• 제목/요약/키워드: Old patient

검색결과 7,873건 처리시간 0.034초

흉벽의 오래된 화상 흉터에서 발행한 악성 섬유성 조직구종 (Malignant Fibrous Histiocytoma Arising in Old Burn Scar on the Anterior Chest)

  • 최의철;권인오;박은수;김용배
    • Archives of Plastic Surgery
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    • 제35권6호
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    • pp.743-747
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    • 2008
  • Purpose: Malignant changes of Marjolin's ulcer arising from chronic burn scar are rare. The majority of them are squamous cell carcinoma and basal cell carcinoma. Malignant fibrous histiocytoma is a deep seated pleomorphic sarcoma, which occurs principally as a mass of the extremities, abdominal cavity, or retroperitoneum in adults. Methods: We report a 58-year-old male patient who was admitted due to $3.5{\times}5cm$ chronic ulceration of anterior chest wall on the center of old burn scar. His scar had been occurred by boiling oil and treated with conservative treatment 45 years ago. Preoperative punch biopsy showed suspicious malignant changes and contrast enhanced chest CT showed well-defined, irregular shape enhancing lesion on anterior chest wall without intrathoracic metastasis. Results: The tumor was widely excised and defect was covered with skin graft without infection, necrosis and any other complication. The pathologic findings are compatible with malignant fibrous histiocytoma(storiform - pleomorphic type). The patient underwent 3 cycles of chemotheraphy. Although distant metastasis to the lung developed 6 months later and the patient died 9 month later, there was no local reoccurrence. Conclusion: Aggressive and early excision is needed because malignant fibrous histiocytoma has characteristics of high malignancy with a propensity for early and distant spread. Furthermore, the patient's education about disease entity and postoperative regular follow-up for local recurrence or metastasis is very important. To prevent malignancy from secondly healing burn scar, early skin graft is recommended for patients with deep second degree burn.

입원한 암환자 가족원의 스트레스, 대처방법 및 신체증상간의 상관관계 (Correlation Between Stress, Coping Patterns and Physical Symptom of Cancer Patient's Caregiver)

  • 김희승
    • 성인간호학회지
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    • 제13권2호
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    • pp.317-326
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    • 2001
  • The purpose of this study was to identify correlation of stress, coping patterns and physical symptoms in cancer patient's caregiver. The stress was measured by VAS(Visual Analogue Scale). The coping methods were measured using the modified Ways of Coping Questionnaire by Yang (1998) and the actual physical symptoms were investigated. The phases of patient illness consisted of 1st (initial) stage, and 2nd (recurred) stage and 3rd (terminal) stage based on literature (Lewandowski & Jones, 1988). The data were collected by a survey conducted from March to July, 2000 and which included 196 cancer patients' caregivers from two hospitals in Seoul. The data were analyzed using paired t-test, unpaired t-test, ANOVA, Scheffe test and Pearson correlation coefficient. The results were as follows: 1. The average of caregivers' stress scores was 62.5. Problem-focused coping methods were significantly used more than emotion-focused coping methods by the cancer patients' caregiver. The mean number of caregivers' physical symptom was 1.03. 2. There were significantly high level of stress in women, those who were more than 60 years old, those who had a low education level, those who had no job, those who are patients' wives' and those who are terminal patients' caregiver. There were significantly low levels of coping in women, those who were more than 60 years old, those who had low education levels, those who had no job and those who are patients' wives. There were significantly higher number of physical symptoms in women, and those who have no job. 3. Caregivers' stress was significantly correlated to problem-focused coping methods (r=-.21, p=.006), and physical symptom (r=-.28, p=.0001). In conclusion, attempts to develop nursing interventions for cancer patients' caregiver in women, those who are more than 60 years old, with a low education level, have no job, and are cancer patients' wives could have an improvement on positive coping methods and provide relaxation from stress in the patients' experience.

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기관지 결석의 수술치험 3례 (Surgery of Broncholithiasis -3 cases report-)

  • 조덕곤;조규도;박건;곽문섭;김치홍
    • 대한기관식도과학회지
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    • 제5권1호
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    • pp.78-84
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    • 1999
  • Broncholithiasis is defined as a condition in which calcified material is present within the bronchial lumen. It is a rare but troublesome disease that can cause life-threatening complications such as massive fatal hemoptysis. Therefore, pulmonary resection is frequently required to remove the broncholiths and irreversibly damaged parenchyma. We experienced 3 cases of broncholithiasis. In one case, a 36 year old female patient suffered from coughing, massive hemoptysis with lithoptysis caused by intrinsic obstructive broncholiths in the right middle and lower lobe. In the 2nd case, a 41 year old male patient complained of long-standing blood tinged sputum and frequent pneumonic symptoms for 10 months because of extrinsic broncholithiasis where the calcified peribronchial lymph node eroded into the bronchial lumen of the right lower lobe. The remaining case involved a 30 year old female patient who complained of intermittent blood-tinged sputum induced by intrabronchial broncholith in the orifice of the right middle lobe bronchus. Two patients underwent bilobectomy(right middle and lower lobe) for removal of the broncholiths, damaged bronchi and parenchyma. The other patient was treated with right middle lobectomy and stone removal by bronchotomy of bronchus intermedius. In all patients, the post-operative course was uneventful.

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구강암 치료에 있어 경부곽청술의 응용 (THE APPLICATION OF NECK DISSECTION IN THE TREATMENT OF ORAL CANCER)

  • 김진수;김성국
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제14권1_2호
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    • pp.97-104
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    • 1992
  • 본 경북대학교 치과대학 구강외과학 교실 및 대구 가톨릭대학병원 구강악안면외과학 교실에서는 3명의 구강암 환자에서 각각의 상태에 따라 국소적 경부곽청술, 양측성 보존적 경부곽청술, 고전적 경부곽청술 및 술후 방사선요법을 시행하여 다소의 지견을 얻었기에 보고하는 바이다. 1. 국소적 경부곽청술을 시행한 증례 1($T2_N0_M0$)의 경우에는 아주 만족한 결과를 나타내었다. 2. 양측성 보존적 경부곽청술을 시행한 증례 2($_T3_N1_M0$)에서는 거의 전이가 일어나지 않는다고 알려진 후경삼각부위에서 술후 약 8개월만에 전이가 관찰되어 화학적 항암요법을 시행하였으나 술후 13개월 만에 사망하였음. 3. 고전적 경부곽청술을 시행한 증례 3($_T2_N1_M0$)에서는 현재 아주 양호한 예후를 보이고 있다.

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One-year experience of oral substrate reduction therapy in three patients with Gaucher disease type I

  • Sohn, Young Bae;Kim, Yewon;Moon, Ji Eun
    • Journal of Genetic Medicine
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    • 제17권2호
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    • pp.62-67
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    • 2020
  • Purpose: Eliglustat is an oral substrate reduction therapy (SRT) approved for adults with Gaucher disease type I (GD1) who are extensive, intermediate, or poor CYP2D6 metabolizers. Here we report one-year experience of eliglustat switch therapy from long-term enzyme replacement therapy (ERT) in three adult patients with GD1. Materials and Methods: Medical history, clinical (hemoglobin concentration, platelet count, and bone mineral density) and biochemical parameters (angiotensin converting enzyme, total acid phosphatase, and lyso-gb1) of the patients were collected and evaluated by retrospective review of medical records at every 3, 6, or 12 month after switch to SRT. Results: Patient 1 was a 43-year old female diagnosed GD1 and her clinical and biochemical parameters were stabilized for more than 20 years by ERT. Due to the burden of regular hospital visit, she switched to SRT. During one-year of SRT, clinical parameters and biomarkers were maintained stable. However, after suffering acute febrile illness during SRT, she decided to re-switch to ERT due to concerns about drug interaction. Patient 2 was 41-year old male, younger brother of patient 1 and Patient 3 was 31-year old male. They switched to SRT in clinically stable condition with long-term ERT. The one-year SRT was tolerable without specific safety issue and the clinical parameters were maintained stable. Conclusion: One-year eliglustat therapy in three adult patients with GDI was generally tolerable and effective for maintaining the clinical parameters and biomarkers. However, the drug compliance, concurrent drug interactions, and long-term safety of eliglustat should be carefully monitored.

쇄골 간부골절의 전하방 부착 재구성 금속판을 이용한 치료 (Anterior inferior reconstruction plate on acute midshaft clavicle fvacture)

  • 강재도;김광열;김형천;임문섭;김성훈;권준형
    • Clinics in Shoulder and Elbow
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    • 제6권1호
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    • pp.44-49
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    • 2003
  • Purpose: Many different operative technique of mid-shaft clavicle fracture have been reported. The aim of this prospective study was to compare the results of anterior or anterior-inferior plating with superior plating on the acute mid-shaft fracture of clavicle Materials and Methods: From February1997 to February 2002, thirty-eight consecutive open reduction and internal fixation with reconstruction plates were performed in thirty-eight patients. from August 1999, anterior or anterior-inferior plating was mainly used, prospectively. The duration of follow-up averaged 17 months (range,23 to 43 months). The mean age was 38 years old (range,21 to 57 years old) on anterior or anterior-inferior plating group and 35 years old (range,24 to 55 years old) on superior plating group. The physician progress note, VAS patient complement score, Roentgenogram and ASES score was evaluated. Results: Four patients were lost to follow-up. There was no statistical difference on mean radiological bone union time (8.7 weeks vs. 8.6 weeks) and ASES score (92 vs 94) at inferior and superior plating groups (P > 0.05). VAS patient complement score was very good or excellent on anterior or anterior-inferior group, average score was 1.1 (ranger,0 to 2) compare with superior plating group (P < 0.05). There were two cases of infection, 1 case of failed fixation on superior plating group and 1 case of delayed union on anterior inferior plating group. Conclusion: Anterior inferior plating on acute clavicle midshaft fracture results in excellent patient complement score compare with conventional superior reconstruction plate.

Difficult airway management in a patient with a parapharyngeal tumor

  • Ji, Sung-Mi
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제15권3호
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    • pp.153-156
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    • 2015
  • A 47-year-old man was referred to the operating room to treat a dentigenous cyst of the mandibular bone. Initial assessment of the airway was considered normal. However, after the induction of anesthesia, we could not intubate the patient due to severe distortion of the glottis. Fiberoptic bronchoscopy and video laryngoscopy were not effective. Intubation using a retrograde wire technique was successful. After the conclusion of surgery, the patient recovered without any complications. Subsequent magnetic resonance imaging of the patient's neck showed a $6{\times}4{\times}8.6cm$ heterogeneous T2 hyperintense, T1 isointense well-enhancing mass in the prestyloid parapharyngeal space. The patient was scheduled for excision of the mass. We planned awake intubation with fiberoptic bronchoscopy. The procedure was successful and the patient recovered without complications. Anesthetic induction can decrease the muscle tone of the airway and increase airway distortion. Therefore, careful airway assessment is necessary.

Sweet BV 병행 치료 후 척수 손상 환자의 감각 분절 호전 1례 (The Clinical Study On 1 Case for The sensation of patient with Spinal Cord Injury whose is improved by using sweet BV)

  • 박인선;윤일지
    • 대한약침학회지
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    • 제12권2호
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    • pp.77-84
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    • 2009
  • Objective : Patients with spinal cord injury are increasing in numbers. However, there is no reliable treatment guide in both conventional & complementary medicine. Also, there are not much clinical case of patients with spina cord injury in oriental medical field. We investigated effect of sweet BV on subacute stage patient with spinal cord injury. Method : 31-year old female patient with spinal cord injury was treated with herb medicine(TID), electro arcupunture (BID), sweet BV injection(QOD), Physical treatment(QD), and conventional-medicine. Result : We had a satisfactory result with using sweet BV injection. The patient's ASIA grade improved from 34 to 52. And Frankle classification of the patient shifted from A to B. Conclusion : We reach a conclusion Using Sweet BV improve the sensation of patient with spinal cord injury. And more study about this disease is needed.

동맥근 농양 및 좌심실유출호 가성 심실류 환자에서 폐동맥 자가이식편을 이용한 대동맥근부치환술 -1례 치험 보고- (Aortic Root Replacement with Pulmonary Autograft in Patient with Subaortic Abscess and False Aneurysm in Left Ventricular Outflow Tract -Report of A Case-)

  • 장병철
    • Journal of Chest Surgery
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    • 제28권7호
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    • pp.704-707
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    • 1995
  • The use of the patient`s pulmonary valve for replacement of the patient`s diseased aortic valve was introduced and developed by Mr. Donald Ross. The long term benefits of having a normal, fully viable, trileaflet semilunar valve in aortic position was demonstrated. A 38 year old male had histories of failures of previously implanted aortic prosthetic valves twice and evidence of progressive heart failure. At operation, aortic root abscess was found; the abscess extension to adjacent structures and partial valve dehiscence had occurred. The patient underwent replacement of the aortic root with autologous pulmonary valve, autologous pericardial patch repair of left ventricuar outflow tract and recontruction of the right ventricular outflow tract and pulmonary artery with prosthetic valved conduit. Postoperatively, the patient recovered well. Postoperative doppler echocardiography demonstrated minimal central regurgitation in new aortic valve. Aortic root replacement with pulmonary autograft in a patient of recurrent aortic root abscess and false aneurysm of left ventricuar outflow tract was experienced and reported with follow up echocardiography.

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