• Title/Summary/Keyword: 방사선괴사

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Pulmonary Infarction Associated with Fracture of Right Clavicle and Multiple Ribs (우측 쇄골 및 늑골골절과 동반된 폐경식 1례)

  • 김수성;이종임
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.941-944
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    • 1997
  • Pulmonary infarction is rarely diagnosed with certainty except at postmortem examination. Part of this uncertainty is because of the inability to distinguish between hemorrhage, congestive a electasis, and necrosis clinically and radiographically. The pathogenesis of pulmonary infarction is poorly understood. It is dif%cult to induce pulmonary infarction in animals by ligation of the arterial supply to the lung. Many factors seem to be important in its pathogenesis, in addition to congestive heart failure, malignant tumor, thrombophlebitis, chronic obstructive lung disease, nephrotic syndrome, and postopeiative state. However, pulmonary infarction have not been reported in association with chest trauma. We report a case of pulmonary infarction associated with fractures of right clavicle and multiple ribs. A 45-year-old male had admitted due to right chest pain and dyspnea, which developed after right chest trauma occurred at about 3 weeks ago. He was treated at local clinics under the diagnosis of fractures of right clavicle and ribs until the admission. Chest CT disclosed a huge mass with central low density in right upper lobe, and small masses were also seen on both l ng fields. Open lung biopsy resulted in negativity for the malignancy. Clinical symptoms and radiological findings were not improved by conservative treatment. Right upper lobectomy was done eventually. The final diagnosis was pulmonary infarction. And, the patient has been well after operation.

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Microsurgical Reconstruction of Severe Radionecrotic Wounds Following Mastectomy (흉부의 심한 방사선 괴사 환부에 대한 미세 수술적 재건)

  • Ahn, Hee-Chang
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.114-121
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    • 1998
  • The purpose of this study is to investigate the appropriate management of severe radionecrotic wounds of the anterior chest wall associated with infection of the soft tissues and ribs and exposure of vital structures(heart and lung), and present our strategies for reconstruction of these complicated patients. 9 patients have undergone radical debridement and immediate microsurgical reconstruction for severe radionecrotic wounds of the anterior chest wall over last 7 years. All patients had extensive osteomyelitis of the ribs or sternum, and chronic infection or cutaneous fistulae. 2 patients had pericardial effusions due to longstanding inflammation, and 6 patients had pleural effusions. 2 patients had ipsilateral lung collapse. 10 free flaps were performed for coverage of the huge defects. One patient required 2 free flaps to control the inflammation. 8 free TRAM flaps were used for coverage of the defects and in addition, the rectus abdominis muscle was packed into any deep cavity. 1 patients underwent latissimus dorsi muscle free flap because of previous abdominal surgery. After extensive debridement of the infected, radionecrotic wounds, all 10 free flaps were successful. All the extensive radionecrotic defects of the anterior chest wall were completely healed. Free flaps successfully covered the exposed vital structures of the heart and lungs. Patients with severe radionecrotic defects of the anterior chest wall after ablative breast cancer surgery and radiotherapy were successfully treated by radical debridement and immediate free flap surgery. The TRAM flap together with the rectus muscle is the treatment of choice for these huge defects. The latissimus dorsi muscle flap was the second choice in patients with previous abdominal surgery. The recipient vessel should be carefully selected because of possible radiation damage and inflammation.

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CONTINUED APEXOGENESIS ON TRAUMA INDUCED NONVITAL IMMATURE PERMANENT TOOTH (외상으로 실활된 미성숙 영구치에서의 계속된 치근 형성)

  • Kang, Yu-Jin;Kim, Hye-Young;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.640-646
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    • 2009
  • In case of luxation injuries, loss of tooth vitality is common. And in case of trauma in the immature permanent teeth, precise diagnosis of pulp necrosis is very difficult. That is because limitation in distinguishing between normal dental papilla in immature permanent teeth, transient apical breakdown(TAB), which is part of normal healing process, and apical radiolucency in pulp necrosis. Especially in non-vital immature permanent tooth, the treatment is complex and requires long time. This clinical case report shows that severely infected immature teeth with periradicular periodontitis can undergo healing and apexogenesis or maturogenesis with no definative treatment or after conservative treatment. In the cases reported, we emphasize the considerable power of regeneration of the tooth, probably due to its large number of undifferentiated mesenchymal cells in the dental papilla, pulp tissue, periodontal ligament tissues. Thus, when endodontic treatment in immature permanent teeth, over instrumentation is not recommend for preserve the apical vital stem cells.

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Various Flap for Treatment of Radiation Ulcer and Osteoradionecrosis (골괴사를 동반한 만성 방사선 궤양의 치료를 위한 피판술)

  • Yun, In Sik;Lee, Won Jai;Jeong, Hii Sun;Lew, Dae Hyun;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.174-180
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    • 2008
  • Purpose: While radiotherapy remains an essential part of the multidisciplinary treatment of cancers, it may cause unwanted consequences such as tissue break down and chronic non-healing wounds as a result of hypoxia, hypovascularity, and hypocellularity. The conservative treatment of osteoradionecrosis was effective only in the early stages or has a limited result. The surgical treatment of osteoradionecrosis includes various local fasciocutaneous flaps, local myocutaneous flaps and different kinds of free flaps with cancellous bone graft or alloplastic material after removal of all devitalized tissue. This study reviews recent cases of osteoradionecrosis in Severance hospital and investigates the use of various flaps for reconstruction of osteoradionecrosis. Methods: From 2000 to 2006, a total of 29 patients, nine men and twenty women with a mean age of 60.4 years were identified and included in the study. Fasciocutaneous flaps were used on 7 patients and myocutaneous flaps were used on the remaining patients. Mean follow-up period was 10.4 months. Results: In the fasciocutaneous flap group, we noted two complications including total flap failure and a partial flap necrosis. In the myocutaneous flap group, four complications were noted including a partial flap necrosis and 3 cases of wound dehiscence. Considering the complications noted in this study, the natural history of progression to flap necrosis appeared to follow the following sequence of events: marginal flap necrosis, infection, wound dehiscence, flap floating and partial flap necrosis, serially. Conclusion: Successful surgical treatment of osteoradionecrosis includes wide radical debridement and reconstruction with a well vascularized flap like myocutaneous flap or fasciocutaneous flap.

Treating a Ruptured Ascending Aorta with an Endovascular Stent Graft (상행 대동맥 파열에서 혈관내 스텐트 그라프트를 이용한 치료)

  • Kim, Gwan-Sic;Lee, Taek-Yeon;Kim, Joon-Bum;Lee, Seung-Hyun;Kim, Hee-Jung;Cho, Won-Chul
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.92-95
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    • 2010
  • Endovascular stent grafting is regarded as a promising alternative approach to open surgical repair for treating various aortic diseases in high risk patients. We report here on a case of a 79-year-old female who underwent endovascular stent-graft insertion in the ascending aorta for treating a complicated ascending aortic rupture that occurred secondary to radiation necrosis during the treatment of recurrent breast cancer.

A Case of Gunshot Injury to the Spinal Cord in a Cat:Clinical, Surgical, and Computed Tomographic Features (고양이 척수 총상 증례: 임상소견, 수술소견, 컴퓨터단층영상소견)

  • Ahn, Seoung-Yob;Yoon, Hun-Young;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.32 no.2
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    • pp.187-190
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    • 2015
  • An 18-month-old female spayed domestic short-haired cat, weighing 4.1 kg, was presented as an emergency case after it suffered a gunshot injury. Physical examination of the cat revealed paraplegia, with loss of deep nociception. A bullet (diameter, 3 mm) lodged in the left epaxial muscle at the level of the first lumbar (L1) was observed on radiographic examination, and a hyperattenuating spot in the spinal canal was confirmed using computed tomography. Exploratory laminectomy was performed, and an incomplete fracture of the right caudal articular process of L1 and a necrotizing spinal cord lesion were found. The animal was euthanized and necropsy was performed, which revealed a crack on the left pedicle of L1. This case report presents the first detailed clinical description of a gunshot injury to the spinal cord in a cat.

The Radiation Sensitizer Effect of $TNF-{\alpha}$ on Heterotransplanted Human Squamous Cell Carcinoma (이종이식된 인체 편평상피세포암에 대한 종양괴사인자의 방사선감작효과에 대한 연구)

  • Chung Phil-Sang;Kim Han-Gyun;Yun Hyong-Geun
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.151-155
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    • 1998
  • Background and Objectives: Numerous studies were conducted to develop radiosensitizers to increase antitumor effect and decrease systemic toxicity of ionizing radiation. In current study, the authors tested the synergistic effect of mutant $TNF-{\alpha}(M_3S)$ with radiation therapy on heterotransplanted hypoparyngeal squamous cell carcinoma. Materials and Method: SNU-1041 cell line was heterotransplanted to nude mice. When the tumors grew up to $70mm^3$ or more, the animals were randomly placed into 4 groups(n=10/group). Group I : 0.1ml of normal saline injected intraperitoneally once a day for 5 days. Group II : 10ug of $TNF-{\alpha}$ injected intraperitoneally once a day for 5 days. Group III : a single radiation dose of 10 Gy per animal delivered. Group IV : single radiation dose of 10 Gy was delivered 1 hour after intraperitoneal injection of $TNF-{\alpha}$ 10 ug. Results: Four weeks after treatment, group IV showed the least tumor growth during the 4 weeks follow up and the relative tumor growth rate(RTG) of each groups after 4 weeks were 31, 5.8, 10, and 3.2 respectively(p<0.05). Conclusion: These study suggests that pretreatment with $TNF-{\alpha}$ can significantly enhance the effects of radiation therapy and further studies may be needed for clinical trials of combination treatment of $TNF-{\alpha}$ and radiation.

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Idiopathic Arterial Thromboembolism(ATE) in a Turkish Angora Cat (터키산 앙고라(Turkish Angora) 고양이에서 발생한 특발성 동맥 색전혈전증(arterial thromboembolism: ATE) 1례)

  • Han, Sung-Kuk;Kim, Jung-Hyun;Jeong, Soon-Wuk;Park, Hee-Myung;Park, Chul;Yoo, Jong-Hyun
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.23-26
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    • 2008
  • A 2-year-old, female, Turkish Angora cat was presented due to hindlimb paralysis with 2-day history of vomiting and depression. Physical examination revealed weak femoral pulse and cyanotic footpads of hind limbs. Chest auscultation, thoracic radiography, and electrocardiogram were no remarkable. Abdominal ultrasonography showed suspected hyperechoic thrombus in abdominal aorta. Underlying causes of the arterial thromboembolism were not found on multiple diagnostic examinations and the cat was diagnosed as idiopathic saddle thromboembolism. Despite 4-week regimen with heparin sodium, aspirin, and diltiazem, the hind limbs were progressively and irreversibly necrotized. Therefore, coxofemoral amputation was performed. After surgery, the clinical condition of this cat returned to normal without further complications.

A Case of Pulmonary Trichomoniasis in a Young Healthy Male (건강한 젊은 남성에서 발생한 폐트리코모나스증 1예)

  • La, Sung Soo;Kong, Jae Hwan;Bang, Chang Seok;Hahn, Sung Hwhan;Myong, Na-Hye;Kim, Doh Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.387-391
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    • 2008
  • Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide.

Oral Malignant Melanoma in a Labrador Retriever (리트리버 개의 구강유래 악성 흑색종 발생 예)

  • Ji-Yun, Lee;Sang-Yeon, Oh;Dae-Yong, Kim;Chul, Park;Hun-Young, Yoon;Soon-Wuk, Jeong;Hee-Myung, Park
    • Journal of Veterinary Clinics
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    • v.20 no.4
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    • pp.489-492
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    • 2003
  • A 12-year-old, intact male Labrador Retriever was admitted to the Veterinary Teaching Hospital of Konkuk University for the evaluation of bleeding mass in the oral cavity. The mass was first noted 2 years ago and has been growing up to a size of $5{\times}6$ cm. On complete blood count(CBC), leukocytosis and mild anemia were observed. Pulmonary metastasis was found in the thoracic radiographic examination. Blackish necrotic oral mass at the left mandibular area was diagnosed as a malignant melanoma based on the histopathological examination. Thus hemimadibulectomy and chemotherapy (carboplatin) were performed. The patient eventually died due to severe secondary infection 3 months after the last treatment.