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1.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 137-143, 2017.
Artículo en Inglés | WPRIM | ID: wpr-111255

RESUMEN

Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality. In the past decade, endovascular repair has become the preferred treatment because of its superior outcomes to open repair and medical therapy. The Valiant Captivia Thoracic Stent Graft System is a third-generation endovascular stent graft with advancements in minimally invasive delivery, conformability to the anatomy, and the minimization of adverse sequelae. Herein, this stent graft is briefly reviewed and its 3-year outcomes are presented. Freedom from all-cause and dissection-related mortality was 79.1% and 90.0%, respectively. The Valiant Captivia Stent Graft represents a safe, effective intervention for acute complicated TBAD. Continued surveillance is needed to verify its longer-term durability.


Asunto(s)
Humanos , Aneurisma de la Aorta Torácica , Rotura de la Aorta , Prótesis Vascular , Procedimientos Endovasculares , Extremidades , Libertad , Hipertensión , Mortalidad , Factores de Riesgo , Stents Metálicos Autoexpandibles
3.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 710-715, 2010.
Artículo en Coreano | WPRIM | ID: wpr-126404

RESUMEN

BACKGROUND: Video-assisted thoracic surgery (VATS) became common in the treatment of spontaneous pneumothorax (SP). Therefor we've reviewed the recurrence rate after VATS and analysed the factors affecting recurrent pneumothorax after VATS on this study. MATERIAL AND METHOD: This retrospective analysis was performed on 321 patients of SP who had undergone VATS from Jan. 2001 to Dec. 2008. The two goups were divided as follow: group A, non-recurrent group (298 patients: 93%); and group B, recurrent group (26 patients: 7%); the two groups were analysed retrospectively. RESULT: The average age of the study groups were 20.9+/-.3 years old in recurrent group vs. 25.9+/-1.7 years old in non-recurrent group with statistical significance (p<0.05). There were no statistical significance in male to female ratio, height/weight ratio, location of pneumothorax, smoking history, operative time, duration of drain, hospital stay, indication of opertion and incidence rate. Average length of duration in recurrence was 12.9 months. There was 22 (95.7%) recurrent patients after VATS within 4 year period among recurrent group. Treatment methods in 23 of recurrent patients were, 8 (VATS), 2 (Axillary thoracotomy) with 15% or more in amount of pneumothorax and 7 (7 Fr. chest tube), 6 (nasal O2) with 15% or less in amount of pneumothorax. Among 10 cases of reoperation, there were 3 cases of over looking type and 7 cases of new growing type. There was no additional recurrence after these procedures were given. CONCLUSION: There was higher recurrence rate in younger age after VATS thus for those under 20 yrs old, detailed and possible preoperative warning for recurrence is warranted. Most recurrence occured within 4 year period, thus for this reason, regular interval based follow up with chest x-ray study is suggested during this period.


Asunto(s)
Femenino , Humanos , Masculino , Estudios de Seguimiento , Incidencia , Tiempo de Internación , Tempo Operativo , Neumotórax , Recurrencia , Reoperación , Estudios Retrospectivos , Humo , Fumar , Cirugía Torácica Asistida por Video , Tórax
4.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 796-799, 2009.
Artículo en Coreano | WPRIM | ID: wpr-183040

RESUMEN

A 63 year-old woman visited our hospital with a palpable chest wall mass in the infrascapular region. We performed excision of the mass. The mass was histolocally diagnosed as elastofibroma. Elastofibroma is characterized by the proliferation of fibrous tissue with elastin. It is a relatively slow growing benign soft tissue tumor and it is most often found in the infrascapular region. We have experienced a cases of this rare disease and we report on it together with a review of the relevant literature.


Asunto(s)
Femenino , Humanos , Elastina , Enfermedades Raras , Pared Torácica , Tórax
5.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 41-45, 2009.
Artículo en Coreano | WPRIM | ID: wpr-85639

RESUMEN

BACKGROUND: Arteriovenous fistula formation is not always easy to perform in hemodialysis patients because of poor preservation of veins due to repeated venipuncture and cannulation. We analyzed the patency rate and complications of prosthetic arteriovenous fistulas using the vena comitantes as a venous outflow in the antecubital fossa, which are protected from venipuncture. MATERIAL AND METHOD: Between January 2006 and June 2008, 12 patients underwent prosthetic arteriovenous fistula formation using the vena comitantes as a venous outflow. Arterial inflow was via the brachial artery and the graft was placed in a loop fashion. The male-to-female ratio was 7:5 and the mean age was 59+/-14 years. Six patients had diabetes mellitus and 10 patients had hypertension. RESULT: There were no complications, such as a graft infection or bleeding. Five patients showed postoperative stenosis at an average of 3 months. The primary patency rate was 75.0, 65.6, and 52.2% at 3, 6, and 12 months, respectively. All the patients with stenosis were able to continue hemodialysis after intervention therapy. The secondary patency rate was 100% at 12 months. CONCLUSION: Creation of a prosthetic arteriovenous fistula using uninjured vena comitantes resulted in a good patency rate and this vein may become a substitute for inappropriate superficial veins.


Asunto(s)
Humanos , Fístula Arteriovenosa , Arteria Braquial , Cateterismo , Constricción Patológica , Diabetes Mellitus , Hemorragia , Hipertensión , Flebotomía , Diálisis Renal , Trasplantes , Venas
6.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 53-58, 2009.
Artículo en Coreano | WPRIM | ID: wpr-85637

RESUMEN

BACKGROUND: The goal of this study was to compare the patency and complications of femoropopliteal bypass with superficial femoral artery stenting for patients with atherosclerotic superficial femoral artery occlusive disease. MATERIAL AND METHOD: Between July 2005 and July 2008, we reviewed 29 femoropopliteal bypass procedures (24 patients) with prosthetic grafts (the bypass group) and 19 superficial femoral artery stentings (15 patients) with nitinol stent (the stent group). There were 35 male patients (89.7%) and the mean age of the patients was 69.2 years (range: 48~84). The number of patients who had DM, hypertension and a smoking history was 25 patients (64.1%), 17 patients (43.6%) and 30 patients (76.9%), respectively. 23 (59.0%) patients had skin ulceration or tissue gangrene at admission. RESULT: There were 27 cases (93.0%) of TASC C&D lesion in the bypass group and 16 cases (84.2%) of TASC A&B lesion in the stent group. There were significant differences for the indications for a procedure between the two groups (p<0.01). The primary patency rates at 6 months, 12 months and 24 months were 91.9%, 79.7% and 79.7% for the bypass group and 93.3%, 86.2% and 86.2% for the stent group, respectively. There were no statistical difference between the two groups (p=0.48). CONCLUSION: There were no significant differences in the outcome between two groups. TASC C&D lesion and failed intervention therapy should be treated with femoropopliteal bypass surgery, and TASC A&B lesion and the high-risk patients should be treated with femoral artery stent insertion.


Asunto(s)
Humanos , Masculino , Aleaciones , Aterosclerosis , Arteria Femoral , Gangrena , Hipertensión , Enfermedades Vasculares Periféricas , Úlcera Cutánea , Humo , Fumar , Stents , Trasplantes
7.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 79-86, 2009.
Artículo en Coreano | WPRIM | ID: wpr-85633

RESUMEN

BACKGROUND: BACKGROUND: Computed tomography (CT) is the main tool for detecting abnormalities of the thoracic aorta, but conventional CT only shows the cross-sectional images. These CT images have some limitations fo accuratly measuring the thoracic aortic diameters at various levels. Multidetector computed tomography (MDCT) overcomes these limitations. We measured the thoracic aortic diameter perpendicular to the loop-shaped thoracic aortic course and this was studied in relation to age, gender, height, weight, the body surface area, the body mass index and the presence of hypertension. MATERIAL AND METHOD: Thirty hundred thirty one patients (males: 141 patients and females: 190 patients) who had no abnormalities of the thoracic aorta were investigated using MDCT aortography. They were divided into three age categories: 20~39 years old, 40~59 years old and over age 60. The image was reformed with multiplanar reconstruction and the diameter of the aorta was measured perpendicular to the aortic course at 5 anatomic segments. Level A was the mid-ascending aorta, level B was the distal ascending aorta, level C was the aortic arch, level D was the aortic isthmus and level E was the mid-descending aorta. RESULT: The mean age was 49.5 years old for males and 54.9 years old for females (p<0.05). The mean diameter of the thoracic aorta at level A was 31.1 mm, that at level B was 30.2 mm, that at level C was 26.5 mm, that at level D was 24.0 mm and that at level E was 22.6 mm. The diameters at all the levels were gradually increased with age. Hypertensive patients had larger diameters than did the non-hypertensive population. There was a positive correlation between the ascending aortic diameter (levels A&B) and height and the body surface area, but there were no statistical differences at the aortic arch (level C) and the descending aorta (levels D&E). There were no statistical differences of the weight and body mass index at all levels. CONCLUSION: The diameters of the thoracic aortas were directly correlated with gender, age and hypertension. Height and the body surface area were only correlated with the ascending aorta. Weight and the body mass index have no statistical difference at all levels. We measured the age related thoracic aortic diameters and the upper normal limits and we provide this data as reference values for the thoracic aortic diameter in the Korean population.


Asunto(s)
Femenino , Humanos , Masculino , Angiografía , Aorta , Aorta Torácica , Aortografía , Índice de Masa Corporal , Superficie Corporal , Hipertensión , Tomografía Computarizada Multidetector , Valores de Referencia
8.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 100-103, 2009.
Artículo en Coreano | WPRIM | ID: wpr-85629

RESUMEN

Traumatic rupture of the thoracic aorta is the second most common cause of death from motor vehicle accidents after head injury. About 85% of these patients do not survive to reach the hospital. The most common mechanism for this is deceleration injury, as occurs in a high speed motor vehicle accident. The aortic isthmus is the site of disruption for about 95% of all blunt thoracic aortic injuries. Another mechanism is crush injury which causes compression of the aorta between the displaced sternal body or manubrium and the thoracic vertebral column. These forces tear the inner layer of the aortic wall at an unusual location. We report here on a case of aortic arch dissection where the injury clearly occurred due to a crush injury and not because of deceleration. The surgical repair was delayed for 10 days after administering intensive medical therapy. The ascending aorta and aortic arch were replaced with an artificial graft with the patient under circulatory arrest and cerebral protection.


Asunto(s)
Humanos , Aorta , Aorta Torácica , Rotura de la Aorta , Causas de Muerte , Traumatismos Craneocerebrales , Desaceleración , Manubrio , Vehículos a Motor , Rotura , Columna Vertebral , Trasplantes
9.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 653-656, 2009.
Artículo en Coreano | WPRIM | ID: wpr-72789

RESUMEN

The entrapment of the popliteal artery is a rare cause of ischemia of the lower extremities among young males. The development of local occlusive or aneurysmal changes of the popliteal artery is caused by abnormal anatomic relationships between vascular and musculo-tendinous structures in the popliteal fossa. An 18-year-old male visited our outpatient clinic with the chief complaint of claudication in his right calf. Three dimensional CT angiography showed an occlusion of the popliteal artery and less opacified arteries of the right leg. Intraoperatively, the popliteal artery was compressed by an accessory muscle band arising from the medial head of the gastrocnemius. After release of the muscle band, thrombectomy with endarterectomy was done. Three years after surgery, he is doing well without any problems.


Asunto(s)
Adolescente , Humanos , Masculino , Instituciones de Atención Ambulatoria , Aneurisma , Angiografía , Arterias , Endarterectomía , Cabeza , Isquemia , Pierna , Extremidad Inferior , Músculos , Arteria Poplítea , Trombectomía
10.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 649-652, 2009.
Artículo en Coreano | WPRIM | ID: wpr-54984

RESUMEN

A 75-year-old man presented with worsening dyspnea and intermittent dysphagia of one month's duration. A plain chest X-ray showed severe tracheal indentation by the right superior mediastinal mass. A chest CT established the diagnosis of a saccular aneurysm arising from the right proximal subclavian artery. Resection of the aneurysm and arterial revascularization was done through a median sternotomy with supraclavicular extension. Aneurysm wall and thrombus culture results were negative and pathology showed an atherosclerotic aneurysm. After the operation, dyspnea and dysphagia were reduced, but he died of advanced stomach cancer 8 months later.


Asunto(s)
Anciano , Humanos , Aneurisma , Arterias , Trastornos de Deglución , Disnea , Esternotomía , Neoplasias Gástricas , Arteria Subclavia , Tórax , Trombosis
11.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 109-113, 2007.
Artículo en Coreano | WPRIM | ID: wpr-198533

RESUMEN

BACKGROUND: In non-small cell lung cancer (NSCLC), malignant pleural effusion is a frequently observed complication, and is an important negative prognostic factor. Although many studies concerned to diagnosis and treatment of malignant pleural effusion have been performed, prognostic factors of malignant pleural effusion have rarely been investigated. This study was performed to determine the prognostic factors of malignant pleural effusion in non-small cell lung cancer. MATERIAL AND METHOD: We evaluated 33 NSCLC patients with malignant effusion treated between January 2002 and December 2003. We analyzed possible factors: gender, age, TNM Stage, fluid analysis (pH, CEA, LDH, glucose, albumin) and treatment modality. Median survival time of each factor was calculated by Kaplan-Meier method and difference of median survival time between groups of factor compared by log-rank test. The Cox proportional hazards regression model was used to confirm the significance of prognostic factor. RESULTS: Of the 33 patients, 23 (69.7%) patients were adenocarcinoma. The median interval of the diagnosis of lung cancer and malignant effusion was 7.3 months (25th~75th: 3.9~11.8), and the median survival time was 3.6 months (95% Confidence Interval: 1.14~5.99). In the univariate analysis, using the log-rank test, those with an adenocarcinoma showed a relatively longer median survival time than those of a non-adenocarcinoma (4.067 vs. 1.867 months, p=0.067) without statistical significance. In the multivariate analysis, using the Cox regression, those with a non- adenocarcinoma showed a trend of high risk of cancer death than those with an adenocarcinoma without statistical significance (Relative risk; 2.754, 95% CI; 0.988~7.672, p=0.053). CONCLUSION: We could not find an independent prognostic factor of malignant pleural effusion in NSCLC. As there was a trend of high risk of cancer death according to histology, further study will be needed.


Asunto(s)
Humanos , Adenocarcinoma , Carcinoma de Pulmón de Células no Pequeñas , Diagnóstico , Glucosa , Neoplasias Pulmonares , Análisis Multivariante , Derrame Pleural Maligno , Pronóstico
12.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 114-121, 2007.
Artículo en Coreano | WPRIM | ID: wpr-198532

RESUMEN

BACKGROUND: Apoptosis plays a crucial role in carcinogenesis, as well as in development and tissue homeostasis. Terminal deoxyribonucleotidyl transferase mediated neck end labelling (TUNEL) and in situ nick end labelling (ISEL) have been used to investigate the apoptosis in tissues. Since the introduction of the M30 monoclonal antibody to overcome drawbacks of TUNEL and ISEL, the apoptosis in various tumors, with the exception of pulmonary carcinomas, has been studied. In this study, attempts were made to examine the correlation of apoptosis in non-small cell carcinomas, using both M30 and the expression of p53 protein, with the clinicopathological factors. MATERIAL AND METHOD: Forty five patients with surgically resected non-small cell carcinomas were included. Immunohistochemical staining with M30 and p53 monoclonal antibody were performed, and their expressions compared with the clinicopathological features. The overall survival time and recurrence-free survival time were calculated, and the factors influencing the survival time analyzed using a univariate analysis. The effects of the expression stati of M30 and p53 on the risks of cancer related to both death and recurrence were evaluated using a multivariate analysis. RESULT: The p53 positive group had many more M30 positive cells than the p53 negative group (p53 positive group; 61.7+/-26.8 cells vs. p53 negative group; 45.6+/-29.6 cells, p=0.005) and significantly more p53 positive patients showing at least 10 positive cells (apoptotic index, AI > or =1) on M30 staining (p53 positive group; 52.4% [11/21] vs. p53 negative group 16.7% [4/24], p=0.025). In the univariate analysis, the survival times in relation to smoking (pack-year), performance status (PS) and AI showed significant differences. The multivariate analysis demonstrated the relative risk (R.R) of cancer death increased almost 7.5-fold (R.R 7.482; 95% CI 1.886~29.678; p=0.004) and the risk of recurrence almost 3.8-fold (R.R 3.795; 95% CI; 1.184~12.158; p=0.025) in the high AI (> or =1) compared to the low AI (<1) group. There was no prognostic effect of p53 expression on the survival time or risk of cancer death and recurrence. CONCLUSION: In non-small cell lung carcinomas, M30 immunohistochemistry was an excellent method for analyzing apoptosis; the high apoptotic index could be an adverse prognostic predictive factor.


Asunto(s)
Humanos , Apoptosis , Carcinogénesis , Muerte Celular , ADN Nucleotidilexotransferasa , Homeostasis , Inmunohistoquímica , Etiquetado Corte-Fin in Situ , Neoplasias Pulmonares , Pulmón , Análisis Multivariante , Cuello , Recurrencia , Humo , Fumar
13.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 122-127, 2007.
Artículo en Coreano | WPRIM | ID: wpr-198531

RESUMEN

BACKGROUND: Spontaneous pneumothorax is a common respiratory condition and has been postulated that it develops because of rupture of subpleural blebs. Although the morphology and ultrastructure of causative lesions are well known, the reason for rupture of sbupleural blebs is not absolutely clear. Broad consensus concerning the role of meteorological factors in spontaneous pneumothorax dose not exist. The aim of the study was to examine the influence of change of atmospheric pressure and temperature on the occurrence of spontaneous pneumothorax. MATERIAL AND METHOD: One hundred twenty eight consecutive spontaneous pnemothorax events that occurred between January 2003 and December 2004 were selected. Changes of meteorological factors of particular days from the day before for 5 consecutive days were calculated and compared between the days with pneumothorax occurrence (SP days) and the days without pneumothorax occurrence (Non SP days). The correation between change of pressure and temperature and the occurrence of SP was evaluated. RESULT: SP occurred on 117 days (16.0%) in the 2-year period. Although there was no significant differences in change of pressure factors prior 4 days of SP occurrence compare to the 4 days prior Non SP day, change of mean pressure was higher (+0.934 vs. -0.191hPa, RR 1.042, CI 1.003~1.082, p=0.033), and change of maximum pressure fall was lower (3.280 vs. 4.791 hPa, RR 1.051, CI 1.013~1.090, p=0.009) on the 4 days prior SP day. There were significant differences in change of temperature factors prior 2 days and the day of SP, Changes of mean temperature (-0.576 vs.+0.099 degrees C, RR 0.886, 95% CI 0.817~0.962, p=0.004) and maximum temperature rise (7.231 vs. 8.079 degrees C, RR 0.943 CI 0.896~0.993, p=0.027) were lower on the 2 days prior SP. But changes of mean temperature (0.533 vs. -0.103 degrees C, RR 1.141, CI 1.038~1.255, p=0.006) and maximum temperature rise (9.209 vs. 7.754 degrees C, RR 1.123, CI 1.061~1.190, p=0.000) were higher on the SP days. CONCLUSION: Change of atmospheric pressure and temperature seems to influence the chance of occurrence of SP. Meteorological phenomena that pressure rise 4 day prior to SP and following temperature fall and rise might explain the occurrence of SP. Further studies should be continued in the future.


Asunto(s)
Presión Atmosférica , Vesícula , Consenso , Conceptos Meteorológicos , Neumotórax , Rotura
14.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 376-381, 2006.
Artículo en Coreano | WPRIM | ID: wpr-69471

RESUMEN

BACKGROUND: The Ki-67 protein is a biomarker associated with cell proliferation and a valuable negative prognostic factor in non-small cell lung cancer. We investigated the Ki-67 protein expression in resected non-small cell lung cancer to evaluate the impact on clinicopathological characteristics and postoperative prognosis. MATERIAL AND METHOD: Using monoclonal antibody Ki-67, we immunohistochemically examined 38 surgically resected non-small cell lung cancers to determine Ki-67 Labeling Index (LI). We analysed the differences of clinicopathological characteristics and postoperative recurrence and survival between High Ki-67 Group (LI> or =20%) and Low Ki-67 Group (LI<20%). RESULT: The Ki-67 LIs were heterogenous and a mean values was 20.0+/-20.05%. There were no significant differences in age, sex, smoking, TNM stage, and vascular invasion between High Ki-67 Group and Low Ki-67 Group. A High Ki-67 Group was significantly associated with squamous cell type, poor differentiation, and lymphatic invasion (p< or =0.05). High Ki-67 Group showed a trend of lower survival (median 47.2 vs. 96.5 months, p=0.312) and lower disease-free survival (median 18.2 vs. 72.3 months, p=0.327) than Low Ki-67 Group. CONCLUSION: These results indicate that increased Ki-67 protein expression may be a negative prognostic factor and showed a trend of shortened survival and disease-free survival. To evaluate the pivotal role of Ki-67 protein expression, a long-term follow-up and further study are required.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Proliferación Celular , Supervivencia sin Enfermedad , Estudios de Seguimiento , Inmunohistoquímica , Neoplasias Pulmonares , Pulmón , Pronóstico , Recurrencia , Humo , Fumar
15.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 245-248, 2005.
Artículo en Coreano | WPRIM | ID: wpr-205027

RESUMEN

Drugs containing ergotamine are widely used in the treatment of migraine. Spastic vasoconstriction is one of the most serious side effects even with recommended dosage. We report a case of 63-year-old male with severe arterial occlusion of the upper limbs which might be related with vasospasm caused by ergotamine-containing medication because of migraine for 15 years. He was treated with bypass graft, sympathicotomy and heparin and prostaglandin E1 infusion. But dramatic clinical reversal of the vasospasm was obtained after withdrawal of ergotamine.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Alprostadil , Ergotamina , Heparina , Trastornos Migrañosos , Espasticidad Muscular , Enfermedades Vasculares Periféricas , Trasplantes , Extremidad Superior , Vasoconstricción
16.
Yonsei Medical Journal ; : 66-72, 2005.
Artículo en Inglés | WPRIM | ID: wpr-35931

RESUMEN

The optimal perioperative anticoagulation management in patients on warfarin therapy is poorly defined due to the lack of randomized trials. Because guidelines are heterogeneous, it was hypothesized that "treatment strategies are not uniform in clinical practice". Between February 2003 and May 2003, a questionnaire with 4 different clinical scenarios was distributed to physicians by e-mail, or direct contact was made by a survey monitor. Two scenarios described the cases of patients with a mechanical heart valve (MHV) in the mitral position, with additional risk factors for a systemic embolism; one undergoing major (scenario 1) and the other minor surgery (scenario 3). Two scenarios described patients with an aortic MHV; one undergoing major (scenario 2) and the other minor (scenario 4) surgery. Different preoperative and postoperative management options were offered. The treatment options for all scenarios were the same. Of the 90 questionnaires distributed, 52 (57.8%) were returned. Hospitalization for full-dose intravenous unfractionated heparin (IV UH) was the most commonly selected strategy in the preoperative phase for scenarios 1 (59%), 2 (42%) and 3 (44%). In scenario 4, 34% chose IV UH. Outpatient, full- dose, subcutaneous UH or low-molecular-weight heparin (LMWH) was the most selected option in the postoperative phase for all scenarios, with the exception of number 4 (52.9% in scenario 1, 34% in scenario 2, 32%, in scenario 3 and 28% in scenario 4). Even among expert clinicians, the management of perioperative anticoagulation is heterogeneous. In particular, the definition of risk categories and the optimal intensity of antithrombotic drugs need to be defined by well-designed prospective studies.


Asunto(s)
Humanos , Anticoagulantes/uso terapéutico , Encuestas de Atención de la Salud , Prótesis Valvulares Cardíacas , Corea (Geográfico)/epidemiología , Atención Perioperativa/métodos , Médicos , Factores de Riesgo , Trombosis/epidemiología , Warfarina/uso terapéutico
17.
Journal of the Korean Radiological Society ; : 113-116, 2005.
Artículo en Inglés | WPRIM | ID: wpr-22266

RESUMEN

Pulmonary arteriovenous malformation (PAVM) is an abnormal direct communication between the pulmonary arteries and veins without any capillary network. The patients may be completely asymptomatic or may they develop serious complications including hemoptysis and brain abscess. We present here a case of incidentally found PAVM in a 33-year-old male who underwent embolization using platinum coils. Coil embolization is a safe, highly effective procedure that should be considered more often for the treatment of PAVM.


Asunto(s)
Adulto , Humanos , Masculino , Malformaciones Arteriovenosas , Absceso Encefálico , Capilares , Embolización Terapéutica , Hemoptisis , Platino (Metal) , Arteria Pulmonar , Venas
18.
Korean Circulation Journal ; : 911-916, 2002.
Artículo en Coreano | WPRIM | ID: wpr-187921

RESUMEN

The treatment of a thoracic aortic dissection is guided by prognostic and anatomical information. Stanford type A aortic dissection requires surgery, but the appropriate treatment of a Stanford type B aortic dissection has not been determined, especially in patients with visceral artery compromise associated with the aortic dissection due to the failure of surgery to improve the prognosis.We report a case of a 35-year-old man, with a Stanford type B aortic dissection, where the superior mesenteric artery was obstructed. This condition was successfully treated with stents inserted at the origin of the artery.


Asunto(s)
Adulto , Humanos , Arterias , Arteria Mesentérica Superior , Stents
19.
Korean Journal of Gastrointestinal Endoscopy ; : 438-442, 2002.
Artículo en Coreano | WPRIM | ID: wpr-47205

RESUMEN

BACKGROUND/AIMS: The precancerous lesion of colorectal cancer is adenoma. Adenoma with high grade dysplasia has been known as the lesion having high malignant potentials. The cancer with invasion to mucosa is limted to the mucosa, and it is difficult to pathologically differentiate the adenoma with high grade dysplasia. METHODS: Fifty three adenomas with high grade dysplasia (type I group) and 40 cancers with invasion to mucosa (type II group) for 4 years, were analyzed for the colonoscopic findings and pathological findings before and after EMR. RESULTS: Mean ages were 57.0 years old for type I group and 60.4 for type II group. Chief complaint for colonoscopy was rectal bleeding (21.0%) for type I group, and rectal bleeding (35.0%) for type II group. Mean sizes of the lesions were 1.18 cm for type I group, and 1.71 cm for type II group. Locations of the lesion were rectum 43.4%, sigmoid colon 32.1%, proximal colon 24.5% for type I group, and rectum 45.7%, sigmoid colon 42.9%, proximal colon 11.4% for type II group. Shapes of the lesions were Is 46.9%, Ip 30.6%, Isp 18.4%, LST 4.1% for type I group, and Isp 34.2%, Ip 31.6%, Is 18.4%, LST 5%, IIa depression 5%, Is+IIc 5% for type II group. Methods for therapy were EMR 60.4%, operation 1.9%, electrocoagulation 11.3%, observation 26.4% for type I group, and EMR 85.0%, operation 15.0% for type II group. Pathological agreement before and after EMR was 57.1% for type I group and 31.3% for type II group. CONCLUSIONS: Type II group had more rectal bleeding, larger, more Isp type, more EMR therapy, more pathological disagreement ratio before and after EMR, than type I group.


Asunto(s)
Adenoma , Colon , Colon Sigmoide , Colonoscopía , Neoplasias Colorrectales , Depresión , Electrocoagulación , Hemorragia , Membrana Mucosa , Recto
20.
Korean Journal of Gastrointestinal Endoscopy ; : 21-26, 2001.
Artículo en Coreano | WPRIM | ID: wpr-166802

RESUMEN

BACKGROUND/AIMS: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. METHODS: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy. By spraying 0.2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. RESULTS: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/18), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening 80% (8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). CONCLUSIONS: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity.


Asunto(s)
Humanos , Colitis , Colitis Ulcerosa , Colon , Colonoscopía , Diagnóstico , Disentería Amebiana , Carmin de Índigo , Enfermedades Inflamatorias del Intestino , Membrana Mucosa , Patología , Úlcera
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