• Title/Summary/Keyword: Auscultation

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만성 비특이성 동맥염에 의한 비전형적 하행 흉대동맥 협착증: Bypass graft 를 시행한 1예 (Atypical Coarctation in the Descending Thoracic Aorta: Treated by Bypass Graft)

  • 장운하;유회성
    • Journal of Chest Surgery
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    • 제11권1호
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    • pp.81-84
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    • 1978
  • A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

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American cocker spaniel dog에서 발생한 삼첨판 이형성 증례 (Tricuspid valve dysplasia(TVD) in an American cocker spaniel dog)

  • 박철;최치봉;서정향;정병현;박희명
    • 대한수의학회지
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    • 제44권1호
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    • pp.125-129
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    • 2004
  • A 2-year-old, female, American cocker spaniel dog presented for a 1-year history of severe ascites, exercise intolerance, tachypnea. At that time, she was in an emergency state. First, the dog was stabilized with oxygen therapy. A diagnosis of cardiac problem was made from history, auscultation, radiograph, ECG, and echocardiography. Jugular pulsation was palpated and a harsh, systolic murmur of tricuspid regurgitation was prominent at the right cardiac apex. Tricuspid valve dysplasia (TVD) was confirmed with echocardiography, accompanying enormous myocardial hypertrophy. The clinical signs had been improved for 8 months with careful therapy and periodic abdominocentesis, and ascites was well controlled. The situation, however, became worse quickly in a week because the client did not follow our management schedule. Finally, she died due to dyspnea and shock. After the spontaneous death, necropsy and histopathological examination were performed and when we opened the thorax, a significantly large heart was observed. On histopathological findings, grossly myocardium appeared pale initially, then progressed to yellow and white. Microscopically, there was an extensive hemorrhage along with loss of myocardial striations. Interstitial fibrosis and various degenerative alterations in myocytes were also present.

Perceived Competency, Frequency, Training Needs in Physical Assessment among Registered Nurses

  • Oh, Heeyoung;Lee, Jiyeon;Kim, Eun Kyung
    • 성인간호학회지
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    • 제24권6호
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    • pp.627-634
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    • 2012
  • Purpose: The purpose of this study was to identify registered nurses learning needs about physical assessment. Specifically, what are the perceived competency, frequency of skill use and the unmet training needs. Methods: The study was an exploratory survey study. The sample was 104 registered nurses. Data were collected through three instruments: The Perceived Competency in Physical Assessment Scale, the Frequency of Physical Assessment Scale, and the Training Needs of Physical Assessment Scale which incorporated 30 core Physical Assessment skills. Descriptive statistics, t-test, and Pearson's correlation coefficient were used to analyze the data. Results: Auscultation of heart and lung sounds and inspection of the spine were rated by the subjects as physical assessment skills they feel least competent and also were less frequently performed. The most competent area for physical assessment was neurological system. The respiratory and abdominal system was identified as two systems that more education would be needed. Nurses with less than one year of working experience reported needing more training. Nurses with more than five years of clinical work experience performed physical assessment more frequently than nurses with less than five year of work experience. The perceived competency was positively related to the frequency of physical assessment. Conclusion: Continuing education is necessary to further train registered nurses regarding physical assessment skills and the program needs to be focused on the area which nurses are less competent for and have high training need.

"황제내경(黃帝內經)"의 사증(死證)에 대한 고찰(考察) (A Study on Sajeung(死證) presented in "Huangjenaegyeong(黃帝內經)")

  • 정창현;백유상;장우창;김도훈
    • 대한한의학원전학회지
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    • 제17권4호
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    • pp.155-170
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    • 2004
  • The word "Sajeung(死證)" in "Huangjenaegyeong(黃帝內經)" includes a warning to lead to death if it is treated wrongly as well as a definite diagnosis saying that it is impossible to care diseases. A disorder condition of the body means that the balance of Eum-yang(陰陽) are broken or O-haeng(五行) doesn't have a good circulation. The prediction to progress is very important as much as decision of whether it is Sajeung or not because it can be changed by the time of day or night and also by changes of the seasons. In addition, according to the relations between Sangsaeng(相生) and Sanggeuk(相克) of O-haeng patients' diseases fall into a dangerous condition at the time under control. But sometimes it can be a severe illness even they are full of vigor. When living and dying has to be determined, it is emphasized the significance of inspection, auscultation and olfaction, inquiring and palpation(望聞問切法). Especially this is the key point to study people's face and pulse.

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문진(問診)에 대한 서지학적 고찰 (A Literature Study on interrogation)

  • 김진호
    • 대한한의학원전학회지
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    • 제28권1호
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    • pp.21-34
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    • 2015
  • Objectives : The treatment starts with physical examination. The four examinations(四診) is a method to examine the disease. The books on history of diagnostics about it contained substantial contents about inspection(望診) and palpation including pulse taking(切診), while they contained little contents about auscultation(聞診) and interrogation or questioning(問診) relatively. For this reason, this study was conducted as on interrogation first of all. Methods : I looked into the contents related to interrogation that were scattered in plenty of books. There were chapters of specialty in interrogation since the Ming dynasty, so I looked into these chapters in chronological order. Results & Conclusions : The level of the contents of interrogation prior to the Ming dynasty were rudimentary and recapitulative. However, there was a turning point by three kinds of books appeared in the Ming dynasty. Yixuerumen Wenzheng dealt with detailed contents. Yixuezhunshengliuyao Wenbingbixiang extended the range of contents. Jingyuequanshu Shiwenpian systematized Eight Principle Pattern Identification(八綱辨證) with increase of contents. Since then, books of the Qing Dynasty were mostly based on three kinds of books ahead. Among these, Yimenfalu Yimingwenbingzhifa(醫門法律 一明問病之法) and Xingsewaizhenjianma wenfa(形色外診簡摩 問法) mentioned the importance of a succinct interrogation that hit the mark and Yibian Yiwenzheng dealt with another detailed contents unlike the previous books based on substantial contents.

간농양에 병발한 심낭염 치험 2례 (Pericarditis Arisen from Liver Abscess: Report of 2 Cases)

  • 서충헌
    • Journal of Chest Surgery
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    • 제14권2호
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    • pp.140-143
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    • 1981
  • Thymolipoma is extremely uncommon benign mediastinal tumor consisting of fatty and thymic tissue. Only 50 verified cases have been reported in the world literatures. This one case is the first reported example of surgically treated thymolipoma associated with spontaneous pneumothorax. A thirty-two year old male patient had been in good health until two days prior to admission, when he noted sudden dyspnea associated with an aching pain over the left precordium. The dyspnea and chest pain had become progressively worse. The physical examination revealed that left hemithorax was tympanic sound on percussion and absence of breathing sound on auscultation and point of maximal impulse was located on the 4th intercostal space at the left sternal border. Emergency closed thoracostomy was performed under the impression of tension type spontaneous pneumothorax of the left lung. After closed thoracostomy, point of maximal impulse was not changed inspire of full expansion of the left lung and chest X-ray was strongly suggested pericardial effusion or cardiomegaly which couldn`t account for by clinical course and hemodynamic evidence. EKG, echocardiogram, bronchofiberoscophy, bronchogram and diagnostic thoracentesis was performed. On Dec. 8, 1980, operation was performed under the impression of mediastinal tumor in the anterior mediastinum. At left posterolateral thoractomy, a large fatty mass, measuring 35 x 27 x 13 Cm in dimension and weighing 3350 gm, was resected and multiple bullae on the apicoposterior segment of the left upper lobe was resected and continuously sutured. The pathologic diagnosis of the fatty mass was thymolipoma. The postoperative course was uneventful and discharged in good general conditions.

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자연기흉을 합병한 흉선지방종의 치험례 (Thymolipoma associated with spontaneous pneumothorax: report of a case)

  • 이철범
    • Journal of Chest Surgery
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    • 제14권2호
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    • pp.135-139
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    • 1981
  • Thymolipoma is extremely uncommon benign mediastinal tumor consisting of fatty and thymic tissue. Only 50 verified cases have been reported in the world literatures. This one case is the first reported example of surgically treated thymolipoma associated with spontaneous pneumothorax. A thirty-two year old male patient had been in good health until two days prior to admission, when he noted sudden dyspnea associated with an aching pain over the left precordium. The dyspnea and chest pain had become progressively worse. The physical examination revealed that left hemithorax was tympanic sound on percussion and absence of breathing sound on auscultation and point of maximal impulse was located on the 4th intercostal space at the left sternal border. Emergency closed thoracostomy was performed under the impression of tension type spontaneous pneumothorax of the left lung. After closed thoracostomy, point of maximal impulse was not changed inspire of full expansion of the left lung and chest X-ray was strongly suggested pericardial effusion or cardiomegaly which couldn`t account for by clinical course and hemodynamic evidence. EKG, echocardiogram, bronchofiberoscophy, bronchogram and diagnostic thoracentesis was performed. On Dec. 8, 1980, operation was performed under the impression of mediastinal tumor in the anterior mediastinum. At left posterolateral thoractomy, a large fatty mass, measuring 35 x 27 x 13 Cm in dimension and weighing 3350 gm, was resected and multiple bullae on the apicoposterior segment of the left upper lobe was resected and continuously sutured. The pathologic diagnosis of the fatty mass was thymolipoma. The postoperative course was uneventful and discharged in good general conditions.

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개에서 농흉증의 영상의학적 접근 (Medical Imaging of Pyothorax in a Dog)

  • 최호정;이영원;박기태;왕지환;김영기;연성찬;이효종;이희천
    • 한국임상수의학회지
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    • 제27권1호
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    • pp.107-112
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    • 2010
  • A 3-years-old female Pointer was evaluated for anorexia, dyspnea and exercise intolerance for 10 days. Auscultation revealed muffling of heart sound. There were leukocytosis, anemia, hypoalbuminaemia and hyperglobulinaemia on the blood profiles. Radiography showed severe pleural effusion. Thorax ultrasonographs described traped pleural effusion, pericardial effusion and collapsed right lung lobe(s). On CT images, thoracic neoplasia and lung torsion were ruled-out. Thoracocentesis with thoracoscopy and bacterial culture revealed pyothorax and pleuritis. The diagnosis of pyothorax in dogs and cats is based on clinical signs, radiography, thoracocentesis and cytology and culture of the exudate. In this case, various diagnostic medical imaging techniques (radiography, ultrasonography, CT and thoracoscopy) were used for diagnosis of pyothorax.

개에서 심실중격결손의 영상의학적 진단 2례 (Medical Imaging of Ventricular Septal Defect in Two Dogs)

  • 최호정;이영원;왕지환;박기태;연성찬;이효종;이희천
    • 한국임상수의학회지
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    • 제25권5호
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    • pp.420-423
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    • 2008
  • Ventricular septal defects (VSDs) is an opening in the ventricular septum that allows blood to flow between the ventricles. Most ventricular septal defects are located in the upper ventricular septum and can be identified by auscultation. In this report, 2 dogs with heart murmur were diagnosed as VSD using radiography and echocardiography. In radiographs, bulging sign of the main pulmonary artery or the enlargement of the left ventricle was observed. The color Doppler examination showed the left-to-right shunting of blood via interventricular septal defect.

심잡음 정량화에 관한 연구 (A Study of Heart Murmur Quantification)

  • 엄상희
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2016년도 춘계학술대회
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    • pp.252-255
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    • 2016
  • 심음은 가장 쉽게 추출, 보관이 가능하고 가장 빨리 심장 질환을 진단하는데 도움을 줄 수 있기에 많이 사용되고 있다. 심음은 청진, 전자 청진을 통하여 얻어지는데 질환의 판정을 위해서는 전문의 많은 경험에 의존하고 있고, 자동 진단을 위한 장비는 매우 고가이며, 이를 위하여 심음의 정량화 과정이 선행되어야 한다. 본 연구에서는 심음의 한 종류인 심잡음을 심장 질환 별로 추출하여 정량화하여 자동 진단에 도움을 주고자 하였다. 심잡음은 심잡음 에너지율을 계산하여 정량화에 이용하였다. 추출된 심잡음 에너지의 파워 스펙트럼은 심장 질환별로 분류 가능한 형태학적 특징을 나타내었다.

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