Background: The occurrence of type II endoleaks after endovascular repair of aortic aneurysm has gradually gained increasing attention. We present a case of a patient with an expanding aneurysm after thoracic endovascular aortic repair (TEVAR) for a type II endoleak, in which successful direct ligations of the intercostal artery were performed using a sac incision without cardiopulmonary bypass (CPB) or graft replacement.
Case Presentation: A 62-year-old male patient, previously treated with TEVAR for a descending thoracic aortic aneurysm, presented with ongoing chest discomfort.
Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is a lifesaving technique for patients experiencing respiratory failure. When VV ECMO fails to provide adequate support despite optimal settings, alternative strategies may be employed. One option is to add another venous cannula to increase venous drainage, while another is to insert an additional arterial return cannula to assist cardiac function.
View Article and Find Full Text PDFBackground: The optimal timing for surgery in infective endocarditis (IE) with hemorrhagic stroke and neurologic deficits is difficult to decide because of the risk of exacerbating the stroke and provoking intracranial hemorrhagic conversion after surgery using cardiopulmonary bypass (CPB). This retrospective study aimed to investigate the impact of the presence or absence of preoperative intracranial hemorrhage (ICH) on surgical outcomes in IE with recent stroke.
Methods: The medical records of all patients who underwent open heart surgery for active IE from February 2009 to December 2020 were retrospectively reviewed.
Hemolytic anemia after thoracic aortic surgery is rare. A 69-year-old female patient, who underwent ascending aorta replacement for acute type A aortic dissection 7 years ago, was transferred from another hospital due to hemolytic anemia necessitating regular blood transfusions. After engaging in interdisciplinary discussions, we ruled out alternative medical diagnoses and treatments, ultimately identifying the kinked aortic graft as the primary cause of hemolysis.
View Article and Find Full Text PDFImplantation of the left ventricular assist device (LVAD) has emerged as a widely employed therapeutic approach for specifically chosen individuals suffering from severe heart failure. Stroke is a well-known complication of LVAD implantation. Concomitant aortic surgeries in patients requiring LVAD implantation to avoid outflow graft anastomosis to a severe atherosclerotic aorta are unknown.
View Article and Find Full Text PDFGreat saphenous vein is a conduit commonly used for coronary artery bypass grafting. However, several complications could occur at leg wound site for vein harvesting. Here, we describe a huge sac of hematoma as an uncommon complication of saphenous vein harvest for coronary artery bypass grafting.
View Article and Find Full Text PDFThe purpose of this study is to develop and evaluate a self-microemulsifying drug delivery system (SMEDDS) to improve the oral absorption of poorly water-soluble olaparib. Through the solubility test of olaparib in various oils, surfactants and co-surfactants, pharmaceutical excipients were selected. Self-emulsifying regions were identified by mixing the selected materials at various ratios, and a pseudoternary phase diagram was constructed by synthesizing these results.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg
November 2023
Background: Granulomatous inflammation results from various causes including infections and allergic reactions. It can appear as high signal intensity in T2-weighted or contrast-enhanced T1-weighted magnetic resonance imaging (MRI). Here, we describe a case of granulomatous inflammation looking like a hematoma on an ascending aortic graft in MRI.
View Article and Find Full Text PDFBackground: This study aimed to introduce our robotic technique, which can minimize dissection extent using the da Vinci SP robotic system via hairline incision.
Methods: Forty patients underwent robotic thyroidectomy using the da Vinci SP robotic system via a hairline incision between February 2020 and April 2021 at Ulsan University Hospital. All procedures were performed successfully by one surgeon using the SP robotic system.
Background: Despite advances in surgical and postoperative care, myocardial injury or infarction (MI) is still a common complication in patients undergoing coronary artery bypass surgery (CABG). Several studies that aimed to reduce postoperative myocardial injury, including those investigating statin loading, have been conducted but did not indicate any clear benefits. Evolocumab, a PCSK9 inhibitor, has been reported to lower lipids and prevent ischemic events in various medical conditions.
View Article and Find Full Text PDFObjective: Postoperative delirium is known to have various adverse effects on head and neck surgery patients. This study was designed to identify possible risk factors of delirium following long periods of head and neck cancer surgery and to help prevent postoperative delirium.
Methods: We enrolled 197 patients who underwent long-time (>6 h) head and neck surgery at the Asan Medical Center from January 2017 to December 2018 in this study.
Pathology of the lumbar spine and hip joint can commonly coexist in the elderly. Anterior and lateral leg pain as symptoms of hip osteoarthritis and spinal stenosis can closely resemble each other, with only subtle differences in both history and physical examinations. It is not easy to identify the origin of this kind of hip pain.
View Article and Find Full Text PDFThe purpose of this study was to compare and to analyze contrast spread patterns between the paramedian and midline approaches to cervical interlaminar epidural injection (CIEI). We retrospectively enrolled 84 CIEI cases that had been performed for unilateral cervical spinal pain from April 2019 to April 2020. After 3 mL of contrast had been injected into the epidural space, fluoroscopic images were obtained.
View Article and Find Full Text PDFElderly patients with femoral fractures are anticipated to endure the most pain caused by positional changes required for spinal anesthesia. To improve pain relief, we compared the analgesic effects of intravenous dexmedetomidine-ketamine and dexmedetomidine-fentanyl combinations to facilitate patient positioning for spinal anesthesia in elderly patients with proximal femoral fractures. Forty-six patients were randomly assigned to two groups and received either 1 mg/kg of intravenous ketamine (group K) or 1 μg/kg of intravenous fentanyl (group F) concomitant with a loading dose of dexmedetomidine 1 μg/kg over 10 minutes, then dexmedetomidine infusion only was continued at 0.
View Article and Find Full Text PDFFipronil (FPN) is a widely used phenylpyrazole pesticide that can kill pests by blocking γ-aminobutyric acid (GABA)-gated chloride channels. In addition, there are lack of studies on the effects of FPN on the female mammalian gametes. In this study, porcine oocytes were used to investigate the effects of FPN on the oocyte maturation process.
View Article and Find Full Text PDFMammalian oocytes lack centrioles but can generate bipolar spindles using several different mechanisms. For example, mouse oocytes have acentriolar microtubule organization centers (MTOCs) that contain many components of the centrosome, and which initiate microtubule polymerization. On the contrary, human oocytes lack MTOCs and the Ran-mediated mechanisms may be responsible for spindle assembly.
View Article and Find Full Text PDFBackground: This study examined the risk factors of pharyngocutaneous fistula development and poor survival after salvage laryngectomy.
Methods: Binary logistic regression analyses were carried out to analyze the relationship between post-salvage fistula development and variables. Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate prognostic factors associated with disease-free survival (DFS) and overall survival (OS) after salvage laryngectomy.
Korean J Thorac Cardiovasc Surg
February 2019
Surgical management of interrupted aortic arch (IAA) with systemic outflow tract obstruction is clearly a challenge. If both ventricles are adequate, the Yasui operation is a useful option. Otherwise, a staged approach through initial hybrid palliation and delayed biventricular repair, tailored to the degree of obstructed outflow, serves to avoid a high-risk neonatal procedure.
View Article and Find Full Text PDFKorean J Anesthesiol
February 2020
Background: The prone position is used for a variety of procedures and surgeries, and hypotension is a commonly encountered complication.
Case: A 75-year-old obese woman with lumbar spinal stenosis underwent posterior lumbar spinal fusion and posterolateral interbody fusion under general anesthesia. Before the surgery, when she was positioned on a Jackson spinal table in the prone position, sudden severe hypotension and hemodynamic collapse developed.
Medicine (Baltimore)
December 2018
Background: Medical researchers have been reluctant to use neuromuscular blocking drugs (NMBD) during the use of intraoperative motor evoked potential (MEP) monitoring despite the possibility of patient movement. In this study, we compared the effects of no NMBD and continuous rocuronium infusion on the incidence of patient involuntary movement and MEP monitoring.
Methods: In this study, 80 patients who underwent neuro intervention with MEP monitoring were randomly assigned into 2 groups.
Thiamethoxam (TMX) is a neonicotinoid insecticide. It has specific high toxicity to insects. Residues of TMX have been detected in various crops.
View Article and Find Full Text PDF