• 제목/요약/키워드: Cases

검색결과 47,270건 처리시간 0.055초

식도암의 임상적 고찰 [III] (Cancer of the Esophagus and Cardia [III]: A Clinical Review of 55 cases)

  • 이강식
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.922-928
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    • 1990
  • Treatment of patients with esophageal carcinoma remains disappointing. Fewer than 20% *of patients with esophageal carcinoma treated with curative intent by surgery and radiation therapy will be alive at 5 years. Fifty five patients underwent treatment for carcinoma of the esophagus and cardia which retrospective clinical study done between January 1983, and December, 1989 in Department of Thoracic and Cardiovascular Surgery, National Medical Center, Seoul, Korea. There were 48 men. 7 women and the mean age was 56.2 years[range, 38 to 78 years]. The most frequent preoperative findings included dysphagia[46 cases], weight loss[33 cases] and substernal pain[19 cases]. 19 cases[34.5%] were underwent resectional surgery, which was total esophagectomy with esophagogastrostomy[ 5 cases], with colon interposition[3 cases], lower esophagectomy with esophagogastrostomy [10 cases], with total gastrectomy and esophagojejunostomy [1 case]. The operative mortality was 15.8%[3/19] and causes of death were respiratory failure in 2 cases, and 1 case of sepsis. Palliative procedures, such as feeding gastrostomy and jejunostomy[14 cases], bypass surgery without resection[ 4 cases], radiation therapy[ 3 cases] were done.

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강원도내 광견병 발생 및 진단 (Recent outbreaks of rabies in Gangwon-do)

  • 신은경;신명균;한태옥
    • 한국동물위생학회지
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    • 제27권1호
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    • pp.31-39
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    • 2004
  • This study was performed to investigate the rabies surveillance in Gangwon-do from 1997 to 2001. Of 185 laboratory submissions for rabies diagnosis, 65(35.1%) cases were determined to be infected with the rabies virus. Annual incidence of animal rabies was 10 cases in 1997, 20 cases in 1998, 16 cases in 1999, 3 cases in 2000, and 16 cases in 2001, respectively. The total number of the reported cases were increased 382% compared with that of the previous period from 1993 to 1996(7 cases). The relative contributions of infected animals in this period were as follows: cattles(24 cases), dogs(26 cases), and raccoons(15 cases). Rabies outbreak in raccoon were steadily expanded. Epidemiologic surveillance showed the rabies outbreaks spreaded to the southern area in Gangwon-do. All rabies cases were showed positive results to rabies tests such as clinical signs, histopathological findings, indirect flourescent antibody test, and mouse inoculation test. Further studies such as genetic and phylogenetic analysis of the isolates should be performed in order to figure out accurate rabies outbreak.

간종대(肝腫大)와 안면모세혈관확장(顔面毛細血管擴張)의 보험의학적연구(保險醫學的硏究) (A Study on Hepatomegaly and Facial Telangiectasia in a Group of the Insured)

  • 임영훈
    • 보험의학회지
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    • 제4권1호
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    • pp.110-132
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    • 1987
  • A study on hepatomegaly detected by abdominal palpation, and facial telangiectasia in a total of 3,418 insured persons medically examined at the Honam Medical Room of Dong Bang Life Insurance Company Ltd. from February, 1984 to August, 1985 was undertaken. The results were as follows: 1) Hepatomegaly was found in 383 cases(27.5%) among the 1,395 insureds of male and in 163 cases(8.1%) among the 2,023 insureds of female. The difference of incidence of hepatomegaly between all males and females showed statistical significance(p<0.001). In each age group, the incidence of hepatomegaly in :nale was higher than that in female. The incidence of hepatomegaly in each age group in male increased cnosiderably with age; it showed 11.6%,16.2%, 42.6% and 52.9% from second to sixth decade in order, thereafter in seventh decade it decreased to 26.7%, While the incidence of hepatomegaly in female increased slightly in each age group. 2) Facial telangiectasia was found in 318 cases(22.8%) among all males and in 157 cases(7.8%) among all females. The difference of incidence of telangiectasia between all males and females showed statistical significance(p<0.001). In each age group, the incidence of telangiectasia in male was higher than that in female, except of second decade. The incidence of facial telangiectasia in each age group in male increased considerably with age; while it increased slightly in female. 3) Facial telangiectasia accompanied by hepatomegaly was found in 235 cases(61.4%) among 383 cases of hepatomegaly in male and in 69 cases(42.3%) among 163 cases of hepatomegaly in female. The difference of incidence of telangiectasia between males and females show ed statistical significance(p<0.001). 4) Facial telangiectasia without spider angiomata accompanied by hepatomegaly was found in 201 cases(52.5%) among 383 cases of hepatomegaly in all males and in 67 casgs(41.4%) among 163 cases of hepatomegaly in all females; facial spider angiomata accompanied by hepatomegaly was found in 34 cases(8.9%) among 383 cases of hepatomegaly in all males and in 2 cases(1.2%) among 163 cases of hepatomegaly in all females. 5) Abnormal SGOT activity was found in 19 cases(7.9%) among 242 cases of hepatomegaly in all males and in one case(1.5%) among 67 cases of hepatomegaly in all females. The difference of incidence of abnormal SGOT activity showed statistical significance(p<0.001). The incidence of abnormal SGOT activity by the size of hepatomegaly, that is, palpated <1 finger's breadth, <2 fingers' breadth and ${\geqq}2$ fingers' breadth, revealed 2.2%, 6.0% and 60.0% respectively in all males, while abnormal SGOT activity was found only one case in fifth decade among 67 cases of hepatomegaly in all females. 6) In ordinary medical examination(the insured amount is low) abnormal SGOT activity was found in 7 cases(4.8%) among 146 cases of hepatomegaly palpated $1\frac{1}{2}$ fingers' breadth and under, while it was not found in 37 cases of the same sized hepatomegaly in all females. Above mentioned 7 cases are thought to be very significant because 7 cases occupy 35% in 20 cases of abnormal SGOT activity with hepatomegaly. 7) Abnormal SGOT activity was found in 12 cases(4.4%) among 273 cases of hepatomegaly of "not firm" consistency, while it was found in 8 cases(22.2%) among 36 cases of hepatomegaly of "firm" consistency. The difference of incidence of abnormal SGOT activity showed statistical significance(p<0.05). 8) Abnormal SGOT activity was found in 5 cases(17.9%) among 28 cases of spider angiomata with hepatomegaly, while it was found in 10 cases(7.3%) among 166 cases of telangiectasia without spider angiomata with hepatomegaly. Owing to a small number of cases, statistical significance was not recognized, but the incidence of abnormal SGOT activity in spider angiomata cases with hepatomegaly is apt to be higher than that in telangiectasia cases without spider angiomata with hepatomegaly. 9) The incidence of abnormal SGOT activity is apt to be higher with age in male group; abnormal SGOT activity was not found among 4 cases of hepatomegaly in second decade and it was 3.8% in third decade, 4.5% in fourth decade, 9.3% in fifth decade, 17.5% in sixth decade and 33.3% in seventh decade, while the incidence of it was only one case among 67 cases in all females. 10) It is believed that the performance of liver function test to the subjects with hepatomegaly even in ordinary medical examination(the insured amount is low) will give considerable contribution for medical selection of hepatomegaly risk. 11) Age of the insured(young or old), presence of facial telangiectasia or spider angiomata especially and their severity, and consistency of enlarged liver(firm or not) should be considered to increase accuracy in evaluating hepatomegaly risk.

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교통사고(交通事故)로 인한 편타성(鞭打性) 손상(損傷) 환자(患者) 37례(例)에 대한 임상연구(臨床硏究) (The clinical study on 37 cases of whiplash injury patients which caused by traffic accident)

  • 강재희;장석근;이현;이병렬
    • Journal of Acupuncture Research
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    • 제19권3호
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    • pp.180-191
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    • 2002
  • Objective : This study was performed to evaluate the effect of oriental medical treatment in whiplash injury patients which caused by traffic accident. Methods : The clinical study was carried out 37 cases of whiplash injury patients which had been admitted in Daejon university Cheon-an oriental hospital from June, 2001 to December, 2001. Results : l. In the distribution of sex distinction was female much more than male in the ratio of 3:2 and thirties was most in age distribution. 2. In situation of traffic accident, The most case was rear-ending(70.27%). 3. Except cervical pain or it's reffered pain, there were whole body symptoms as fallow, insomnia in 11cases(29.73%), night pain in 10 cases(27.03%), general body pain in 8cases(21.62), dizziness in 6cases(16.22%). 4. According to Meridian Muscle theory, a injured parts of patient were devided as follows. There were 22cases(59.46%) which have injury in Bladder, Small Intestine Meridian Muscle, 10cases(27.03%) in Gallblader, Triple Energizer Meridian Muscle, 5cases(13.51%) in Stomach, Large Intestine Meridian Muscle. 5. There were 6cases(16.22%) of the grade of complete recovery, 10cases(27.03%) of the grade of excellent, 12cases(32.43%) of the grade of improvement, 6cases(16.22%) of the grade of disimprovement and 3cases(8.11%) of the grade of poor. So 28cases(75.68%) were efficacious. 6. Generally Herb-meds that have efficacy of Geo-Eohyeol were most used(27cases, 72.97%) in early stage. Secondly Herb-med that have efficacy of Yiqi-sunqi were used(20case, 54,05%) in middle stage and Herb-med of Bo-Qiheol were used(l0cases, 27.03%) in latter term. The most used Herb-med was Hoisu-san, Oyaksungi-san(22cases, 54.96%). 7. In l5cases which have Aqua-Acupuncture treatment, There were 3cases of Complete recovery, 5cases of Excellent, 4cases of Improvement, 2cases of Disimprovement, 1cases of Poor. 8cases(53.33%) were above Excellent grade, so it is more efficatious Than simple treatment without Aqua-Acupuncture(36.37%). 8. The improvement of Bladder, Small Intestine Meridian Muscle was 77.27%, Gallblader, Triple Energizer Meridian Muscle was 70% and Stomach, Large Intestine Meridian Muscle was 80%. Additional Aqua-Acupuncture treatment improved to be effective in Bladder, Small Intestine Meridian Muscle(77.78%), in Gallblader, Triple Energizer Meridian Muscle(75%), in Stomach, Large Intestine Meridian Muscle(100%). Conclusions : In this study, Oriental treatment especially Aqua-Acupuncture was effective in whiplash injury patients which caused by traffic accident.

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늑막강내 저류액의 임상적 고찰 (Clinical Evaluation of Pleural Fluid)

  • 정황규
    • Journal of Chest Surgery
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    • 제21권2호
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    • pp.316-325
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    • 1988
  • Author made a clinical study of 248 cases of pleural effusion patients who were diagnosed and treated at departments of chest surgery and internal medicine, Pusan National University Hospital, during the period from Jan. 1983 to Dec. 1985. The age distribution ranged from 1 to 76 years old and the ratio of male to female was 1.38:1. The cardinal symptoms were chest pain[69.4%], dyspnea[66.1%], cough[57.7%], fever[37.1%], sputum[26.2%], general malais[13.7%] and cyanosis[1.6%] in this order. The causes of pleural effusion were pulmonary tuberculosis[42.4%], pneumonia[23.0%], malignancy[16.5%], congestive heart failure[9.3%], liver cirrhosis[2.8%] and nephrosis[2.0%] in this order. The protein in the pleural effusions was 1.61*0.90[mean*SD] gm% in transudate and 5.05*1.10[Mean*SD] gm% in exudate. In 34 cases[89.5%]out of 38 transudates, the protein was under 3 gm% and in 201 cases [95.7%] out of 210 exudates, the protein was over 3 gm%. The protein ratio of pleural effusion to serum was 0.2650.11[Mean LSD] in transudates and 0.73*0.12[Mean LSD] in exudate. The ratio under 0.5 was in 36 cases[94.8%] out of 38 transudates and over 0.5 was in 206 cases[98.1%] out of 210 exudates. The LDH in the pleural effusion was 114.7550.3[mean*SD] units / ml in transudate and 627.05325.9[mean*SD] units / ml in exudate. The LDH less than 200 units / ml was in 36 cases[94.6%] out of 38 transudates and more than 200 units / ml was in 199 cases[94.7%] out of 210 exudates. The LDH ratio of pleural effusion to serum was 0.34k 0.11[mean*SD] in transudate and 1.15*1.12[mean*SD] in exudate. The LDH ratio of pleural effusion to serum was less than 0.6 in 36 cases[94.8%]out of 38 transudates and more than 0.6 in 200 cases[95.2%] out of 210 exudates. Etiologic organisms were confirmed in 78 cases[48.1%] among the requested 162 cases. In the 78 cases of etiologic organisms, staphylococcus was 33 cases[20.3%], streptococcus 24 cases[14.8%], Klebsiella pneumonia 7 cases[4.3%], pseudomonas 6 cases[3.7%], E. coli[3.1%], enterobacter 3 cases[1.9%]. 43 patient of pleural effusion from malignancy were undergone three or more thoracenteses. In 13 cases[31.7%], three specimen were negative and in 7 cases[17.1%], three specimens were positive for malignancy. In the remaining of 21 cases[51.2%], malignant cells were found in one or more of the specimens but not in all. Methods of treatment of pleural effusion by closed thoracotomy was 188 cases[75.8%], thoracentesis 27 cases[10.9%], decortication 16 cases[6.5%], thoracoplasty 6 cases[2.4%] and decortication with thoracoplasty 3 cases[1.2%].

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화이버기관지경검사에 관한 임상적 연구 (A Clinical Study on Fiberoptic Bronchoscopy)

  • 홍영호;정해영;민양기;김중환
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1979년도 제13차 학술대회 연제순서 및 초록
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    • pp.7.1-7
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    • 1979
  • 1978년 7월부터 1979년 2월까지 8개월간 중앙대학교의과대학 이비인후과에서 화의버기관지경검사를 시행한 총 31명에 대하여 통계학적으로 분석, 검토하여 다음과 같은 결과를 얻었기에 문헌적 고찰과 함께 보고하는 바이다. 1) 성별로는 남자 20명, 여자 11명으로 약 2 : 1로 남자가 많았다. 2) 연령별로는 40∼60세 군이 가장 많은 분포를 보였으며, (22례, 70.1%), 다른 연령군은 비교적 고른 분포를 보였다. 3) 주소는 혈담(35.5%), 기침(29.0%), 흉통(19.4%), 호흡곤란(9.7%) 순으로 많았다. 4) 기관지 흡입물의 그람염색으로는 그람음성쌍구균이 12례(38.7%), 그람양성균이 10례(32.3%), 그람양성간상균이 6례(19.4%), 그람음성간상균이 3례(9.7%)이었다. 배양결과는 17례(58.4%)에서는 자라지 않았으며, 나이세리아속 6례 (19.4%), 프로테우스와 크레브시엘라 속이 각각 1례이었고 혼합군이 3례이었다. 병리조직학적 진단으로는 만성기관지염이 11례 (35.5%), 기관지암이 9례(29.0%), 만성육아종이 3례(9.7%)였고 2례는 특이한 소견이 없었고 6례는 표본이 너무 작아 병리조직학검사가 실패하였다. 5) 기관지경검사소견, 검사실성적 및 임상소견에 의해 얻은 진단에 의하면, 기관지의 원발성 암이 9례(29.0%), 만성기관지염이 6례(19.4%), 폐렴이 4례 (12.9%) 순으로 많았다.

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감염성 심내막염의 외과적 치료 (Surgical Treatment of Native Valve Endocarditis)

  • 김애중;김민호;김공수
    • Journal of Chest Surgery
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    • 제28권9호
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    • pp.822-828
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    • 1995
  • This paper reports 15 native valve endocarditis cases had surgical operation in the past 10 years at the department of Cardiovascular and Thoracic Surgery, Chonbuk National University Hospital. In this study, 10 cases out of 15 were in class I or II by the New York Heart Association functional classification. None of the cases had a history of taking addictive drugs. Five cases were congenital heart disease, three cases were rheumatic heart disease and two cases were degenerative heart disease. Thus 10 cases had the underlying disease. All cases had antibiotics treatment for 3 to 6 weeks before operation. In the culture test, only four cases were positive in the blood culture and one case was positive in the excised valve culture. Organisms on blood and valve culture were Streptococcus epidermis, Streptococcus viridans, Staphylococcus aureus and Staphylococcus epidermidis. In the 10 cases without ventricular septal defect, the aortic valve was involved in four, mitral in four, both in two and involved valves in the 5 cases with ventricular septal defect were tricuspid in three, pulmonic in two. Eight cases had operation because they showed moderate congestive heart failure due to valvular insufficiency and vegetation with or without embolism. Seven cases had operation because they showed persistent or progressive congestive heart failure and/or uncontrolled infection. Five cases with ventricular septal defect underwent the closure of ventricular septal defect, vegetectomy and leaflet excision of the affected valves without valve replacement. In the cases without ventricular septal defect, the affected valves were replaced with St. Jude mechanical prosthesis. Postoperative complications were recurrent endocarditis in two, embolism in one, allergic vasculitis in two, spleen rupture in one and postpericardiotomy syndrome in one. At the first postoperative day, one case died of cerebral embolism. At the 11th postoperative month, one case died of recurrent endocarditis and paravalvular leakage in spite of a couple of aortic valve replacement. In the survived cases[13 cases in this study , all cases but one became class I or II by the New York Heart Association functional classification.

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소아 막성 신병증의 원인에 따른 빈도 및 임상양상의 차이 (The Differences in Frequencies and Clinical Manifestations According to the Causes of Membranous Nephropathy in Children)

  • 문윤희;김세진;김성도;조병수
    • Childhood Kidney Diseases
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    • 제10권2호
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    • pp.162-173
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    • 2006
  • Purpose : To report the decreasing indicence of HBV(Hepatitis B virus)-associated membranous nephropathy in children after HBV vaccination and to elucidate the clinical course and treatment strategies of IMN(Idiopathic membranous nephropathy). Methods : We retrospectively reviewed the clinico-pathological findings of HBV-MN and IMN patients who underwent a renal biopsy from 1986 to 2005. We compared the HBV-MN and the IMN groups and the remission and the non-remission groups of patients with IMN. Results : Among 24 cases of MN patients, HBV-MN comprised 6 cases(25%) and IMN 18 cases(75%). Clinical masnifestations were nephrotic syndrome(3 cases, 50%), nephritic syndrome(1 case, 16.7%), asymptomatic(2 cases, 33.4%) in the HBV-MN group, asymptomatic(10 cases, 55.5%), nephrotic syndrome(5 cases, 27.8%), and gross hematuria(3 cases, 16.7%) in the IMN groups. From 1996 to 2000, there were 2 cases(28%) of HBV-MN and 5 cases(72%) of IMN. After 2001 all 10 cases were IMN. In the HBV-MN group, 4 cases(66.7%) received interferon and 1 cases received methylprednisolone pulse therapy. In the IMN group, 16 cases(88.9%) received methylprednisolone, 8 cases(44.4%) were in complete remission, 2 cases(11.1%) were in partial remission, 2 cases(11.1%) were in chronic renal failure, and 5 cases(27.8%) were lost to follow-up with sustained proteinuria, 1 case(5.6%) continued to have frequent relapse of nephrotic syndrome without renal insufficiency. In the comparison between remission and non-remission groups, nephrotic range proteinuria and hypertension were more significantly common in the non-remission group(P<0.05). Conclusion : With HBV vaccination, HBV-MN has decreased markedly. IMN is a rare glomerular disease in children. Because the prognosis for patients with nephrotic range proteinuria is poor this group needs more aggressive treatment.

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탄산(呑酸)에 관(關)한 임상적(臨床的) 연구(硏究) (Clinical studies for Tan-San (呑酸))

  • 김인상;문구;문석재
    • 대한한방내과학회지
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    • 제13권2호
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    • pp.77-83
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    • 1992
  • Clinical studies were done on 43 cases of Tan-San(呑酸) patient which were treated by outpatient, took medicine with Ge-Wool-Hwa-Dam-Jeon (開鬱火痰煎) in Dept. of 2nd clinic, Christian Oriental Hospital from June in 1991 to end of May in 1992. The results were as follows. 1. The ratio of sex and age was 37.2% males (16 cases) and 62.7% females (27 cases) somewhat higher than males, In the age distribution, the highiest decade was thirtieth decade 48.83% (21 cases). 2. In the vocational distribution, housewives 51.16% (22 cases), commerces 23.25% (10 cases), company employee, teachers, students were in order of frequency and in the regional distribution was city 93.02% (40 cases), from village 6.97% (3 cases). 3. In the type distribution, the highiest frequency was Gan-Gi-Beom-Wi(肝氣犯胃) type 53.48% (23 cases), and Sik-Jeok (食積) 18.8% (8 cases), Bi-Gi-Heo(脾氣虛) 16.27% (7 cases) were in order of frequency. 4. In the western name of a disease distribution, the highiest frequency was chronic gastritis 37.20% (16 cases). 5. In the period of history, the highiest freguency was between six months and one year 23.25% (10 cases), furthermore between 5 years and 10 years 2.32% (40 cases). 6. In the treatment period, the highiest frequency was between 3 weeks and 4 weeks 38.46% (10 cases), and between one month and 2 months 30.76% (8 cases) was in order of frequency. 7. Treatment progress found out progressed 74.2% (26 cases) among the 35 cases which was known treatment progress.

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항통(項痛)을 주소(主訴)로 입원(入院) 치료(治療)한 환자(患者) 25례(例)에 대(對)한 임상적(臨床的) 고찰(考察) (A clinical observation for 25 cases of patients who are taken by chiefly complained of neck pain)

  • 이은용;이병렬
    • Journal of Acupuncture Research
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    • 제15권2호
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    • pp.393-406
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    • 1998
  • Twenty five cases of the patient admission-treatment from chiefly complained of neck pain observed clinically from first January 1997 to thirty first December 1997 in the Dept. of Acupuncture and Moxibustion, Oriental Hospital, Taejon University, Taejon, Korea. And the results were obtained as follows; 1. The distribution of sex was male 13(52%) cases, female 12(48%) cases and the male to female ratio was 1.1 : 1. The distribution of age was the most predominant as the fifties 6(24%) cases. 2. The contributing factors were the most predominant as the reason unknown 9(36%) cases, unstable position 5(20%) cases. 3. The distribution of duration was the most predominant of 9(36%) cases in a week. 4. The distribution of before admission-treatments were the most predominant as west-medication 13(32.5%) cases. 5. The distribution of patient's condition of first treatment was the most predominant as Gr.III 13(52%) cases. 6. The distribution of duration for admission was the most predominant as 13(52%) cases in a week. 7. The distribution of radiological studies were the nust predominant as the HIVD 26(63.4%) cases. 8. The distribution of clinical symptoms were the most predominant as neck pain 25(21.0%) cases, radiating pain to the upper extremities 23(19.3%) cases. 9. The distribution of located on clinical syrnptoms were the most predominant as neck-shoulder and back-upper extremities 11(44%) cases. 10. The distribution of clinical diagnosis was the most predominant as HIVD 16(45.7%) cases. 11. The distribution of methods of treatment were the most predominant as Acupuncture -­ Herb Medication - Electro Acupuncture treatment 8(32%) cases. 12. The effect of treatment by discharge was the most predominant of 11(44%) cases as Good result.

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