• Title/Summary/Keyword: 삼출액

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Pleural Effusion Followed by Multiple Intercostal Nerve Blocks in the Patient with Postherpetic Neuralgia (대상포진후 신경통 치료중에 발생한 흉막 삼출액)

  • Song, Jung-Ja;Han, Young-Jin;Choe, Huhn
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.269-272
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    • 1992
  • We experienced a case of pleural effusion while treating postherpetic neuralgia in a 70 year old male patient. The patient had scar and color change on the skin along the course of the right Th4-5 intercostal nerve, characteristics of healed herpes zoster. The patient also complained of severe pain along the lesion site which made sleeping difficult. He had been treated with; epidural blocks with or without catheterization; epidural or regional corticosteroids; multiple intraspinal and intercostal blocks with local anesthetic; or neurolytic, alcohol, transcutaneous electrical nerve stimulation, etc., for about six months by the time of pleural effusion development. We came to the conclusion that the effusion was due to pleural irritation by multiple intercostal nerve blocks, because it was bloody and developed on the affected right side, although the patient had a history of a certain hepatic pathology and pulmonary tuberculosis which may be a predisposing factor to the effusion.

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A Case of Focal Reexpansion Pulmonary Edema after Conventional Thoracentesis of Pleural Effusion (흉막삼출액의 관례적 천자 후 발생한 국소성 재팽창성 폐 부종 1예)

  • Sohn, Seong Dong;Yoo, Jee Hong;Choi, Cheon Woong;Park, Myung Jae;Kang, Hong Mo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.297-301
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    • 2004
  • A 60-year old male patient admitted with complaints of dyspnea and pleuritic chest pain. The chest X-ray demonstrated right pleural effusion. We planed to do the conventional thoracentesis to evaluate the characteristics of pleural effusion and to relieve the symptom of the patient. Focal reexpansion pulmonary edema was seen on the follow-up chest X-ray. After the 5-day conservative management, the patient recovered without any complications.

Therapeutic Effect of Prednisolone in Tuberculous Pleurisy -A prospective study for the prevention of the pleural adhesion- (결핵성 흉막염에서 프레드니솔론의 치료효과 -흉막유착 발생에 대한 전향적 연구-)

  • Lee, Byoung-Hoon;Jee, Hyun-Suk;Choi, Jae-Chul;Park, Yong-Bum;An, Chang-Hyeok;Kim, Jae-Yeol;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.481-488
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    • 1999
  • Background: The routine application of the combined regimen of corticosteroid-antituberculosis therapy to the tuberculous pleurisy remains controversial. Steroid therapy to tuberculous pleurisy could be effective on the acceleration of absorption of pleural effusion and symptom improvement, but there has been debate about the effect of prednisolone on the prevention of pleural adhesion. So we studied the efficacy of combined regimen of prednisolone-antituberculosis therapy on the absorption of pleural effusion and prevention of pleural adhesion. Method: A prospective, randomized study was performed in 82 patients, 50 patients(non-steroid group) were treated with only antituberculosis regimen for 6 months and in 32 patients(steroid group) prednisolone(30mg/day) were administered in addition to antituberculosis regimen for one months and tapered for another month. The amount of pleural effusion was compared at the beginning of treatment, 2nd month, 6th month and final visit with chest X-ray findings which were graded from grade 0(complete absorption) to grade 6(near total haziness). Results: The amount of pleural effusion of steroid group at 2nd month, 6th month and final visit was lesser than that of non-steroid group(P<0.05). The incidence of the complete absorption of the pleural effusion was 3/32(9.4%) in steroid group, 1/50(2%) in non-steroid group at 2nd month after treatment; and 12/32(37.5%) in steroid group, 6/50(12%) in non-steroid group at 6th month after treatment(P<0.05). At final observation, the incidence of residual pleural thickening was 15/32(47%) in steroid group and 37/50(74%) in non-steroid group(P<0.05). No serious side effects were noted during the treatment with prednisolone. Conclusion: The administration of prednisolone in conjunction with antituberculosis chemotherapy improved the absorption of pleural effusion and decreased the residual pleural thickening.

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Intrapleural Doxycycline and Bleomycin in the Management of Malignant Pleural Effusions : A Randomized Study (악성 흉막삼출액에서 Doxycycline과 Bleomycin을 이용한 흉막경화요법의 치료효과 비교)

  • Oh, Won Sup;Choi, Jin;Kim, Yong Su;Do, Yong Hee;Jang, Tae Won;Jung, Maan Hong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.85-92
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    • 1997
  • Background : The standard treatment of recurrent, symptomatic malignant pleural effusion is intrapleural instillation of a chemical agent in an attempt to achieve a sterile inflammation and pleurodesis. There are many drugs used as pleural sclerosing agents, but the efficiency and side effects are different. The present study was undertaken to compare the commonly used drugs, doxycycline and bleomycin. Methods : Thirty-four patients with malignant pleural effusion who needed repeated thoracentesis were randomized to receive treatment with intrapleural instillation of doxycycline or bleomycin Fluid volumes before and after pleurodesis, drainge time, and side effects were analyzed, and the response to treatment was evaluated by clinical examination and chest radiography during admission in the hospital. Also median survival rime were evaluated according to the responses. Results : The response rate was higher in the patients receiving doxycycline than in those receiving bleomycin (87.5% vs 50.0%, p=0.02), and fever, nausea and vomiting were more common in the patients receiving bleomycin. The median survival time was significantly longer in the patients who responded to the sclerotherapy regardless of sclerosing agents. Conclusions : Chemical pleurodesis with doxycycline or bleomycin could reduce or stop pleural effusions and prolong the median survival rimes in these patients. Doxycycline appeared to be more efficient as sclerosing agent than bleomycin in the short-term follow-up periods. But a prospective study with a larger number of patients is warranted.

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A Case of Acute Myeloid Leukemia with Multilineage Dysplasia accompanying Malignant Pleural Effusion (악성흉막삼출액을 동반한 다계열형성이상 급성골수백혈병 1예)

  • Seo, Young Ik;Choi, Tae Youn;Shin, Jeong Won;Won, Jong Ho;Lee, Sang-Cheol;Park, Hee-Sook;Lee, Nam-Soo;Park, Rojin
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.1
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    • pp.49-51
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    • 2008
  • We report a case of acute myeloid leukemia with multilineage dysplasia accompanying malignant pleural effusion. A 73 year-old male patient was admitted complaining of febrile sensations and right chest pain. The cytology of the pleural fluid revealed malignant pleural effusion showing many blasts, which had previously been identified in his bone marrow when he was diagnosed with acute myeloid leukemia with multilineage dysplasia two months earlier. His age and poor general condition had precluded chemotherapy with the exception of hydroxyurea and conservative treatment. Unfortunately, he succumbed to the disease 4.5 months after diagnosis. This case highlights the importance of determining if the pleural effusion of acute leukemia is malignant or not because it can suggest a pleural metastasis and influence the prognosis.

Diagnostic Significance of Total Lactate Dehydrogenase(LD) and LD Isoenzyme Measurement in the Body Fluids (체강액에서 총 Lactate dehydrogenase 및 Lactate dehydrogenase 동위효소 측정의 진단학적 의의)

  • Jeon, Chang-Ho;Bae, Eun-Kyung;Hong, Seok-Il;Kim, Chung-Sook;Lee, Young-Hyun
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.193-199
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    • 1986
  • Body fluid Lactate dehydrogenase and its isoenzyme measurement was performed in 132 patients: 8 cases with peritonitis, 21 cases with malignant ascites, 43 cases with liver cirrhosis, 48 cases with tuberculous pleuritis, 12 cases with malignant pleural effusion respectively. Body fluid protein and glucose contents, red blood cell counts, white blood cell counts, cytologic examination were also performed as a comparative study. The results were as follows: 1. Measurement of total LD and protein amount could differentiate between transudate and exudate in the ascitic fluids. 2. In the malignant exudate of ascites and pleural fluid, the activity of LD2 isoenzyme was statistically increased compared with that of inflammatory exudate and the activity of LD4 isoenzyme was also increased compared with that of serum(P<0.05). 3. The inflammatory exudate of pleural fluid and ascites demonstrated the increase of LD5 isoenzyme activity stastistically compared with that of serum and malignant exudate(P<0.05). 4. A difference of total LD activity between malignant ascites and inflammatory ascites was significant statistically, while this was not observed in the pleural exudate. 5. Total LD and LD5 isoenzyme activity didn't correlated with the number of white blood cells in the exudate.

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Subxiphoid Pericardial Drainage of Pericardial Effusions (심낭삼출액에 대한 검상하 심낭배액술)

  • 오삼세;장우익
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.693-700
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    • 1997
  • To assess the effectiveness of subxipoid pericardial drainage for the treatment of pericardial effusion, we reviewed 80 cases of subxiphoid pericardial drainage between January 1986 and December 1995. There were 39 males and 41 females with ages ranging from 20 to 80 years. The diagnosis of pericardial effusion was made by echocardiography. The procedure was carried out under general anesthesia in 50(62.5%) and under local anesthesia in 30 patients(37.5%). Among the 33 p tients with malignant pericardial effusion, cytology was positive .in 14 of 31(45%), and pericardial biopsy showed malignancy in 7 of 29 patients(24%). Among the 27 patients with tuberculous pericardial effusion, the diagnosis was confirmed by histology of pericardial biopsy in 12 patient or bacteriologic culture in 1 patient. The operative mortality was 17.5% (14180 patients) and all the mortality occurred in the malignant group. There were no operation-related mortality Sixty six patients were followed from 9 days to 5 years; mean follow-up was 452 days. Recurrent pericardial effusions, necessitating further surgical intervention, occurred in 6 (7.5%) patients. Constrictive pericarditis developed later in 4 patients(5%) and two of them had undergone complete pericardiectomy. In summary, subxiphoid pericardial drainage allowed safe and efficient drainage of pericardial effusions with sampling for cytology and pericardial biopsy, and had an acceptable morbidity and mortality.

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