A 69-year-old male was admitted for dyspnea and chest pain. The patient had undergone coronary artery bypass graft surgery and tube thoracostomy three years ago. The chest radiograph showed pleural effusion, which was drained using a percutaneous catheter with CT guidance. However, residual pneumothorax was observed four days later. Despite insertion of the 12 Fr trocar-type tube, pneumothorax did not improve and air leaks were observed. Chest CT showed that the tube was placed in the left main bronchus. After removal of the tube, the patient recovered uneventfully from pulmonary hemorrhage and bronchial perforation without complications.
Aged ; Bronchi ; Catheters* ; Chest Pain ; Coronary Artery Bypass ; Dyspnea ; Hemorrhage ; Humans ; Iatrogenic Disease ; Male ; Pleural Effusion ; Pneumothorax ; Radiography, Thoracic ; Thoracostomy* ; Tomography, X-Ray Computed ; Transplants

A 67-year-old female presented to the emergency department with complaints of dyspnea and chest wall pain after a fall from a cultivator. Initial chest CT showed multiple left rib fractures, a loculated hematoma without active bleeding, and hemothorax. On the third day of admission, the chest X-ray showed an abrupt aggravation of haziness and the chest CT showed that the size of the hematoma had increased with active bleeding from the pulmonary artery. In cases of loculated hematomas adjacent to the hilum on CT scan, the diagnosis of pulmonary artery injury should be considered.
Aged ; Delayed Diagnosis* ; Diagnosis ; Dyspnea ; Emergency Service, Hospital ; Female ; Hematoma ; Hemorrhage ; Hemothorax ; Humans ; Lung* ; Pulmonary Artery* ; Rib Fractures ; Thoracic Wall ; Thorax ; Tomography, X-Ray Computed

No abstract available.
Neutrophils*

This report describes clinical cases of a palato-gingival groove on a maxillary lateral incisor with associated localized periodontal disease and pulp necrosis. The tooth of the first case was extracted because of severe bone destruction. The palato-gingival groove of the second case was eliminated using a round bur, and the resulting defect was filled with synthetic graft and covered by an absorbable membrane. Both diagnosis and treatment of palato-gingival groove were very difficult and usually extraction of the involved tooth is the treatment of choice, but combined endodontic-periodontic treatment allowed the tooth to be saved.
Dental Pulp Necrosis ; Diagnosis ; Incisor* ; Membranes ; Periodontal Diseases ; Tooth ; Transplants

PURPOSE:To compare the diameter of central retinal vessels between patients with normal-tension glaucoma, primary open-angle glaucoma and healthy (control) eyes. METHODS: The authors reviewed 30 eyes of 30 normal-tension glaucoma patients, 20 eyes of 20 primary open-angle glaucoma patients and 30 eyes of normal persons who had no systemic vascular diseases. The diameters of the central retinal arteries and veins were measured and calculated using a revised Parr-Hubbard formula, and results were compared between the groups. RESULTS: The diameter of the central retinal vessel showed no statistical differences between the eyes with normal-tension glaucoma and primary-open angle glaucoma. However, there were significant differences between the eyes of patients with glaucoma and the normal control eyes (p<0.05). Conclusion: The diameter of the central retinal vessels in glaucoma patients were narrower than that in the control group. Our results suggest that the diameter of the central retinal vessels may affect the development of glaucoma both in normal tension and primary open-angle types, or that glaucomatous damage may influence the diameter of the central retinal vessels.
Eye ; Glaucoma ; Glaucoma, Open-Angle ; Glycosaminoglycans ; Humans ; Low Tension Glaucoma ; Retinal Artery ; Retinal Vessels ; Retinaldehyde ; Vascular Diseases ; Veins

PURPOSE: To evaluate the outcome following Ahmed valve implantation in patients who developed flat anterior chamber. METHODS: The authors reviewed 60 eyes of 60 patients who underwent Ahmed valve implantation and divided these patients into the flat anterior chamber group (18 eyes) and the control group (42 eyes). The influence of clinical variables on the development of flat anterior chamber and the effect of flat anterior chamber on the success of Ahmed valve implantation were evaluated. RESULTS: The preoperative intraocular pressure, age, and the incidence of neovascular glaucoma as a preoperative diagnosis were higher in the flat anterior chamber group than in the control group (p<0.05). The overall success rates for the mean follow-up period of 12 months were similar between the two groups (p>0.05). CONCLUSIONS: The development of a flat anterior chamber after Ahmed valve implantation appeared not to affect the outcome of the surgery.
Anterior Chamber ; Eye ; Follow-Up Studies ; Glaucoma, Neovascular ; Humans ; Incidence ; Intraocular Pressure

Aplasia cutis congenita is a congenital localized or widespread absence of the skin. We report a case of aplasia cutis congenita, type V, in a 6-day-old male infant born with the stellate and linear skin lesions covered by granulation tissue and soft capsule with slightly elevated erythematous edges on the trunk and lower extremities without any associated family history. The patient had amniotic bands and were diagnosed as aplasia cutis, type V. The patient received conservative treatment such as antiseptic dressing and prophylactic systemic antibiotics with healing of the ulcer.
Amniotic Band Syndrome ; Anti-Bacterial Agents ; Bandages ; Ectodermal Dysplasia* ; Granulation Tissue ; Humans ; Infant ; Infant, Newborn ; Lower Extremity ; Male ; Skin ; Ulcer

BACKGROUND: Maintenance of adequate vascular access for hemodialysis is important in patients with end-stage renal disease. Once arteriovenous fistula (AVF) occlusion occurs, the patient should be treated with rescue therapy. This study was performed to evaluate the results of a rescue therapy for AVF occlusion. METHODS: From January 2008 to December 2012, 47 patients who underwent surgical rescue therapy for AVF occlusion after graft AVF formation, were enrolled in this study. The patients were divided into two groups, namely the graft repair group (group A, n=19) and the thrombectomy group (group B, n=28). Postoperative results of both groups were analyzed retrospectively. RESULTS: There were no statistically significant differences in the clinical characteristics between the two groups. In terms of the duration of AVF patency after the first rescue therapy, group A showed a longer AVF patency duration than group B (24.5+/-21.9 months versus 17.7+/-13.6 months), but there was no statistically significant difference (p=0.310). In terms of the annual frequency of AVF occlusion after the rescue therapy of group A was lower than that of group B (0.59 versus 0.71), but there was no statistically significant difference (p=0.540). The AVF patency rates at 1, 2, 3, and 5 years after the first rescue therapy in group A were 52.6%, 31.5%, 21.0%, and 15.7%, respectively, and those in group B, they were 32.1%, 25.0%, 17.8%, and 7.14%, respectively. There was no statistically significant difference (p=0.402). CONCLUSION: Graft repair revealed comparable results. Although there was no statistically significant difference, the patent duration and annual frequency of AVF occlusion of group A were better than those of group B. Therefore, graft repair is considered as a safe and useful procedure for maintaining graft AVF.
Arteriovenous Fistula* ; Humans ; Kidney Failure, Chronic ; Psychotherapy, Group ; Renal Dialysis* ; Retrospective Studies ; Thrombectomy ; Transplants*

Extracorporeal life support (ECLS) has well demonstrated its efficacy in treating in-hospital cardiac arrest and is being used for broader indications. However, ECLS after prolonged cardiopulmonary resuscitation (CPR) has been traditionally contraindicated and is now challenging. Here, we introduce two cases of successful ECLS after prolonged CPR, resulting in a immediate and full recovery. Both these acute ST elevation myocardial infarction patients waiting for primary percutaneous coronary intervention (PCI) suddenly collapsed due to ventricular fibrillation (VF), which was refractory to conventional treatment. After 2 hours of conventional CPR, the ECLS had been implemented and primary PCI could be performed. Subsequent to successful revascularization, the VF was stopped with a single electric shock. In our second case, normal sinus rhythm was spontaneously restored after ECLS implementation, which was completed after 45 minutes of conventional resuscitation. Both patients made a full neurological recovery on the day of the event and were discharged with only minor complications.
Cardiopulmonary Resuscitation ; Extracorporeal Membrane Oxygenation ; Heart Arrest ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Resuscitation ; Shock ; Ventricular Fibrillation

Delayed massive hemothorax requiring surgery is relatively uncommon and can potentially be life-threatening. Here, we aimed to describe the nature and cause of delayed massive hemothorax requiring immediate surgery. Over 5 years, 1,278 consecutive patients were admitted after blunt trauma. Delayed hemothorax is defined as presenting with a follow-up chest radiograph and computed tomography showing blunting or effusion. A massive hemothorax is defined as blood drainage >1,500 mL after closed thoracostomy and continuous bleeding at 200 mL/hr for at least four hours. Five patients were identified all requiring emergency surgery. Delayed massive hemothorax presented 63.6±21.3 hours after blunt chest trauma. All patients had superficial diaphragmatic lacerations caused by the sharp edge of a broken rib. The mean preoperative chest tube drainage was 3,126±463 mL. We emphasize the high-risk of massive hemothorax in patients who have a broken rib with sharp edges.
Chest Tubes ; Diaphragm* ; Drainage ; Emergencies ; Follow-Up Studies ; Hemorrhage ; Hemothorax* ; Humans ; Lacerations ; Radiography, Thoracic ; Rib Fractures* ; Ribs* ; Thoracic Injuries ; Thoracostomy ; Thorax