• Title/Summary/Keyword: Difficulty in breathing

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A Huge Intra-Abdominal Mass Associated with Long-Term Surgical Gauze Retention in a Toy Breed Dog

  • Lee, Sung-Jun;Jeong, Soon-Wuk;Eom, Ki-Dong;Shin, Jong-Il;Yoon, Hun-Young
    • 한국임상수의학회지
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    • 제33권2호
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    • pp.116-121
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    • 2016
  • A 1.83 kg, 9-year-old, spayed female Yorkshire Terrier was referred to the Veterinary Medical Teaching Hospital of Konkuk University for evaluation of an intra-abdominal mass with a week history of vomiting and diarrhea. On physical examination, survey radiography, abdominal ultrasonography, and computed tomography, a huge firm mass was identified in the mid-caudal abdomen. Surgical exploration of the abdominal cavity was performed to remove the mass. The encapsulated mass adhered to the mesentery, tail of the spleen, small intestine, omentum, and right lobe of the pancreas was removed using blunt dissection with dry gauze and cotton swabs. Macroscopic and histopathological examination revealed that the mass was foreign-body granuloma consistent with gauze fiber. Plain abdominal radiography demonstrated no remarkable findings 8 months post-operatively. There was no evidence of vomiting, diarrhea, coughing, difficulty breathing, and cyanosis on exertion 13 months post-operatively.

Using Lymphovenous Anastomosis and Lymph Node to Vein Anastomosis for Treatment of Posttraumatic Chylothorax with Increased Thoracic Duct Pressure in 3-Year-Old Child

  • Kim, Yeongsong;Kim, Hyung B.;Pak, Changsik J.;Suh, Hyunsuk P.;Hong, Joon P.
    • Archives of Plastic Surgery
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    • 제49권4호
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    • pp.549-553
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    • 2022
  • Chylothorax is a rare disease and massive lymph fluid loss can cause life-threatening condition such as severe malnutrition, weight loss, and impaired immune system. If untreated, mortality rate of chylothorax can be up to 50%. This is a case report of a 3-year-old child with iatrogenic chylothorax. Despite conservative treatment and procedures, like perm catheter insertion, the patient failed to improve the respiratory symptoms over 3 months of period. As an alternative to surgical option, such as pleurodesis and thoracic duct ligation which has high complication rate, the patient underwent lymphovenous anastomosis (LVA) and lymph node to vein anastomosis (LNVA). Follow-up at fourth month showed clear lungs without breathing difficulty despite perm catheter removal. This is the first report to show the effectiveness of LVA and LNVA against iatrogenic chylothorax.

폐암 환자의 정위체부방사선치료 시 기준선 변화에 따른 3D-CBCT(Cone Beam Computed-Tomography)와 Gated-CBCT의 영상 품질 및 유용성 평가 (Image quality and usefulness evaluaton of 3D-CBCT and Gated-CBCT according to baseline changes for SBRT of Lung Cancer)

  • 한국희;신충훈;이충환;유순미;박자람;김진수;윤인하
    • 대한방사선치료학회지
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    • 제35권
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    • pp.41-51
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    • 2023
  • 목 적: 본 연구는 폐암 환자의 정위체부방사선치료 시(Stereotactic Body Radiation Therapy, SBRT) 기준선(Baseline) 변화에 따른 3D-CBCT(Cone Beam Computed-Tomography)와 Gated-CBCT의 영상 품질(Image quality)을 비교 분석하여 호흡에 따른 움직임의 보정에 유용한 CBCT 촬영 방법을 찾고자 한다. 대상 및 방법: QUASARTM(Modus Medical Devices Inc, Canada) 팬텀에 지름이 3 cm인 고체 종양 물질(Solid Tumor)을 삽입하여 팬텀의 속도를 주기 3 sec, 최대 진폭 20 mm 로 4DCT(4-Dimentional Computed-Tomography)를 촬영하였다. 전산화 치료계획시스템 EclipseTM을 이용하여 고체 종양 물질에 육안적 종양용적(Gross Target Volume, GTV)을 윤곽 묘사하였다. Truebeam STxTM을 이용해 4DCT 촬영 시와 동일하게 설정한 후, 기준선 변화가 1 mm, 3 mm, 5 mm인 호흡 패턴을 팬텀에 입력하여 3D-CBCT(Spotlight, Full)와 Gated-CBCT(Spotlight, Full) 영상을 5회 반복하여 획득하였다. 획득된 영상을 4DCT 영상을 기준으로 신호대잡음비(Signal-to-Noise Ratio, SNR), 대조대잡음비(Contrast-to-Noise Ratio, CNR), 종양 체적 길이(Tumor Volume Length) 및 모션 블러링 비(Motion Blurring Ratio, MBR)를 측정하여 비교하였다. 결 과: Spotlight Gated-CBCT 영상이 기준선 변화에 따른 신호대잡음비가 평균 13.30±0.10%, 대조대잡음비가 평균 7.78±0.16%, 종양 체적 길이가 평균 3.55 ± 0.17%, 모션 블러링 비가 평균 1.18 ± 0.06%로 Spotlight 3D-CBCT보다 우수한 값을 보였다. 또한, Full Gated-CBCT 영상이 기준선 변화에 따른 신호대잡음비가 평균 12.80 ± 0.11%, 대조대잡음비가 평균 7.60 ± 0.11%, 종양 체적 길이가 평균 3.54 ± 0.16%, 모션 블러링 비가 평균 1.18 ± 0.05%로 Full 3D-CBCT보다 우수한 값을 보였다. 결 론: 3D-CBCT 촬영 영상과 비교하여 Gated-CBCT 촬영 영상이 기준선 변화에 따른 영상 품질이 우수한 값을 보였으며, 호흡으로 인한 모션 블러링 인공물(Motion Blurring Artifacts)의 영향이 적은 것을 확인했다. 따라서 단기간에 고선량을 전달하는 폐암의 정위체부방사선치료 시 불규칙한 호흡으로 인한 기준선 변화가 발생하는 경우 Gated-CBCT를 이용해 영상유도(Image Guide)를 하는 것이 유용하다고 판단된다.

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Effects of Deep Abdominal Muscle Strengthening Exercises on Pulmonary Function and the Ability to Balance in Stroke Patients

  • Kang, Jeong-Il;Kim, Beom-Ryong;Park, Seung-Kyu;Yang, Dae-Jung;Jeong, Dae-Keun;Kim, Je-Ho
    • The Journal of Korean Physical Therapy
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    • 제27권4호
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    • pp.258-263
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    • 2015
  • Purpose: This study investigated effects of deep abdominal muscle strengthening exercises on pulmonary function and the ability to balance in stroke patients and was conducted to propose an exercise program for improving cardiovascular function. Methods: Study subjects were 20 patients with hemiplegia due to stroke, who were divided into the deep abdominal muscle strengthening exercise group (experimental group), 10, and the control group, 10. Pulmonary function tests measured FVC and FEV1, dynamic balance ability was measured using TUG. Static and dynamic balance ability was measured using BBS. The experimental group performed exercises during a period of 6 weeks, 5 times a week for 40 minutes, whereas the control group did not participate in regular exercise. The difference before and after the exercise was compared using paired t-test, difference in exercise before and after between groups was ANCOVA and level of significance was set at ${\alpha}=0.05$. Results: The changes in FVC and FEV1 within the group showed a significant difference only in the experimental group (p<0.001) (p<0.01), between-group difference was statistically significant only in FVC and FEV1 changes in the experimental group (p<0.001). The TUG changes within the group showed a significant difference in the experimental group and control group (p<0.001) (p<0.05), while BBS changes showed a significant difference only in the experimental group. Between-group difference was statistically significant only in TUG and BBS changes in the experimental group. The experimental group showed a more effective significant difference than the control group (p<0.001). Conclusion: Can exercise involving a deep abdominal muscle strengthening program be applied in patients with stroke with difficulty in control of trunk and decreased breathing ability?

Relative Risk Ratio of Residents Living Near the Municipal Solid Waste Landfill Site at Some Province in South Korea

  • Lee Jin-Heon;Choi Jin-Ha
    • 한국환경보건학회지
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    • 제32권3호
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    • pp.240-248
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    • 2006
  • The purposes of this study were to investigate the symptoms, diseases and deaths of residents living near the municipal solid waste landfill site, and to compare the relative risk ratio of their adverse health effects with control group. In self-evaluation, the scores were especially severe lowest in residents of v2 and v3 villages(which were located about 500 m toward under the landfill site) such as 32.2 and 16.7 for village-environment, 24.8 and 16.0 for management of landfill site, and 23.5 and 16.5 for confidence of environmental policy, respectively. On symptoms, relative risk ratios were also highest as 3.53 and 3.55 for breathing difficulty, and 3.36 and 3.00 for respiratory symptom in v2 and v3 villages, respectively. On morbidity, they were slightly high as much as 1.39 and 1.24 in v5 and v2 villages, respectively. On mortality, relative risk ratios were $1.15{\sim}2.46$ in experimental villages. They were especially high as much as 2.46 in v3 village where located near under the landfill site, and also 2.14 in v5 village where located at area affected with the landfill site, but near the sea. The rate of cancer causing death was average 35.2% of total deaths. It was very highest as much as 61.1 % in v2 village, where was closely located near under the landfill site. Cancers causing death in this village were lung cancer(3 cases), larynx cancer(2 cases), stomach cancer(2 cases), pancreatic cancer(1 case), thryoid cancer(1 case), leukemia(1 case) and other(1 case). Our data, although based on limited number of cases and geographical coverage, suggest that residents living near landfill site have the increasing relative risks of various symptoms and mortality causing cancer. No causal mechanisms are available to explain these findings. But the possibility of a causal association between the increased adverse health effects and the municipal solid waste landfill site cannot be fully excluded.

Implications of Managing Chronic Obstructive Pulmonary Disease in Cardiovascular Diseases

  • Deshmukh, Kartik;Khanna, Arjun
    • Tuberculosis and Respiratory Diseases
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    • 제84권1호
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    • pp.35-45
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    • 2021
  • Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.

COVID-19 임상표현에 대한 한의학적 접근 -국내외 논문을 중심으로- (Clinical features of COVID-19 as presented in journal articles : A Korean Medical Approach)

  • 김종현;안진희;김상현
    • 대한한의학원전학회지
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    • 제35권1호
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    • pp.1-32
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    • 2022
  • Objectives : This paper examines major symptoms representation in COVID-19 patients as groundwork for development of an effective clinical data collection format in Korean Medicine. Methods : Major symptoms representation in COVID-19 related papers published worldwide were collected. Corresponding symptoms in Korean Medicine were then examined, followed by discussion of symptomatic features that require further consideration in regards to a more systematic clinical data collection. Results : Of 256 papers, most papers listed fever and cough while symptoms such as difficulty breathing, diarrhea, muscle pain, headache, nausea, fatigue, chest pain, phlegm, nasal discharge were also mostly listed. Clinical representations could be categorized into general symptoms, throat symptoms, chest symptoms, head and facial symptoms, gastrointestinal symptoms, musculo-skeletal and cutaneous symptoms, psychiatric symptoms and sensory problems. Conclusions : Although each clinical representation could be likened to certain clinical representations of Korean Medicine, the variety of symptoms were too limiting and lacking in detail to be applied in the pattern identification[辨證] of Korean Medicine. For effective clinical data collection and analysis in the future, symptom change according to time, comparison between location, climate and ethnicity, existence of interior symptoms when diagnosing exterior symptoms, deficiency-excessiveness of blood patterns, consciousness levels, etc., need to be considered in establishing criteria for symptom evaluation.

COVID-19 후각 이상에 대한 한의학적 고찰 (Olfactory Dysfunction in COVID-19 from a Korean Medical Perspective)

  • 김상현;김종현
    • 대한한의학원전학회지
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    • 제35권2호
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    • pp.99-120
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    • 2022
  • Objectives : To analyze symptoms of olfactory dysfunction caused by COVID-19 from a Korean Medical Perspective. Methods : Previous studies dealing with olfactory dysfunction accompanying COVID-19 were studied and analyzed for general characterization. Physiology and pathology of olfactory functions within the classical texts of Korean Medicine were collected and analyzed, through which symptoms of olfactory dysfunction in COVID-19 were examined. Results : Olfactory dysfunction manifested in high ratios in the early stages of confirmed COVID-19 cases, at times independent of other nasal symptoms such as blockage or discharge. There was a high chance of loss of taste being accompanied, while mental problems such as a tendency to have difficulty concentrating were present as well. In most cases, recovery took one to two weeks. From a Korean Medical perspective, physiology of olfactory function is closely linked to the Lungs, Ancetral Qi[宗氣], and the Heart, while its dysfunction could be explained by pathological factors such as Wind-Cold, Fire stagnation, Qi deficiency, Wind stroke, etc. Conclusions : In the context of external contraction disease[外感病], olfactory dysfunction could be caused by problems in the Lungs and Stomach that are responsible for breathing, or the Heart which is involved in recognizing and differentiating scent. General characteristics of COVID-19 imply it to be closely related to the Heart. In clinical application, overall symptoms need to be considered in diagnosis and treatment planning, after which further approaches could made to determine the problem to be of the Lung and Stomach, or of the Heart.

TOP DOWN 지하공사의 작업환경체크 컴퓨터시물레이션에 관한 기초적 연구 (Computer Simulation for Working Condition of Undergroundwork Using TOP DOWN Technique)

  • 고성석;손기상;심경수
    • 한국안전학회지
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    • 제10권3호
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    • pp.96-105
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    • 1995
  • The better industry develops, the more spaces need but in the limited area. Most building become larger and more complicated if the more spaces need in the constant area. And this leads to do underground work in long period generally six(6) months for 6 basement stories due to the selection of TOP DOWN technique. Working environment in this underground area can be problems and should not be overlooked, because air quality in underground spaces become quickly worse. Recently, department name to control construction safety has been changed to ENVIRONMENT & SAFETY TEAM from SAFETY TEAM. This means that it is very important to control against environmental condition at site so much. Overall construction work as well as underground work should conform to the requirement of working environment, particularly against inhabitants around the construction area. Strut protection, one of earth protection method, in case to 40m long strut may become weaker due to thermal stress or its longitudinally compressive strain and the another one, earth anchor protection may not be applied to the site In case of encroaching on vertical underground borderline because of regulation to prohibit it. It is necessary that TOP DOWN technique should be introduced in order to solve the external and internal problem of the site such as difficulty level of the work, potential danger with excavating depth, and shortening workperiod. It is needed that improving way of working condition should be shown and simplified computer simulation program should be also provided for checking pollution level & ventilation, excluding of lighting problem here. Results measured with conformance to the Regulation for Working Environment Measurement, enforced by Ministry of Labor have been applied to the computer program developed here. Sample air taken at unit workplace which was considered as exposing condition of pollutant at breathing point and within a range of behavior of the workers, Identified exposing group in underground work, using Moded Flow Life Finally, three types of ventilation system, type I with blower & ventilator, type II natural supply with mechanical ventilation system, and type I mechanical ventilation with Drivent Fan Unit System are selected for this study.

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중·고등학교 교사의 정신건강 관심군 학생 지도 경험 (Experiences with Guiding Students with Mental Health Support Needs among Middle and High School Teachers)

  • 박옥남
    • 한국학교보건학회지
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    • 제30권3호
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    • pp.211-223
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    • 2017
  • Purpose: The purpose of this study is to clarify the social stigma phenomenon in teachers' perceptions and attitudes toward students who are classified as mental health support needs students in middle and high schools. Methods: Qualitative research was conducted through in-depth interviews and observations of 17 teachers and 2 consultants from 2 middle and high schools in Green City, which were evaluated as successful among the six pilot project schools designated by the Ministry of Education in 2013. The study's analysis is based on Hatch's hermeneutical method. Common categories were developed from the interviews and observations. Then, inferences were made per category and given importance to draw conclusions and lessons. Results: Teachers had a strong stigma in their perceptions of and attitudes to special needs students. Their perception was that those students are bound to go wrong due to family problems, even some having difficulty breathing, and that it's beyond their limit to help them. In addition, their attitudes included stereotypes, favoritism, punishment, and referral to experts. As a result, teachers did not expect those students would be cured or change and showed passive attitudes while shifting the responsibility to families and experts. Conclusion: This study is meaningful in that it showed the limitations of the role of teachers regarding mental health support needs students from the perspective of the teachers themselves. Today, when students' mental health problems are emerging as a serious issue, it is necessary to provide support to improve teacher's awareness and capabilities regarding adolescent mental health problems. In addition, we suggest the current selective policy that sorts out special needs students and provides care for them to evolve into a universal policy that improves public awareness and focus on prevention.