• Title/Summary/Keyword: 만성폐쇄성

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Pancreatico-pleural Fistula: A Rare Cause of Hemorrhagic Pleural Effusion - A case report - (췌흉강루에 의한 혈성 흉수의 치험 - 1예 보고 -)

  • Yu, Jeong-Hwan;Kang, Shin-Kwang;Kim, Yong-Ho;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young;Chun, Kwang-Sik
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.263-267
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    • 2009
  • A pancreatico-pleural fistula (PPF), caused by rupture of a pancreatic pseudocyststectomy or obstruction of the pancreatic duct, is a rare condition. A 48-year-old man with chronic alcoholism was admitted with a massive pleural effusion. Pleural fluid studies revealed elevated amylase and lipase. A PPF complicated by a ruptured pancreatic pseudocyststectomy was diagnosed by computerized tomography scan. Although the symptoms improved with conservative management, (chest tube drainage, NPO, total parenteral nutrition, and a pancreatic secretion inhibitor), a distal pancreatectomy, including a pseudocystectomy and thoracotomy, were performed for an increasing size of the hemorrhagic pancreatic pseudocyststectomy and a recurrent hemorrhagic pleural effusion. There were no post-operative complications and the patient was discharged on post-operative day 27.

Treatment of Deep Venous Thromboses of Lower Leg with Thrombolysis (혈전용해술을 이용한 하지 심부정맥 혈전증의 치료)

  • 이재원
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.711-715
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    • 2001
  • Background: Deep venous thrombosis(DVT) is a curable disease when it is appropriately treated in the early stages of onset. The long term follow up of chronic DVT shows poor prognosis with serious complications such as venous valvular insufficiency, venous claudication, venous ulcer and leg swelling. Thrombolytic therapy is a very active treatment that delivers thrombolytic agents via catheter to the target thrombi. The aim of this study is to evaluate the effect of catheter directed thrombolysis using urokinase to acute DVT. Material and Method: We studied 5 patients, who were diagnosed as acute DVT and had no contraindication for selective hemolysis using urokinase. Result: All the patients were successfully recanalized. Total infusion time of urokinase was 2.0$\pm$0.6 days, and the amount was 5.9$\pm$2.45 million IU. In 4 patients, who were diagnosed as May-Therner syndrome, we performed the balloon angioplasty and inserted the stent at the stenotic portion. There were minor complications such as hematuria, hematoma at puncture site, and all of them are self limited. Conclusion: Catheter induced thrombolysis is an effective treatment in acute DVT.

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The Effect of Fatigue of Patients with Chronic Obstructive Pulmonary Disease on Depression and The Health-Related Quality of Life (만성폐쇄성폐질환환자의 피로도가 우울정도와 건강관련 삶의 질에 미치는 영향)

  • Kang, Jeong-Il;Jeong, Dae-Keun;Choi, Hyun
    • The Journal of Korean Physical Therapy
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    • v.26 no.4
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    • pp.262-268
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    • 2014
  • Purpose: This study was conducted in order to measure fatigue as an objective index, depression and health-related quality of life of patients with COPD in daily life, to understand the correlation between them, and to present reasons for using the results clinically. Methods: This study is intended to evaluate and compare depression, the health-related quality of life of each group after measuring lactic acid levels of 39 male patients with COPD, and dividing those with measurement values than the normal value into the experimental group, and those with normal values into the control group. Results: When comparing depression between the experimental group and the control group, it was measured at 10.38 in the experimental group, and at 7.00 in the control group (p<0.05). Health-related quality of life between the experimental group and the control group was measured at 51.8 in the experimental group, and at 48.67 in the control group (p>0.05). Conclusion: According to the results described above, it appears that patients with COPD have adapted to their disease in some degree for a long period of time, and they are physically and psychologically adjusting to the fatigue they experience, in their own ways of adapting. These results imply that improving physical activity is associated with relief of fatigue and improvement of the quality of life. Thus, there is a need for developing and researching an exercise program and a physical therapy intervention for enhancement of physical activity.

Re-Expansion Pulmonary Edema Associated with Resection of Ruptured Hlediastinal Thymic Cyst -A Case Report (파열된 종격동 흉선낭종의 절제술후 동반된 재팽창성 폐부종 -1례 보고-)

  • Jo, Deok-Geun;Lee, Jong-Ho;Gwak, Mun-Seop
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1149-1153
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    • 1997
  • Unilateral reexpansion pulmonary edema(RPE) is generally considered a rare complication occurring when a chronically atelectatic lung is rapidly reexpanded by tube thoracostomy or thoracentesis. It can also take place when the lung collapse is of short duration or when the lung is reexpanded without intrapleural sucti n. We experienced a case of RPE following surgical resection in mediastinal thymic cyst A 26 year old female patient suffered from long-standing atelectasis of the right lung due to a huge mediastinal cyst that was misrecognized as tuberculous pleural effusion. Empyema developed after iatrogenic rupture of mediastinal cyst by pig-tailed tube thoracostomy. We successfally managed the ruptured mediastinal thymic cyst, empyema and postoperatively developed RPE following reexpansion of the collapsed lung. The patient was treated with drugs and mechanical ventilation with positive end-expiratory pressure for RPE. The remainder of her hospital course was uneventful.

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Influencing Factors of Plasma Levels of Total Peroxide and Oxidative Stress Index in Retired Miners with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환을 동반한 이직광부에서 혈장 총 Peroxide 및 산화스트레스 지수 수준에 미치는 영향요인)

  • Lee, Jong Seong;Shin, Jae Hoon;Baek, Jin Ee;Jeong, Ji Yeong;Choi, Byung-Soon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.30 no.2
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    • pp.196-204
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    • 2020
  • Objective: Chronic obstructive pulmonary disease(COPD) is characterized by persistent airflow limitations associated with chronic inflammatory response due to noxious particles or gases in the lung. Increasing oxidative stress associated with COPD. The aim of this study was to evaluate the influencing factors of biomarkers for oxidative stress in retired miners with COPD. Methods: The levels of total peroxide(TPx), total antioxidant capacity(TAC), and oxidative stress index(TPx/TAC ratio, OSI) in plasma as biomarkers for oxidative stress, serum C-reactive protein(CRP) as a biomarker for inflammation, and general characteristics were measured in 93 male subjects with COPD. COPD was defined as post bronchodilator FEV1/FVC<0.7 by spirometry. Results: Mean levels of TPx(p=0.013), TAC(p=0.010), OSI(p=0.040), and CRP(p=0.024) were higher in current smokers. Levels of TPx(β=0.445, p<0.001), TAC(β=0.490, p<0.001), and OSI(β=0.351, p<0.001) were related to CRP levels, and CRP levels were related to %FEV1 predicted(β=-0.295, p=0.003) and current smoking(β=0.214, p=0.032). Conclusions: These results suggest that oxidative stress was related to inflammation, and inflammation were related to decreasing %FEV1 predicted and current smoking in retired miners with COPD.

Preliminary Study to Develop a Korean Oriental Medical Assessment Tool for Syndrome Differentiation of Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환에 대한 한의학적 변증 평가도구 개발을 위한 기초연구)

  • Lee, Beom-Joon;Jung, Hee-Jae;Choi, Jun-Young;Kang, Wee-Chang;Jung, Sung-Ki
    • The Journal of Korean Medicine
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    • v.33 no.3
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    • pp.82-94
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    • 2012
  • Objectives: The aim of study was to develop a standard clinical oriental medicine evaluation instrument for chronic obstructive pulmonary disease (COPD). Methods: We appointed 10 respiratory professors of oriental medicine as the advisory committee. The committee was organized and met several times to discuss the patterns of syndrome differentiation (辨證) and its items based on clinical symptoms of COPD patients and review of published literature. Then the committee investigated the importance of items by e-mail and decided the weight and final weight, respectively. Results: According to the answers and conferences, we determined the Korean oriental medical assessment tool for COPD comprised of the 7 type of patterns of syndrome differentiation which have 9 items with the mean weight and final weight of each item, respectively. Conclusions: This Korean oriental medical assessment tool for COPD was newly developed through expert consensus. We expect to apply this tool to subsequent research as its validity and reliability is further confirmed.

Use of a Foley Catheter for Anal Sacculectomy in Dogs (개에서 항문낭 절제를 위한 폴리카테터의 이용)

  • Han, Tae-Sung;Kim, Joong-Hyun;Cho, Ki-Rae;Lee, Hye-Yun;Kim, Gon-Hyung;Choi, Seok-Hwa
    • Journal of Veterinary Clinics
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    • v.24 no.1
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    • pp.35-37
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    • 2007
  • Eight dogs were presented with anal sacculitis with purulent exudates and/or open in the right or left anal sac. Patient dogs, ranging in size from 3-to-8 kg, were treated with closed anal sacculectomies, in which the balloon of a Foley catheter (No. 6, 1.5 ml) was used to facilitate surgical dissection of the sac. In all cases, the Foley catheter successfully distended the anal sac during its removal. Clinical signs associated with the diseased anal sac were abated In the all dogs for a follow-up period of one-to-three months. Anal sacculectomy is a good therapeutic option for cases of chronic anal sacculectomy or impaction. The use of a small Foley catheter to distend the anal sacs during surgery was easy, Inexpensive, and successful.

A Study about Voice of Patients with Chronic Obstructive Pulmonary Disease/Asthma before & after ${\beta}_2$-agonist (${\beta}_2$-촉진제 사용전후에 따른 만성폐쇄성폐질환/천식 환자의 음성 연구)

  • Kang, Young-Ae;Kim, Se-Hun;Jong, Seong-Su;Lee, Tae-Yong;Seong, Cheol-Jae
    • Phonetics and Speech Sciences
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    • v.2 no.2
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    • pp.101-108
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    • 2010
  • An inhaled salbutamol and salmeterol for chronic obstructive pulmonary disease(COPD) and asthma have been used worldwidely. But there has been few study about the voice change evoked from the post-medicine effect. To evaluate the voice influenced of short-acting and long-acting ${\beta}_2$-agonists, two experiments were carried out: one was salbutamol experiment 1 with eight patients, the other was salmeterol experiment 2 with six patients. Experiment 1 was made of two stages: premedication & postmedication. Experiment 2 was four stages: stageI was premedication, stageII was postmedication & pregaggling, stageIII was postmedication & postgaggling(100 ml with water), and stageIV was postmedication & 30 minutes later. Measured parameters were F0, F0_SD, Jitter_rap, Shimmer_apq11, HNR, BW(1, 2, 3), Intensity, and H1-H2. The mean data collected from 3 repetitions each was statistically analyzed by Wilcoxon signed rank test for experiment 1 and repeated measures ANOVA for experiment 2. In experiment 1, significant differences were found in the Jitter_rap(Z= -2.10, p=0.036). The findings indicated that the postmedicated voice was worse than premedicated voice. In experiment 2, there wasn't significant difference, but values of parameters related to voice quality(Jitter_rap, Shimmer_apq11, HNR, and H1-H2) showed changes toward stageⅣ, that is, the voice quality was worse under medication.

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Serum Lipid Profiles after Abstinence in Korean Male Patients With Alcohol Dependence (남성 알코올 의존 환자들에서 금주 치료 후의 혈청 지질 농도 변화)

  • Lee, Seoung-Ho;Park, Woong-Sub
    • Korean Journal of Biological Psychiatry
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    • v.15 no.1
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    • pp.23-28
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    • 2008
  • Objectives : The treatment of alcohol dependence requires maintaining abstinence. However, some previous studies have suggested that the abstinence may increase the cardiovascular risk in patients with alcohol dependence. The aim of the present study was to examine the effect of alcohol abstinence on lipid profile in Korean male patients with alcohol dependence. Methods : Twenty-eight male patients with alcohol dependence were recruited from a psychiatric unit located at Gangneung Dongin Hospital. Lipid profiles of the patients were compared before and after a month of alcohol abstinence. Results : After abstinence of 1 month, high-density lipoprotein(HDL) cholesterol and triglyceride(TG) level was significantly decreased(p=0.000; p=0.0086, respectively). Low-density lipoprotein(LDL) cholesterol level showed a tendency to increase(p=0.066). Total cholesterol level also showed a tendency to decrease(p=0.074). Conclusions : These results show that acute abstinence of alcohol might paradoxically aggravate dyslipidemia in patients with alcohol dependence. Thus, this study shows that more concern associated with cardiovascular risk is needed during short-term abstinence period.

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The Supreme Decision on the Withdrawal of Life Sustaining Treatment: 'Madam kim' Case Reviewed by the Life Sustaining Treatment Determination Act ('김할머니' 사례로 살펴본 가정적 연명의료결정에 관한 연구 -호스피스·완화의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법률과 관련하여-)

  • Kim, Jang Ha
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.257-279
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    • 2016
  • Recently, the Well-dying Act was legislated in Korea, and it will come into effect in August 4, 2017. This Act allows to withdraw the life sustaining treatment from impending death patients and also provide the hospice and palliative treatment to terminal patients. In the Supreme Court's case so called "Madam Kim", medical condition of Madam Kim was a persistent vegetative status owing to brain damage and her family members wanted to remove the artificial ventilation. In 2009, the Supreme Court allowed to withdraw the artificial ventilation under the specific conditions. We applied this new Well-dying Act to the Madam Kim's case hypothetically in order to know this Act can reasonably solve the problem of life sustaining treatment for dying or terminal patients. For the impending patients, the Well-dying Act has the problem not to withdraw the futile treatment due to the advance directives of patients. Vice versa, the terminal patients have no chance to withdraw the life sustaining treatment due to the this Act impose the duty to provide the hospice and palliative treatment despite of advance directives. We need to ruke out the persistent vegetative patients from the terminal patients caused by the cancer, acquired immune deficiency syndrome, chronic obstructive lung disease and chronic liver cirrhosis, In addition, we have to discuss the effect of the advance directives of terminal patients in view of self determination right.

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