• Title/Summary/Keyword: 삼출

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Intramural Hematoma of the Descending Thoracic Aorta Misdiagnosed as Aortic Rupture - A case report- (대동맥 파열로 오인된 흉부 하행 대동맥의 벽내 혈종 치험 1예)

  • 조원민;민병주;이인성;신재승
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.872-875
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    • 2004
  • The treatment modalities of the intramural hematoma (IMH) remain controversial. Nowadays, the IMH of the descending thoracic aorta is generally classified in the medical treatment category. We describe a patient with IMH of the descending thoracic aorta who received the medical treatment. During the follow-up, we speculated that the IMH had been aggravated leading to an aortic rupture including hemothorax. Therefore, we performed an emergency operation. Contrary to our expectations, operative findings showed a well-organized aortic wall and serous pleural effusion. The exact diagnosis was IMH of the descending thoracic aorta with penetrating atherosclerotic ulcer (PAU). This case reminded us of the importance of accurate diagnosis and proper treatment.

Clinical Experience with Subxiphoid Drainage of Pericardial Effusions (검상돌기하 심낭절개술에 의한 심낭 삼출액의 치료에 관한 고찰)

  • 김문환
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.397-403
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    • 1991
  • From June 1987 to January 1991, 24 patients with moderate or massive pericardial effusion underwent subxiphoid pericardial window procedures for diagnosis and therapy. The patients` ages were ranged from 28 years to 71 years. The underlying diseases were chronic renal failure with long term hemodialysis in 3 cases, malignant lung cancer in 7 cases, stomach cancer in 2 cases, tuberculous pericarditis in 5 cases, pyogenic pericarditis in 2 cases, myxedema in one case, one metastatic squamous cell carcinoma from unknown origin and three of undefined etiology. Preoperative diagnoses of pericardial effusions were confirmed by echocardiogram in all cases. Subxiphoid pericardial drainages were performed under general[n=19] or local anesthesia[n=5]. Histological diagnoses were made from the inferior pericardial tissue in all cases except one. In this one case[tuberculous pericarditis], the subxiphoid pericardial approach was failed from intraoperative bleeding. There were two postoperative death, one[in malignant lung cancer] had postoperative ventricular tachycardia which result in cardiac arrest, and the other[unknown origin metastatic malignant effusion] had persistent tachyarrhythmia postoperatively and died on postoperative 5th days. Twenty three patients were followed up from 3 days to 9 months; mean follow-up day was 43 days. The preoperative and postoperative mean cardiothoracic ratio in chest x-ray were 0.69 and 0.52 respectively. Subxiphoid pericardial drainage may provide definitive diagnosis and treatment for pericardial effusions. The approach through subxiphoid pericardium under general or local anesthesia avoids the complications of pericardiocentesis and is effective for malignant pericardial effusion.

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Surgical Management of Chylothorax Complicating Transhiatal Esophagectomy in Benign Esophageal Stricture (식도 열공을 통한 식도 제거술 시행후 발생한 유미흉의 외과적 치료)

  • 홍종면;노윤우
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.672-674
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    • 1996
  • Chylothorax is a rare, but well-recognized complication of cardiothoracic surgery and operations in the region of the esophageal or aortic diaphragmatic hiatus. Especially, in nutritionally depleted patients requiring esophagectomy for benign or malignant diseases, it is a potentially life-threatening disorder that has profound respiratory, nutritional and immunologic co sequences . We have experienced a case of chylothorax after transhiatal esophagectomy in benign esophageal stricture. The diagnosis of chylothorax was confirmed after feeding through the jejunostomy tube by the change of the character of pleural effusion and high triglyceride level on the 5th postoperative day. On the thirteenth postoperative day, supradiaphragmatic thoracic duct ligation was performed through right thoracotomy. We could remove the chest tube on the 22th postoperative day, and the patient is being followed-up at out patient clinic without complications.

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Pulmonary Cystic Lymphangioma -A case report- (폐에 발생한 낭성림프관종 -1예 보고-)

  • Yoon, Yong-Han;Cho, Jung-Soo;Lee, Kyung-Hee;Kim, Lucia;Kim, Kwang-Ho
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.872-874
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    • 2006
  • Although pulmonary lymphangioma is very rare, it is usually discovered as cystic or cavitary or solitary pulmonary nodular shadow on radiological studies. The final diagnosis is usually made pathologically after surgical intervention. We report an unusual case of pulmonary cystic lymphangioma developed in the lingular segment of the left upper lobe which was diagnosed and treated by surgical resection.

Effusion in magnetic resonance imaging of the temporomandibular joint (측두하악관절 자기공명영상에서의 삼출에 관한 연구)

  • Nah Kyung-Soo
    • Imaging Science in Dentistry
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    • v.33 no.1
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    • pp.1-4
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    • 2003
  • Purpose : The purpose of this study was to investigate the distribution and frequency of temporomandibular joint (TMJ) effusion in magnetic resonance (MR) images of patients with disc displacements. Materials and Methods: On T2 weighted MR images of 148 TMJs taken from 74 patients presenting with TMJ pain and dysfunction, we assessed the cases showing TMJ effusion, defined as an amount of fluid that exceeded the maximum amount seen in a control group of asymptomatic volunteers. The amount of TMJ fluid was graded as: I (none or minimal), II (moderate), III (marked), and IV (extensive), according to a standard set by a reference. Disc displacement categories were also recorded. Results: Of the 148 TMJs examined in this study, 52 joints (35.1%) presented with joint effusion, 24 (16.2%) showing bilateral joint effusion. 38 joints showed upper joint space effusion, 3 showed lower joint space effusion, and 11 showed both upper and lower joint space effusion. 96 joints (64.9%) had grade I joint fluid, 27 (18.2%) grade II, 15 (10.1 %) grade III, and 10 (6.8%) grade IV. 80.0% of the joints presenting with grade IV effusion showed disc displacement without reduction. Conclusion: Joint effusion was found not only in upper, but also in lower joint spaces. The higher the effusion grade, the greater the frequency of disc displacement without reduction.

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A Case of Inferior Vena Cava Obstruction Accompanying Pericardiacophrenic Collateral Circulation (심막횡격정맥 측부순환을 동반한 하대정맥 폐쇄 1예)

  • Kim, Jeong-Su;Han, Seong-Hoon;Song, Young-Soo;Jeon, Woo-Ki;Yum, Ho-Kee;Choi, Soo-Jeon;Lee, Bong-Choon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.787-792
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    • 1995
  • The obstruction of inferior vena cava(IVC) is uncommon condition. The classification is based on the obstructive sites of major anatomic segments of IVC. The main collateral pathways of interruption of IVC were central channels through ascending lumbar veins, intervertebral veins and azygos-hemiazygos complex. However, the complete obstruction of mid-portion of IVC, accompanying collateral cirulation with pericardiacophrenic vein was rarely reported. We had experienced a case of complete obstruction of mid-portion of IVC with lobulated left cardiac border, which was unforgettable characteristic finding on chest radiograph. It was confirmed by venographic examination that the lobulated left cardiac shadow was a collateral circulation of pericardiacophrenic vein.

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The change of SCORAD index using Phellinus linteus grown in germinated brown rice (발아현미상황에 의한 SCORAD 지수의 변화)

  • Lee, Yeon-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.9 no.6
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    • pp.1806-1810
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    • 2008
  • Thirty five AD patients were treated with Phellinus linteus grown in germinated brown rice(PB) p.o., at 6, 9, and 12 g/day to the patients with their body weight for 12 weeks. A significant reduction in mean severity scores and mean symptom scores was observed after PB treatment. The mean SCORAD indices pre and post PB treatment were $31.28{\pm}10.01$ and $22.39{\pm}15.59$ (p<0.05), respectively. And the mean symptom score of pruritus assessment decreased from $7.37{\pm}1.33$ to $4.6{\pm}2.34$ (p<0.05) after PB treatment. These results suggest that PB shows alleviation of atopic dermatitis symptoms.

Surgical Treatment of the Wolff-Parkinson-White Syndrome (Wolff-Parkinson-White 증후군의 외과적 치료)

  • 박남희;이광숙
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1373-1376
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    • 1996
  • From October 1993 to February 1996, 9 patients with Wolfr-Parkinson-White syndrome underwent surgical ablation of the accessory atrioventricular conduction pathways. The indications for surgical ablation we e radiofrequency ablation failure in 6 cases, multiple accessory pathways in 1 case, catheter tip fracture ducting catheter ablation in 1 case and additional procedure(redo mitral valve replacement due to valve thrombosis) in 1 case. There was no operative mortality. The postoperative complications were noted In 2 cases pericardial effusion and wound Infection. All patients had accessory atrioventricular connections ablated which were proven by surface ECG and follow-up electrophysiologic study and have remained free of symptomatic tachycardia. The indications for surgical treatment of Wolff-Parkinson-White syndrome are radiofrequency ablation failure, multiple pathways, or when additional procedures are required The present results were satisfactory.

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Case Report of Generalized Edema with Hypoalbuminemia and Pleural Effusion Improved by Combined Traditional Korean and Western Medical Treatments in a Patient with Chronic Myeloid Leukemia Medicated with Dasatinib (Dasatinib 제제 복용 중이던 chronic myeloid leukemia 환자의 hypoalbuminemia를 동반한 전신부종 및 흉막삼출에 대한 한⋅양방 병행치료 1례 보고)

  • Kang, Mi-jung;Lee, Dong-keun;Son, Ah-hyun;Shin, Hyeon-su
    • The Journal of Internal Korean Medicine
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    • v.37 no.2
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    • pp.202-211
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    • 2016
  • Objective: This clinical study reports on a case of generalized edema with hypoalbuminemia and pleural effusion improved by combined traditional Korean and Western medical treatments in a patient with chronic myeloid leukemia medicated with dasatinib.Method: Combined traditional Korean and Western medical treatment was carried out, including herbal medicine, acupuncture, moxibustion, and albumin injection. We examined the serum albumin, measured the circumference of both thighs and ankles to estimate the volume of the edema, and evaluated the pleural effusion symptoms.Results: The serum albumin increased, and generalized edema and pleural effusion improved significantly after the administration of Bojungchiseub-tang-gami.Conclusion: These results showed that complications of generalized edema and pleural effusion associated with dasatinib medication have the potential to be improved via combined traditional Korean and Western medical treatments.

Early Imaging Findings of Hypertrophic Osteoarthropathy Mimicking Bone Metastasis from Extrathoracic Malignancy (뼈 전이로 오인될 수 있는 흉강 외 악성 종양으로 인한 비대성 골관절증의 초기 영상 소견)

  • Ji Yeon Hwang;Jang Gyu Cha;Yu Sung Yoon;Ahrim Moon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1606-1612
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    • 2021
  • Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by digital clubbing, periosteal bone formation, and synovial effusions. Secondary HOA is associated with intrathoracic malignancy in most cases; however, in rare cases, HOA can be caused by extrathoracic conditions. We report early ultrasound, computed tomography, magnetic resonance imaging, and bone scintigraphy findings of HOA in a patient with breast cancer. Its ambiguous clinical and imaging findings that mimicked malignant conditions are particularly interesting and informative.