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Correction of Funnel Chest: A Report of 4 Cases (누두흉의 수술교정)

  • 노준량
    • Journal of Chest Surgery
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    • v.7 no.2
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    • pp.153-162
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    • 1974
  • Four patients with funnel chest deformity corrected in the Department of Thoracic Surgery, Seoul National University Hospital are presented. The first case was a 21-year old female with cyanosis, clubbed fingers and systolic murmur on the left infrascapular region on physical examination associated with agenesis of the right lung. The deformity was of asymmetrical funnel chest, in which the left hemithorax was more sunken. She was corrected by the method of Funnel Costoplasty of Wada. The second case was a three years old boy whose anterior chest wall was symmetrically deformed, and he was corrected by the method of Ravitch using Adkins strut under the sternum. The third was a 22-year old man with symmetrical deformity, and was corrected by the method described by Shannon in 1973. The last patient was a 22-year old man and he had dyspnea on exertion, palpitation and apical systolic murmur with symmetrical funnel chest deformity. He was also corrected by Ravitch operation, All of them has excellent result.

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Seven Cases of Severe Esophageal Stricture (고도의 식도 협착증 7 예)

  • 김기주;김호성;조중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.5.2-5
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    • 1982
  • With the improvement of living standard and socioenvironmental change, esophageal stricture due to acetic acid, Hcl, insecticides and lye has led to decrease remarkably. Esophageal stricture has decreased because of immediate treatment and adequate management. However there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. The authors recently have experienced seven severe cases of esophageal stricture. All six patients were treated with 18-51 French Sippy esophageal dilating bougie. One patient was transfered to thoracic surgery department due to complete esophageal obstruction. Case 1. A 23 year old housewife who ingested Hcl for suicide. After Witzel's operation, she visited to dilate esophageal first constriction stircture due to swallowing difficulty postoperation 2 months later. We were treated successfully. Case 2. A case of esophageal stricuture in the second and third physiologic constriction part. The patient was 51 years old man who ingested lye accidently, and was dilated by bougination. Case 3. The patient was 43 year-old man who ingested acetic acid as a mistake and was treated inadequately at hopsital. Inspite of treatment, esophageal stricture developed at the third physiologic part. We are trying to dilate the esophagues now. Case 4. The patient was 55 year-old woman who had ingested Hcl for the purpose of suicidal attempt. 2 months later gastroduodenal anastomoisis due to pyloric region stenosis, the first physiologic constriction stricture was dilated successfully. Case 5. The patient was 41 year-old woman who ingested Hcl for suicide 4 months ago. There was indwelled orogastric tube for 1 month but esophageal stricture developed at the first and 3rd constriction part. She was treated by using a bougination. Case 6. An athlete 21 year old man, ingested acetic acid 2 spoonful per 3 days by purpose in order to soften the bone for last 14 months. There was complete esophageal obsturction in esophagogram and transferred to the thoracic surgery department. Case 7. A 3 year-old girl was ingested lye at a accident. She had a bougination for 16 months under the general anesthesia for dilation due to whole irregular esophageal stricture. She developed lower esophageal perforation, but healed eventually.

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Creation of the dental virtual patients with dynamic occlusion and its application in esthetic dentistry (심미치의학 영역에서 동적 교합을 나타내는 가상 환자의 형성을 통한 전치부 보철 수복 증례)

  • An, Se-Jun;Shin, Soo-Yeon;Choi, Yu-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.222-230
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    • 2022
  • Digital technology is gradually expanding its field and has a great influence on various fields of dentistry. Recently in digital dentistry, the importance of superimposing various 3-dimensional (3D) image data is emerging, in order to utilize gathered data effectively for diagnosis and prosthesis fabrication. Integrating data from facial scans, intraoral scans, and mandibular movement recordings can create a virtual patient. A virtual patient is formed by integrating digital 3D diagnostic data such as intraoral and extraoral soft tissues, residual dentition, and dynamic occlusion, and the results of prosthetic treatment can be evaluated virtually. The patients in this case report were a 37-year-old female whose chief complaint is that the appearance of the existing prosthesis was distorted and a 55-year-old female patient whose anterior prosthesis needed to be refabricated after the endodontic treatment. 3D facial scans were obtained from each patient, and the patient's mandibular movements were recorded using ARCUS Digma 2 (KaVo Dental GmbH, Biberach an der Riss, Germany). The collected data were integrated on computer-aided design (CAD) software (Exocad dental CAD; exocad GmbH, Darmstadt, Germany) and transferred to a virtual articulator to create a digital virtual patient. The temporary fixed prostheses were designed, restored, and evaluated, and it was reflected into the final restorations. With the aid of the virtual dental patient, accuracy and predictability could be increased throughout treatment, simplifying the occlusal adjustment and clinical evaluation with improved esthetic outcomes.

Extracranial systemic antitumor response through the abscopal effect induced by brain radiation in a patient with metastatic melanoma

  • D'Andrea, Mark A.;Reddy, G.K.
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.302-308
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    • 2019
  • The abscopal effect is a term that has been used to describe the phenomenon in which localized radiation therapy treatment of a tumor lesion triggers a spontaneous regression of metastatic lesion(s) at a non-irradiated distant site(s). Radiation therapy induced abscopal effects are believed to be mediated by activation and stimulation of the immune system. However, due to the brain's distinctive immune microenvironment, extracranial abscopal responses following cranial radiation therapy have rarely been reported. In this report, we describe the case of 42-year-old female patient with metastatic melanoma who experienced an abscopal response following her cranial radiation therapy for her brain metastasis. The patient initially presented with a stage III melanoma of the right upper skin of her back. Approximately 5 years after her diagnosis, the patient developed a large metastatic lesion in her upper right pectoral region of her chest wall and axilla. Since the patient's tumor was positive for BRAF and MEK, targeted therapy with dabrafenib and trametinib was initiated. However, the patient experienced central nervous system (CNS) symptoms of headache and disequilibrium and developed brain metastases prior to the start of targeted therapy. The patient received radiation therapy to a dose of 30 Gy delivered in 15 fractions to her brain lesions while the patient was on dabrafenib and trametinib therapy. The patient's CNS metastases improved significantly within weeks of her therapy. The patient's non-irradiated large extracranial chest mass and axilla mass also shrank substantially demonstrating the abscopal effect during her CNS radiation therapy. Following radiation therapy of her residual chest lesions, the patient was disease free clinically and her CNS lesions had regressed. However, when the radiation therapy ended and the patient continued her targeted therapy alone, recurrence outside of her previously treated fields was noted. The disease recurrence could be due to the possibility of developing BRAF resistance clones to the BRAF targeted therapy. The patient died eventually due to wide spread systemic disease recurrence despite targeted therapy.

Osteomyelitis in an Osteopathia Striata with Cranial Sclerosis Patient

  • Park, Heung-Chul;Kim, Hang-Gul;Kim, Yong-Hwan;Kim, Joo-Hwan;Kim, Moon-Young;Kim, Kyung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.6
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    • pp.285-291
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    • 2014
  • Osteopathia striata with cranial sclerosis (OS-CS) is characterized by linear bone dysplasia at the long bone radiographically and sclerotic change at the cranium. The purpose of this case report is to study the symptoms and treatments of osteomyelitis in a patient with OS-CS. A 41-year-old patient had pus discharge from a fistula at the mental region and increase in radiolucencies with sequestra in panoramic radiograph images. Computed tomography (CT) as well as radiograph images for the whole skeleton were taken. The patient was diagnosed with OS-CS. Sequestrectomy and fistulectomy were performed. The patient recovered and no relapse occurred within six months after surgery. For diagnosis of OS-CS, CT and additional radiograph images for the whole skeleton are required. Because of the increased bone density, this patient is prone to relapse after sequestrectomy. Therefore, the surgeon must minimize trauma with the least incision and exfoliation, and preoperative antibiotics.

Predicting Life Span for Terminal Colon Cancer using Clinical Symptoms (말기 대장암환자에서 중상을 통한 예후 측정 및 증상조절)

  • Lee, Do-Haeng;Choi, Youn-Seon;Hong, Myung-Ho;Kim, Jun-Suk;Lee, Kyung-Jin;Kim, Young-Soo
    • Journal of Hospice and Palliative Care
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    • v.2 no.2
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    • pp.138-143
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    • 1999
  • Accurately estimating survival times in terminal cancer patients is very difficult for palliative care clinicians. But a reasonably accurate estimate of survival would permit the medical team to : Plan the ideal therapeutic strategy between overtreatment and too early discontinuation of specific therapy. Answer any questions asked by the patient or family. Organize adequate assistance for the patient concerned. Decide on the eligibility of the patient for clinical trials and whether to begin a treatment, the effects of which will not be immediate. This case was a 79 year-old male patient with colon cancer. He complained of dry mouth, anorexia, weight loss and showed KPS $40{\sim}50$ on admission day. 40 days later he died. To improve patient/family quality of life, it is necessary to improve the ability to estimate accurately a patient's length of survival.

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A Case of Relaxation Training and Oriental Medical Treatment On SimDamHeoGup type of ChilJungGuQiJung (이완요법과 한방치료를 병행한 심담허겁형(心膽虛怯型) 칠정구기증(七情九氣證) 환자 1례(例)의 증례(證例)고찰)

  • Lim, Jung-Hwa;Jung, In-Chul;Hong, Sang-Su;Lee, Sang-Ryong
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.2
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    • pp.223-231
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    • 2005
  • The purpose of this study was to investigate the clinical application of relaxation training and oriental medical treatment to the SimDamHeoGup(心膽虛怯) type of ChilJungGuQiJung(七情九氣證) patient. In this case, a male patient, 31 years old, who lost his job two months ago, complained of the tension of body and anxiety. We treated the patient with relaxation training and oriental medical treatment such as herbal medicine, acupuncture treatment and aroma therapy. And we diagnosed his state SimDamHeoGup(心膽虛怯) type of ChilJungGuQiJung(七情九氣證), so we prescribed HaChuBoSimTang(夏朮補心場) for patient. In result, the patient’s tension of body and anxiety was improved, so he could recover his confidence slowly. Conclusionally, relaxation training and oriental medical treatment could be effective method to treat the patient of adjustment disorder with the tension of body and anxiety.

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A Case Report of the Effects of Jia Wei Si Wu Tang (Augmented Four-Substance Decoction) On A Menopausal Disorder Patient (갱년기 증상 여성에 가미사물탕 효과에 대한 증례 보고)

  • Cho, Katherine Hyun-Sook;Kim, Brian Han-Gyu;Ahn, Scott Seung K.;Yoo, Gi-Na
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.15 no.2
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    • pp.215-222
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    • 2011
  • Objectives: The purpose of this study is to report the effect of Kamisamul-tang / Jia Wei Si Wu Tang / Augmented Four - Substance Decoction on a Menopausal Disorder Patient. This is a clinical report about a 49 year old female patient with a Menopausal Disorder treated by herb medicine, Kamisamul-tang / Jia Wei Si Wu Tang / Augmented Four-Substance Decoction without any other medicine or treatment. Methods: The patient was treated by herb medicine, Kamisamul-tang / Jia Wei Si Wu Tang / Augmented Four - Substance Decoction. The improvement of the patient was judged by Visual Analog Scale. Results The symptoms were gradually reduced and VAS became 1 after 8weeks of treatments, since then the symptoms were not reappearing for 3 months. Conclusions: Herb medicine, Kamisamul-tang / Jia Wei Si Wu Tang / Augmented Four - Substance Decoction is effective to improve a Menopausal Disorder Patient's symptoms. It is necessary to have more observation and many cases of patients with a Menopausal Disorder.

A Case Study of Patient with Diaphragmatic Hernia who was Treated by Taeeumjowi-tang (태음조위탕(太陰調胃湯)을 활용한 횡격막 탈장 환자 1례)

  • Kim, Min-Ji;Bae, Hyo-Sang;Park, Seong-Sik
    • Journal of Sasang Constitutional Medicine
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    • v.24 no.1
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    • pp.66-74
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    • 2012
  • 1. Objectives : The purpose of this case study is to report that the general symptoms in 83 years-old female pateint with diaphragmatic hernia improved through oral administration of Taeeumjowi-tang(太陰調胃湯) 2. Methods : We considered the patient as Taeeumin, and administered Taeeumjowi-tang(太陰調胃湯) to improve chief complaints, such as general weakness, anorexia, sense of distension, dyspnea. The change of symptoms were evaluated by VAS(visual analogue score). 3. Results : The patient received hospital treatment for 4 weeks, and the chief complaints such as general weakness, anorexia, sense of distension, dyspnea improved in general 4. Conclusions : The patient with the above symptoms (general weakness, anorexia, sense of distension, dyspnea) was confirmed as diaphragmatic hernia by chest CT scan. But the patient decided not to have surgical operation. Observating the progress, we treated the patient through oral administration of Taeeumjowi-tang(太陰調胃湯), acupuncture and moxibustion treatment. And the general symptoms improved.

Unpredictable Postoperative Global Cerebral Infarction in the Patient of Williams Syndrome Accompanying Moyamoya Disease

  • Sim, Yang-Won;Lee, Mou-Seop;Kim, Young-Gyu;Kim, Dong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.256-259
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    • 2011
  • We report a rare case of Williams syndrome accompanying moyamoya disease in whom postoperative global cerebral infarction occurred unpredictably. Williams syndrome is an uncommon hereditary disorder associated with the connective tissue abnormalities and cardiovascular disease. To our knowledge, our case report is the second case of Williams syndrome accompanying moyamoya disease. A 9-year-old boy was presented with right hemiparesis after second operation for coarctation of aorta. He was diagnosed as having Williams syndrome at the age of 1 year. Brain MRI showed left cerebral cortical infarction, and angiography showed severe stenosis of bilateral internal carotid arteries and moyamoya vessels. To reduce the risk of furthermore cerebral infarction, we performed indirect anastomosis successfully. Postoperatively, the patient recovered well, but at postoperative third day, without any unusual predictive abnormal findings the patient's pupils were suddenly dilated. Brain CT showed the global cerebral infarction. Despite of vigorous treatment, the patient was not recovered and fell in brain death one week later. We suggest that in this kind of labile patient with Williams syndrome accompanying moyamoya disease, postoperative sedation should be done with more thorough strict patient monitoring than usual moyamoya patients. Also, we should decide the revascularization surgery more cautiously than usual moyamoya disease. The possibility of unpredictable postoperative ischemic complication should be kept in mind.