RESUMEN
BACKGROUND: Pulsatile pumps for extracorporeal circulation have been known to be better for tissue perfusion than non-pulsatile pumps but be detrimental to blood corpuscles. This study is intended to examine the risks and benefits of T-PLS(TM) through the comparison of clinical effects of T-PLS(TM) (pulsatile pump) and Bio-pump(TM) (non-pulsatile pump) used for coronary bypass surgery. MATERIAL AND METHOD: The comparison was made on 40 patients who had coronary bypass using T-PLS(TM) and Bio-pump(TM) (20 patients for each) from April 2003 to June 2005. All of the surgeries were operated on pump beating coronary artery bypass graft using cardiopulmonary extra-corporeal circulation. Risk factors before surgery and the condition during surgery and the results were compared. RESULT: There was no significant difference in age, gender ratio, and risk factors before surgery such as history of diabetes, hypertension, smoking, obstructive pulmonary disease, coronary infarction, and renal failure between the two groups. Surgery duration, hours of heart-lung machine operation, used shunt and grafted coronary branch were little different between the two groups. The two groups had a similar level of systolic arterial pressure, diastolic arterial pressure and mean arterial pressure, but pulse pressure was measured higher in the group with T-PLS(TM) (46+/-15 mmHg in T-PLS(TM) vs 35+/-13 mmHg in Bio-pump(TM), p<0.05). The T-PLS(TM)-operated patients tended to produce more urine volume during surgery, but the difference was not statistically significant (9.7+/-3.9 cc/min in T-PLS(TM) vs 8.9+/-3.6 cc/min in Bio-pump(TM), p=0.20). There was no significant difference in mean duration of respirator usage and 24-hour blood loss after surgery between the two groups. Plasma free Hb was measured lower in the group with T-PLS(TM) (24.5+/-21.7 mg/dL in T-PLS(TM) versus 46.8+/-23.0 mg/dL in Bio-pump(TM), p<0.05). There was no significant difference in coronary infarction, arrhythmia, renal failure and morbidity rate of cerebrovascular disease. There was a case of death after surgery (death rate of 5%) in the group tested with T-PLS(TM), but the death rate was not statistically significant. CONCLUSION: Coronary bypass was operated with T-PLS(TM) (Pulsatile flow pump) using a heart-lung machine. There was no unexpected event caused by mechanical error during surgery, and the clinical process of the surgery was the same as the surgery for which Bio-pump(TM) was used. In addition, T-PLS(TM) used surgery was found to be less detrimental to blood corpuscles than the pulsatile flow has been known to be. Authors of this study could confirm the safety of T-PLS(TM).
Asunto(s)
Humanos , Arritmias Cardíacas , Presión Arterial , Células Sanguíneas , Presión Sanguínea , Puente Cardiopulmonar , Puente de Arteria Coronaria , Circulación Extracorporea , Máquina Corazón-Pulmón , Hipertensión , Infarto , Enfermedades Pulmonares Obstructivas , Mortalidad , Perfusión , Plasma , Flujo Pulsátil , Insuficiencia Renal , Medición de Riesgo , Factores de Riesgo , Humo , Fumar , Trasplantes , Ventiladores MecánicosRESUMEN
Central venous stenosis or occlusion is a serious complication in end-stage renal disease patients undergoing maintenance hemodialysis. It is mostly secondary to trauma caused by temporary or permanent hemodialysis catheter placement. Venous hypertension may cause pain, edema of the ipsilateral arm and increased venous pressure prevents acceptable flow rates during dialysis. Venous bypass to the internal jugular vein, the external jugular vein, or axillary vein to saphenous vein bypass have been described as alternative options of surgical management. Our patients underwent internal jugular vein bypass. We think it is an effective and low risk surgical option.
Asunto(s)
Humanos , Brazo , Vena Axilar , Catéteres , Constricción Patológica , Diálisis , Edema , Hipertensión , Venas Yugulares , Fallo Renal Crónico , Diálisis Renal , Vena Safena , Venas , Presión VenosaRESUMEN
A 46-year-old man who had been diagnosed with esophageal tumor by PET-CT was admitted to our hospital for operation. Preoperative examination and intraoperative findings showed leiomyoma-like lesion and enucleation was done, but an immunohistochemical test on the case found gastrointestinal stromal tumor (GISTs). GISTs are very rarely found in the esophagus. As GISTs differ from leiomyoma pathogenetically and clinically, different treatments and follow-up strategies are required. The patient is under continuous observation to check recurrence and metastasis.
Asunto(s)
Humanos , Persona de Mediana Edad , Neoplasias Esofágicas , Esófago , Estudios de Seguimiento , Enfermedades Gastrointestinales , Tumores del Estroma Gastrointestinal , Leiomioma , Metástasis de la Neoplasia , RecurrenciaRESUMEN
Chondromyxoid fibroma (CMF) is a rare, benign tumor of the bone that represents fewer than 2% of all benign tumors of bone. CMF is most often found in the long tubular bones, especially the tibia and femur near the knee joint. Less common sites included the pelvis, fibula, calcaneus and rib. A 54-year-old male patient presented to us with history of swelling and mild, intermittent local pain without any rise in overlying skin temperature in lateral portion of left 7th rib for one-month duration, which was diagnosed as benign rib tumor by plain chest X-ray and CT scan, and treated successfully by excision of rib with good result. Pathologic diagnosis of this tumor was CMF. Without any medical therapy, there was no evidence of recurrence after operation. We report this case and follow-up of the patient.