• 제목/요약/키워드: Medical indications

검색결과 330건 처리시간 0.02초

Completion pneumonectomy의 임상적 고찰;11례 임상보고 (Clinical analysis of completion pneumonectomy; report of 11 cases)

  • 허용;박재홍;문준호;차경태;안욱수;김병열;이정호;유회성
    • Journal of Chest Surgery
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    • 제26권11호
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    • pp.851-855
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    • 1993
  • Among elevn consecutive cases having undergone Completion Pueumonectomy[CP]between 1958 and Aug. 1993 at the Dep. of Thoracic & Cardiovascular Surgery in National Medical Center. The patient`s mean age was 43 years[range 28 yrs, to 68yrs.],& they consisted with 10 males and 1 female. The indications for CP were benign diseases in 9 cases & 2 cases of lung cancer. The mean interval between the first operation & CP was 62.3 months[from 17 days to 288 months]. The several special intraoperative procedures such as intrapericardial pulmonary vesselsdivision & suture ligation, reinforcement of bronchial stumpmargin, & applied the Fibrin glue & hemostatics. The mean intra operative bleeding was 3582ml.[1500ml. to 6500ml.] The post orerative complication were developed in 5 cases[45.5%] they were empyema with BPF in 2 cases, empyema in 2 cases, & 1 case of repiratoy insufficiency which leading to death. We concluded that the C P noted high morbidity & mortality compared with ordinary first pulmonary resectional surgery. But, it will be a challenge to improved the morbidity because of increasing trend of completion pneumonectomy in a furture time.

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지총(知聰)의 실존(實存)과 고대 한국 의학 교류(古代 韓國 醫學 交流)에 대한 역할(役割) (The Existence and Role of Ji-chong for Medical Exchange in Ancient Korea)

  • 김재효;김성철;정헌영;김용;권오상;김경식;손인철
    • 대한한의학회지
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    • 제28권3호통권71호
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    • pp.70-85
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    • 2007
  • Objectives : Considering the indigenousness of Korean medicine, the historical record was first introduced in 1946 as follows; a Chinese person, Ji-chong (知聰), brought 164 volumes of medical books to Japan via Goguryeo (高句麗) in A.D. 562. Since this event happened, Korean Oriental Medicine has been derived from Traditional Chinese Medicine because ancient Korean Medicine originated and was developed in China. The purpose of this study was to investigate the existence and role of Ji-chong in the history of medical exchanges between ancient Korea and Japan. Methods : We studied Ji-chong through ancient and modern historical literatures such as Nihon Shoki (日本書紀), the record of $Shinsen-sh{\bar{o}}jiroku$ (新撰姓氏錄), Korean Medical History (韓國醫學史), Japanese Medical History (日本醫學史), Samguk Sagi (三國史記), etc. Results : We found indications of the existence of Ji-chong and the import of Chinese medical literature to the ancient Korean peninsula by examining domestic and foreign historical literature. Especially, he was closely related to historical assumptions about the Japanese conquest of Goguryeo in A.D. 562, although without objective historical evidence and described only in modern Japanese historical records and Korean Medical History. However, substantial medical exchange toward Japan was accomplished by Korean medicine of either Goguryeo, Baekje (百濟), or Silla (新羅) dynasty until the late A.D. 6 century. Conclusions : Based on the above investigation, the idea that Ji-chong carried medical literature via Goguryeo in A.D. 562 needs to be reconsidered and the role of Ji-chong as recorded in a variety of literature and databases should be amended., Korean Oriental Medicine has been derived from Traditional Chinese Medicine because ancient Korean Medicine originated and was developed in China. The purpose of this study was to investigate the existence and role of Ji-chong in the history of medical exchanges between ancient Korea and Japan. Methods : We studied Ji-chong through ancient and modern historical literatures such as Nihon Shoki (日本書紀), the record of Shinsen-$sh{\bar{o}}jiroku$ (新撰姓氏錄), Korean Medical History (韓國醫學史), Japanese Medical History (日本醫學士), Samguk Sagi (三國史記), etc. Results : We found indications of the existence of Ji-chong and the import of Chinese medical literature to the ancient Korean peninsula by examining domestic and foreign historical literature. Especially, he was closely related to historical assumptions about the Japanese conquest of Goguryeo in A.D. 562, although without objective historical evidence and described only in modern Japanese historical records and Korean Medical History. However, substantial medical exchange toward Japan was accomplished by Korean medicine of either Goguryeo, Baekje (百濟), or Silla (新羅) dynasty until the late A.D. 6 century. Conclusions : Based on the above investigation, the idea that Ji-chong carried medical literature via Goguryeo in A.D. 562 needs to be reconsidered and the role of Ji-chong as recorded in a variety of literature and databases should be amended.

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Safety of a Totally Implantable Central Venous Port System with Percutaneous Subclavian Vein Access

  • Keum, Dong-Yoon;Kim, Jae-Bum;Chae, Min-Cheol
    • Journal of Chest Surgery
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    • 제46권3호
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    • pp.202-207
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    • 2013
  • Background: The role of totally implantable central venous port (TICVP) system is increasing. Implantation performed by radiologist with ultrasound-guided access of vein and fluoroscope-guided positioning of catheter is widely accepted nowadays. In this article, we summarized our experience of TICVP system by surgeon and present the success and complication rate of this surgical method. Materials and Methods: Between March 2009 and December 2010, 245 ports were implanted in 242 patients by surgeon. These procedures were performed with one small skin incision and subcutaneous puncture of subclavian vein. Patient's profiles, indications of port system, early and delayed complications, and implanted period were evaluated. Results: There were 82 men and 160 women with mean age of 55.74. Port system was implanted on right chest in 203, and left chest in 42 patients. There was no intraoperative complication. Early complications occurred in 11 patients (4.49%) including malposition of catheter tip in 6, malfunction of catheter in 3, and port site infection in 2. Late complication occurred in 12 patients (4.90%). Conclusion: Surgical insertion of TICVP system with percutaneous subclavian venous access is safe procedures with lower complications. Careful insertion of system and skilled management would decrease complication incidence.

현맥의 특징에 대한 현대 의학적 고찰 (Modern Medical Scientific Study on the String Pulse)

  • 유현희;이전;전영주;이유정;이시우;김종열
    • 동의생리병리학회지
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    • 제22권3호
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    • pp.535-539
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    • 2008
  • Pulse diagnosis is one of the typical examination methods in traditional oriental medicine. Pulse type classification is a major element of this diagnosis. There are more than 20 pulse types which have each clinical significance. However, pulse type's indications are implicative and obscure. In this study, we reviewed string pulse which is often diagnosed in Traditional Korean Medicine by analysis of Traditional Oriental Medical Literatures and modern medical papers. String pulse is taut and stiff pulse with high tension and low softness. It appears in 'blood vessel endothelial dysfunction', 'autonomic imbalance', 'arteriosclerosis'. Persistent string pulse can bring about cardiovascular or central nervous disease.

양격산화탕(凉膈散火湯)의 기원(基源), 변천과정(變遷過程) 및 구성원리(構成原理) (The Origin, Changes and Compositive Principles of Yangkyuksanhwa-tang)

  • 박병주;이준희;이의주;고병희
    • 사상체질의학회지
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    • 제23권2호
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    • pp.184-193
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    • 2011
  • 1. Objectives: This paper investigates the origin, the progressive changes and the constructive principles of Yangkyuksanhwa-tang (凉膈散火湯). 2. Methods: Yangkyuksanhwa-tang and other related prescriptions were analyzed in terms of their pathological indications, based on previous literature including "Donguisusebowon Chobongwon (東醫壽世保元 草本卷)", "Donguisusebowon Gabobon (東醫壽世保元 甲午本)", "Donguisusebowon Sinchukbon (東醫壽世保元 辛丑本)" and "Dongmuyugo (東武遺稿)". 3. Results and Conclusion: 1) The Yangkyuksanhwa-tang most likely originates from Sodokeum, Yangkyuksan, Baekho-tang and Indongdeung. 2) Sodoksanhwa-tang introduced in "Donguisusebowon Chobongwon (東醫壽世保元 草本卷)" progressively transformed into Chungyangsanghwa-tang ("Donguisusebowon Gabobon (東醫壽世保元 甲午本)") and ultimately into Yangkyuksanhwa-tang ("Donguisusebowon Sinchukbon (東醫壽世保元 辛丑本)"), a prescription appropriate for usage in the Sangso symptomatology (上消證). 3) Yangkyuksanhwa-tang is composed of 9 herbs. Of these, Schixonepetae herba(荊芥), Ledebouriellae Radix(防風), Forsythiae fructus(連翹), Menthae Herba(薄荷), Gardeniae fructus(梔子) scatter the Hwa-qi(火氣), and Rehmanniae Radix(生地黃), Gypsum fibrosum(石膏), Anemarrhenae(知母) put off the Stomach-heat(胃熱), whereas Lonicerae caulis(忍冬藤) support the prevention of carbunculosis(癰疽).

진화하고 있는 동종 반월연골판 이식술의 적응증 (Evolving Indication of Meniscal Allograft Transplantation)

  • 이범식;빈성일;김태형
    • 대한정형외과학회지
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    • 제55권3호
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    • pp.200-209
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    • 2020
  • 사람에서의 동종 반월연골판 이식술이 시행된 지도 30년이 흘렀다. 이식술의 초창기에는 양호한 관절 상태를 가진 환자들만으로 그 대상이 제한이 되었다. 현재까지도 반월연골판 이식술은 기본적으로 반월연골판 아전절제술 혹은 전절제술 후 이환구획의 통증이나 부종 등의 증상이 있는 환자들이 그 수술의 대상인데, 최근에는 이식술의 적응증의 범위가 과거에는 이식술이 시행되지 않았던 환자들에게까지 그 대상을 넓혀 가고 있다. 본 종설에서는 이식술의 적응증이 그동안 어떻게 변화해왔는지에 대해 살펴보고자 한다.

Imaging Evaluation of Peritoneal Metastasis: Current and Promising Techniques

  • Chen Fu;Bangxing Zhang;Tiankang Guo;Junliang Li
    • Korean Journal of Radiology
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    • 제25권1호
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    • pp.86-102
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    • 2024
  • Early diagnosis, accurate assessment, and localization of peritoneal metastasis (PM) are essential for the selection of appropriate treatments and surgical guidance. However, available imaging modalities (computed tomography [CT], conventional magnetic resonance imaging [MRI], and 18fluorodeoxyglucose positron emission tomography [PET]/CT) have limitations. The advent of new imaging techniques and novel molecular imaging agents have revealed molecular processes in the tumor microenvironment as an application for the early diagnosis and assessment of PM as well as real-time guided surgical resection, which has changed clinical management. In contrast to clinical imaging, which is purely qualitative and subjective for interpreting macroscopic structures, radiomics and artificial intelligence (AI) capitalize on high-dimensional numerical data from images that may reflect tumor pathophysiology. A predictive model can be used to predict the occurrence, recurrence, and prognosis of PM, thereby avoiding unnecessary exploratory surgeries. This review summarizes the role and status of different imaging techniques, especially new imaging strategies such as spectral photon-counting CT, fibroblast activation protein inhibitor (FAPI) PET/CT, near-infrared fluorescence imaging, and PET/MRI, for early diagnosis, assessment of surgical indications, and recurrence monitoring in patients with PM. The clinical applications, limitations, and solutions for fluorescence imaging, radiomics, and AI are also discussed.

Peripheral Blood Immune Cell-based Biomarkers in Anti-PD-1/PD-L1 Therapy

  • Kyung Hwan Kim;Chang Gon Kim;Eui-Cheol Shin
    • IMMUNE NETWORK
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    • 제20권1호
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    • pp.8.1-8.15
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    • 2020
  • Immune checkpoint blockade targeting PD-1 and PD-L1 has resulted in unprecedented clinical benefit for cancer patients. Anti-PD-1/PD-L1 therapy has become the standard treatment for diverse cancer types as monotherapy or in combination with other anticancer therapies, and its indications are expanding. However, many patients do not benefit from anti-PD-1/PD-L1 therapy due to primary and/or acquired resistance, which is a major obstacle to broadening the clinical applicability of anti-PD-1/PD-L1 therapy. In addition, hyperprogressive disease, an acceleration of tumor growth following anti-PD-1/PD-L1 therapy, has been proposed as a new response pattern associated with deleterious prognosis. Anti-PD-1/PD-L1 therapy can also cause a unique pattern of adverse events termed immune-related adverse events, sometimes leading to treatment discontinuation and fatal outcomes. Investigations have been carried out to predict and monitor treatment outcomes using peripheral blood as an alternative to tissue biopsy. This review summarizes recent studies utilizing peripheral blood immune cells to predict various outcomes in cancer patients treated with anti-PD-1/PD-L1 therapy.

Clinical Factors Associated with the Non-Operative Airway Management of Patients with Robin Sequence

  • Albino, Frank P.;Wood, Benjamin C.;Han, Kevin D.;Yi, Sojung;Seruya, Mitchel;Rogers, Gary F.;Oh, Albert K.
    • Archives of Plastic Surgery
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    • 제43권6호
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    • pp.506-511
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    • 2016
  • Background The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. Methods The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. Results Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5-70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of $19.2{\pm}5.3events/hour$, and an oxygen saturation level <90% during only 4% of the total sleep time. Conclusions Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.

Radiobiological mechanisms of stereotactic body radiation therapy and stereotactic radiation surgery

  • Kim, Mi-Sook;Kim, Wonwoo;Park, In Hwan;Kim, Hee Jong;Lee, Eunjin;Jung, Jae-Hoon;Cho, Lawrence Chinsoo;Song, Chang W.
    • Radiation Oncology Journal
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    • 제33권4호
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    • pp.265-275
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    • 2015
  • Despite the increasing use of stereotactic body radiation therapy (SBRT) and stereotactic radiation surgery (SRS) in recent years, the biological base of these high-dose hypo-fractionated radiotherapy modalities has been elusive. Given that most human tumors contain radioresistant hypoxic tumor cells, the radiobiological principles for the conventional multiple-fractionated radiotherapy cannot account for the high efficacy of SBRT and SRS. Recent emerging evidence strongly indicates that SBRT and SRS not only directly kill tumor cells, but also destroy the tumor vascular beds, thereby deteriorating intratumor microenvironment leading to indirect tumor cell death. Furthermore, indications are that the massive release of tumor antigens from the tumor cells directly and indirectly killed by SBRT and SRS stimulate anti-tumor immunity, thereby suppressing recurrence and metastatic tumor growth. The reoxygenation, repair, repopulation, and redistribution, which are important components in the response of tumors to conventional fractionated radiotherapy, play relatively little role in SBRT and SRS. The linear-quadratic model, which accounts for only direct cell death has been suggested to overestimate the cell death by high dose per fraction irradiation. However, the model may in some clinical cases incidentally do not overestimate total cell death because high-dose irradiation causes additional cell death through indirect mechanisms. For the improvement of the efficacy of SBRT and SRS, further investigation is warranted to gain detailed insights into the mechanisms underlying the SBRT and SRS.