• 제목/요약/키워드: Chest Wall

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ST714-SCCmec type IV CA-MRSA에 의한 피부 연부조직 감염증으로 내원한 소아 증례 (ST714-SCCmec type IV CA-MRSA isolated from a Child with Recurrent Skin and Soft Tissue Infections in South Korea: A Case Report)

  • 유리나;김서희;이진아
    • Pediatric Infection and Vaccine
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    • 제23권1호
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    • pp.62-66
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    • 2016
  • 최근 전세계적으로 지역사회 기원 메티실린내성 황색포도알균(CA-MRSA)에 의한 피부연부조직 감염증이 증가하고 있다. 16개월의 한국 여아가 생후 6개월부터 시작된 반복되는 피부연부조직 감염증을 주소로 내원하였다. 환아의 가족들도 환아와 비슷한 시기에 피부연부조직 감염증의 병력이 있었다. 환아의 혈중 면역글로불린 및 NBT 검사는 정상이었고, 피부 병변 외에는 가족 모두 건강하였다. 환아의 감염증 부위의 고름 배양 및 비강 내 보균 검사시 모두 PVL genes을 생성하는 CA-MRSA ST714 SCCmec type IV가 확인되었고, 이는 ST30의 single locus variant로서 국내에서는 보고된 적이 없는 MRSA의 유전형이다. 환아와 함께, 환아의 균주와 동일 항생제 감수성 양상을 보이는 MRSA 보균자인 환아부에게 재발 방지를 위해서 비강내 mupirocin 5일 요법을 시행하였고 이후 10개월간 추가적인 재발은 없었다.

Spontaneously Occurring Chemodectoma in a Yorkshire Terrier Dog

  • Park, Chul;Yoo, Jong-Hyun;Kim, Dae-Young;Park, Hee-Myung
    • 한국임상수의학회지
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    • 제25권3호
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    • pp.187-191
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    • 2008
  • A 7-year-old, intact female Yorkshire terrier dog was presented for coughing, anorexia, chest pain and dyspnea. Right lateral thoracic radiograph demonstrated a large mass shape on the heart base with decreased cardiac silhouette and severe right deviation of the trachea with the heart shifted to the left thoracic wall was observed on the ventrodorsal thoracic projection. Echocardiographic examination revealed a large rounded mass compressing left atrium around the heart base without signs of pericardial effusion. On computed tomographic (CT) findings, sagittal CT images depicted the possibility of cranial vena caval invasion and heart base involvement of the mass associated with biatrial compression. Dorsal CT image revealed the right deviation of trachea due to the heart base mass and markedly shrunk lung space was detected on the transverse CT image. Because the dog suddenly had died during the recovery from anesthesia after finishing CT scan, necropsy was performed. On gross findings, a large and lobulated mass was located at the base of the heart. A poorly-demarcated, infiltrative, multilobulated tumor composed of polyhedral cells in solid cellular sheets was confirmed based on histopathologic examination. This dog was diagnosed as a chemodectoma. This case report describes the clinical findings, diagnostic consistency of thoracic radiography, echocardiography and CT, and histopathologic confirmation in a spontaneously occurring chemodectoma with a Yorkshire terrier dog.

May-Thurner 증후군의 혈관 내 스텐트를 이용한 치료 - 치험 2예 - (May-Thurner Syndrome Treated with Endovascular Wall Stent - Report of two cases -)

  • 윤유상;원제환;최호;소동문;이철주;김형태
    • Journal of Chest Surgery
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    • 제36권3호
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    • pp.202-205
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    • 2003
  • 중심정맥혈전증은 흔히 관찰되는 질병이다. 그러나 그 원인 중 오른총장골정맥이 왼총장골동맥의 눌림과 협착에 의해 정맥 흐름이 방해받는 경우가 드물게 있으며, 이를 May-Thurner 증후군 또는 장골눌림증후군(Iliac compression syndrome)이라 한다. 이에 대한 치료는 중심정맥혈전증이 있을 경우에 카테터를 이용한 혈전 용해술과 혈전 용해 후 왼총장골정맥 내 스텐트(Stent) 삽입이 추천되고 있다. 저자들은 좌측 하지 부종으로 내원하여 시행한 정맥조영술상 May-Thurner syndrome으로 진단된 2예에서 혈전용해술 및 풍선확장술과 왼총장골정맥 내에 스텐트를 삽입하여 성공적으로 치료하였기에 관련 문헌과 함께 보고하는 바이다.

폐의 방선균증 1예 (A Case of Pulmonary Actinomycosis)

  • 장지정;김성수;김치홍;권순석;김영균;김관형;한기돈;문화식;송정섭;박성학;서은주
    • Tuberculosis and Respiratory Diseases
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    • 제39권5호
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    • pp.438-442
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    • 1992
  • 저자들은 최근 폐만을 침습하여 임상 및 방사선학적으로 기타 염증성 질환이나 악성 암과의 감별이 어려웠던 환자에서 기관지경하 생검을 통해 진단된 방선균종 1예를 경험하였기에 문헌고찰과 함께 이를 보고하는 바이다.

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실험쥐모델에서 이식전 제공자 전혈 수혈이 이식심장의 생존에 미치는 영향 (Effect of Pretransplant Donor-specific Blood Transfusion on Cardiac Allograft Survival in Rats)

  • 서충헌;박만실
    • Journal of Chest Surgery
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    • 제32권11호
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    • pp.984-988
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    • 1999
  • Background: Donor-specific blood transfusion(DSBT) before organ transplantation has been demonstrated to prolong allograft survival; the mechanism of this effect has remained unclear. Only a few researches have been performed on this subject in our country. Material and Method: To investigate the effect of DSBT, we selected 5 donor recipient combinations using rats of pure strain such as PVG, ACI, and LEW. One ml of donor whole blood was transfused to each recipient through the femoral vein 7 days prior to transplantation. The donor heart was transplanted to the recipient's abdominal vessels heterotopically using modified Ono and Lindsey's microsurgical technique. Five transplantations were done for each combination. Postoperatively, donor heart beat was palpated everyday through the recipent's abdominal wall. Rejection was defined as complete cessation of donor heart beat. Result: The allogeneic heart grafts transplanted from PVG strain to ACI strain(PVG ACI) without DSBT were acutely rejected(mean survival 10.2 days). With pretransplant DSBT, the cardiac allografts in PVG ACI and LEW PVG combinations survived indefinitely(more than 100 days), those in ACI PVG combination survived 12 to 66 days(mean 31.8 days), those in PVG LEW survived 8 to 11 days(mean 10.0 days), and those in ACI LEW survived 7 to 9 days(mean 8.0 days). In brief, DSBT prior to heart transplantation was definitely effective in PVG ACI and LEW PVG combinations and moderately effective in ACI PVG combination, but not effective in PVG LEW and ACI LEW combinations. Conclusion: DSBT prior to heart transplantation showed variable effects, but might prolong cardiac allograft survival indefinitely in some donor recipient strain combinations. The mechanism of this effect should be further investigated.

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폐암(肺癌)의 한의치료(韓醫治療)에 관(關)한 문헌적(文獻的) 고찰(考察)

  • 박정희;김병탁;김성훈
    • 대한한의학회지
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    • 제16권1호통권29호
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    • pp.71-95
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    • 1995
  • To be helpful to the treatment of pulmonary cancer with oriental medicine, we got clinical reports together and analyzed the data. The results were obtained as follows: 1. The treating methods could be summarized as three methods that were reinforcing vital energy, eliminating harmful Qi, and reinforcing vital energy with eliminating harmful Qi. The methods of reinforcing vital energy were supplementing Qi & Yin, increasing pahological heat & reinforcing kidney, augmenting Qi & blood, supplementing vital energy and strengthening fundermental energy, reinforcing spleen and increasing Qi, lubricate Yin and lung, and the other methods of eliminating harmful Qi were transforming pathological fluid and softening, clarifying heat and eliminating poison, dipersing lung and softening, toxicding and softening, guiding Qi and activating blood, clarifying heat and dispersing lung, guiding Qi and counteracting stress etc., and the methods of supplementing vital energy with eliminating poison were reinforcing spleen and transforming pathological fluid, increasing Qi and activating blood, supplementing Yin and clarifying heat, reinforcing spleen and dry the dampness, lubricating lung and transforming patholigical fluid and supplementing Qi and activating blood. 2. The oriental prescriptions used for pulmonary cancer were Chunkeum-Weekyungtang & Sohamhwingtang, Jinhayookgunjatang, Hyulboochukeotang, Bokbangkyogonamtang was reported to be effective in the treatment of metastasis. 3. Bokbangshinjingtang and haewool were applied for the complications of pulmonary cancer, Soshihotang for fever, hangamryung for tumor pain. Prunus ansu Komarov, Eriobotrya japonica Lirdley, Pyrrosiae lingua Farwel, Steomon japonica Miguel, Maximowiczia chinensis Ruprecht var, Morus bombycis Koidzumi for cough, Panax Pseudo-ginseng Wall. var, Bletilla striata Reichenbach f., Acacia catechu(兒茶) for hemoptysis, Lonicerae flos, Aspongopus chinensis(九香蟲) for chest pain, Cypsum Fibrosum, Gazella gutturosa, Scutellaria baicalensis Georgi, Gypsophila oldhamiana Miquel for fever, Lepidii semen descurainiae semen, Belamcanda chinensis D.C, Gnaphalium affine(佛耳草) for asthma. 4. For the reduction of side effect by chemotherapy and radiotherapy it was known that supplementing Qi was used chiefly for side effect of chemotherapy and augmenting Yin applied to side effect of radiotherapy. 5. The oriental presciptions were suggested for the side effect by chemotherapy and radiotherapy ; Sammaekaek(參麥液), Whaebokwontang(化瘀復元湯), Hwangjungomitang(黃精五味湯), Yukmijihwangtang(六味地黃湯), Hyangsayukgunjatang(香砂六君子湯), Samlyeekulsan for side effect by chemotherapy while Geumgweisingiwhan, Hwanglyentang(黃連湯), Hwanglyenhaedoktang(黃連解毒湯), Yangyeunchungpeitang(養陰淸肺湯), Idongtang(二冬湯), Jayeunkanghwatang(滋陰降火湯) for side effect by radiotherapy.

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Poland-Mobius syndrome 신생아 1례 (The first Korean case of poland-Mobius syndrome associated with dextrocardia)

  • 정지영;김한규;안혜미;조수진;박은애
    • Clinical and Experimental Pediatrics
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    • 제52권12호
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    • pp.1388-1391
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    • 2009
  • Poland 증후군은 일측 대흉근의 부재나 저형성과 다양한 동측 손기형을 특징으로 한다. Mobius 증후군은 완전 혹은 불완전의 안면마비를 특징으로 하는 선천적 신경학적 이상을 말한다. 이들의 병인은 명확히 밝혀지지 않았지만, 이환된 측의 혈류가 감소됨으로서 발생된다 여겨지고 있다. 2.670 g 남자아이가 38주 3일에 왼쪽 안면마비와 우심증이 동반된 왼쪽 흉벽 결손에 2번째, 3번째 손가락 합지증을 가지고 태어났다. Poland-Mobius 증후군은 드물며, 세계적으로 우심증과 관련된 증례는 단지 2례 밖에 없었다. 이에 우리는 우심증이 동반된 Poland-Mobius 증후군의 국내 첫 증례를 보고하는 바이다.

Orienting the superficial inferior epigastric artery (SIEA) pedicle in a stacked SIEA-deep inferior epigastric perforator free flap configuration for unilateral tertiary breast reconstruction

  • Yu, Ya-han;Ghorra, Dina;Bojanic, Christine;Aria, Oti N.;MacLennan, Louise;Malata, Charles M.
    • Archives of Plastic Surgery
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    • 제47권5호
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    • pp.473-477
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    • 2020
  • Superficial inferior epigastric artery (SIEA) flaps represent a useful option in autologous breast reconstruction. However, the short-fixed pedicle can limit flap inset options. We present a challenging flap inset successfully addressed by de-epithelialization, turnover, and counterintuitive rotation. A 47-year-old woman underwent left tertiary breast reconstruction with stacked free flaps using right deep inferior epigastric perforator and left SIEA vessels. Antegrade and retrograde anastomoses to the internal mammary (IM) vessels were preferred; additionally, the thoracodorsal vessels were unavailable due to previous latissimus dorsi breast reconstruction. Optimal shaping required repositioning of the lateral ends of the flaps superiorly, which would position the ipsilateral SIEA hemi-flap pedicle lateral to and out of reach of the IM vessels. This problem was overcome by turning the SIEA flap on its long axis, allowing the pedicle to sit medially with the lateral end of the flap positioned superiorly. The de-epithelialized SIEA flap dermis was in direct contact with the chest wall, enabling its fixation. This method of flap inset provides a valuable solution for medializing the SIEA pedicle while maintaining an aesthetically satisfactory orientation. This technique could be used in ipsilateral SIEA flap breast reconstructions that do not require a skin paddle, as with stacked flaps or following nipple-sparing mastectomy.

흉부 압박손상에 의한 대동맥궁 파열 - 1예 보고 - (Aortic Arch Rupture due to Compression Injury of the Thorax - A case report -)

  • 이건;임창영;이헌재
    • Journal of Chest Surgery
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    • 제42권1호
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    • pp.100-103
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    • 2009
  • 흉부 대동맥의 외상성 파열은 두부 손상 다음으로 흔한 교통사고의 사망원인으로 약 85%의 환자가 병원 도착 전에 사망한다. 가장 흔한 기전은 고속의 차량이 충돌 등으로 인한 급작스런 감속에 의해 발생되며 대동맥 협부가 전체 대동맥 손상의 95%에 해당된다. 또 다른 기전으로는 흉부 압박 손상에 의해 골절되어 전위된 흉골병과 흉부 척추 사이에 대동맥이 끼이면서 나타날 수 있는데 이로 인해 흔하지 않은 위치의 대동맥벽의 내막이 파열된다. 저자들은 감속사고가 아닌 흉부 압박에 의해 대동맥궁이 파열되어 박리된 증례에 대해 집중적인 내과 치료 후에 지연 수술로 완전 순환정지 하에 뇌보호를 시행하면서 상행 대동맥의 일부와 대동맥궁을 인조혈관으로 치환하였기에 보고하는 바이다.

Characterization of Venous Involvement in Vasculo-Behçet Disease

  • Lee, Na Hyeon;Bae, Miju;Jin, Moran;Chung, Sung Woon;Lee, Chung Won;Jeon, Chang Ho
    • Journal of Chest Surgery
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    • 제53권6호
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    • pp.381-386
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    • 2020
  • Background: Behçet disease is a chronic inflammatory disorder with a varying etiology. Herein, we report the involvement of peripheral veins in Behçet disease and discuss the treatment thereof. Methods: Thirty-four patients with venous involvement in vasculo-Behçet disease were retrospectively analyzed over 15 years. We reviewed the clinical manifestations, treatment choices, and complications of these patients. Results: Deep vein thrombosis (DVT) was observed in 24 patients (70.59%) and varicose veins in 19 (52.94%). Immunosuppressive treatment was administered to all patients due to the pathological feature of vein wall inflammation. In patients with DVT, anticoagulation therapy was also used, but post-thrombotic syndrome was observed in all patients along with chronic luminal changes. Eleven patients with isolated varicose veins underwent surgery; although symptoms and lesions recurred in half of these patients, no cases of secondary DVT occurred. Conclusion: When DVT was diagnosed in patients with Behçet disease, there was no cure for the lesions. Ultrasonographic abnormalities were observed in all patients, and post-thrombotic syndrome remained to varying degrees. In cases of isolated varicose veins in patients with Behçet disease, DVT did not occur after surgical treatment. If the activity of Behçet disease is controlled, surgical correction of varicose veins is preferable.