Han, Sang-eun;Chang, Jiyeon;Paik, Seung Sam;Kim, Yong Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.209-213
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    • 2018
  • Most solitary gastrointestinal (GI) polyps in children are either inflammatory or hamartomatous. Solitary hyperplastic polyp, sentinel polyp and solitary adenomatous polyp have been occasionally diagnosed in adults, but very rarely reported in Korean children. We recently came across a case with adenomatous polyp in the colon, a case with hyperplastic polyp beneath the gastroesophageal junction, a case with hyperplastic polyp in the prepyloric area, and a case with sentinel polyp in the distal esophagus, which are unusual pathologic types in children. These mucosal lesions were diagnosed incidentally during elective endoscopic examinations for GI symptoms. Most polyps do not cause significant symptoms, so the diagnosis might be delayed, especially in children, in whom GI endoscopy is not commonly performed for screening purpose as in the adults.

An 87-year-old patient with repeated oligorecurrences over six years whose disease were treated with radiotherapy alone

  • Yun, Hyong Geun
    • Radiation Oncology Journal
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    • v.32 no.4
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    • pp.266-271
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    • 2014
  • In the clinical state of oligometastases or oligorecurrence, a transitional state between localized and widespread systemic disease, local control of the disease may yield improved systemic control. Radiotherapy may be a good means for controlling oligometastatic tumors, particularly in very old patients for whom surgery may be infeasible. A combination of systemic therapy and local therapy is necessary to prevent systemic progression. Some kinds of cancers found in the elderly are known to be somewhat indolent for systemic progression. So, for very old patients who refuse or cannot tolerate chemotherapy, the use of radical radiotherapy alone to treat oligorecurrences may be very helpful. We successfully treated an 87-year-old patient who had been diagnosed with oligorecurrences three times over six years with radiotherapy alone. The patient is now, about four years after his first radiotherapy for liver metastasis, alive without any evidence of cancer and with fully active performance status.

Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy in Malignant Thyroid Nodules: Utility for Micronodules

  • Unal, Betul;Sezer, Cem
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8613-8616
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    • 2014
  • Background: The diagnostic approach to thyroid nodules involves ultrasound-guided fine needle aspiration biopsy (US-FNAB). We especially aimed to evaluate the contribution and the place of US-FNAB in preoperative evaluation of the malignant cases and draw attention to discordant cases diagnosed with papillary thyroid microcarcinoma (PTMC). Materials and Methods: A total of 276 cases were retrospectively reviewed who were subsequently diagnosed with a malignancy and who underwent US-FNAB. Results: Some 45 were found to have previously undergone the US-FNAB procedure. Of the patients in whom the surgical specimen was diagnosed with a malignancy, 21 (46.7%) were diagnosed as malignant or suspicious for malignancy, and 24 (53.3%) were concluded as benign or insufficient for diagnosis. Patients with the diagnosis of PTMC outnumbering the others was a striking finding (11 cases, 24%). Conclusions: We suggest performing repeat aspiration biopsy considering sampling errors in cases where inconsistency exists between clinical findings and cytological results in thyroid nodules smaller than 10 mm in diameter and with suspicious findings on ultrasonography.

A Severe Hepatotoxicity by Antituberculosis Drug, and its Recovery in Oriental Hospital

  • Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.37 no.2
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    • pp.119-124
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    • 2016
  • Objectives: To demonstrate a clinical course and feature of a female patient with a severe liver injury (DILI) during antituberculosis treatment for her intestinal tuberculosis, whom traditional Korean medicine completely recovered. Methods: A female patient with diagnosed as DILI by antituberculosis drugs had been treated with herbal drugs; and then the clinical outcome and biochemical parameters had been monitored. Result: A 45-year old female had taken antituberculosis drugs for about 2 months, and complained severe abdominal discomfort and dyspepsia. The RUCAM score was 10, which met the criteria for DILI (AST 584 IU/L, ALT 1212 IU/L, ALP 100 IU/L, and GGT 161 IU/L, total bilirubin 0.9 mg/dL). She had been treated with herbal drugs and acupuncture as inpatient and outpatient, and then her symptoms had been completely recovered with normalization of hepatic enzymes. Conclusion: This report provides a clinical characteristic for a severe hepatotoxicity induced by antituberculosis drugs, and showed an example of TKM-based application.

Management of severe hidradenitis suppurativa with biologic therapy and wide excision

  • Lim, Shi Yu Derek;Cheong, Ee Cherk;Oon, Hazel H.
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.272-276
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    • 2019
  • Hidradenitis suppurativa (HS) is a chronic inflammatory follicular occlusive disease that involves the intertriginous areas. Treatment methods include conventional topical and systemic medication, radiotherapy, biologic agents, and surgical excision. Of late, there has been an increased focus on the use of biologic agents in patients with moderate to severe HS. Here, we present the case of a 46-year-old man with Hurley stage III HS for whom wide excision was ultimately curative, after aggressive medical therapy with the use of infliximab and adalimumab had succeeded in limiting the body surface area affected by the disease. This case demonstrates the effective treatment of severe HS with a combination of biologic therapy and surgery.

A Hybrid Intervention for Post-infarction Papillary Muscle Rupture with Severe Mitral Regurgitation: A Case Report

  • Nakamae, Kosuke;Oshitomi, Takashi;Uesugi, Hideyuki
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.239-242
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    • 2022
  • Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.

CSF Ascites Complicating Ventriculoperitoneal Shunting - A Case Report - (뇌실복강간 단락술의 합병증으로 생긴 뇌척수액 복수 - 증 례 보 고 -)

  • Lee, Byoung Hoi;Kang, Sung Don;Kim, Jong Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1345-1347
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    • 2001
  • Ventriculoperitoneal(VP) shunting has been associated with a variety of complications. CSF ascites secondary to VP shunting is very rare. We report a case of 68-year-old man with VP shunt in whom subclinical peritoneal infection presented with ascites. The patient was treated successfully with antibiotics and removal of the shunt. CSF ascites complicating VP shunt is reviewed and the pathogenesis of this condition is discussed.

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The Change of Derum and Urine Amylase Level Following Cardiopulmonary Bypass in the Patients with Congenital heart disease (선천성 심기형 환아에서 체외순환후 혈청 및 소변 Amylase치의 변화)

  • Baek, Hui-Jong;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.892-899
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    • 1995
  • Pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass. Although ischemia is believed to be a factor, the exact cause of pancreatitis after cardiopulmonary bypass remains unknown.We prospectively studied 67 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass for evaluation of the pancreatic injury after cardiopulmonary bypas. Serial measurement of amylase level in serum and urine was done postoperatively. Hyperamylasemia was detected in 15 patients[22.4% , of whom no patient had pancreatitis. There was no significant difference between serum amylase level and parameters such as cardiopulmonay bypass time, aortic cross clamp time, mean blood pressure, rectal temperature, flow rate, and use of circulatory arrest during cardiopulmonary bypass. Hyperamylasuria was detected in 8 patients[11.9% , and urine amylase level was elevated significantly in the groups with prolonged cardiopulmonary bypass, mean blood pressure more than 40mmHg, and rectal temperature more than 20 $^{\circ}$C. We recommend that serum amylase level and/or amylase-creatinine clearance ratio is measured for ealy detection and management of pancreatitis after cardiopulmonary bypass.

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