• 제목/요약/키워드: Old patient

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원발성 폐평활근육종의 외과적 치료;2례 보고 (Surgical Treatment of Primary Pulmonary Leiomyosarcoma; Two Cases Report)

  • 이문금
    • Journal of Chest Surgery
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    • 제26권8호
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    • pp.654-660
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    • 1993
  • The incidence of pulmonary leiomyosarcoma is very rare as a primary lung tumor. Usually, pulmonary leiomyosarcoma arise from the smooth muscle present in the bronchi or blood vessles. We had experienced two cases of primary pulmonary leiomyosarcoma. The first case was 28-year old male patient who had been in good health until admission, when he experienced an episode of dyspnea and sudden hemoptysis. The chest X-ray film revealed a large round tumor mass in left lower lobe measuring 6.5x9.5x5.3cm in dimension. On physical examination,the patient was friction rub and rales on the left lower chest and postoperative course was smooth and non-eventful. Emergency left lower lobectomy was performed due to repeated hemoptysis. Chemotheraphy was done postoperatively as an adjuvant therapy.The second case was 52-year-old man who had been well prior to admission, when recently he noticed a abrupt growing tendency of old pulmonary coin lesion in right lower lobe on routine physical examination. Since 1968, small round mass was gradually enlarged very slowly, during recent one year interval, the tumor mass was enlarged abruptly as twice in size on chest X-ray. Bronchoscopic examination revealed no specipic findings. Right lower lobectomy was performed and pathologic examination was answered as primary leiomyosarcoma without lymph node metastasis. Postoperative course was smooth, except local wound infection.

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Masticator space abscess in a 47-day-old infant

  • Kim, Eun-Hee;Jeon, Ju-Hee;Shim, Yoon-Hee;Lee, Kyu-Seok;Kim, So-Young;Kim, Eun-Ryoung
    • Clinical and Experimental Pediatrics
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    • 제54권8호
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    • pp.350-353
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    • 2011
  • A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about $2.0{\times}1.5cm$ that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.

뇌졸중 환자의 장애물 보행능력 향상과 하수족 개선을 위한 고유수용성신경근촉진법의 적용: 증례보고 (Approach of Proprioceptive Neuromuscular Facilitation on Foot drop and Crossing Obstacles in stroke patient: Case report)

  • 송귀빈
    • PNF and Movement
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    • 제13권2호
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    • pp.111-118
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    • 2015
  • Purpose: The purpose of this study was to describe the effects of proprioceptive neuromuscular facilitation (PNF) on episodes of foot drop and the ability to cross obstacles in stoke patients. Methods: The patient was a 57-year-old man with left hemiplegia. This patient displayed episodes of foot drop while walking and issues with crossing obstacles. The patient underwent therapeutic exercises and occupational therapy twice daily at a hospital five times a week. The patient was treated with PNF outside of these therapeutic sessions. Each session, which was 60 minutes in length, was conducted 3 times a week over 8 weeks. Over the course of treatment, a pre-test and post-test were completed. The patient walked for a test time of 6M. During the testing process, the patient crossed obstacles. In addition, the number of foot drop episodes was recorded. Each test was measured three times to determine the mean value. Results: After the PNF treatments, the number of foot drop episodes decreased from five to one. The 6M walking test time during which the patient crossed obstacles also decreased from 18 seconds to 10 seconds. Conclusion: The use of PNF treatments is beneficial to reduce the number of foot drop episodes while walking and to improve the ability to cross obstacles in stroke patients.

살모사 교상 후 발생한 범발성 혈관내 응고장애 2례 (Two Cases of Disseminated Intravascular Coagulation (DIC) Following Pit Viper Envenomation)

  • 김석환;최세민;오영민;박규남;이원재;최경호
    • 대한임상독성학회지
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    • 제4권2호
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    • pp.137-142
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    • 2006
  • Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

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지황백호탕(地黃白虎湯)으로 호전된 고관절 통증 환자 치험례 (A Clinical Study of Hip Joint Pain Improved with Gihwangbaekho-tang)

  • 반덕진;이희승;강태곤;한경석;배효상;박성식
    • 사상체질의학회지
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    • 제19권2호
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    • pp.195-203
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    • 2007
  • 1. Objectives The purpose of this study is to evaluate the effects of Gihwangbaekho-tang which is based on the Sasang Constitutional Medicine for the patient who has suffered from hip joint pain. 2. Methods The subject is about 86-year-old patient suffering from hip joint pain who was diagnosed as Soyangin interior over heated disease based on his Nature & Emotion, physical characteristics, symptoms, and we have prescribed Gihwangbaekho-tang. We used Visual analogue scale(VAS) for the assessment of Hip joint pain. 3. Results and Conclusions The patient was treated with Gihwangbaekho-tang and hip joint pain, thirst, redness of the face, constipation and general condition were improved. This study describes tile improvement of Hip joint pain and the change of symptoms by using Gihwangbaekho-tang. In this study, we applied Gihwangbaekho-tang to 86-year-old patient for about forty days, and Gihwangbaekho-tang didn't cause any serious side effect on the patient.

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한방안이비인후피부과 입원환자의 임상적 고찰 (A Clinical Analysis of Inpatient of Dermatology, Ophthalmology & Otorhinolaryngology)

  • 정아름누리;홍승욱
    • 한방안이비인후피부과학회지
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    • 제21권1호
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    • pp.121-132
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    • 2008
  • Objective : This study was performed to examine the patterns of inpatients that had visited Dept. of Dermatology Hospital of Oriental Medicine, Dongguk University. Methods : We analysed statistic study in 106 patients, who had admitted to the Dept. of Dermatology, Ophthalmology & Otorhinolaryngology Hospital of Oriental Medicine, Dongguk University from July, 2005 to January, 2008. Results : The results were as follows; 1. Males were 50.94% and females were 49.06%. 2. Distribution of aging was 18.87% in twenties and 17.92% in fifties. 3. Common disease group were Facial palsy(33.96%); Atopic dermatitis(21.7%); Tinnitus(7.55%); Sudden Sensorineural Hearing loss(4.72%); Sore throat(5.66%). 4. Average age of Facial palsy patients was 50.9 years old, average hospitalized period were 10.47days and subjective satisfaction rate was 2.56 points on the basis of 4 points. 5. Average age of Atopic dermatitis patient's average age was 22.22 years old, average hospitalized period were 8.35days and subjective satisfaction rate was 3.44 points on the basis of 4 points. 6. 47.2% of all patient were admitted into the hospital on 1st or 2nd outpatient service and 44% of Facial palsy patient were admitted into the hospital via emergency room. 7. All patient's average hospitalized period were 7.5 days. 8. All patient's subjective satisfaction rate were 2.97 points on the basis of 4 points. Conclusion : This study suggests that oriental medical treatments is especially popular in facial palsy and atopic dermatitis. We have to take steps for effective management and treatment for special diseases and ages.

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방사선치료 후 방사선 폐렴이 유발된 암 환자에 생맥산을 투여한 증례 보고 2례 (Effect of Saengmaek-san on Cancer Patients with Symptoms Related to Radiation Pneumonitis after Radiotherapy : Report of 2 Cases)

  • 채진;이지영;송안나;최성헌;이수민;정의홍;이수경
    • 대한암한의학회지
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    • 제18권1호
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    • pp.1-7
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    • 2013
  • Objective : This study is purposed to report 2 cases of cancer patient whose symptoms related to radiation pneumonitis had been controlled with Saengmaek-san treatment. Methods : A 56-year-old female rectal cancer patient was prescribed with Saengmaek-san due to the symptoms which had developed 4 weeks after the completion of her radiotherapy session in both lungs. Her chief complaints were shortness of breath, dry cough and fatigue. Another case, 53-year-old male patient with hepatocellular carcinoma, had also developed symptoms of fatigue, weight loss and dry cough after his radiotherapy session in left upper lung zone. Radiological changes of both patients' chest X-ray suggested radiation pneumonitis. Results : Symptoms of the female patient were improved, especially shortness of breath, after Saengmaek-san treatment, without any aggravation in her chest X-ray result. However, infiltrative opacity in the left upper lung zone of the male patient was aggravated despite the improvement of his clinical symptoms. His remaining symptoms and radiological change were effectively controlled after steroid therapy. Conclusion : Seangmaek-san may be considered as a potential treatment for symptoms related to radiation pneumonitis with proper monitoring.

Aberrant growth of the anterior cranial base relevant to severe midface hypoplasia of Apert syndrome

  • Cha, Bong Kuen;Choi, Dong Soon;Jang, In San;Yook, Hyun Tae;Lee, Seung Youp;Lee, Sang Shin;Lee, Suk Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제40권
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    • pp.40.1-40.8
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    • 2018
  • Background: A 9-year-old male showed severe defects in midface structures, which resulted in maxillary hypoplasia, ocular hypertelorism, relative mandibular prognathism, and syndactyly. He had been diagnosed as having Apert syndrome and received a surgery of frontal calvaria distraction osteotomy to treat the steep forehead at 6 months old, and a surgery of digital separation to treat severe syndactyly of both hands at 6 years old. Nevertheless, he still showed a turribrachycephalic cranial profile with proptosis, a horizontal groove above supraorbital ridge, and a short nose with bulbous tip. Methods: Fundamental aberrant growth may be associated with the cranial base structure in radiological observation. Results: The Apert syndrome patient had a shorter and thinner nasal septum in panthomogram, PA view, and Waters' view; shorter zygomatico-maxillary width (83.5 mm) in Waters' view; shorter length between the sella and nasion (63.7 mm) on cephalogram; and bigger zygomatic axis angle of the cranial base (118.2°) in basal cranial view than a normal 9-year-old male (94.8 mm, 72.5 mm, 98.1°, respectively). On the other hand, the Apert syndrome patient showed interdigitating calcification of coronal suture similar to that of a normal 30-year-old male in a skull PA view. Conclusion: Taken together, the Apert syndrome patient, 9 years old, showed retarded growth of the anterior cranial base affecting severe midface hypoplasia, which resulted in a hypoplastic nasal septum axis, retruded zygomatic axes, and retarded growth of the maxilla and palate even after frontal calvaria distraction osteotomy 8 years ago. Therefore, it was suggested that the severe midface hypoplasia and dysostotic facial profile of the present Apert syndrome case are closely relevant to the aberrant growth of the anterior cranial base supporting the whole oro-facial and forebrain development.

선천성심질환(先天性心疾患)의 심폐기(心肺器) 개심수술(開心手術) - 4례(例) 보고(報告) - (Open Heart Surgery of Congenital Heart Diseases -Report of Four Cases-)

  • 김근호;박영관;지행옥;김영태;이종배;정윤채;오철수
    • Journal of Chest Surgery
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    • 제9권1호
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    • pp.1-9
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    • 1976
  • The present. study reports four cases of congenital heart diseases, who received open heart surgery by the Sarn's Heart-Lung-Machine in the department of Thoracic Surgery, Hanyang University Hospital during the period between July 1975 and May 1976. The Heart-Lung-Machine consisted of the Sarn's five head roller pump motor system (model 5000), heat exchanger, bubble trap, the Rygg-Kyvsgaard oxygenator, and monitors. The priming of pump oxygenator was carried out by the hemodilution method using Hartman's solution and whole blood. Of the four cases of the heart diseases, three whose body weight were below 30kg, received the partial hemodilution priming and the remaining one whose body weight was 52kg received the total hemodilution priming with Hartman's solution alone. The rate of hemodilution was in the average of 60.5ml/kg. Extracorporeal circulation was performed at the perfusion flow rate of the average 94.0ml/kg/min, and at the moderate hypothermia between 35'5"C and 30'5"C of the rectal temperature. In the total cardiopulmonary bypass, arterial blood pressure was anged between 30 mmHg and 85 mmHg, generally maintaining over 60 mmHg and venous pressure was measured between 4 and $23cmH_2O$, generally maintaining below $10cmH_2O$. The first case: The patient, a nine year old girl having the symptoms and physical signs typical to cardiac anomaly was definitely diagnosed as isolated pulmonary stenosis through the cardiac catheterization. There was, however, no cyanosis, no pathological finding by X-ray and E.C.G. tracings. The valvulotomy was performed through the arteriotomy of pulmouary artery under the total cardiopulmonary bypass. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The second case: A 12 year old boy with congenital heart anomaly was positively identified as having ventricular septal defect through the cardiac catheterization. As in the case with the first case, the patient exhibited the symptoms and physical signs typical to cardiac anomaly, but no pathological abnormality by X-ray and E.C.G. tracings. The septal defect was localized on atrioventricular canal and was 2 by 10 mm in size. The septal defect was closed by direct simple sutures under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle and pulmonary artery were decreased satisfactory. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The third case: The patient, a 19 year old girl had been experienced the clinical symptoms typical to cardiac anomaly for 16 years. The pink tetralogy of Fallot was definitey diagnosed through the cardiac catheterization. The patient was placed on an ablolute bed rest prior to the operation because of severe exertional dyspnea, fatigability, and frequent syncopal attacks. However, she exhibited very slight cyanosis. Positive findings were noted on E.C.G. tracings and blood picture, but no evidence of pathological abnormality on X-ray was observed. All of the four surgical approaches such as Teflon patch closure (3 by 4cm in size) of ventricular septal defect, myocardial resection of right ventricular outflow tract, valvulotomy of pulmonary valvular stenosis, and pericardial patch closing of ventriculotomy wound were performed in 95 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and murmur and the clinical symptoms disappeared. The fourth case: The patient, a 7 1/4 year old girl had the symptoms of cardiac anomaly for only three years prior to the operation. She was positively identified as having acyanotic tetralogy of Fallot by open heart surgery. The patient showed positive findings by X-ray and E.C.G. tracings, but exhibited no cyanosis and normal blood picture. All of the three surgical approaches, such a myocardial resection of hypertrophic sight ventricular outflow tract, direct suture closing of ventricular septal defect and pericardial patch closing of ventriculotomy wound were carried out in 110 minutes under the cardiopulmonary bypass. Postoperative hemodynamic study revealed that the pressure of the right ventricle was decreased and pulmonary artery was increased satisfactorily. Postoperative course of the patient was uneventful, and the symptoms disappeared.

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