• Title/Summary/Keyword: 흉부형태

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Twenty Four Cases of Idiopathic Bronchiolitis Obliterans Organizing Pneumonia, Reported in Korea and a Review of Literatures (국내 보고된 특발성 폐쇄성세기관지염 기질화폐렴 24예와 문헌 고찰)

  • Chang, Jung-Hyun;Park, Sa-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.709-717
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    • 1999
  • Background & Method : Bronchiolitis obliterans organizing pneumonia(BOOP) is a specific clinicopathologic condition characterized by chronic inflammatory interstitial infiltrates. Cryptogenic form of BOOP presents subacute clinical course of flu-like illness, such as cough, fever, dyspnea with exertion and other constitutional symptoms. Pathologically it shows the presence of granulation tissue filling the lumen of terminal and respiratory bronchioles, extending into distal airspaces. Recently, we reviewed 24 cases of idiopathic type of BOOP, 5 cases of our hospital and another 19 cases on Korean literatures, and compared with reviewed data from foreign literatures. Results : Mean age was 54 years old and there was female preponderance in domestic reports. Their common presenting symptoms were dyspnea and cough, and mean duration of illness was 41 days. On chest examination, inspiratory crackle was a common finding. The laboratory findings were nonspecific except hypoxemia. Lung function studies revealed restrictive defect or combined obstructive and restrictive pattern in most patients. Bilateral patchy and nonsegmental alveolar opacities constituted characterized radiographic finding, highlighted on high resolution computed tomogram. It showed a favorable prognosis with an excellent responsiveness to corticosteroid therapy. The clinical features and laboratory findings were similar between domestic and foreign cases except female preponderance in Korean cases. Conclusion : If the clinical course is atypical or pregressive under proper treatment, clinicians should reevaluate clinical features and radiographic findings under the consideration of BOOP. Tissue confirmation would be recommended for the definitive diagnosis of BOOP.

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Surgical Repair of Inferior Sinus Venosus Defect - A Report Four Cases- (하정맥동형 심방중격결손의 외과적처지 -4례 보고-)

  • 최형호;김천석;윤향석;최종범;최순호
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.168-172
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    • 1998
  • Inferior sinus venosus defect is a rare lesion in which there is a large interatrial communication adjacent to the atrial connection of the inferior caval vein. The defect is located posteriorly and inferiorly, outside the confines of the true atrial septum, and partial anomalous pulmonary venous connections are the rule. We underwent surgical repair in four patients with inferior sinus venosus defect and partial anomalous pulmonary venous return. There were three males and one female with an age range from four months to 25 years. A cross- sectional echocardiogram and cardiac catheterization had been performed preoperatively in all patients, but the correct diagnosis had been made in only one case. Surgical repair was indicated due to congestive heart failure, and one patient of 4-month-old needed urgent operation. The repair was accomplished by suturing a untreated autologous pericardial patch to the right of the pulmonary veins, so that the defect was closed and all the pulmonary venous blood was directed to the left atrium. The preoperative knowledge of the unusual anatomy allows the surgeon to repair the anomaly without difficulties. For the patients in whom interatrial communication and anomalous pulmonary venous return are suggested, surgeon has to pay careful attention to the anatomical landmarks to avoid incorrect placement of the patch.

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Surgical Management of Malignant Mesenchymoma of the Lung in an Adult -A Case Report- (악성간엽종의 외과적 치료 -1례보고-)

  • Yang, Soo-Ho;Chon, Yang-Bin;Chon, Soon-Ho;Kim, Hyuk;Chung, Won-Sang;Choi, Yo-Won;Chon, Suk-Chul;Chon, Suk-Hoon;Park, Moon-Hyang;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.186-189
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    • 1998
  • Malignant mesenchymoma is a very rare tumor presented during the embryonic and infant period and malignant mesenchymoma in the adult is extremely rare. Tumor is composed of two or more unrelated mesenchymal derivatives apart from fibrous tissue. These tumors are thought to be originated from embryonic mesenchyme capable of differentiating into any type of connective tissue. A 61 years old man with complaints of cough and copious sputum of onset of two months was admitted after initial examinations, showing a very huge mass over the right upper lobe. Right pneumonectomy with partial rib resection of 3rd, 4th, and 5th ribs was performed due to the initial diagnostic impression of squamous cell carcinoma by the fine needle aspiration biopsy. The operative field presented a mass locating across the interlobal fissure with severe adhesions to the chest wall. Postoperatively, the patient received 5,000 rads of radiotherapy and presently, 6 months later, has shown no signs of recurrence.

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Comparison of Different Thawing Methods on Cryopreserved Aorta (냉동 보존된 대동맥의 해동방법)

  • 오영민;심성보;사영조;박재길;곽문섭;이선희
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.113-118
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    • 2004
  • The studies on cryopreserved arterial allograft have been focused on cooling methods, pre-treatment, cryoprotectant agents, and preservation temperature. But recently, several studies have reported that thawing methods also play an important role in the occurrence of macroscopic and microscopic cracks. This study was designed to investigate the cell injury after thawing, using a rabbit model to clarify the effect of thawing methods on cryopreserved arteries. Material and Method: Segments of the rabbit aorta were obtained and divided into 3 groups (n=60) according to whether the specimens were fresh (control, n=20), cryopreserved and rapidly thawed (RT) at 37$^{\circ}C$ (n=20), or cryopreserved and subjected to controlled, automated slow thawing (ST)(n=20). Cell damage was established using the TUNEL method and the morphological changes were also evaluated. Result: In the group that was rapidly thawed, the expression of TUNEL (+) cells increased significantly more than in the slowly thawed group. In addition, the endothelial denudation, microvesicles and edema were significant in the rapidly thawed group compared with those changes in the slowly thawed group. Conclusion: Our study suggests that the rapid thawing method may be one of the major causes of cellular damage and delayed rupture in cryopresewed arterial allografts. The expression of TUNEL (+) cells and structural changes were significantly low in the slowly thawed group, which might have contributed to the improvement of graft failure after transplantation.

Ascending Aortic Rupture in a Young Woman with Loeys-Dietz Syndrome: The First Case Report in Korea (Loeys-Dietz 증후군으로 진단된 젊은 여자 환자의 상행 대동맥 파열: 국내 첫 번째 증례 보고)

  • Kim, Hwan-Wook;Lee, Taek-Yeon;Moon, Duk-Hwan;Choo, Suk-Jung;Chung, Cheal-Hyun;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.639-644
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    • 2009
  • Characterized by unique phenotypic features such as aortic aneurysm/dissection, hypertelorism, bifid uvula/cleft palate and generalized tortuosity in the arterial system, Loeys-Dietz syndrome is a newly described aggressive connective tissue disorder associated with mutation in the gene encoding transforming growth factor-$\beta$ receptor type I or type II. Some phenotypic manifestations of Loeys-Dietz syndrome overlap with those of Marfan syndrome or Ehlers-Danlos syndrome type IV. However, due to its more malignant pathophysiologic nature, physicians should be alert to Loeys-Dietz syndrome. High suspicion, early diagnosis, preventive surgery and serial imaging assessments are warranted for optimal management of Loeys-Dietz syndrome. We present here a case of a young patient with Loeys-Dietz syndrome who had aortic rupture, bifid uvula and hypertelorism. We also present a review of the medical literature.

CT 영상에서의 간 영역 추출 및 간 종양 분석

  • Jang Do-Won;Lim Eun-Kyung;Kim Chang-Won;Kim Min-Hwan;Kim Kwang-Baek
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2006.06a
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    • pp.183-192
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    • 2006
  • 간세포암은 우리나라에서 전체 암사망자 중 17.2%로 3번째의 흔한 사망원인이며, 간암에 의한 사망률은 인구 10만 명당 약 21명에 이른다. 본 논문에서는 간 내부에서 발생하는 간세포암을 CT 영상에서 자동으로 추출하는 방법을 제안하여 간세포암의 보조진단으로서의 유용성에 대해 알아보고자 한다. 간 내부의 종양을 추출하기 위해 흉부의 윗부분에서 시작하여 2.5mm의 간격으로 약 45-50장 정도를 촬영한 CT 영상들을 대상으로 먼저 간 영역을 추출한다. 간 영역 추출은 먼저 관심이 없는 외부 영역을 갈비뼈를 중심으로 제거한 후 영상의 밝기 정보를 이용하여 각 기관의 영역을 분할 한다. 분할된 영역들은 위 아래로 인접한 영상에서의 분할 영역들과 밝기 값을 비교하여 적절하게 병합하는 3차원적 접근방법을 사용한다. 간 영역은 여러개의 영역들 중에서 간 영역의 구조 및 위치 등의 정보를 활용하여 추출한다. 추출된 간 영역에서 종양 판별과 추출을 위해 종양이 가지는 특징을 분석하여 종양을 추출한다. 전형적인 간세포암은 과혈관성 종양이므로 조영증강 CT 영상에서 주위보다 밝은 색으로 나타나며, 팽창 형성장을 보일 경우에는 구형으로 나타나는 특징이 있다. 이에, 주위 보다 밝은 색을 가지고 둥근형태를 가지는 영역을 종양의 후보영역으로 선정한 후, 그 영상의 위와 아래로 연결되는 영상에서도 같은 위치에서 같은 특징을 보이는 영역이 있으면 간 내부의 종양으로 판별하여 추출한다. 제안된 간 영역 및 간 종양 추출 방법의 정확성을 판별하기 위하여 CT 영상을 대상으로 실험하여 영상의학 전문의가 판단한 결과와 비교하였다. 간 영역 추출은 정확히 모두 추출되었으며, 간 종양 추출 및 판별은 전문의의 보조 진단도구로 활용할 수 있는 가능성이 매우 높다는 것을 확인할 수 있었다.emantic Similarity Measure 등을 단계적으로 수행하여 자동화되고 정확한 규칙식별을 하고자 한다. 이러한 방법들의 조합으로 인하여 규칙구성요소 추출이 되지 않을 후보 단어들의 수를 줄여서 보다 더 정확하고, 지능적인 규칙구성요소 추출 방법론을 제시하고 구현하여 지식관리자의 규칙습득에 대한 부담을 줄여 주고자 한다. 도움을 받을 수 있게 되었다.을 거치도록 되어있다. 교통주제도는 국가의 교통정책결정과 관련분야의 기초자료로서 다양하게 활용되고 있으며, 특히 ITS 노드/링크 기본지도로 활용되는 등 교통 분야의 중요한 지리정보로서 구축되고 있다..20{\pm}0.37L$, 72시간에 $1.33{\pm}0.33L$로 유의한 차이를 보였으므로(F=6.153, P=0.004), 술 후 폐환기능 회복에 효과가 있다. 4) 실험군과 대조군의 수술 후 노력성 폐활량은 수술 후 72시간에서 실험군이 $1.90{\pm}0.61L$, 대조군이 $1.51{\pm}0.38L$로 유의한 차이를 보였다(t=2.620, P=0.013). 5) 실험군과 대조군의 수술 후 일초 노력성 호기량은 수술 후 24시간에서 $1.33{\pm}0.56L,\;1.00{\ge}0.28L$로 유의한 차이를 보였고(t=2.530, P=0.017), 술 후 72시간에서 $1.72{\pm}0.65L,\;1.33{\pm}0.3L$로 유의한 차이를 보였다(t=2.540, P=0.016). 6) 대상자의 술 후 폐환기능에 영향을 미치는 요인은 성별로 나타났다. 이에 따른 폐환기능의 차이를 보면, 실험군의 술 후 노력성 폐활량이 48시간에 남자($1.78{\pm}0.61L$)가 여자(

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Artificial Trachea Covered by Ipithelium (상피세포 피복 인공기관의 개발)

  • 김광택;이윤신
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.739-746
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    • 1997
  • A variety of experiments concerning the development of ideal prosthetic grafts for correcting circumferential tracheal defects have been performed. The requirements for an ideal tracheal prosthesis are impermeability to air, consistency to prevent collapse, and acceptance by the host tissue causing a minimum inflammatory reaction, allowing fibroblastic infiltration and epithelialization. The synthetic material, polyurethane(PU), is known as a biocompatible polymer with an inert component. In this study, the tracheal prosthesis was made from microporous PU(30 micrometer in diameter) coated with gelatin and reinforced with isoplastic rings. This procedure provides the prosthesis with a compression strength. The out side diame er of the prosthesis was 20 mm with a length of 30 mm. The gelatin used in the study was obtained from pig skin and immobilized and cross-linked by irradiation(60 Co gamma ray) to promote host tissue incorporation and render the prosthesis epithelization after implantation. Animal experiments using 10 mongrel dogs were performed to compare three kinds of prosthesis; gelatin coated polyurethane graft, uncoated polyurethane graft, and prosthesisf pericadium complex graft. After 6 weeks of implantation, the epithelialization of implants was seen on the gelatin-coated and prosthesisfpericadium complex grafts. Implanted prosthesis were complicated by airway obstruction due to anastomosis granuloma. Early tracheal stenosis was found in the uncoated graft group. Two kind of anastomosis techniques were tested on the gelatin-coated prosthesis. Everted anastomosis resulted severe granuloma than the inverted anastomosis. In the prosthesislpericadium complex graft, bacteria and inflammation at a anastomotic site was found. Based on these results, gelatin coated porous polyurethane trachea prosthesis is biocompatible and may be useful in clinical application with further investigation.

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Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation (승모판 폐쇄 부전증에서 발생한 국소적 폐부종 1예)

  • Yoon, Young Gul;Bang, Do Seok;Park, Bum Chul;Lee, Sung Hoon;Kim, Jae Su;Park, Yol;Hong, Young Chul;Ko, Kyoung Tae;Park, Sang Min;Han, Sang Hoon;Park, Sang Hoon;Lim, Jun Cheol;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.432-435
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    • 2005
  • An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The $O_2$ saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.

Detection and Analysis of the Liver Area and Liver Tumors in CT Scans (CT 영상에서의 간 영역과 간 종양 추출 및 분석)

  • Kim, Kwang-Baek
    • Journal of Intelligence and Information Systems
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    • v.13 no.1
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    • pp.15-27
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    • 2007
  • In Korea, hepatoma is the thirdly frequent cause of death from cancer occupying 17.2% among the whole deaths from cancer and the rate of death from hepatoma comes to about 21's persons per one-hundred thousand ones. This paper proposes an automatic method for the extraction of areas being suspicious as hepatoma from a CT scan and evaluates the availability as an auxiliary tool for the diagnosis of hepatoma. For detecting tumors in the internal of the liver from CT scans, first, an area of the liver is extracted from about $45{\sim}50's$ CT scans obtained by scanning in 2.5-mm intervals starting from the lower part of the chest. In the extraction of an area of the liver, after unconcerned areas outside of the ribs being removed, areas of the internal organs are separated and enlarged by using intensity information of the CT scan. The area of the liver is extracted among separated areas by using information on position and morphology of the liver. Since hepatoma is a hypervascular turner, the area corresponding to hepatoma appears more brightly than the surroundings in contrast-enhancement CT scans, and when hepatoma shows expansile growth, the area has a spherical shape. So, for the extraction of areas of hepatoma, areas being brighter than the surroundings and globe-shaped are selected as candidate ones in an area of the liver, and then, areas appearing at the same position in successive CT scans among the candidates are discriminated as hepatoma. For the performance evaluation of the proposed method, experiment results obtained by applying the proposed method to CT scans were compared with the diagnoses by radiologists. The evaluation results showed that all areas of the liver and liver tumors were extracted exactly and the proposed method has a high availability as an auxiliary diagnosis tools for the discrimination of liver tumors.

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Development of Bioelectric Signal Sensor System using Band Type ECG (밴드형 심전도 생체신호 전극시스템의 구현)

  • Kang Sung-Chul;Kim Gi-Ryon;Kim Kwang-Nyeon;Jung Dong-Keun;Kim Min-Sung;Jeong Do-Wun;Jeon Gye-Rok
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.1023-1026
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    • 2006
  • There are some cases in trouble with monitoring emergency patient by existing electrode sensor in measuring instrument in home and hospital etc. And there are problem to measure because of coming down electrode in emergency car or vessel of shaking and fat, humidity of patient. In this study, it has designed band-type for patient to put on the breast easily and go around anywhere freely putting band electrode on his body. Gold has used as electrode material in this electrocardiogram because of its excellent electronic resistance peculiarity and no trouble with skin. And it is able to monitor multi-body-signal by additional design of periphery temperature. There are good results of body signal transmission in the breast or the rib, and get a little body signal in abdomen. We get a result it is better case of gold than usual electrode on signal detection, and know usual electrode was disposable, but we have more correct result from gold electrode sensor, being semi-permanent ana. great contact ability even if movement.

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