• Tuberculosis and Respiratory Diseases
• /
• v.53 no.2
• /
• pp.221-226
• /
• 2002

A 58-year-old man was admitted after suffering dyspnea and pleuritic chest pain on his right side for one week. A chest X-ray revealed necrotizing pneumonia and a lung abscess on right upper lobe. Despite of antibiotics and supportive care, a complicated parapneumonic effusion developed on his right side. Closed thoracostomy was performed for drainage. However, after the thoracostomy, a bronchopleural fistula (BPF) occurred with a continuous air leak. After 30 days intensive therapy, the underlying necrotizing pneumonia and lung abscess resolved, but the BPF continued. Bronchoscopic treatment was performed because the patient was a poor candidate for surgery. After localizing the BPF with a systemic occlusion of the segmental bronchi, small strips of Gelfoam were placed in the suction channel of the flexible bronchoscopy, and either flushed with a saline solution or inserted with forceps until the cessation of air leak. The patient was discharged 10 days after the bronchoscopic treatment.

• Journal of Haehwa Medicine
• /
• v.8 no.2
• /
• pp.107-122
• /
• 2000

As a result of studing on the "shashen(沙蔘)", we could reach conclusions as follows. 1. Shashen is the root of "lunyeshashen(潤葉沙蔘)", "kuoyeshashen(闊葉沙蔘)", and its same generic plants that belong to Companulaceae. In china people has used twenty-four species as a shashen together with other generic plants, in korea sixteen species as a shashen. 2. At first, in the "Shen Nong's Herbal(神農本草經)" it was recorded and then in the "Benchingfengyuan(本經逢原)" divided into "nanshashen(南沙蔘)" and "beishashen(北沙蔘)". Recently, nanshashen called shashen belongs to Companulaceae and have strong efficacies of clearing away heat from lung, resolving phlegm, beishashen belongs to Umbelliferae and have strong efficacies of nourishing stomach, nourishing yin. 3. Shashen is the root of Adenophora stricta Miq., and yangru(羊乳) is that of Codonopsis lauceolata Bentham et Hooker, jini is that of Adenophora remotiflora (SIEBOLD et ZUCCARINI.) MIQUEL. From a efficacious point of view, it is the characteristics that shashen have efficacies of nourishing yin and clearing away heat from lung, supplementing stomach and promoting production of body fluid, resolving phlegm and relieving cough, eliminating pus and abscess, expelling wind and pruritus, jini have those of clearing away heat and toxic material, resolving phlegm and yanru have those of nourishing yin and moistening lung, resolving phlegm and eliminating pus, clearing away heat and toxic material, stimulating milk secretion. 4. After being recorded as "zhimu(知母)" in Shen Nong's Herbal, the alias of shashen was recorded as kuxin(苦心), shimei(識美), huxu(虎須), baishen(白參), zhiqu(志取), wenhu(文虎), baolishen(保利參), paoshen(泡參), jibantui(鷄半腿), yangponai(羊婆妨) and so on. Moreover shashen was named after its characteristics of that it grows well in the sandy soil and as a wushen(五參) with a renshen(人蔘) its form is different from that of wushen but their chief virtues are alike. 5. In the numerous medical books, xinyeshashen(杏葉沙蔘) regarded as nanshashen. It was called as the alias of jini, so I thouhgt that it was wrong xinyeshashen to be regarded as nanshashen. 6. It was used shashen for renshen, renshen was used to treat lung-cold syndrome by its efficacy of tonifying yang and shashen lung-heat syndrome by its efficacy of nourishing yin, the reasons of that because shashen had amount of sap, its properies and flavours of herbs are light and clean. 7. The constituents of shashen were essential oil, starch, shashen-saponin, furocoumarin, xanthotoxin(ammoidin), inulin, sugar, mucus and have efficacies of resolving phlegm, promoting production of body fluid, immunomodulational and antibiotic efficacies. above results indicated that the origin of shashen and substitutional plants was various. Their efficacies are somewhat alike, but there were characteristic efficacies each other. Nowadays they are used together with, so we should know the characteristic efficacies of them and then we using them clinically, more deep discrimination and experimental support shoud be accomplished.

• Herbal Formula Science
• /
• v.18 no.1
• /
• pp.23-42
• /
• 2010

This report describes 90 prescriptions related to the use of Platycodi Radix main blended from Dongeuibogam. The following conclusions were reached through investigations on the prescriptions that use Platycodi Radix as a key component. Prescriptions that Platycodi Radix was taken as a monarch drug are utilized for 30 therapeutic purposes, for example, cough disease, throat disease, abscess and pus, and wind disease. In particular, 12.1% of prescriptions appear in the chapter of cough, and 9.9% of those appear in the chapter of throat, and each 8.8% of those appear in the chapter of abscess and of wind disease. Prescriptions that utilize Platycodi Radix as the main ingredient are used in the treatment of cough disease, throat disease and abscess, and they are also used for treating 74 different types of disease. The prescriptions are compounded with Platycodi Radix as a monarch drug are related to exogenous agents such as wind-cold pathogen, wind-heat pathogen, epidemic diseases, and endogenous agents such as seven emotions, and non-endo-exopathogenic factors like excessive labor, deficiency of Qi and blood, phlegm-mass, phlegm-fire, ect. The dosage of Platycodi Radix is 2pun(about 0.75g) to 1nyang(about 37.5g), however 1don (about 3.75g) has been taken the most for clinical application. We can find out that according to herbs or prescriptions blended with it self, Platycodi Radix makes a variety of functions to penetrate lung stagnancy and remove phlegm, relieve throat pain and get rid of pus, and regulate Qi flow. And Gamgiltang is the most useful base prescription which used the Platycodi Radix as the main component.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.8 no.1
• /
• pp.131-132
• /
• 1995

After studing of viewpoint of surgical disease in seven medical books related with Ju Dan Gye(朱丹溪) among four eminent physicians in the Jin and Yuan dynasties(金元四大家) I get conclsion as following. 1. Studied surgical diseases are total 40 kinds. 2. In 40 kinds surgical diseaes, case of having theory are 20 kinds, cases of having no theory and having only treatement by medicine are 20 kinds. 3. In therapy, cases that mainly use a method to eliminate pathogenic factors are 27 kinds; Acute mastitis(乳癰), Deep-seated mammary abscess(내巖), Acute appendicitis(陽癰), Bone cellulitis(附骨疽), Carbuncle of the lower abdomen near external genitalia(便毒), Leprosy(癩風), Macule(斑), Rash(疹), Urticaria(은疹), Scrofula(나역), Stagnant plegm(結核), Goiter andtumer(영유), Erysipelas(丹), Furuncle(정瘡), Scabies(疥瘡), Chancre(下疳瘡), Syphilitic skin disease(樣梅瘡), Incised wound (金瘡), Dermatopathy of lower limb and heel(脚足部瘡), Pemphigus(天疱瘡), Itching eruption due to blood-heat or wind heat(血風瘡), Dermatopathy of head(頭面瘡), Scald and burn(湯火瘡), Tetanus(破傷風) , Ecthyma(염瘡), Fistula(久漏瘡), Tinea(癬瘡), Cases that mainly use external therapy are 5 kinds; Rhagades of hand and foot(手足군裂), Vulvar ulceration(婦人陰瘡), Chilblain(凍瘡), Rabies(풍狗咬), Tinea capitis(白禿瘡), Cases that mainly use a reinforcing method are 4 kinds; Internal deep-rooted carbuncle(內疽), Pruritus and dryness of skin(皮膚乾燥), Anul fistula(漏瘡), Macule Caused by disorder of internal organ(內傷發斑), Cases that mainly use eliminating first and then reinforcing are 2 kinds; Pyogenic infection and ulcerous disease of slin( 疽瘡상癰疽瘡瘍), Lung abscess(肺癰), Case that mainly uses reinforcement and elimination in combination is only Haemorroid(痔瘡). Case divided into two groups that are reinforcing method and a method to eliminate pathogenic factor is only Trauma(打撲). Case that have no treatment by medicine is only Abscess of the scrotum(囊癰). 4. In 40 kinds surgical diseases, we can know that except a few important surgical diseases, Ju Dan Gye haven't distinguished viewpoint in many surgical diseases, because there are many cases that have no theory and have only simple treatment of medicine, and that mainly use a method to eliminate pathogenic factors and external therapy. 5. Representative theory of Ju Dan Gye, nourishing Yin and extinguishing fire(滋陰降火), has little effect on therapy of surgical disease. We need to try statistical division of internal and external remedy in the future, and by studing of surgical disase in medical books related with four eminent physicians in the Jin and Yuan dynasties, I think we can see their viewpoint of surgical disease.

• Journal of Chest Surgery
• /
• v.50 no.3
• /
• pp.202-206
• /
• 2017

Background: Empyema is the collection of purulent exudate within the pleural space. Overall, 36%-65% of patients with empyema cannot be treated by medical therapy alone and require surgery. Multiloculated empyema is particularly difficult to treat with percutaneous drainage. Therefore, we describe our experiences with early aggressive surgical treatment for rapid progressive multiloculated empyema. Methods: From January 2001 to October 2015, we retrospectively reviewed 149 patients diagnosed with empyema who received surgery. The patients were divided into 2 groups according to whether they underwent emergency surgery or not. We then compared surgical outcomes between these groups. Results: The patients in group A (emergency surgery, n=102) showed a more severe infectious state, but a lower complication rate and shorter length of hospital stay. The incidence of lung abscess was higher in group A, and abscesses were associated with diabetes and severe alcoholism. Conclusion: Early aggressive surgical treatment resulted in good surgical outcomes for patients with rapid progressive multiloculated empyema. Furthermore, we suspect that the most likely causes of multiloculated empyema are lung abscesses found in patients with diabetes mellitus as well as severe alcoholism.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.5
• /
• pp.574-578
• /
• 1994

The incidence of traumatic rupture of the tracheobronchial tree has been increased considerably with advent of widespread mechanization and high speed era. Rupture of the bronchus is an unusual result of nonpenetrating trauma to chest. Early diagnosis and primary repair not only restore normal lung function but also avoid difficulties and complications associated with delayed diagnosis and repair. These complications are pneumonia, atelectasis and lung abscess secondary to the bronchial obtruction. We experienced a case of partial rupture on left main bronchus caused by nonpenetrating blunt chest trauma with rib fractures 1 year ago. He was suffered from progressively developing dyspnea on exercise and treated as bronchial asthma at other hospital. Bronchoscopic finding was the narrowed lumen of left main bronchus at 1cm from carina by web-like membrane. We confirmed by bronchogram and repaired by end to end anastomosis, which is rare delayed finding in bronchial rupture without pulmonary complications. We report a case of nonpenetrating traumatic bronchial rupture, manifested by bronchial web in bronchoscopy.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.1
• /
• pp.86-88
• /
• 2010

Oral metastatic tumors are uncommon and account for about 1% of malignant oral neoplasm. The metastatic lesions are common in breast, lung, kidney and thyroid cancer. About 20% of oral mucosal metastasis is founded before detection of primary lesions. Usually, the metastatic lesions of the oral cavity are involved in the jaw bone, especially mandible more than the oral soft tissues. We report a case diagnosed as the stomach cancer with mandible metastatic lesion looking like TMJ abscess.

• Journal of Chest Surgery
• /
• v.28 no.3
• /
• pp.280-286
• /
• 1995

In our hospital we have seen 38 cases of esophageal cancer from June 1984 until June 1994. They composed of 34[89% men and 4[11% women, their age distributed from 35 to 74, mean age was 57.55 7.43. Their symptoms were varied, dysphagia[97% , pyrosis[58% , chest pain[31% , weight loss[31% , anemia[8% , vomiting[5% , and hoarseness[1% . Surgical treatment was done with esophagectomy and upper GI reconstruction 35 cases, and palliative gastrostomy was 3 cases. There was no operative mortality, and operative morbidity was 8 cases of anastomotic leakage, 5 cases of wound infection, 5 cases of pleural effusion, hoarseness, pneumothorax, and lung abscess. Pathologic lesion distribution: upper thoracic esophagus 6 cases[16% , middle thoracic esophagus 17 cases[45% , and lower thoracic esophagus 15 cases[39% . There was no statistical difference of transhiatal esophagectomy and transthoracic esophagectomy in complications and hospitalization period in this study but we proved the superiority of gastric upper GI reconstruction rather than colon upper GI reconstruction in anastomotic leakage and hospitalization period. Cumulative survival rate was 76.2% in 1 year survival, 33.9% in 3 year survival, 25.4% in 5 year survival, 12.7% in 10 year survival. There was no relationship with the time of dysphagia with survival in this study.

• Journal of Chest Surgery
• /
• v.24 no.2
• /
• pp.190-196
• /
• 1991

Clinical experience of 48 acute pericarditis with effusion was reviewed and presented. There were 28 male and 20 female patients ranging from 3 years to 77 years old. Malignant effusion; Twenty patients had underlying malignancy. These etiologies were lung ca[8 patients, 40%], breast ca[7 patients 35%], lymphoma[2 patients, 10%], esophageal ca[1 patients, 5%], stomach ca[1 patient, 5%], ovarian ca[1 patient, 5%]. Uremic effusion; 15 patients with renal failure required surgical intervention. Traumatic effusion; 7 patients had traumatic pericarditis. These etiologies were stab wound [5 patients, 71.4%] and aspiration[2 patients, 28.6%]. Pyogenic effusion: 6 patients had pyogenic pericarditis. These etiologies were empyema thoracis[3 patients, 50%], liver abscess[2 patients, 33.3%], pneumonia[1 patient, 16.7%]. The patients were treated by pericardiocentesis, subxiphoid tube drainage, pericardiectomy: 4 of them underwent pericardiocentesis; 37, subxiphoid tube drainage; 5, pericardiectomy. We conclude that subxiphoid tube pericardial drainage was effective for treatment of pericardial effusion.

• Journal of Chest Surgery
• /
• v.20 no.1
• /
• pp.65-70
• /
• 1987

Empyema thoracis following pneumonia, pulmonary tuberculosis, trauma and surgical procedures continues to be a source of major morbidity and mortality. We retrospectively reviewed the hospital records of 330 patients [child:87, adult243] treated for empyema thoracis at Catholic Medical Center between 1964 and 1986. The causes of empyema in these patients were as follows: pneumonia [C***:66%, A***:30%], pulmonary tuberculosis [C:2%, A:20%], lung abscess [C:3%, A:5%], postoperative complication [C:0%, A:13%], trauma [C:1%, A:4%] and unknown origin [C:23%, A:17%]. Three patients in this series died of sepsis from necrotizing pneumonia. Staphylococcus [29.3%], Streptococcus [8.8%], E. coli [8%], Mycobacterium tuberculosis [7.9%], Klebsiella [7.4%], Pseudomonas [6.4%], Bacteroides [3.4%] were the organisms most commonly isolated. Bacterial isolates were single in 68.3%, multiple 7.5% and absent 24.2%. The type of organism did not correlate with severity of disease or eventual requirement for closed thoracotomy drainage, open thoracotomy drainage [Modified Eloesser*s procedure], thoracoplasty, decortication or pleuropneumonectomy. Successful methods of treatment included aspiration in 44%, tube thoracotomy in 66%, open thoracotomy drainage in 98.7%, thoracoplasty in 98%, decortication in 96% and pleuropneumonectomy in 73%. Initial mode of management in empyema thoracis are thoracentesis and closed thoracotomy drainage. If the initial management was failed, we performed another surgical procedures. Before 1973, we manage with Schede`s thoracoplasty in the postpneumonectomy empyema patients. But thoracoplasty, with or without the use of muscle flaps, is a hazardous operation in the poor-risk patients. The permanent, open thoracotomy drainage is a relatively minor operation which is well tolerated even by cachexic, septic patients. It controls infection, and sometimes results in the bronchopleural fistula closing spontaneously.