• Title/Summary/Keyword: 하지부종

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Effects of the use of elastic compression stockings among dental hygienists (치과위생사의 탄력압박스타킹 착용 효과)

  • Lee, Jeong-Hui;Park, Ji-Hye;Sakong, Joon
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.5
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    • pp.675-682
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    • 2018
  • Objectives: This study was performed to characterize edema of the lower extremities that occurs among hygienists during working hours, and to determine the effects of the use of elastic compression stockings. Methods: The study subjects were 40 dental hygienists working at a dental hospital in Daegu. Symptoms of edema of the lower extremities during working hours were characterized by measurement of calf and ankle circumference. Results: Calf and ankle circumference increased during working hours. The use of elastic compression stockings reduced edema of the lower extremities during working hours. Conclusions: Use of elastic compression stockings can reduce levels of lower extremity edema among dental hygienists.

Combined Primary IgA nephropathy and Membranous Glomerulonephritis in a Child (소아에서 IgA 신병증과 막성 사구체신염이 병발한 사구체신염 1례)

  • Kim Mi-Kyung;Choi Jeong-Hoon;Won Nam-Hee;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.232-236
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    • 1999
  • IgA 신병증은 사구체 중맥에 IgA가 침착하는 것이 특징적인 질환이며 막성 사구체 신염은 IgG가 사구체 기저막의 상피하에 미만성으로 침착하는 질환이다. 원발성 사구체 질환중 IgA 신병증과 막성 사구체신염은 비교적 흔한 질환이나 전체적인 빈도는 낮은 편으로, 한 환자의 사구체에서 두 질환이 동시에 발생하는 경우는 매우 드물다. IgA 신병증과 막성 사구체신염의 중복 신염은 Doi등이 1983년 원발성 신질환으로서 처음 보고한 이래, 성인에서 20여례가 보고되었다. 저자들은 신증후군이 발생한 환아에서 신생검을 시행한 결과 원발성 신질환으로서 IgA 신병증과 막성 사구체신염의 소견이 동시에 보이는 중복신염의 드문 예를 경험하였기에 보고하는 바이다. 환아는 7세된 남아로 내원 한달 전부터 발생한 전신부종을 주소로 내원하였다. 가족력과 과거력상 특이 소견없었으며, 내원시 이학적 소견상 전신적인 허약감과 안와부종, 복부팽만, 하지의 함요부종이 관찰되었고, 검사소견에서는 WBC $19,800/mm^3$, Hb 14.1g/dL, Platelet $397,000/mm^3$, BUN/Cr 10/0.4mg/dL, protein/albumin 4.43/2.73g/dL, cholesterol 429mg/dL, IgA 85mg/dL, $C_3$ 68.8mg/dL, $C_4$ 13.4mg/dL, ANA(-), ANCA(-), RF(-), HBsAg/Ab(-/-)이었다. 뇨검사에서는 RBC many/HPF, WBC 2-3/HPF, protein ${\le}\;300mg/dL$ 였으며, 24시간 소변 검사상 protein 9.18g/day, Ccr 66.67ml/min의 소견을 보였다. 신생검을 시행한 결과 광학현미경상에서 몇몇 사구체의 분절성 경화와 중맥역의 증식이 관찰되었고, 면역형광현미경검사에서는 IgA(3+)가 과립상으로 미만성 분포를 보이며 중맥역에 침착되어 있고, 미세한 과립상과 위선의 양상으로 IgG(1+)가 모세혈관벽에 침착되어 있었으며, 전자현미경 소견상 중맥역과 모세혈관 기저막 상피하에 소량의 전자 고밀도 침착이 함께 관찰되었다. 환아는 prednisolone을 경구 투여 받았으나 단백뇨와 혈뇨가 지속되어 solumedrol pulse therapy, captopril과 cyclophophamide로 치료 받은 후, 전신 상태 호전되고, 혈뇨가 사라졌으며, 24시간 소변 검사상 단백뇨가 487.5mg/day로 감소하여 외래에서 추적 관찰 중이다.

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Streptococcal Toxic Shock Syndrome Occurred during Postoperative Radiotherapy in a Cancer Patient with Preexisting Lymphedema and Chronic Illness -Case Report- (수술 후 림프부종과 만성질환을 동반한 종양 환자에서 방사선치료 기간 동안 발생한 연쇄구균독소충격증후군 예)

  • Jang, Ji-Young;Oh, Yoon-Kyeong;Kim, Dong-Min
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.317-321
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    • 2006
  • A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

May-Thurner Syndrome with Deep Vein Trombosis after Total Knee Arthroplasty (인공 슬관절 전치환술 후 발생한 메이-터너 증후군 및 심부정맥 혈전증)

  • Lee, Hwa-Sung;Kim, Yong-Woo;Jung, Se-Hoon;Lee, Se-Won
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.343-347
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    • 2020
  • May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is a condition, in which compression of the common venous outflow tract of the left lower extremity can cause discomfort, swelling, pain or blood clots in the iliofemoral veins. The problem is due to left common iliac vein compression by the overlying right common iliac artery. This paper describes the case of a 75-year-old female with MTS after performing right total knee replacement arthroplasty. The authors diagnosed MTS through intravenous angiography and angiographic computed tomography on swelling and pain of the left lower extremities after performing right total knee replacement arthroplasty. The thrombus was removed using a thrombolytic agent and mechanical thrombectomy, and an intravenous stent then inserted after angioplasty. No case of MTS after performing total knee replacement arthroplasty has been reported in Korea. Therefore, this case is reported along with review of the relevant literature.

May-Thurner Syndrome after Total Knee Arthroplasty (인공 슬관절 전치환술 후 발생한 May-Thurner 증후군)

  • Shim, Chang Heon;Park, Jin Woo;Wang, Lih
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.277-281
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    • 2021
  • Iliac vein compression syndrome, which results in thrombosis of the left iliac veins, was first described by May and Thurner in 1957. May-Thurner syndrome should be considered when deep vein thrombosis-like symptoms appear, especially in the left lower extremities without an invasive procedure. The authors encountered an interesting case of a middle-aged female patient, who presented with sudden pain, swelling and skin color changes to the left lower extremity after right total knee arthroplasty and was diagnosed May-Thurner syndrome by computed tomography venography. This case is of clinical significance in that the early diagnosis of May-Thurner syndrome in the left lower extremity was made, which might have been overlooked after right total knee arthroplasty. This case is reported with a review of the literature review.

The Early Results of Endovenous Radiofrequency Ablation Using the 7 Fr. VNUS $ClosureFAST^{(R)}$ System in Varicose Veins (혈관 내 고주파열치료법인 7 Fr. VNUS $ClosureFAST^{(R)}$ System을 이용한 하지 정맥류 치료의 조기 결과)

  • Ryu, Sang-Woo;Oh, Hye-Ryung;Kim, Mi-Kyung;Moon, Seung-Ho;CheKar, Jay-Key;Yun, Ju-Sik;Hong, Seong-Beom
    • Journal of Chest Surgery
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    • v.42 no.2
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    • pp.238-243
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    • 2009
  • Background: Radiofrequency obliteration and endovenous laser therapy of the greater saphenous vein have recently been introduced as alternative, minimally invasive techniques for the treatment of saphenous vein incompetence. The 7 Fr. VNUS $ClosureFAST^{(R)}$ radiofrequency obliteration system was introduced in Gwang-Ju Veterans hospital. The purpose of this study is to evaluate the efficacy and complications of radiofrequency obliteration using the 7 Fr. VNUS $ClosureFAST^{(R)}$ system. Material and Method: Between May 2, 2007 and May 31, 2008, we performed radiofrequency obliteration on 90 patients. The number of males was 67 and their mean age was $57.9{\pm}11.0$ (range: $23{\sim}78$) years old. The patients underwent follow up exams at 3 weeks after the procedures and then every 3 months. The effects of treatment and the complications were reviewed. Result: The postoperative complications were ecchymosis (94.4%), pain (27.8%), paresthesia (25.6%), bullous formation (8.9%), edema (6.7%) and phlebitis (2.2%). One patient showed good blood flow after 3 weeks and one patient showed good blood flow after 3 months. The one-year success rate of radiofrequency obliteration in varicose veins was 97.6%. Conclusion: Our data showed acceptable operative results and short-term clinical results for treating varicose veins with radio frequency obliteration. Long-term follow-up and comparison of radio frequency obliteration with high ligation and stripping, previous radiofrequency ablation and endovenous laser therapy are needed in the future.

Transilluminated Powered Phlebectomy Using Arthroscopic Equipment in Varicose Vein of Lower Extremities (하지정맥류에서 관절경 장비를 이용한 광투시 전동형 정맥적출술)

  • 박형주;이철세;이길노;이석열
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.391-396
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    • 2003
  • Background: Recently transilluminated powered phlebectomy was introduced and used as a method of surgical treatment for varicose vein in lower extremities. The advantage of transilluminated powered phlebectomy are minimal scar and good cosmetic effect. However, the disadvantages of transilluminated powered phlebectomy is that a high priced Trivex system must be used which increases the patient's expenses. Therefore, we performed a transilluminated powered phlebectomy using an existing arthroscopic equipment instead of Trivex system and observed the effect of treatment and efficiency of the treatment. Material and Method: From March, 2000 to February, 2003, 78 patients (113 limbs) underwent transilluminated powered phlebectomy with an arthroscopic equipment. Patient's disease history, the number of operative scars and complications were reviewed. Result: The operation was performed in 133 limbs of the 78 patients (34 men, 44 women) and the age of patients were ranged from 16 to 72 years with mean age of 41.8 years. Operative time ranged from 20 to 65 minutes (average 48.7 minutes) per limb. The number of operative scar per limb from 2 to 7 (average 4.9). Postoperative complications are transient ecchymosis (78 cases) that desappeared spontaneously, edema persisting longer than 3 weeks (6 cases), remnant varicose vein (4 cases), skin perforation during operative procedure (2 cases), and contact dermatitis due to compression stocking (4 cases) The mean hospitalization day was 3.09 days. Subjective mean satisfaction degree of operation by the patients using a visual analogue scale was 92.6%. Conclusion: Our findings demonstrated that transilluminated powered phleectomy using arthroscopic equipment was possible and had good cosmetic results with acceptable complications.

Transilluminated Powered Phlebectomy for Varicose Vein (하지정맥류의 투시조명하 전동형 정맥류 수술법)

  • 신화균;원용순;송철민
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.611-614
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    • 2001
  • To determine the efficacy and safety of endoscopic resection and ablation of superficial varicosities using a powered vein resector, irrigated illuminator. Material and Method: 83 consecutive patients were involved in the study. 103 limbs in 83 patients were treated using a minimal invasive, powered, vein resecting devide with cutaneous transillumination and tumescent anesthesia technique. There were 51 women and 32 men. All patients were operated under general anesthesia or regional anesthesia. Operative time and patient satisfaction scores were recorded along with the number of incisions made. Result: 83 patients(51/61.4% female, 32/38.6% male, aged 25-78 years) had varicose vein. Average age at the time of operation was 45 years(range, 25 to 78 years). There were 63 unilateral procedures and 20 bilateral operations. Operative time ranged from 24 to 46 minutes (average 35.3 minutes) in the unilateral procedure. The number of incisions per limb averaged 2.7(range, 2 to 5). Postoperative complications occurred in 7(8.4%) patients. Patients were asked to describe their pain on an analog scale ranging form 1 to 10 with r representing no pain and 10 worst imaginable pain. Immediately postoperative pain score was 2.4 Postoperative pain score at 72 hours had a mean score of 2.0. Postoperative pain score at 1 months were 1. Conclusion: Varicose vein removal using Transilluminated Powered Phlebectomy(TIPP) is a safe and efficient procedure. The procedure saves time, is easy to perform, and gives direct visualization and a distinct endpoint of the removal of veins. It is also less tedious to perform and gives good cosmetic results with significant pain relief.

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수캐와 고양이의 번식력에 관한 검사

  • 권춘수
    • Journal of the korean veterinary medical association
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    • v.34 no.8
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    • pp.547-550
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    • 1998
  • 수의사들은 수캐와 고양이를 구입하기전 수캐의 번식력에 대한 검사를 요청 받을 때가 가끔 있다. 미국의 경우 Kennel club 지침에서는 7개월 보다 어린 개 또는 12세 이상된 개를 종견으로 등록할때는 번식력에 대한 소견서 혹은 증명서를 제출하여야만 한다고 되어있다. 번식력 검사에는 수캐의 완전한 병력을 수집해야하며 병력으로 과거 상처, 질병, 예방접종, 투약상태, 고환이 음낭으로 하강한 상태, 년령, 음낭부종 또는 외상의 발생상태 등이 포함되어야한다. 또한 애완동물의 가계에 대한 번식력에 대해서도 찾아보도록 노력해야 한다. 환축을 검사하기전 병력을 축주에 문의하는 것도 하나의 좋은 방법이다. 건강한 수컷이 암캐와 교미를 하지 못할 경우에는 번식관리의 검사에 세심한 주의를 기우려야 한다. 또한 산자의 최종출생일, 산자수, 교미회수, 번식시킨 암컷의 수, 교미형태, 수컷의 성욕 및 승가행위 등에 과한 것들을 조사해야 할 것이다. 이러한 병력으로 수컷은 항상 불임성을 최초에 불임성을 보였는지 또는 저임성을 보였는지를 알수있게 된다. 새끼를 낳아보지 못한 개와 고양이는 선천적으로 불임이 되고 이러한 수컷도 예후는 불량하다. 개와 고양이가 과거에 새끼를 임신한 경험이 없다면 생식기의 전염성 또는 염증과 관련이 있을 수도 있다. 축주는 개 인공수정을 하기 위하여 정액을 채취할 때 물, 소독약 및 윤활제 등으로 인하여 정자의 사멸을 의식하지 못하고 있기 때문에 채취방법을 상세하게 설명하여 주어야 한다. 또한 암컷의 번식문제에 대해서도 상세하게 검사하여야 하며 개와 고양이가 불임되는 가장 흔한 이유는 번식관리에 문제점이 있으며, 이와 같은 경우에는 암컷을 검사하기 전에 수컷을 검사하는 것이 중요하다. 수컷의 검사는 사진으로도 용이하므로 비용도 절감되나 암컷은 생식기관을 검사하여야 되기 때문에 많은 경비가 든다. 그러나 번식력의 유일한 증거는 태아를 생산하는 것이며 많은 다른 검사 방법으로 평가 할 수도 있으나 번식력을 증명할 수는 없다.

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A Facial Nerve Palsy Cases Managed by Yinyang Balancing Appliance (YBA) of FCST, a TMJ Therapy for the Balance of Meridian and Neurological System (턱관절자세음양교정술(FCST)의 음양균형장치를 활용한 구안와사 증례보고)

  • Kim, Yun Sang
    • Journal of TMJ Balancing Medicine
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    • v.6 no.1
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    • pp.5-10
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    • 2016
  • Therapeutic effect of temporomandibular joint postural training by functional cerebrospinal therapy (FCST) for the balance of the meridian and neurologic system was observed in a facial palsy case. An idiopathic facial palsy case of House-Brackmann grade V was managed with FCST, combined with acupuncture and postural training of the cervical and pelvic structures. Clinical outcome measurement was performed by House-Brackmann grade and Yanagihara's scale. The patient showed positive changes in the degree of palsy and subjective symptoms within one month. Further research on the effect of FCST is expected.

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