• Title/Summary/Keyword: 고식적치료

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A Case of Bronchiolitis Obliterans Organizing Pneumonia After Thoracotomy (개흉술후 발생한 Bronchiolitis Obliterans Organizing Pneumonia 체험 1례)

  • 원경준;박종호;백희종;이향림;조재일
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.1040-1043
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    • 1997
  • We report a patient who suffered from bronchiolitis obliterans organizing pneumonia(BOOP) after Ivor Lewis operation for esophageal cancer. The patient presented low grade fever, dry cough and mild dyspnea at day after operation. Chest roentgenograms and chest CT revealed bilateral patchy and infiltrative shadows. The respiratory symptoms worsened and respiratory failure developed with mild elevation of WBC count despite of conservative treatment. An open lung biopsy was done and the biopsy specimen showed bronchiolitis obliterans organizing pneumonia(BOOP). After several weeks of steroid therapy, there were marked clinical, physiological and roentgenographic improvements. Our experience suggests that BOOP may be one of the underlying pathology in a number of patients presenting with ARDS after thoracotomy. Since steroid therapy may improve survival in these patients, thoracic surgeons should heighten their index of suspicion for this entity. Early histologic diagnosis should be considered in patients with treatment-resistant ARDS after thoracotomy.

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Arthroscopic Treatment of Calcific Tendinitis of the Rotator Cuff (회전근 개 석회화 건염의 관절경적 치료)

  • Lee Kwang-Won;Ryu Chang-Soo;Kim Ha-Yong;Kim Byung-Sung;Choy Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.27-31
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    • 2001
  • Purpose : The purpose of this study was to evaluate results of the arthroscopic treatment of calcific tendinitis of the shoulder resistant to conservative treatment. Materials and Methods : From March, 1996 to June, 1998, fourteen patients underwent shoulder arthroscopy to treat resistant calcific tendinitis of the rotator cuff despite conservative treatment for more than 6 months. Calcium deposits were localized to the supraspinatus tendon only in eleven patients, the supraspinatus and infraspinatus tendon in two patients, and to the supraspinatus and subscapularis tendon in one patient. Each shoulder was evaluated with UCLA shoulder rating scale and Constant-Murley score Results : The Constant-Murley pain score improved from average score 3.2 before surgery to average score 8.3 after surgery, and the UCLA functional average score improved from 4.5 preoperatively to 8.3 postoperatively. Preoperative ROM averaged $110^{\circ}$ of flexion, $45^{\circ}$ of external rotation, $90^{\circ}$ of abduction, and internal rotation with the thumb reaching to the spinous process of the third lumbar vertebra, but postoperative range of motion averages improved as follows: $170^{\circ}$ or flexion, $50^{\circ}$ of external rotation, $140^{\circ}$ abduction, and internal rotation with the spinous process of the twelveth thoracic vertebra. Overall 3 patients were rated excellentm 9 were good, 2 were fair. Conclusion : Shoulder arthroscopy is an effective treatment in patients with refractory calcific tendinitis.

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A Case of Long-term Survival of Metastatic Pancreatic Cancer (전이성 췌장암 환자의 장기 생존 1예)

  • Jin Sil Pyo;Yong Woo Choi;Hoon Sup Koo;Kyung Ho Song;Yong Seok Kim;Sun Moon Kim;Tae Hee Lee;Kyu Chan Huh;Young Woo Kang
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.72-74
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    • 2014
  • Pancreatic cancer is well known to have a poor prognosis and poor responses to both of chemotherapy and radiation therapy. We report a metastatic pancreatic cancer treated successfully with chemotherapy and radiation therapy. A 71-year-old female with epigastric pain and weight loss was diagnosed as advanced pancreatic cancer with main vessels invasion and multiple mesenteric lymph node's metastasis. She was taken chemotherapy of gemcitabine single regimen and radiation therapy. Although she experienced one recurrence and concomitant primary lung cancer, she has survived for over 7 years with no symptoms. The authors report this case of long term survival in metastatic pancreatic cancer after chemoradiation therapy.

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Lung Cancer Presenting as Spontaneous Pneumothorax (자연기흉에 동반된 폐암의 수술치험 1예)

  • 이승훈;안용찬;한정호;김진국
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.535-538
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    • 2003
  • Spontaneous pneumothorax accompanying primary lung cancer is rare and its occurrence as an initial sign of primary lung cancer is much rarer. A few articles on spontaneous pneumothorax accompanying lung cancer have been published in Korea so far. Lung cancers, diagnosed after spontaneous pneumothorax, are usually in advanced stage, so that conservative treatment modalities such as closed tube thoracostomy, chemotherapy, or radiotherapy are the mainstream of the treatment. We experienced a case of local recurrence of primary lung cancer in six months after radical resection and radiotherapy of neoplasm performed immediately after the diagnosis by excisional biopsy of bulla, for which resection and pleurodesis had been done under the impression of spontaneous pneumothorax. In this paper, we report the case and follow-up observation of the patient.

Absent Pulmonary Valve with Intact Ventricular Septum, PDA. ASD (온전한 심실중격을 가진 폐동맥판막무형성증, 동맥관개존, 심방중격결손의 수술치험 1례)

  • 유지훈;박계현;이영탁;박표원;전태국
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.590-593
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    • 2002
  • Absent pulmonary valve syndrome with intact ventricular septum(APVS with IVS) is a rare congenital anomaly. The severe form of this syndrome, characterized by severe respiratory distress presented soon after birth, has been attributed to the compression of the airways caused by aneurysmal dilatation of pulmonary artery. Several operative treatments such as pulmonary valve insertion, or reductive angioplasty of pulmonary artery have been applied. We present a 3-day-old male who showed improvement after PDA ligation, reductive angioplasty of pulmonary artery, pulmonary valve reconstruction, and ASD closure.

A Comparison of Continuous Intravenous Infusion and Traditional Intramuscular Injection for Postoperative Pain following Cesarean Section (제왕절개술후 통증치료로 지속적 정주방법과 고식적 근주방법의 비교)

  • Cho, Yung-Lae
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.374-379
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    • 1996
  • Background: Recently, improvements in drug administration technology have intensified interest in the treatment of postoperative pain. this has resulted in increased use of continuous intravenous infusion of opioid and epidural opioid as alternative to traditional intramuscular administration of opioid. The goal of this study, therefore, was to document the effects of pain control and side effects following continuous intravenous infusion of morphine or meperidine and intramuscular meperidine following cesarean section. Methods: The vital signs, pain score, oxygen saturation and side effects were compared in 150 patients receiving continuous intravenous infusion of morphine, 30 ${\mu}g/kg/hr$ (n=50, group 1); continuous intravenous infusion of meperidine, 150 ${\mu}g/kg/hr$ (n=50, group 2); or intramuscular meperidine, 50mg/every 6hrs (n=50, group 3). Results: VAS (Visual Analogue Scale) was significantly decreased after 30 minutes of administration in all three groups and was significantly lower at 1 hour, but higher at 6 hours in group 3 than two other groups. Severe desaturation episode, defined as $SpO_2$<90%, occurred in the group 3(0.2%). Moderate desaturation episodes, defined as $SpO_2$ 91~95%, occurred more in group 3 than in group 1 and 2 (17.4% vs. 10.4%, 8.2%). The incidence of side effects were similar among three groups. Conclusion: The continuous infusion of opioid was more effective and safe method of postoperative pain control than traditional intramuscular injection.

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Role of Interventional Managements for Malignant Colorectal Obstruction (소화관 폐색을 동반한 대장암 환자에서 중재적 치료의 역할)

  • Eun Soo Kim
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.1-5
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    • 2013
  • Incidence of colorectal cancer has been increasing in Korea probably due to the westernized life style. Although the technical development of colonoscopy and introduction of screening examination has led to the detection of early colorectal cancer, considerable patients still have clinical symptoms of colorectal obstruction. Most of these patients are old and they have advances stage of cancer or severe co-morbidities. In addition, the emergency operation under poor preparation state of colon can lead to serious mortality or complications. Since the introduction of colorectal stent, there have been a large number of studies for recent 10 years. It seems that the role of colorectal stent in the palliative indication or bridge to surgery has been recognized. A well designed, randomized prospective study with long term data is necessary to support the role of colorectal stent in the malignant colorectal obstruction.

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Reconstruction of Distal Radius Using Ultrahigh Molecular Weight Polyethylene Liner after Excision of Giant Cell Tumor - A Case Report - (원위 요골에 발생한 거대 세포종의 일괄 절제 후 초고분자량 폴리에틸렌 삽입물을 이용한 재건술 - 증례보고 -)

  • Jeon, Dae-Geun;Song, Won-Seok;Oh, Jung-Moon
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.29-33
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    • 2004
  • A giant cell tumor (GCT) of the distal radius is not common. Curettage with bone cementation is considered as a treatment of choice but, in the case of recurrence, marked cortical disruption, or articular invasion, en bloc excision and reconstruction with proximal fibular bone graft is usual procedure. In reconstruction of en bloc resected distal radius which had recurred GCT after conservative operation, we used the ultrahigh molecular weight polyethylene (UHMWPE) liner with intramedullary rod and bone cement, because the contamination was extent in previous operation and recurrence after fibular bone graft was fearful. This article introduce our new surgical procedure.

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Usefulness of High Resolution MRI in Confirmation of Mechanism:A Case Report (척추동맥폐색의 기전 확인에서 고해상도MRI의 유용성:증례 보고)

  • Hur, Wook;Kang, Hyun Goo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.7
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    • pp.239-244
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    • 2018
  • Both arterial dissection and atherosclerosis are major causes of cerebral infarction and appear to be occlusion or stenosis in magnetic resonance angiography(MRA) and computed tomographic angiography(CTA). But there are differences in treatment because they have different mechanisms. Recently, as high resolution magnetic resonance image(HR-MRI) develops, the image of blood vessel wall can be confirmed non-invasively. Though HR-MRI has become a very useful method for patients with suspected arterial dissection, differential diagnosis of the two diseases has not yet been fully established due to differences in the findings according to stages of arterial dissection and atherosclerosis. We investigated the differences between vertebral artery dissection and atherosclerosis through HR-MRI in two patients and confirmed the diagnosis by CTA follow-up. In addition to the previously established diagnostic criteria, we determined that the long and severe stenosis and recanalization suggest arterial dissection. Characteristics of arterial dissection confirmed by HR-MR and additional studies will be helpful for the treatment.

A Case of Spinal Epidural Emphysema Complicating in Patient with Bronchial Asthma (척추 경막외 기종이 동반된 기관지 천식 1례)

  • Lee, Cheol-Ho;Kwon, Hyung-Joo;Park, Young-Woo;Lee, Moo-Yeol;Yu, Heung-Sun;Hwang, In-Seog;Kim, Jin-Kwan;Kim, Mi-Young;Sin, Mi-Jeong;Hwang, Soon-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.372-375
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    • 2000
  • Spinal epidural emphysema is rare, and only a few cases have ever been reported. A 18 year-old man was admitted for neck and chest pain for 3 days. Before admission he experienced rhinorrhea and severe cough. Physical examination revealed wheezing on whole lung field and subcutaneous emphysema over the upper portion of the chest and neck. Chest radiograph showed pneumomediastinum and subcutaneous emphysema in the neck and chest CT images demonstrate a free air in the prevertebral fascia. With conservative management, the patient's condition and the pneumomediastinum improved. The patient was discharged to home on the fourteenth day.

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