• Title/Summary/Keyword: Sinus

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Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation (승모판 폐쇄 부전증에서 발생한 국소적 폐부종 1예)

  • Yoon, Young Gul;Bang, Do Seok;Park, Bum Chul;Lee, Sung Hoon;Kim, Jae Su;Park, Yol;Hong, Young Chul;Ko, Kyoung Tae;Park, Sang Min;Han, Sang Hoon;Park, Sang Hoon;Lim, Jun Cheol;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.432-435
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    • 2005
  • An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The $O_2$ saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.

Surgical Treatment of Ebstein Anomaly (Ebstein 기형의 외과적 치험)

  • 이종호;김병렬
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.5-9
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    • 1999
  • Background: Ebstein anomaly is a rare congenital disease distinguished by its unique deformity in tricuspid valve and right ventricle & atrium. In its surgical treatment , tricuspid valve reconstruction and valve replacement are well known method, but various surgical methods were suggested. Material and Method : From January 1984 to December 1995, 8 patients with Ebstein anomaly underwent surgical correction. Age and sex distribution, clinical symtoms, radiologic findings, preoperative studies, operative findings, operative methods and its results were analyzed. Result: The sex ratio was 5 to 3(male : female). Patients' ages were averaged 17.6(2-28) years. In all cases, it showed typical deformities of the tricuspid valve. Associated anomalies were permenant foramen ovale, atrial septum defect, pulmonary stenosis. Surgical procedures included tricuspid valve replacement(n=4) and tricuspid valve reconstuction(n=4). Two cases of sinus tachycardia and complete AV block occured postoperatively. There were two hospital death and no late death. All survivors are in NYHA class I or II with median follow up of 64.8 months. 2-D echocardiogram disclosed improvement tricuspid regurgitation during the follow up period. Conclusion: Even though operative method of Ebstein anomaly should be decided according to each anatomical characteristics, we recommended that tricuspid valvuloplasty and plication can be one of the good methods method in the selective cases.

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Histological Comparison Study with Primo Node and Immature Liver Tissue on Liver Surface in Rat (흰쥐의 간 장기 표면에서 관찰되는 프리모 노드와 미성숙 간조직과의 조직학적 비교연구)

  • Ryu, Yeon-Hee;Lee, Sung-Won;Hwang, Sung-Yeoun;Kim, Min-Su;Ban, Hyo-Jeong;Choi, Sun-Mi;Kim, Jae-Hyo;Sohn, In-Chul;Ahn, Seong-Hun
    • Korean Journal of Acupuncture
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    • v.28 no.1
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    • pp.47-52
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    • 2011
  • 목적 : 프리모 모드와 미성숙 간조직에 대한 조직학적 특성을 비교하고자 하였다. 방법 : 흰쥐에서 간절제한 후, 간장기 표면에서 관찰되는 프리모 모드와 그와 유사한 미성숙 간조직을 H&E, Oil red O, Masson trichrome and van Gieson 염색방법을 통해서 비교 연구하였다. 결과 : 상기 실험 연구를 진행한 결과, 다음과 같은 결론을 얻었다. 1. 조직의 일반적인 특징을 관찰할 수 있는 H&E 염색결과, 프리모 노드에서는 많은 수의 조그마한 동(sinus)이 관찰되었고 적혈구나 영양을 공급하는 혈관의 분포는 관찰되지 않았다. 이와 반대로 미성숙 간조직에서는 동이 관찰되지 않았으며 혈관의 분포와 적혈구가 관찰되었다. 2. 양 조직의 지방성분의 유무를 관찰하기 위한 Oil red O 염색결과, 프리모 노드에서는 지방성분이 관찰되지 않았으나 미성숙 간조직에서는 관찰되었다. 3. 양 조직의 콜라겐성분의 유무를 관찰하기 위한 Masson trichrome and van Gieson 염색결과, 프리모 노드에서는 약간의 콜라겐 성분이 관찰되었으나 elastic 성분은 관찰되지 않았으며, 미성숙 간조직에서는 콜라겐 성분과 elastic 성분이 관찰되지 않았다. 결론 : 상기 결과는 프리모 노드와 간조직과는 조직학적 성질이 다른 것으로 사료되며, 특히 콜라겐 성분의 적은 결과는 프리모 노드가 불규칙한 형태를 이루고 있는 이유에 대한 실마리를 제공하였다. 이러한 결과는 프리모 노드의 특성에 대한 기본 자료로 활용될 수 있을 것이다.

Elliptical Centric Techniques and Tricks About the Usefulness of the Clinical Application (Elliptical Centric과 TRICKS 기법의 임상 적용에 관한 유용성 연구)

  • Kim, Sae-Ssak;Goo, Eun-Hoe;Dong, Kyung-Rae;Kweon, Dae-Chel;Lee, Jae-Seung;Cho, Jae-Hwan;Park, Chang-Hee
    • Korean Journal of Digital Imaging in Medicine
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    • v.13 no.2
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    • pp.83-90
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    • 2011
  • To prospectively determine the diagnostic performance a combination of standard bolus-chase magnetic resonance (MR) angiography and MR angiography with time-resolved imaging of contrast kinetics (TRICKS) for depicting severity of the head and neck vascular diseases. Over a period of two months, A total of 100 patients(average ages : $50{\pm}8$, male : 60, female : 40) with head and neck vascular diseases were performed on the GE excite 3.0 T units with 8-channel head coil and 4-channel NV coil. Imaging parameters for a typical study were as follow: SBC(TR/ TE/ FA/ SliceThicken./ Slab/ Freq./ FOV/ BW/Scan Time) = 5.4/ min/ 30/ 2/ zip2/ 70/ $224{\times}448$/ 30/ 62.50/ 28, TRICKS(TR/ TE/ FA/ Slice Thicken/Slab/ Freq./ FOV/ BW/ Temp Res./ Scan Time = 3.6/ min/ 25/ 4/ 30/ $160{\pm}384$, zip512/ 30/ 100/ 1 to 1.5/ 23). The analysis of all MR images, which have respect-ively classified two techniques into some diseases. The results of the former were divided into two groups(SBC, TRICKS)with 4 grading of two reader, respectively. Wilcoxon signed rank test was used to determine if a significant difference between imaging techniques existed(p < 0.05). In 33 of 100 patients, arterio-venous malformation was 11% at TRICKS, subclavian vein stenosis : 8%, fistular sinus : 4%, jugular vein stenosis:6%, Middle Cerebral Artery bypass surgery : 4%, p < 0.05). The rest of 67 patients were considered as the results of SBC(14% in the basilar artery stenosis, carotid stenosis : 16%, vertebral stenosis : 17%, central neuro-cytoma : 5%, meningioma : 5%, Not appliable : 10%, p < 0.05). Sensitivity and specificity of TRICKS MR angiography in SVS, FS, JVS, MCABS were improved compared with those at standard MR angiography. In SBS MR angiography which were improved in BAS, CS, VS, CN, Meningioma. In conclusion, TRICKS MR angiography of the SVS, FS, JVS, MCABS is superior to standard MR angiography regarding the number of diagnostic grading. The SBS MR angiography were improved in BAS, CS, VS, CN, Meningioma. and assessment of the degree of luminal narrowing on both TRICKS and SBS.

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Effect of Mahuang on Heart Rate Variability in Adults : a Double-Blind, Placebo-Controlled, Randomized Trial (마황 복용이 정산인의 심박변이도에 미치는 영향에 대한 무작위배정 이중맹검 임상연구)

  • Son, Dong-Hyuk;Hsing, Li-Chang;Kim, Lak-Hyung;Jeong, Seung-Il;Seo, Eui-Seok;Jang, In-Soo
    • The Journal of Korean Medicine
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    • v.28 no.1 s.69
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    • pp.105-116
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    • 2007
  • Objectives : Mahuang (Ephedra sinica), well known as an herbal medicine in the East and West, contains a relatively high percentage of ephedrine known as sympathomimetic alkaloid. We investigated the effects of Mahuang on sympathetic nervous system with heart rate variety (HRV). Time and frequency domain analysis of HRV is a noninvasive technique capable of providing information on autonomic modulation of the sinus node. Methods : We investigated 57 healthy volunteers consisting of 37 subjects in the Mahuang group and 20 subjects in the placebo group. Study form was a randomized, placebo-controlled, double-blind clinical trial. The 37 subjects in the Mahuang group took 3 Mahuang capsules (1 capsule equivalent to 2g herb Mahuang) twice a day at 10 a.m. and 2 p.,., while the 20 subjects in the placebo group took 3 placebo-capsules filled with glutinous rice powder at the same times. Mahuang medicine and placebo medicine were made into opaque capsules. We measured HRV at 3 p.m. 1 or 2 days before medication and at 3 p.m. after medication. Results : Mean-RR and SDNN of the Mahuang group significantly decreased compared with that of the placebo group, but the heart rate of the Mahuang group significantly increased compared with the placebo. HRV-Index, RMSSD and SDSD of the Mahuang group significantly decreased compared with that of the placebo group, but PNN50 of the Mahuang group significantly increased compared with placebo. Ln(TP), Ln(VLF), Ln(LF) and Ln(HF) of the Mahuang group significantly decreased compared with those of the placebo group. There were no significant differences in normalized LF, normalized HF and LF/HF ratio between the Mahuang and placebo groups. Conclusion : The results suggest that Mahuang in healthy adults tends to reduce the autonomic nervous system within the normal range.

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A CLINICAL AND RADIOGRAPHIC STUDY OF DENTIGEROUS CYSTS (함치성 낭의 임상 방사선학적 연구)

  • Lee Kang-Sook;Choi Karp-Shik
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.2
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    • pp.399-408
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    • 1995
  • The purpose of this study was to obtain information on the clinical and radiographic features of the dentigerous cysts in the jaws. For this study, the authors examined and analysed the clinical records and radiographs of 233 patients who had lesions of dentigerous cyst diagnosed by clinical and radiographic or histopathological examinations. And the obtained results were as follows: 1. Dentigerous cysts occurred the most frequently in the 2nd decade(38.2%) and occurred more frequently in males(67.4%) than in females(32.6%). 2. The most common clinical symptom was swelling of the jaw(33.9%), and the lesions were treated by the method of surgical removal. 3. The type of lesions was mainly observed as central type(72.5%), and size of the lesion was most frequently observed 2 - 2.9cm in the widest length. 4. The lesions were most frequently observed well-defined outline with hyperostotic border(49.8%), and smooth margin(73.4%), and homogeneous lesional radiolucency(79.4%). 5. Cortical thinning and expansion of the lesions(82.0%) were observed, and their direction were most frequently observed toward buccal side(64.0%). 6. The effect on the causative tooth were observed as tooth displacement(41.2%) and delayed root development(l9.3%), and the distance between cemento-enamel junction and lesional wall attachment of the causative tooth was mainly observed as below 2mm(79.6%). 7. The effect on the adjacent tooth were observed as loss of lamina dura(66.8%), root resorption(33.9%), and tooth displacement(31.5%). 8. The effects on the adjacent anatomic structures were observed as displacement of the mandibular canal(46.5%) and maxillary sinus or nasal cavity(72.2%).

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A Case of Primary Mediastinal Germ Cell Tumor Associated with Klinefelter's Syndrome (Klinefelter 증후군에 병발된 원발성 종격동 생식세포종 1예)

  • Kim, Yong-Jo;Kwun, Gyo-Seon;Lee, Young Wo;Kim, Kyung-Tae;Park, Yeon-Hee;Ryoo, Baek-Yeol;Kim, Tae You;Im, Young-Hyuck;Lee, Choon-Taek;Kang, Yoon-Koo;Cho, Kyung Ja;Lee, Jhin-Oh;Kang, Tae-Woong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.1035-1041
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    • 1996
  • Klinefelter's syndrome is characterized by small testes, azoospermia, gynecomastia, and elevated levels of plasma gonadotropins in men with two or more X chromosomes. Previous investigators reponed that patients with Klinefelter's syndrome are predisposed to the development of a non-seminomatous germ cell tumor in the mediastinum. It is suggested that this linkage may be due to the hormonal imbalance in Klinefelter's syndrome and consequently, the formation of dysgenetic germ cell and/or abnomal migration of germ cell We report here a case of Klinefelter's syndrome in a 24-years-old man who was presented with anterior mediastinal mass. The clinical and laborarotory fmdings were compatible with Klinefelter's syndrome and he was found to have 47 XXY karyotype. Pathological findings for mediastinal mass revealed mixed germ cell tumor composed of mature cystic teraloma and endodermal sinus rumor. He was treated with cis platin containing chemotherapy and followed up in partial remission.

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P Wave Dispersion as a Predictor of Idiopathic Paroxysmal Atrial Fibrillation (특발성 발작성 심방세동 환자에서 P파 간격분산의 의의)

  • Hong, Gue-Ru;Kim, Woong;Park, Jong-Seon;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Sup
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.267-276
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    • 2001
  • Background: P wave dispersion(PWD) is defined as the difference between the maximum and minimal P wave duration in any of the 12 leads of the surface ECG. The prolongation of atrial conduction time and the inhomogeneous propagation of sinus impulse are known electrophysiologic features in patients with paroxysmal atrial fibrillation(PAF). The purpose of this study was to determine the role of P wave dispersion for the prediction of PAF and to evaluate the effectiveness of prophylactic antiarrhythmic therapy. Materials and Methods: The study population included 20 patients with a history of idiopathic PAF and 20 age and sex matched healthy control subjects. We measured the maximum P wave duration(P maximum) and P wave dispersion from 12 lead ECG. Results: P maximum and P dispersion in idiopathic PAF were significantly higher than normal control group($97.2{\pm}12$, $48.5{\pm}9$ msec vs, $76.5{\pm}11$, $21{\pm}8$ msec, respectively p<0.001, <0.001). After 12-month follow up period P maximum and P dispersion were significantly reduced than those of initial state($77.2{\pm}13$, $26.4{\pm}9$ msec vs. $97.2{\pm}12$, $48.5{\pm}9$ msec, respectively p<0.001,<0.001). Conclusion: P dispersion and P maximum were significantly different between patients with idiopathic PAF and healthy control group. Those are easily accessible, non-invasive simple electrocadiographic markers that could be used for the prediction and prognostic factors of idiopathic PAF.

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A COMPARATIVE STUDY OF VARIOUS TYPE OF AUTOGENEOUS BONE GRAFT ON THE RABBIT-SKULL DEFECT HEALING (가토 두개골에 이식한 다양한 형태의 자가골에 의한 골성 회복 양상 비교 평가)

  • Choi, So-Young;Lee, Su-Youn;Kim, Jin-Wook;Kim, Chin-Soo;Lee, Sang-Han;Shin, Hong-In;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.428-434
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    • 2008
  • Introduction: Piezosurgery device is one of the most commonly used instrument on the intraoral surgery such as maxillary sinus lift and autogeneous bone graft. Piezosurgery instrument also contains the tips that are manufactured especially for the convenient bone graft, which now many surgeons apply them for collecting bone graft materials in the curettage method for the restoration of skull defects. However, objective data has not been shown concerning the effects about bone graft with using Piezosurgery. Therefore we investigated the effects of Piezosurgery on the rabbit-skull defect healing. Materials & Methods: To investigate the regeneration of the bony defect with various bone graft, 10 adult New Zealand white rabbits (average weight : $2.8{\pm}0.3kg$, about 12weeks) were used. The four circular bony defects measuring 6mm in diameter were made with Piezosurgery device on each rabbit cranial bone. The harvested bone tissues during defect formation were also used for autogeneous bone graft. They were grafted into the defects in a various type; block type (Group 1), particulated type by the bone mill (Group 2), chopped type by curette shaped Piezosurgery tip (Group 3), the defect without any graft was served as control (control group). The animals were sacrificed after 6 weeks and bone regeneration capacity was evaluated histomorphometrically. Result & Conclusion: Autogeneous bone graft harvested using a Piezosurgery instrument showed satisfactory bone regeneration. There was no conspicuous difference bone prepared among by bone mill or Piezosurgery and block bone graft. Therefore, the bone harvested from the intraoral site near the operation field using the piezosurgery device can be a feasible and reliable graft for intraoral bony defects.

The effect of various thread designs on the initial stability of taper implants

  • Park, Ju-Hee;Lim, Young-Jun;Kim, Myung-Joo;Kwon, Ho-Beom
    • The Journal of Advanced Prosthodontics
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    • v.1 no.1
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    • pp.19-25
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    • 2009
  • STATEMENT OF PROBLEM. Primary stability at the time of implant placement is related to the level of primary bone contact. The level of bone contact with implant is affected by thread design, surgical procedure and bone quality, etc. PURPOSE. The aim of this study was to compare the initial stability of the various taper implants according to the thread designs, half of which were engaged to inferior cortical wall of type IV bone(Group 1) and the rest of which were not engaged to inferior cortical wall(Group 2) by measuring the implant stability quotient(ISQ) and the removal torque value(RTV). MATERIAL AND METHODS. In this study, 6 different implant fixtures with 10 mm length were installed. In order to simulate the sinus inferior wall of type IV bone, one side cortical bone of swine rib was removed. 6 different implants were installed in the same bone block following manufacturer s recommended procedures. Total 10 bone blocks were made for each group. The height of Group 1 bone block was 10 mm for engagement and that of group 2 was 13 mm. The initial stability was measured with ISQ value using Osstell $mentor^{(R)}$ and with removal torque using MGT50 torque gauge. RESULTS. In this study, we found the following results. 1. In Group 1 with fixtures engaged to the inferior cortical wall, there was no significant difference in RTV and ISQ value among the 6 types of implants. 2. In Group 2 with fixtures not engaged to the inferior cortical wall, there was significant difference in RTV and ISQ value among the 6 types of implants(P < .05). 3. There was significant difference in RTV and ISQ value according to whether fixtures were engaged to the inferior cortical wall or not(P < .05). 4. Under-drilling made RTV and ISQ value increase significantly in the NT implants which had lower RTV and ISQ value in Group 2(P < .05). CONCLUSIONS. Without being engaged to the inferior cortical wall fixtures had initial stability affected by implant types. Also in poor quality bone, under-drilling improved initial stability.