• 제목/요약/키워드: Definitive

검색결과 978건 처리시간 0.021초

폐격리증에 대한 임상적 고찰 (Clinical study of Pulmonary Sequestration)

  • 안혁
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.320-326
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    • 1985
  • Pulmonary sequestration occurs when some disturbance produces a cystic mass of nonfunctioning lung tissue which lacks normal communication with the tracheobronchial tree. Between 1971 and 1985, pulmonary sequestration was diagnosed in 11 patients, ranging age from 3 to 29 years. All sequestration were intralobar type. Definitive diagnosis can only be obtained by aortography and/or surgical exploration in 10 cases. The other one was confirmed by pathologic examination postoperatively. The presenting complaints were mostly recurrent local pulmonary infection, but in 2 cases mediastinal mass with respiratory symptoms was presented, and cardiac murmur was only finding in one case. Preoperative diagnostic procedure revealed 3 associated anomalies which were funnel chest, right aortic arch, and pulmonic stenosis with vascular ring. Operative treatment for sequestration was lobectomy in 10 cases, and a segmentectomy in one. There was no operative mortality, but 3 complications [empyema, B-P fistula, post-op bleeding] which were controlled by subsequent operations or conservative measure. Aortography is strongly advocated not only for its diagnostic value, but for its preoperative localization of the aberrant vessels that are the major concern to the surgeon.

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신성고혈압을 동반한 Takayasu 동맥염의 수술치험 1 (Surgical Treatment of Takayasu`s Arteritis with Renovascular Hypertension)

  • 권우석
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.171-176
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    • 1987
  • Takayasu`s arteritis is one of chronic inflammatory disease characteristically involving the aorta and its major branches. Symptoms and signs of the disease are various depending on the involved area. We experienced a surgical case of Takayasu`s arteritis mainly involving both renal arteries with renovascular hypertension in a 13 year old girl. Hypertension was not controlled by medical treatment including diuretics and captopril [160/140 mmHg]. Aortogram showed severely stenosed right renal artery, nearly obstructed left renal artery and not visulalized superior mesenteric artery. Angioplasty was performed for the right renal artery but aorta-renal bypass graft with greater saphenous vein was inevitable for the left renal artery. Blood pressure was controlled sufficiently with some adjunct of captopril postoperatively [130/90 mmHg]. While the patient was discharged with much improvement, she was lost follow up and died of not identified definitive cause 3 months later.

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척추경막외 지방종증 - 증례보고 - (Spinal Epidural Lipomatosis - Report of Four Cases -)

  • 김태완;허용석;지문표;김재오;김정철
    • Journal of Korean Neurosurgical Society
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    • 제29권11호
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    • pp.1527-1532
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    • 2000
  • Althogh spinal epidural lipomatosis is relatively rare, it is a widely recognized complication of excess exogenous glucocorticoids. We report 4 cases of epidural lipomatosis. None of the patients had definitive history of steroid treatment, obesity, or diabetes mellitus, but all had sciatica and radiating pain. In all cases, the authors removed excess amount of epidural fat with surgery after which significant improvement of symptoms was noted.

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Glioblastoma Mimicking Herpes Simplex Encephalitis

  • Nam, Tai-Seung;Choi, Kang-Ho;Kim, Myeong-Kyu;Cho, Ki-Hyun
    • Journal of Korean Neurosurgical Society
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    • 제50권2호
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    • pp.119-122
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    • 2011
  • We report a case of 70-year-old man with glioblastoma presenting as acute encephalitic illness. The patient exhibited sudden onset of cognitive impairment and headache for 2 days. Initial brain MRI showed left temporal lobe hyperintensity, and cerebrospinal fluid cytology revealed a mild pleocytosis. The patient had initially improved after medical treatment with a presumptive diagnosis of herpes simplex encephalitis (HSE). After 8 months, the patient complained of recurrent seizures. A follow-up brain MRI revealed marked increases in size and surrounding perilesional edema in the left temporal lesion on T2-weighted images and a new contrast-enhancing lesion on gadolinium-enhanced T1-weighted images. Stereotactic brain biopsy revealed a glioblastoma. The atypical encephalitic presentation of glioblastoma should be considered if definitive evidence for the diagnosis of HSE cannot be obtained.

Use of the Sundt Clip Graft in a Previously Coiled Internal Carotid Artery Blister-Like Aneurysm

  • Cho, Jae Ik;Cho, Jae Hoon
    • Journal of Korean Neurosurgical Society
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    • 제56권6호
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    • pp.496-499
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    • 2014
  • Owing to the focal wall defect covered with thin fibrous tissues, an aneurysm arising from the dorsal wall of the internal carotid artery (ICA) is difficult to manage either surgically or endovascularly and is often associated with high morbidity and mortality. Unfortunately, the definitive treatment modality of such highly risky aneurysm has not yet been demonstrated. Upon encountering the complex intracranial pathophysiology of such a highly precarious aneurysm, a neurosurgeon would be faced with a challenge to decide on an optimal approach. This is a case of multiple paraclinoid aneurysms including the ICA dorsal wall aneurysm, presented with spontaneous subarachnoid hemorrhage. With respect to treatment, direct clipping with a Sundt graft clip was performed after multiple endovascular interventions had failed. This surgical approach can be a treatment modality for a blood blister-like aneurysm after failed endovascular intervention(s).

Isolated pulmonary cryptococcosis in an immunocompetent boy

  • Bauer, Siegfried;Kim, Ji-Eun;La, Kyong-Suk;Yoo, Young;Lee, Kee-Hyoung;Park, Sang-Hee;Choung, Ji-Tae;Kim, Chul-Whan
    • Clinical and Experimental Pediatrics
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    • 제53권11호
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    • pp.971-974
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    • 2010
  • Pulmonary cryptococcosis is rare in immunocompetent subjects. Here, we present the case of a 16-year-old boy who was referred to our pediatric department for the management of multiple consolidations detected on chest radiography, which was routinely performed when the patient was being evaluated for an ankle fracture. Fine needle aspiration biopsy was performed, and the definitive diagnosis was established as cryptococcal pneumonia. After 8 weeks of antifungal treatment, the pulmonary nodules on the chest radiographs disappeared.

유리 장 이식편을 이용한 식도 재건 (Free jejunal graft for replacement of cervical esophagus)

  • 이홍섭;이인성;김창호
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.775-779
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    • 1984
  • Reconstruction of the pharynx and cervical esophagus is a difficult surgical problem. A successful case of reconstruction of cervical esophagus by free jejunal graft upon a 23-year-old female who had stricture in the pharynx and cervical esophagus after ingestion of hydrochloric acid is presented. This procedure was done after the primary traditional reconstruction with right sided colon had resulted in restenosis due to necrosis of the cervical portion of the graft. A proximal jejunal segment, about 12 cm in length was isolated for free graft preserving its vascular arcade. Both superior thyroid artery and vein were anastomosed to the graft vessels in end to end by continuous suture of 8-0 monophil. Nylon. The postoperative course was uneventful. The patient has been followed for 4 months after operation and she can eat every kind of food without dysphagia. We think free jejunal graft offers an excellent and safe method of reconstructing cervical esophagus and pharynx with definitive advantages over other traditional techniques.

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MATHEMATICAL UNDERSTANDING OF CONSCIOUSNESS AND UNCONCIOUSNESS

  • LEE, NAMI;KIM, EUN YOUNG;SHIN, CHANGSOO
    • Journal of the Korean Society for Industrial and Applied Mathematics
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    • 제21권2호
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    • pp.75-79
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    • 2017
  • This paper approaches the subject of consciousness and unconsciousness from a mathematical point of view. It sets up a hypothesis that when unconscious state becomes conscious state, high density energy is released. We argue that the process of transformation of unconsciousness into consciousness can be expressed using the infinite recursive Heaviside step function. We claim that differentiation of the potential of unconsciousness with respect to time is the process of being conscious in a world where only time exists, since the thinking process never have any concrete space. We try to attribute our unconsciousness to a special solution of the multi-dimensional advection partial differential equation which can be represented by the finite recursive Heaviside step function. Mathematical language explains how the infinitive neural process is perceived and understood by consciousness in a definitive time.

Contralateral Juxtafacet Cyst Development after the Spontaneous Resolution of a Previous Facet Cyst

  • Kim, Hyeun Sung;Ju, Chang Il;Kim, Seok Won;Kim, Sung Hoon
    • Journal of Korean Neurosurgical Society
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    • 제58권6호
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    • pp.563-565
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    • 2015
  • Juxtafacet cysts are implicated in neural compression. Thus far, it is known that surgical removal is the definitive treatment for symptomatic juxtafacet cyst because spontaneous regression is rare, and the failure rate of conservative treatment is high. We have reported a rare case of right-sided juxtafacet cyst development after the spontaneous resolution of contralateral left-sided facet cyst. The left-sided facet cyst resolved spontaneously without surgical treatment, but a juxtacyst developed on the contralateral facet on the right side, as illustrated on 4-year follow-up magnetic resonance images. To the best of our knowledge, this is the first report of newly developed contralateral juxtafacet cyst after spontaneous regression. Herein, we have discussed the natural history and the management of this rare case.

Clinical Features in 9 Dogs with Immune-Mediated Polyarthritis

  • Lim, Seula;Song, Kun-Ho;Seo, Kyoung-Won
    • 한국임상수의학회지
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    • 제34권6호
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    • pp.434-436
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    • 2017
  • Nine dogs with history of lameness and anorexia were presented. On physical examination, all dogs had gait abnormality and six dogs had high body temperature. Their clinical signs were mostly episodic, and only non-specific symptoms were occasionally observed. Arthrocentesis was performed in all dogs, and immune-mediated polyarthritis (IMPA) was diagnosed. Definitive rheumatoid arthritis (RA) and systemic lupus erythematous (SLE) were diagnosed in one dogs, one each. Prednisolone (PDS) was chosen as the first-line therapy for all dogs, except for the one with RA. Most cases responded to PDS but some cases including those of SLE and RA were refractory to PDS. IMPA can be challenging to diagnose due to its vague symptom and is commonly implicated in 'fever of unknown origin'. Therefore, clinicians should consider IMPA as a differential diagnosis when the patient has fever with systemic, non-specific signs, such as anorexia and depression, but does not respond to antibiotics.