• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.90-94
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• 2024

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignancy of the sweat glands that most commonly affects the periorbital area. It is characterized by slow growth over a prolonged period, and its morphology can be easily confused with a benign tumor, such as an epidermal cyst. Consequently, many patients experience recurrence after undergoing multiple resections. However, there are few reports concerning the surgical management of PCMC. We present two cases of PCMC originating in the periorbital area. The first case involved a 76-year-old man with a mass measuring 3.0×1.5 cm that had been increasing in size. The second case was a 61-year-old man with two masses, each measuring 1.0×1.0 cm, that were also growing. Both patients underwent wide excision with a 5-mm safety margin, which was determined based on the widest view of the cross-section of the mass on the magnetic resonance imaging. Subsequently, based on the intraoperative frozen biopsy results, both patients underwent additional excision with a 5-mm safety margin in only one direction. This report shows that, when determining the surgical margin of PCMC in periorbital area, employing imaging modalities and intraoperative frozen biopsies can be helpful for narrowing the surgical margin.

• 중환자간호학회지
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• 제10권1호
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• pp.1-12
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• 2017

Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

• Journal of Chest Surgery
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• 제13권4호
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• pp.455-461
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• 1980

This is one case report of surgically treated ventricular septal defect [VSD] with aortic insufficiency [AI] at department of thoracic and cardiovascular surgery, Hanyang university hospital. He had had progressive dyspnea on exertion and palpitation for 3 years prior to admission to our hospital. On examination, the blood pressure was 120/0 mmHg and the pulse rate 88 times/min. Bobbing motion of the head, Water hammer pulse, Corringan`s pulse, Quincke`s pulse and to and fro murmur were present. The heart murmur was consistent with .VSD and AI. Cardiomegaly was seen in chest X-ray. EKG, echocardiogram, aortogram and right heart catheterization was performed. On Sep. 9, 1980, open heart surgery was performed under the impression of VSD with AI. Infracrystal type VSD measuring 2 x 1.5 cm in diameter was closed with Teflon patch graft through the transverse ventriculotomy. AI was due to prolapsed, elongated right coronary and noncoronary cusp, especially noncoronary cusp. The prolapsed, elongated aortic leaflets were plicated by placing three 8-figure sutures between the free edge and the base of the leaflet [Frater`s method] through a transverse aortotomy. Postoperatively, he made an uneventful recovery, his blood pressure was 120/70 mmHg and showed no signs AI or residual shunt at discharge.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.753-756
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• 2006

Purpose: Pilomatrixoma is a benign, usually asymptomatic tumor. It presents clinically as a solitary superficial subcutaneous nodule measuring between 0.5 cm and 5 cm in diameter on the head or upper extremeties and has not been reported after skin graft. The objective of this article is to report our experience in treating pilomatrixoma which occurred after split thickness skin graft on the lower extremity. Methods: A 56-year-old female was treated in August 2005 with a $0.5{\times}0.5cm$ firm subcutaneous nodule at recipient site of split thickness skin graft on the left medial thigh. The tumor was successfully removed by complete excision and histologic examination was followed. Results: The diagnosis was pilomatrixoma which was characterized by a dual population of proliferating basophilic cells and diagnostic shadow cells. Conclusion: The tumor was successfully treated by complete resection. The authors report this very rare case of pilomatrixoma which occurred at recipient site of split thickness skin graft.

• 대한세포병리학회지
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• 제7권1호
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• pp.64-68
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• 1996

The report of aspiration cytologic findings of epithelial-myoepithelial carcinoma(EMC) in the salivary gland is extremely rare. We present a case of fine needle aspiration cytology(FNAC) from EMC in the right submandibular gland of a 46 years old male patient. Neck CT scan revealed a confined lesion in the submandibular gland without enlargement of the regional lymph node. FNAC from the tumor showed several three-dimensional cellular clusters with admixed normal acinar cells. They frequently formed blanching tubular structures composed of two type of cells; darker cells haying eosinophilic scanty cytoplasm with round dense nuclei and clear cells having abudant pale cytoplasm with vesicular nuclei at the periphery of clusters. The tumor cells of both types did not show pleomorphism or mitoses. The resected submandibular gland showed an ill-defined whitish firm tumor, measuring $2{\times}1.5{\times}2cm$. The histology revealed an infiltrative tumor showing characteristic two cell types in a duct-like arrangement surrounded by thin basement menbrane. An inner layer of darker cells and outer layer of clear cells were postive for cytokeratin in the former and S-100 protein in the taller on the immunohistochemical stain.

• 대한한방내과학회지
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• 제38권5호
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• pp.753-762
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• 2017

Objectives: We conducted this study to report the clinical effects of Sibak-tang (Saiboku-to) in an elderly patient suffering from sputum and dysphagia after conventional treatment for pneumonia. Methods: The Sibak-tang was administered to the patient to treat sputum and dysphagia. The results were assessed by measuring the frequency of the sputum and conducting a videofluoroscopic swallowing study. Results: After about three weeks of herbal medicine treatments, the patient's symptoms of respiratory problems improved. The results of the videofluoroscopic swallowing study were also improved. Conclusion: Sibak-tang could be an effective treatment for elderly patients suffering from sputum and dysphagia after conventional treatment for pneumonia.

• Journal of Chest Surgery
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• 제15권4호
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• pp.447-450
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• 1982

A 45 year old male officer was admitted due to upper substernal pain for 1 month, which was aggravated by swallowing. On past and family history, there was no specific history except heavy drinking. Simple chest x-ray revealed no specific abnormal findings. Preoperative esophagofiberscopy and Barium study showed midesophageal diverticulum, pulsion type, at about 2 cm below the left main bronchus. The opening of the diverticulum was located at the left posterolateral aspect of esophagus. Midesophageal false diverticulum, measuring 2 x 2 x 1 .S cm in size, was noted at about 5 cm under the aortic arch protruding through a slit-like muscular defect. After inversion of diverticular sac, interrupted sutures with 3-0 silks were done on muscular defect site, and mediastinal pleura was reinforced on the lesion with interrupted sutures. On 4th postoperative day, esophagography revealed no diverticulum or stenosis. Also esophagofiberscopy showed smooth mucosal tag without disturbance of passage. On 14th postoperative day, the patient was discharged uneventfully, and follow-up for 3 months after discharge revealed nothing abnormal symptoms. The authors report one case of midesophageal, pulsion type, false diverticulum.

• 한방재활의학과학회지
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• 제23권1호
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• pp.65-75
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• 2013

The objective of this study is to report the effect of Chuna manipulation and foot orthosis treatment on juvenile, adolescent idiopathic scoliosis by observing four clinical case studies. Pre-and post-treatment, we investigated the changes in Cobb's angle, pelvic height and walking pattern by using the standing full spine X-ray. After application of a Chuna manipulation and foot orthosis treatment, Cobb's angle was reduced in 4 cases. Difference of pelvic height was reduced in 3 cases, and other 1 case was increased rather. And walking balance was improved in the case of measuring walking balance pattern. This study showed that Chuna manipulation and foot orthosis treatment has meaningful effect on juvenile, adolescent idiopathic scoliosis and more researches should be followed.

• 척추신경추나의학회지
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• 제4권1호
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• pp.7-17
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• 2009

Objectives: The objective of this study is to report the effectiveness of Chuna treatment and burning acupuncture therapy on shoulder impingement syndrome. Methods: Among the patients with shoulder pain, We selected 3 patients diagnosed as shoulder impingement syndrome by physical examination and magnetic resonance imaging(MRI). After Chuna treatment and burning acupuncture therapy, we evaluated the effectiveness by measuring range of movement(ROM) and checking The Shoulder Pain And Disability Index(SPADI) every three times the patients called at the clinic for three weeks. Results: The symptoms of the patients got improved relatively in short period considering shoulder impingement syndrome belongs to chronic diseases and steps chronical procedure in recovering. Conclusions: These cases showed Chuna treatment and burning acupuncture therapy could be applied on shoulder impingement syndrome and were effective for improving the symptoms. We suggest that further studies and clinical trials will be needed afterwards.

• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.430-433
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• 2000

Infantile myofibromatosis is a rare and benign myofibroblastic tumor that may occur in either solitary or multicentric form in the soft tissue of infants. A 13-month-old girl presented with a painless firm mass, measuring $2.5{\times}2.5cm$ in the right temporal area. Skull X-ray and CT scan revealed a well enhancing soft tissue tumor with a round skull defect and sclerotic margin. The tumor was totally excised with curettage of the skull defect followed by cranioplasty. Pathology was confirmed to be a solitary infantile myofibromatosis. We report this rare solitary infantile myofibromatosis of the temporal bone with review of the pertinent literature.