• 제목/요약/키워드: Lung abscess

검색결과 147건 처리시간 0.02초

농흉의 외과적 치료330 (Surgical Management of Thoracic Empyema.* - 330 cases -)

  • 김치경
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.65-70
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    • 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.

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Mycoplasma pneumoniae 폐렴에 동반된 양측 특발성 긴장성 기흉 1례 (A Case of Bilateral Spontaneous Tension Pneumothorax Associated with Mycoplasma pneumoniae Infection)

  • 이재원;허미영;김혜순;이승주
    • Clinical and Experimental Pediatrics
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    • 제45권3호
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    • pp.401-405
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    • 2002
  • 저자들은 호흡곤란, 흉통 및 경부종창을 주소로 내원한 6세 남아에서 M. pneumoniae 폐렴에 동반된 양측성 특발성 긴장성 폐기흉 1례를 경험하였기에 문헌 고찰과 함께 국내 첫 증례로 보고하는 바이다.

폐암의 외과적 치료에 대한 임상적 고찰 (A Clinical Evaluation of the Surgical Treatment of Primary Bronchogenic Carcinoma)

  • 김근호
    • Journal of Chest Surgery
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    • 제2권1호
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    • pp.13-18
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    • 1969
  • A clinical evaluation was done on a total of 41 cases of primary bronchogenic carcinoma, which came to the department of thoracic surgery, Chonnam University Hospital for the period of 5 years from May 1964, and the various factors led the patients to an inoperable stage were searched. The incidence ratio of male to female was 5.8:1 and the age group of fifty and sixty decade occupied 78% of the total. The subjective symptoms of the patients were cough with or without sputum [83%], chest pain or chest discomfort [76%], and a few incidence of bloody sputum and hemoptysis. The histological findings were 40% of squamous cell carcinoma, 35% of adenocarcinoma and 25% of anaplastic carcinoma, including 5 cases of unclassified bronchogenie carcinoma in scalene biopsy. 12 cases [29%] of a total of 41 cases received thoracotomy, but 8 cases among them were operable and 4 cases inoperable. The rest of 29 cases [71%] could not receive thoracotomy because of the various contraindication. 23 cases [70%] out of inoperable 33 cases had wasted time over 2 months duration for an operation owing to physicians` misdiagnosis of bronchogenic carcinoma as pulmonary tuberculosis, chronic lung abscess, asthma, pleurisy, pneumonia. common cold, neuralgia in order. The delaying factors led the patients to an inoperable stage were physicians misdiagnosis of bronchogenic carcinoma due to non-specific symptoms and signs of the patients, old aged patients dependance on herb medicine, and poor economical condition of the patients.

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당뇨병(糖尿病)의 원인(原因)과 증상(症狀)에 대한 동서양(東西洋)의 병기론적(病機論的) 접근(接近) 및 동(東),서양(西洋),대체의학적(代替醫學的) 치료연구(治療硏究) (A study of a pathological approach about symptoms of Diabetic)

  • 황우준;전현정
    • 대한한의정보학회지
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    • 제11권1호
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    • pp.1-23
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    • 2005
  • A symptoms of Diabetic is finded in many recordes, that is said to Diabetic or dryness or migratory arthralgia or flaccid paralysis of limb or abscess or arthralgia, but Diabetic is most closely symptom. So, study the 3-symptoms of Diabetes mellituscause, thses are polyuria and polyphasia and thirst, and this is similar symptoms of So-gal. So, bibliographic study or pathological approach of symptoms of So-gal, and So-gal in oriental medicine has come to the following conclution. The symptoms of So-gal is polyuria and polyphasia and thirst, is due to Simsinbulgyo, that is mean to breakdown of the normal physiological coordination between the heart and the kidney. A thirst is due to heat-transformation have an effect to the upper energizer and the heart and the lung and the stomach in Simsinbulgyo. A polyuria is due to failure of the kidneys Yang, that is due to failure of Yang of the heart in Simsinbulgyo.

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흉부손상에 대한 임상적 고찰 (clinical evaluation of chest trauma)

  • 문경훈
    • Journal of Chest Surgery
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    • 제22권1호
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    • pp.123-133
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    • 1989
  • A clinical evaluation was done on 182 cases of chest trauma which experienced at the Department of Thoracic and Cardiovascular Surgery, National Medical Center, from Sep. 1980 to Dec. 1987. 1] Of 182 cases, 125 cases resulted from non-penetrating chest trauma and 57 cases from penetrating wound. 2] The ratio of male to female was 4.87:1, and age groups between 3rd and 6th decade were 71.9%. 3] The most common causes of chest trauma were traffic accident in non-penetrating and stab wound by knife in penetrating cases. 4] Left thorax was the preferred site of chest injury. 5] The incidences of hemothorax, pneumothorax, and hemopneumothorax were 69.6% in non-penetrating and 91% in penetrating. 6] Rib fractures between 4th rib and 8th rib were 68.8% of total rib fracture cases and left side was preferred site. 7] Methods of treatment were conservative management in 24.7%, closed thoracostomy in 54.9%, open thoracotomy in 14.3%, and etc. 8] The incidence of complications, were 11.5% of total cases, and they were atelectasis [8 cases], empyema [3 cases], pneumonia [3 cases], acute renal failure [2 cases], lung abscess [1 case], and etc. 9] The overall mortality was 6%, and causes of death were hypovolemic shock, renal failure, hepatic failure, respiratory failure, septic shock, and etc.

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급성 화농성 심낭염의 임상적 관찰: 5예 (Clinical Observation of Acute Suppurative Pericarditis: 5 Cases)

  • 마중성
    • Journal of Chest Surgery
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    • 제7권1호
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    • pp.79-84
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    • 1974
  • Acute suppurative pericarditis is recognized as a rare disease since development of antibiotics but therapeutically as an important one. To our knowledge, acute suppurative pericarditis alone has not been reported previously in Korea. In this paper, we report 5 cases of acute suppurative pericarditis which were experienced during the period between January 1959 and December 1973. The patients ranged in age from 9 months to 59 years at the time of admission. Four of 5 patients were male and one female. Acute suppurative pericarditis is usually associated with pneumonia, empyema, sepsis, osteoarthritis, lung abscess, cholecystitis or tonsillitis. In our series, pneumonia was the most common associated disease. One patient had osteoarthritis. Pleural effusions were observed in three of the 5 patients. Staphylococcus aureus was cultured from pericardial fluid in 4 patients and also cultured from both pericardial and synovial fluid in one. Three of the 5 patients had cardiac tamponade and one patient required prompt pericardiocentesis. 3 of the 5 patients were treated with antibiotics and pericardiostomy, one with antibiotics and pericardiocentesis, and one with antibiotics and saline irrigation through drainage sinus from the pericardial sac. Four of the five patients were recovered without pericardial constriction. One was discharged with poor condition. In this instance, follow-up study couldn`t be made.

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$^{57}Co-BLM$을 이용한 종양진단 신티그라피에 관한 연구 (Clinical Evaluation of $^{57}Co-labelled$ Bleomycin for Tumor Localization)

  • 유용운;김장휘;이진오
    • 대한핵의학회지
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    • 제21권1호
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    • pp.61-68
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    • 1987
  • Investigation with $^{57}Co-Bleomycin$ in patients with the various cancers and in tumor bearing animals are descirbed. In the patients, $^{57}Co-Bleomycin$ appears to be one of the useful tumor-seeking radiopharmaceuticals, and worth applicable to clinical uses. Labelled yield of $^{57}Co-Bleo$ was about 97 % by thin layer chromatography. The pyrogen free tests were performed to meet U.S.P. critical ranges. In clinical studies with $^{57}Co-Bleo$, 4 cases out of 5 patients with lung cancer., 2 cases among 3 thyroid cancer patients, and all 3 hepatoma patients showed positive tumor scans. The patients with stomach cancer, and the esophageal cancer showed false negative scintigraphy. A case with pulmonary tuberculosis showed a positive scan while liver abscess showed a negative picture. The merits of $^{57}Co-Bleomycin$ scintigraphy seems to be its relatively high affinity to tumors and low radiation hazard in spite of long physical half life.

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흉곽 성형술의 임상적 고찰 (Clinical Evaluation of Thoracoplasty)

  • 김형준
    • Journal of Chest Surgery
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    • 제25권1호
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    • pp.96-104
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    • 1992
  • The 242 patients were operated due to chronic empyema in Hanyang University Hospital From Jan, 1983 to Aug, 1991, we operated 17 patients by modified.Schede`s thoracoplasty with myoplasty and we concluded to next scentences. 1. The age of patients were varied from 28 to 65[Average 39.1] and male preponderance was seen[more than 3 times]. 2. The preoperative cause of disease were tuberculosis in 14 patients[3 patients were associated with aspergillosis, and 1 patient was associated vrith actinomycosis], lung abscess in 2 patients, and haemophilia in 1 patient. 3. The Preoperative duration of empyema were varied from 1 month to 30 years[Average 49.8 month], and the duration from pulmonary resection to thoracoplasty were 1 month to 13.5 years[Average 55 month] except 3 patients, who were operated pneunectomy with thoracoplasty at the same time. 4. The total number of thoracoplasty were 19, because in 2 patients, we operated 2 steps, and we failed in 6 cases, so the success rate was 68.5%. 5. In failure analysis of 6 cases, the cause were obliteration failure in 3 cases, inadequete drainage in 1 case, and in the other 1 case was mixed type. 6. From 1990 to 1991, there were no death associated with operation and there were 1 failure, so the success rate was greatly improved. 7. The bronchopleural fistula or spontaneous rupture of trachea were seen in 12 cases, and the success rate was high in absent cases.

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Achalasia 의 외과적 치료 -Modified Heller Operation을 시행한 9례의 관찰성적- (Surgical Treatment of Achalasia of the Esophagus -Report of 9 Cases Performed Modified Heller Operation-)

  • 이호일
    • Journal of Chest Surgery
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    • 제1권1호
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    • pp.53-60
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    • 1968
  • Achalasia is a functional disorder of a short segment of the lower esophagus showing obstruction of the esophagogastric junction. Dysphagia. regurgitation and weight loss are outstanding features,however, complicated pulmonary troubles aspiration pneumonitis, bronchiectasis, lung abscess etc. --are sometimes more apparent than the disease entity in children though achalasia is rarely encountered in children. During the period of January, 1961, to May, 1968, the authors experienced 9 cases of achalasia of the esophagus in Chest Surgery Department,N.M.C. 1. Seven of nine were male and four were under 5 years of age. 2. So-called symptoms triad noted in almost every case, and 3 of 4 children showed recurrent attacks of pneumonitis. 3. Chest film showed widened superior mediastinum by dilated esophagus in 6 cases, and pulmonary infiltrations in 3 cases of children. 4. Preoperative diagnosis were achalasia,esophageal stricture by rodent-cidal ingestion and suggestive esophageal cancer in 7 cases,one case and remaining one case. respectively. 5. Modified Heller procedure was performed in all cases with definite diagnosis of achalasia at operation table in misdiagnosed 2 cases. 6. Immediate postoperative complications were 2 cases of wound infection and one case of atelectasis and no operative mortality encountered. 7. Seven of nine showed excellent result of operation, and good in one case. Remaining one case failed relieving obstruction and underwent interposition of ileocolonic segment with excellent result.

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식도이물 사망례 (A rare case of esophageal foreign body complicating mediastinitis, pulmonary atelectasis, and daeth)

  • 배정보;조승호;강주원;김병우
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1976년도 제10차 학술대회연제 순서 및 초록
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    • pp.90.4-90
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    • 1976
  • 식도이물은 이비인후과 영역에서 흔히 볼 수 있는 질환으로서 국내외를 막론하고 수많은 보고가 있으며 특히 유소아에 있어서 가장 많은 이물로는 주화라는 사실도 대부분의 보고자와 일치하는 것은 자타가 공인하는 사실이라고 하겠다. 그런데 특별한 경우를 제외하고는 이 주화로 인하여 합병증을 일으키는 경우는 별로 많지 않으며 간혹 유아에서 호흡곤란을 초래하여 기도이물과 혼동하기 쉬운 경우가 있다. 저자들은 최근에 만 1세된 여아에서 유아에게서는 보기드문 생선뼈가 식도 제1 협착부에 5일간 개재되어 있으면서 연하곤란, 흡기성 호흡곤란 및 발열을 주소로 래원 하였으나 엑스선검사로 피하기종, 식도주위농양, 종격동기종, 종격동염 및 폐확장부전증의 병발이 확인되어 불행한 결과를 초래한 보기드문 1례를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다.

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