• 제목/요약/키워드: Abdominal approach

검색결과 163건 처리시간 0.025초

외상성 횡격막 헤르니아: 3례 수술 보고 (Traumatic Diaphragmatic Hernia: A Report of 3 Cases)

  • 유세영
    • Journal of Chest Surgery
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    • 제2권1호
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    • pp.59-64
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    • 1969
  • Three cases of traumatic diaphragmatic hernia were repaired in this department from June 1967 to Nov.1968. The first case, a 14 year old girl, was diagnosed as diaphragmatic hernia during the operation of the diffuse peritonitis from jejunaI perforation 3 days after the traffic accident at local clinic and she was transfered to this hospital after the closure of the perforated jejunum. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture at the posterolateral portion of the left diaphragm was repaired with two layer sutures by transthoracic approach. The second case. a 26 year old man. was diagnosed immediately after the traffic accident at local clinic and transfered to this hospital 24 hours later. Herniated and distended stomach, transverse colon and jejunum were repositioned and the large diaphragmatic rupture, about 9 cm in length, from the posterolateral portion to the base of the pericardium was directly repaired with two layer sutures. The third case, a 26 year old man, who had a history of stab wound at left lower lateral chest two years ago,was admitted with the sudden onset of abdominal pain and vomiting. The diaphragmatic hernia was confirmed with barium enema. The herniated stomach and transverse colon through the defect, about 3.5 cm in diameter, at anterolateral portion of the left diaphragm, were repositioned and the defect was repaired with two layer sutures. All of the cases recovered uneventfully.

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잡견에서의 알진 코팅 인조혈관 삽입실험 (Experimental Evaluation of Algin-coated Vascular Grafts in Dogs)

  • 김원곤
    • Journal of Chest Surgery
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    • 제28권6호
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    • pp.557-564
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    • 1995
  • Microvel knitted double velour vascular grafts coated with biodegradable algin were evaluated in the canine experimental model as a new biologically coated Dacron graft. Three series of implantations were conducted involving the insertion of 6 mm diameter grafts in the abdominal aortae of mongrel dogs. The first series used the regular Microvel vascular grafts coated with algin,whereas the second and third series used Hemashield [collagen-coated grafts and the regular Microvel grafts with preclotting,respectively as control groups. Each series involved the implantation of one prosthesis for each of 2 preselected periods,namely 3 months and 6 months. In addition,algin-impregnated grafts were implanted for 4 hours,72 hours,2 weeks,and 4 weeks. All grafts were patent when the animals were sacrificed at intervals ranging from 4 hours to 6 months. Histological examinations revealed no obvious or significant differences in the healing characteristics of the algin-coated grafts and the control grafts after 3 months and 6 months of implantation. Endothelial cell-like cells were present on the midsegments of all grafts explanted from animals sacrificed after 3 months and 6 months,except a suspicious finding in the 3 month-implantation animal of a preclotted graft. With special stains,the algin became invisible between the polyester filaments during the first 3 months of implantation. This study has demonstrated that the use of a biodegradable algin coating is a feasible approach as biological sealants for textile arterial prostheses.

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음성장애가 있는 성악인에 대한 성악치료의 효과 (The Effect of Singing Therapy on Classical Singers with Voice Problems)

  • 문영일;홍현정;신혜정;박애경;정성민
    • 대한후두음성언어의학회지
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    • 제11권1호
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    • pp.32-38
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    • 2000
  • Background and Objectives : Voice therapy has been used as a viable adjuvant to surgery and pharmacological therapy fir the management of voice disorders. The singing voice features a special brand of emotion, intensity, and energy so successful therapeutical approach requires the doctor is able to involve himself into the physical and psychic condition and artistic usage of the voice. The purpose of this study was to evaluate the effect and utility of singing therapy as an initial treatment for classically trained singers with voice disorders. Material and method : Twenty-one male and fifty-five female classic singers with voice disorders were treated with singing therapy. At first, abdominal breathing, resonant phonation, and relaxation method was trained, then after accessing each patient's singing abilities, treatment methods for each specific problems was applied. The results were compared according to age, sex, treatment duration, part, laryngeal pathology, patient subjective evaluation, perceptual evaluation of voice, and maximal phonation time. Results : Patients subjective evaluation, perceptual evaluation, pathologic findings of larynx, maximal phonation time showed superior results after singing therapy. Conclusion : Singing therapy changes the mode of respiration and phonation and enhances the vocal function and improves the laryngeal pathology, The result of this study indicate that singing therapy is an effective treatment method that laryngologists can use for classical singers with voice disorders.

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좌측성상교감신경절차단후(左側星狀交感神經節遮斷後)에 합병증(合倂症)으로 온 좌측하지온감(左側下肢溫感) (Warm Sensation of Left lower Extremity as a Complication of Left Stellate Ganglion Block)

  • 오흥근
    • The Korean Journal of Pain
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    • 제1권1호
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    • pp.125-128
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    • 1988
  • A case of the left stellate ganglion block (SGB) with a warm serration of the left lower extremity in a 25-year-old male soldier is presented. During the Korean War, this patient received a penetrating gun shot wound from the right knee through the left abdominal wall, left upper arm and left thumb. He was evacuated to the a marine corps surgical hospital where amputation of the left thumb and an end-to-end anatomosis of the left brachial artery were performed. After surgery, left ulnar and median nerve paralysis and causalgia developed and about 9 months later an upper thoracic ganglionectomy was proposed at the Chin-Hae Navel Hospital. Before the ganglionectomy a stellate ganglion block for diagnostic and prognostic purposes was requested by the surgeon. This block was performed by the supraclavicular anterior approach using 10 ml of 2% procaine. The effect of the block including Horner's syndrome was confirmed 5 minute later in this patient. This patient returned to the ward by walking unassisted 10 minutes after the block, and complained of a warm sensation in the left lower extremity 20 minutes later as well as the left upper arm. This warm sensation in the lower extremity following ipsilateral stellate ganglion block indicates that the local anesthetics solution injected tinto the neck spread down to lumbar sympathetic ganalgion along the fascial membrane of the sympathetic chain as a consequence of the 10 minutes walk.

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Chronic Gastric Volvulus with Laparoscopic Gastropexy after Endoscopic Reduction: A Case Report

  • Lee, Hye Yeon;Park, Jung Hyun;Kim, Sung Geun
    • Journal of Gastric Cancer
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    • 제15권2호
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    • pp.147-150
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    • 2015
  • Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroesophageal junction. We attempted an endoscopic reduction, but it was unsuccessful. The patient got laparoscopic anterior gastropexy. Based on our result, laparoscopic gastropexy can be considered as a good choice of the treatment for gastric volvulus.

연령군별 성인 음주자의 고위험음주 관련 요인 (Factors Related to High Risk Drinking in Adult Drinkers by Age Group)

  • 이은숙;서영미
    • 동서간호학연구지
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    • 제27권1호
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    • pp.51-60
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    • 2021
  • Purpose: The purpose of this study was to identify factors associated with high risk drinking in adults. Methods: Multi-variate logistic regression was used to analyze the data of 15,949 adults age 19 years or older from the sixth (2013-2015) Korea National Health and Nutrition Examination Survey. Results: Factors associated with high risk drinking included education level, employment and smoking status among the age group of 19-39. In the 40-59 year age group, the associated factors were gender, employment, smoking, obesity, and depressive mood. In the over 60 year age group, related factors included gender, employment, smoking, abdominal obesity, and subjective health status. Conclusion: The result of this study suggests that early risk factor screening may be helpful to avoid the progression to high-risk drinking. An individualized approach for each age group can be used as a preventive measure.

Thallium poisoning: a case report

  • Oscar Jimenez;Hector Caceres;Luis Gimenez;Luciana Soto;Micaela Montenegro;Jhon Alexander Avila Rueda
    • Journal of Yeungnam Medical Science
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    • 제40권3호
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    • pp.311-314
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    • 2023
  • Thallium poisoning is usually accidental. We present a case of a 51-year-old woman who was evaluated in June 2018 for myalgia, vertigo, asthenia, and abdominal pain. Physical examination revealed temporal-spatial disorientation, jaundice, and asterixis. The laboratory reported the following: bilirubin, 10.3 mg/dL; aspartate transaminase, 78 U/L; alanine transaminase, 194 U/L; albumin, 2.3 g/dL; prothrombin time, 40%; and platelet count, 60,000/mm3. Serology performed for hepatitis A, B, and C; Epstein-Barr virus; cytomegalovirus; and human immunodeficiency virus was negative, and a collagenogram was negative. Physical reevaluation revealed alopecia on the scalp, armpits, and eyebrows; macules on the face; plantar hyperkeratosis; and ulcers on the lower limbs. Tests for lead, arsenic, copper, and mercury were carried out, which were normal; however, elevated urinary thallium (540 ㎍/g; range, 0.4-10 ㎍/g) was observed. The patient was treated with D-penicillamine 1,000 mg/day and recovered her urinary thallium levels were within normal range at annual follow-up. Thallium poisoning is extremely rare and can be fatal in small doses. An adequate clinical approach can facilitate early diagnosis.

분노 관련 제반 증상에 대한 한의학 고문헌 고찰 - 간헐적 폭발성 장애의 한의학적 접근을 모색하며 - (A Literature Review on Symptoms Related to Anger in Korean Medical Texts - Searching for a Korean Medicine Approach to Intermittent Explosive Disorder -)

  • 김연태
    • 대한한의학원전학회지
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    • 제36권3호
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    • pp.15-25
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    • 2023
  • Objectives : This study aims to investigate a wide range of symptoms related to anger and their corresponding treatments as described in Traditional Korean Medical literature. Additionally, the study aims to propose key prescriptions for Intermittent Explosive Disorder(IED), thereby striving to explore potential therapeutic strategies. Methods : This comprehensive study examines the correlations between the pathologies, symptoms, and treatments related to anger, as described in the Yixuerumen (醫學入門), the Donguibogam (東醫寶鑑), and the Xiezhenglun (血證論), and their relevance to IED. Results : Anger impairs the liver, giving rise to a spectrum of symptoms including dry hair, headaches, dizziness, a bitter taste in the mouth, tinnitus, vomiting of blood, sharp chest and flank pains, abdominal discomfort, tremors, diarrhea, and hyperventilation. Furthermore, this heightened anger can serve as a potential trigger for strokes and, considering its potential to hinder recovery from various other conditions, calls for proactive therapeutic intervention. Conclusions : Severe anger has the potential to trigger strokes and hinder recovery from a range of illnesses, underscoring the necessity for tailored and proactive treatment based on the severity of symptoms. In the instance of IED, clinical application of the Danggui Luihuiwan (當歸蘆薈丸) is warranted.

Management of Asymptomatic Gallstones in Renal Transplantation

  • Lee, Ru Da;Youn, Seok Hwa;Shin, Dong Hoon
    • 대한이식학회지
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    • 제28권3호
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    • pp.160-164
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    • 2014
  • Background: In solid organ transplantation patients, complications of cholelithiasis may run a fulminant course, resulting in high morbidity and mortality under immunosuppression and may even result in rejection. Here, we reviewed medical records of 66 patients in order to determine the outcome of management approach for asymptomatic gallstones in renal transplantation patients. Methods: We retrospectively reviewed clinical courses of 66 cases of renal transplantation performed between 2000 and 2012 at Kosin University Gospel Hospital. Results: Among 66 cases, eight had gallstones before transplantation. Three of these cases had undergone previous cholecystectomy for symptomatic gallstones, one had a simultaneous laparoscopic cholecystectomy and renal transplantation, and four were observed by regular abdominal ultrasonography. One patient was found to have cholangitis, and endoscopic retrograde biliary drainage was performed, resulting in alleviation of symptoms. Among 58 cases without preoperative gallstones, three developed gallstones after transplantation. One patient had cholecystitis, and the symptoms subsided after conservative treatment. Conclusions: For patients with asymptomatic gallstones who are awaiting renal transplantation, expectant management should be considered.

통합 의학 치료로 5년 생존 및 완전 관해에 도달한 췌장암 증례 보고 1례 (Case Report on the Five-year Survival and Complete Response of a Patient with Pancreatic Cancer Treated with Integrative Medicine)

  • 정유진;김지수;박경덕;오유나;정범진;방선휘
    • 대한한방내과학회지
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    • 제44권3호
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    • pp.562-577
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    • 2023
  • Objectives: This is a five-year survival and complete response (CR) report on pancreatic cancer treated with western medicine and Korean traditional medicine. Method: A 59-year-old woman diagnosed with pancreatic cancer visited ○○ Korean traditional medicine hospital after neoadjuvant chemotherapy and pylorus-preserving pancreaticoduodenectomy. She was treated with Korean traditional medicine, including acupuncture, abdominal moxibustion, wild ginseng pharmacopuncture, and herbal medicine, which was based on integrated medicine therapy (IMT), from March 2018 to September 2022. The tumor size was measured by scanning with computed tomography (CT), magnetic resonance imaging, and positron-emission tomography/CT. Adverse events were evaluated using laboratory conclusion and National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Result: During four years and three months of treatment, IMT maintained safety. The patient finally reached five-year survival without any recurrence or complication (CR) on October 26, 2022. Conclusion: We suggest that an integrative approach including Korean traditional medicine can be a meaningful treatment option for pancreatic cancer. Further studies should be performed to establish the proper treatment protocol of integrative medicine for pancreatic cancer.