• 제목/요약/키워드: Definitive

검색결과 962건 처리시간 0.025초

검상돌기하 심낭절개술에 의한 심낭 삼출액의 치료에 관한 고찰 (Clinical Experience with Subxiphoid Drainage of Pericardial Effusions)

  • 김문환
    • Journal of Chest Surgery
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    • 제24권4호
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    • pp.397-403
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    • 1991
  • From June 1987 to January 1991, 24 patients with moderate or massive pericardial effusion underwent subxiphoid pericardial window procedures for diagnosis and therapy. The patients` ages were ranged from 28 years to 71 years. The underlying diseases were chronic renal failure with long term hemodialysis in 3 cases, malignant lung cancer in 7 cases, stomach cancer in 2 cases, tuberculous pericarditis in 5 cases, pyogenic pericarditis in 2 cases, myxedema in one case, one metastatic squamous cell carcinoma from unknown origin and three of undefined etiology. Preoperative diagnoses of pericardial effusions were confirmed by echocardiogram in all cases. Subxiphoid pericardial drainages were performed under general[n=19] or local anesthesia[n=5]. Histological diagnoses were made from the inferior pericardial tissue in all cases except one. In this one case[tuberculous pericarditis], the subxiphoid pericardial approach was failed from intraoperative bleeding. There were two postoperative death, one[in malignant lung cancer] had postoperative ventricular tachycardia which result in cardiac arrest, and the other[unknown origin metastatic malignant effusion] had persistent tachyarrhythmia postoperatively and died on postoperative 5th days. Twenty three patients were followed up from 3 days to 9 months; mean follow-up day was 43 days. The preoperative and postoperative mean cardiothoracic ratio in chest x-ray were 0.69 and 0.52 respectively. Subxiphoid pericardial drainage may provide definitive diagnosis and treatment for pericardial effusions. The approach through subxiphoid pericardium under general or local anesthesia avoids the complications of pericardiocentesis and is effective for malignant pericardial effusion.

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흉부둔상에 의한 식도파열의 성공적인 보존적 치료 (A successful conservative management of traumatic thoracic esophageal rupture)

  • 노태훈
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.169-174
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    • 1988
  • Thoracic esophageal rupture caused by blunt trauma is often not recognized until late because of the vague symptoms in the initial state as well as its rare incidence, which can easily lead to fulminant mediastinitis with frequent fatal outcome. Once extensive mediastinitis occurs, the primary surgical repair of the esophageal tear is considered to be practically impossible. Various methods have been proposed for the management of these desperately ill patients, but no one provides an acceptable good result yet. The purpose of this article is to report the successful result obtained in the treatment of a patient with fulminant mediastinitis from traumatic esophageal rupture by continuous transesophageal irrigation. A 27 year-old male patient was brought to the emergency room of our hospital complaining of dyspnea and chest pain after blunt trauma. The diagnosis of esophageal rupture in the thorax was made late, about 46 hours after the initial injury, when mediastinitis had already progressed. The transesophageal irrigation method was immediately instituted which consisted of profuse transesophageal irrigation of the mediastinum with orally ingested fluid and/or by Levin tube, positioned proximal to the site of the rupture, and drainage of the irrigation fluid by thoracoscopically accurately positioned chest tubes connected to a well suctioning system. With subsiding inflammatory signs and symptoms, the esophagogram, obtained 54 days after the treatment, showed no evidence of the mediastinal leakage of contrast material which contrasted previous esophagograms with definitive dye collections in the mediastinum. Additional endoscopic finding confirmed complete healing of the esophageal mucosa, previously ruptured. He has been followed up without any problem until recently, 6 months after discharge.

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Metastatic Pulmonary Ameloblastoma Misdiagnosed as Primary Squamous Cell Carcinoma Preoperatively

  • Yun, Ju Sik;Kim, Do Wan;Kim, Sung Sun;Choi, Yoo Duk;Song, Sang Yun;Na, Kook Joo
    • Journal of Chest Surgery
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    • 제47권1호
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    • pp.63-65
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    • 2014
  • Ameloblastomas are rare odontogenic epithelial tumors that occur mainly in the mandible. Despite their benign histologic appearance, they are locally aggressive with a high recurrence rate. However, a metastasizing ameloblastoma has been rarely reported. According to the current World Health Organization classification system, the definitive diagnosis of metastasizing ameloblastoma can only be carried out in retrospect, after the event of metastasis. This case report describes a patient with metastatic pulmonary ameloblastoma, 17 years after the surgical excision of an odontogenic tumor, preoperatively misdiagnosed as primary squamous cell carcinoma.

케타민의 소량 분할 정주에 의한 척수손상 환자의 통증 관리 -증례 보고- (Management of Spinal Cord Injury Pain with Small Divided Doses of Intravenous Ketamine -Two case reports-)

  • 한찬수;박진혁;김진수;김일호;김유재;김천숙;안기량
    • The Korean Journal of Pain
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    • 제12권1호
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    • pp.123-127
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    • 1999
  • Chronic pain is a frequent complication after spinal cord injury. Various medical and surgical approaches have been applied for management of spinal cord injury pain but none of them are definitive. The N-methyl-D-Aspartate (NMDA) receptor antagonist, ketamine has been reported to have a significant effect in the management of neuropathic pain. We used small divided doses of intravenous ketamine (30 mg divided by 6 equals 5 mg, 5 min interval) in spinal cord injury patients suffering from chronic pain, and accomplished significant pain relief without side effects.

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플라보노이드에 의한 사람 Low Density Lipoprotein 변형에 대한 항산화 효과 (Antioxidative Effects of Flavonoids toward Modification of Human Low Density Lipoprotein)

  • 류병호
    • 한국식품영양학회지
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    • 제12권3호
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    • pp.320-327
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    • 1999
  • The flavonoids are one of the most numberous and widespread groups of natural consituents. The low molecular weight of benzo-${\gamma}$-pyrone derivative are ubiquitous in plants and are vegetables nuts, seeds, leaves, flowers, and bark. The flavonoids constitute of a large class of compounds ubiquitous in plants containing a number of phenolic hydroxyl groups attached to ring structures conferring the antioxidant activity. Epidemiologic studies suggest that the dietary intake of antioxidants constitutes a risk factor for vasclar disease indicating that oxidation may be important in the pathogenesis of human athero-sclerosis. Elevated plasma low density lipoprotein (LDL) cholesterol concentration are associated with accelerated atherosclerosis, LDL is oxidized by smooth muscle cells resulting in several chemicals and physical changes of LDL. Oxidized LDL is responsible for cholesterol loading of macrophages foam cells formation and atherogenesis. There have been insulficient tests of the protective effects of flavonoids against LDL oxidation to make definitive statements about their structure activity relationships. How-ever hydroxylation of the flavone uncleas can appears to be advantageous because polyhydroxylated aglycone flavonoids are potent inhibitor of LDL modification. This identification may lead to new and more effective antioxidant strategies for abrogating the atherosclerotic process the leading cause of death and disability in industrialized societies.

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좌측 하악골에 생긴 골육종(Osteosarcoma) 1예 (A Case of Osteosarcoma of the Mandible)

  • 김찬종;이재동;남순열
    • 대한두경부종양학회지
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    • 제19권2호
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    • pp.179-183
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    • 2003
  • Osteosarcoma is one of the most frequently occurring malignant bone tumor except for multiple myeloma. However, osteosarcoma of the mandible is rare and aggressive malignancy constituting about 5% to 13% of all cases of skeletal osteosarcoma. The authors experienced a case of osteosarcoma of the mandible in a 31-years old male patient. He visited our outpatient clinic with painless mass of the cheek. On the basis of the clinical and imaging findings, the differential diagnosis included giant cell tumor, histiocytosis and malignant bone tumor. In the first operation, the mass of the mandible was excised. Intraoperative microscopic examination of a frozen section did not yield a diagnosis: however, the final definitive histologic examination revealed osteoblastic osteosarcoma. After 15days, wide excision with hemimandibulectomy was completed followed by postoperative radiotherapy and chemotherapy. With our experience, we report the progression of diagnosis and management for mandibular osteosrcoma.

경상남도 천연기념물 노거수의 생육환경 연구 (Growth Conditions of Natural Monument Old Big Trees in Gyeongsangnamdo, Korea)

  • 김효정
    • 한국환경복원기술학회지
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    • 제14권5호
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    • pp.103-112
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    • 2011
  • Old big tree transcends the simple meaning of trees as they are the natural monuments that embody the people's history and culture of this land. The Cultural Heritage Administration of Korea(CHA) defines and protects old big tree based not only on the size of the tree but also on its definitive cultural and natural factors such as value, implications, and originality. This research aims to identify and analyze the growth conditions, soil conditions and location character of 20 old big tree in Gyeongsangnamdo korea. The research examined the soundness of the arboreal form, the degree of damage on the bark, as well as the quantity of leafs levels to evaluate the overall condition of growth and development. Also, 9 elements such as soil texture, nitrogen and organic matter content, soil pH, phosphoric acid and EC were further analyzed The research analyzed in correlation of Growth condition and soil. Tree health related positivity that total nitrogen and organic matter. The result which analyzes location character, With natural monument old big trees raising a hand the area where is contiguous appeared with the fact that the farming village style where the rice field and the arable land of field etc. This research aimed at generating some foundational reference data for the analysis of the habitation and management conditions of natural monument old big tree within the Gyeongsangnamdo korea.

과학중점학교 교육과정 운영이 정의적 영역 및 비교과 체험활동 만족도에 미치는 영향 (An Influence of Curriculum of Science Core School on the the Affective Domain and Non-subject Hands-on Activities Satisfaction)

  • 송경훈;최성봉
    • 대한지구과학교육학회지
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    • 제6권2호
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    • pp.112-123
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    • 2013
  • Under this research, the survey is made on the definitive influence of the first-year education process of the science focus school for each of humanities, science and science core courses and the level of satisfaction of the non-curriculum experiment activity program for each course to find out the effectiveness of the first-year education process of the science focus school. For this purpose, this research has set three research issues. First, By clarifying the research result through the first-year education curriculum for science core school, noticeable change was observed for science focus school students through the change of attitude related to science for each desired course of students. Second, in the self-directed learning characteristics change, there was meaningful change for each desired field of students. Students hoping for humanities curriculum had great help in improvement of creative thinking for openness, creativeness and the like, but the influence was slightly insufficient in the moderation and control capability on themselves in learning attitude. Third, By analyzing the research result comprehensively, the first-year education curriculum for science core school provides high level of tailored science learning for the science focus school students and the level of satisfaction for students was significantly high.

영아기 치루와 수술의 필요성 (Is Definitive Surgery Necessary for Fistula-in-ano in Infant)

  • 이명덕
    • Advances in pediatric surgery
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    • 제8권1호
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    • pp.6-10
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    • 2002
  • To clarify the necessity of surgery for fistula-in-ano (FIA) in infant, a retrospective analysis of 82 cases FIA in infant were performed for 11 years period from 1987 to 1998. Group A included 44 cases in the period of surgery oriented treatment to 1992, and group B contained 38, period of feeding control oriented management (FC) after 1993. FC, that was indicated in case with loose stool and eczematoid perianal skin (LSES), composed of quit breast feeding, change of cow milk or complete weaning. Surgical decision was made after improvement of stool condition. Fistulectomy was performed in 29 cases (65.9 %) of group A. However, in group B, only 15 cases (39.5 %) required surgery (p=0.0036). Thirty-four cases in B had the history of LSES, and Fe was applied in 25, and was effective in 24. Among 24 cases, 21 showed complete healing with FC, 3 had surgery because of the persistent FIA, and 1 got operation due to no improvement of stool condition. In conclusion, Fe has to be applied to FIA in infant before surgery, particularly in cases with history of LSES. As one of the etiologic factors for FIA, LSES could be considered to this particular age group.

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선천성 담도폐쇄증으로 Kasai 수술 후 장기 치료성적(10년 이상 생존자 대상으로) (Outcome of Patients Undergoing Kasai Procedure for Biliary Atresia: a Study of Those Surviving More Than 10 Years with Their Native Livers)

  • 임병훈;송영택;정재희
    • Advances in pediatric surgery
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    • 제14권2호
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    • pp.125-133
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    • 2008
  • To evaluate the long-term prognosis of biliary atresia after Kasai operation, a total of 14 patients (of the 41 patients operated upon from 1982 to 1997), who had been followed up for more than 10 years, were included in this retrospective study. Eleven out of 14 patients survived with their native livers, and their data analyzed for age at operation, clearing time of jaundice, histological outcome, postoperative complications, effectiveness after the application of an intussusception anti-reflex valve, and quality of life. Average age at surgery was 62.8 days. Serum bilirubin was normalized within three months in all patients. Six among the eleven long-term survivors had ascending cholangitis as one of the postoperative complications. The application of an intussusception anti-reflux valve did not show any statistical significance in long-term survival. Most of long-term survivors appeared to enjoy good quality of life. Kasai operation might not be the definitive treatment for biliary atresia; however, Kasai operation made it possible to achieve long-term survival for patients with biliary atresia when the patients were detected and treated as early as possible.

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