• 제목/요약/키워드: bilateral ratio

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Virus-associated Rhabdomyolysis in Children

  • You, Jihye;Lee, Jina;Park, Young Seo;Lee, Joo Hoon
    • Childhood Kidney Diseases
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    • 제21권2호
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    • pp.89-93
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    • 2017
  • Purpose: Virus-associated rhabdomyolysis is very rare. We report 15 patients with rhabdomyolysis caused by various viruses. Methods: Fifteen patients who were diagnosed with rhabdomyolysis and a viral infection were included in this study. Clinical, laboratory, and radiologic findings were evaluated through retrospective chart reviews. Results: Chief complaints were severe bilateral lower leg pain and leg weakness. The median age was 5.7 years. The male:female ratio was 2:5. The viral infections were caused by influenza virus B, parainfluenza virus, and rhinovirus. One patient with influenza virus B had coinfection with coronavirus. Median initial laboratory values and ranges were as follows: serum creatinine, 0.4 (0.1-0.5) mg/dL; serum aspartate transaminase, 124 (48-1,098) IU/L; serum alanine transaminase, 30 (16- 1,455) IU/L; serum creatine kinase, 2,965 (672-16,594) IU; serum lactate dehydrogenase, 400 (269-7,394) IU/L; serum myoglobin, 644 (314-3,867) ng/mL; urine myoglobin, 3 (3-10,431) ng/mL. All patients recovered without complications. Conclusion: This is the first report of the simultaneous occurrence of rhabdomyolysis caused by various viruses. This is also the first report of rhinovirus-associated rhabdomyolysis.

자연기흉의 임상적 고찰 (A Clinical Evaluation of Spontaneous Pneumothorax - A Review of 237 Cases -)

  • 김창수
    • Journal of Chest Surgery
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    • 제25권9호
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    • pp.955-961
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    • 1992
  • In this study, 237 cases of spontaneous pneumothorax experienced at the department of Thoracic and Cardiovascular Surgery, Kosin Medical College during from January 1986 to December 1990 were analysed retrospectively. 1. The ratio of male to female was 4.6: 1, predominent in male. The incidence of age group was highest as 36% between 21 and 40 years old. 2. The associated diseases of pneumothorax were 27 cases, in which pyothorax were 8 cases, and hydrothorax were 19 cases. 3. The site of pneumothorax was as follows: right side was 53%, left side was 45%, and both side was 2%, so right side was slight high. 4. The empolyed managements were as follows: bed rest with oxygen inhalation in 13 cases, closed thoracostomy in 155 cases, open thoracotomy in 69 cases. 5. The operative procedures of thoracotomy were as follows; simple pleurodesis in 2 cases, blebectomy & bullectomy in 38 cases, parietal pleurecttnny in 4 cases, segmentectomy in 12 cases, lobectomy in 9 cases. 6. The indication of open thoracotomy were as follows, recurrent history in 35 cases, contralateral pneumothorax history in 2 cases, continuous air leakage in 24 cases, bilateral pneumothorax in 2 cases, and visible blebs & bullaes on the chest X-ray in 6 cases. 7. The hospital duration after management was as follow, open thoracotomy in 13.2 days, closed thoracostomy in 22.4 days. The recurrent pneumothorax after closed thoracostomy was 25 cases, about 15%.

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자연기흉에 대한 임상적 고찰 (Spontaneous Pneumothorax: Clinical Investigation of 142 Cases)

  • 정상조
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.887-893
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    • 1990
  • We have experienced 142 cases of spontaneous pneumothorax from January 1987 to June 1990 at the department of Thoracic and Cardiovascular Surgery, Inha General Hospital, Inha University College of Medicine. The age of patients ranged from 16 to 79 years \ulcornerold. The incidence was highest between late 2nd and 3rd decades in non tuberculous group. Males occupied 110 cases [77.6%] and females 32 cases [22. 5%], and its ratio was 3.4: l. The incidence of right side pneumothorax was 76 cases [53.5%] and left side was 65 cases [45.8%]. There was one case of bilateral pneumothorax. The most common chief complaints were chest pain and dyspnea. The associated pulmonary lesions were pulmonary tuberculosis, active or healed in 51 cases [35.9%], Subpleural bleb in 19 cases [13.4%], emphysematous bulla in 12 cases [13.4%], asthma in 3, bronchiectasis in 3, pneumonia in 1, cyst in 1. The unknown origin pneumothorax, so called "idiopathic spontaneous pneumothorax”, which seemed to be caused by the rupture of bleb or bulla most likely, were 52 cases [36. 6%] in our series. Generally, closed [tube] thoracotomy with underwater sealed drainage is the treatment of choice in spontaneous pneumothorax. We experienced 94 cases[66.2%] which were cured by closed thoracotomy. However, open thoracotomy and adequate surgical procedures were undertaken in patient with continuous air leakage or recurrent attacks of spontaneous pneumothorax in 48 cases [33.8%]. The minithoracotomy is a good procedure for the bullectomy of upper lobe.lobe.

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소아에서 발생하는 선천성 두경부 기형 (Congenital Anomalies of Head and Neck in Children)

  • 이경근;정풍만
    • Advances in pediatric surgery
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    • 제7권1호
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    • pp.7-14
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    • 2001
  • Congenital anomalies of the head and neck region such as preauricular sinus and skin tag, thyroglossal duct cyst, branchial anomaly, cystic hygroma and dermoid cyst are common in pediatric population. It is important for pediatricians and pediatric surgeons to be familiar with the embryology and the anatomical characteristic of these lesions in order to diagnose and treat them properly. Three hundred and nineteen patients with congenital head and neck anomalies treated at Hanyang University Hospital between 1980 and 1999 were reviewed to determine the relative frequency of the anomalies and to analyze the method of management. Eight-four (25.1 %) of 335 lesions were preauricular sinus and skin tag, 81 (24.2 %) were thyroglossal duct cyst, 81 (24.2 %) branchial anomaly, 58 (17.3 %) cystic hygroma and 31 were (9.2 %) dermoid cyst. The male-to-female ratio was 1.4:1. Thyroglossal duct cyst most commonly present at 3-5years, however branchial anomalies commonly are diagnosed in children younger than 1 year. Preauricular sinus showed familial tendency in three patients and was bilateral is 33.8 %. Most head and neck anomalies in children have specific clinical and anatomical characterics. A careful history and physical examination is very useful for diagnosis and proper management. Experienced pediatric surgeons should do the initial surgery since the recurrence rate after incomplete surgical excision can be high.

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Relationship between Hip Medial Rotation Range of Motion and Weight Distribution in Patients with Low Back Pain

  • Kim, Sang-Kyu;Kim, Won-Bok;Ryu, Young-Uk
    • 대한물리의학회지
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    • 제9권3호
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    • pp.279-284
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    • 2014
  • PURPOSE: This study intended to verify whether there was actual correlation between weight-bearing asymmetry and a limitation in hip joint rotation range in patients with low back pain. METHODS: Thirty five low back pain patients voluntarily participated this study. For each participant, hip joint medial rotation symmetry rate and the weight-bearing symmetry rate were calculated. The correlation between the two variables was investigated. RESULTS: A decrease in the left hip joint medial rotation range of motion (ROM) was observed more often than a reduction in the right hip joint medial rotation ROM. However, similar number between right and left side was observed in ground reaction force more weighted. The coefficient between the passive hip joint medial rotation symmetry rate and the weight loading symmetry ratio was -0.19 (p < 0.05). CONCLUSION: The present study demonstrated a weak correlation between the hip joint medial rotation ROM and the weight distribution of both feet. Such result suggests that careful evaluation by separating each element is needed in treating patients with low back pain. Future research should take into account asymmetric alignment and abnormal movement in different joints of the body as well as asymmetry in the bilateral hip joint rotation and the unilateral weight supporting posture.

만성 교약성 심낭염의 외과적 치료 (Surgical Treatment of Chronic Constrictive Pericarditis)

  • 강면식
    • Journal of Chest Surgery
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    • 제22권1호
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    • pp.67-73
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    • 1989
  • Forty two patients with chronic constrictive pericarditis, who were admitted to the Yonsei University College of medicine over a period of 18 years from January, 1970 to August, 1988, were analyzed retrospectively. Mean age of the patient was 33.5 year ranging from 6.8 to 60 years old. Male to female ratio was 1.3 to 1. Twenty-one cases [50%] were tuberculous origin [based on either associated pulmonary tuberculosis and/or caseous necrosis in thickened pericardial specimen] and 17 cases [40.5%] were idiopathic [non specific chronic inflammatory change was considered to be idiopathic]. Dyspnea on exertion was evident in 30 cases [71.4%] and abdominal distention in 21 cases [50%]. On physical examination, hepatomegaly [83.3%], neck vein distention [54.8%], distant heart sound [47.6%] and ascites were found. Thirty-nine patients showed low voltage of QRS and/or T wave flattening or inversion on EKG. Thirty-one cases had undergone cardiac catheterization which showed data compatible with chronic constrictive pericarditis. Midsternostomy group [n=15] had shown the most remarkable CVP decline [12.20 mmHg] as compared with bilateral submammary incision group [n=25, 8.96 mmHg] and left thoracotomy group [n=2, 7.75 mmHg] but difference was not significant statistically There was four early death among 42 patients [9.5%] including 3 cases of left ventricular failure and one cardiac tamponade. Main postoperative complications were wound infection [6 cases] and arrhythmia [3 cases]. Follow-up of 24 patients [mean; 55.3 months, ranging from 2 months to 155 months] revealed good functional status.

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자연 기흉의 임상적 고찰 -244례- (Clinical Evaluation of Spontaneous Pneumothorax -A Review of 244 Cases-)

  • 김병린
    • Journal of Chest Surgery
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    • 제27권4호
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    • pp.292-296
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    • 1994
  • From March, 1985, to June, 1993, 244 patients with 345 episodes of spontaneous pneumothorax treated at Koryo General Hospital were reviewed. Most of the patients were male, and the ratio of male to female was 8:1. The average age of the patients with spontaneous pneumothorax was 32.8 years old. The site of pneumothorax was revealed left side in 53.3%, right side in 42.6%, and bilateral in 4.1%. The cause of pneumothorax were shown primary spontaneous pneumothorax in 73.4%, and secondary spontaneous pneumothorax in 26.6%. The underlying pathologic lesion in secondary spontaneous pneumothorax showed pulmonary tuberculosis in 56patients[86.1%], COPD in 4patients[6.2%], bronchial asthma in 2patients[3.1%], lung cancer in 2patients[3.1%], and pneumoconiosis in a patient[1.5%]. The usual clinical symptomes were dyspnea, chest pain and chest discomfort. Recurrence rate was as follow; 2nd episode 33.6%, 3rd episode in 26.8%, and above in 4th episode in 18.2%. All the patient of pneumothorax was treated as following; Closed thoracostomy tube drainage in 127patients, bullectomy in 88patients, lobectomy in 5patients, wedge resection in 2patients, conservative treatment with oxygen therapy in 21patients, and video assisted thoracoscopic bullectomy in a patient. The course of treatment of all of the patients were smooth and uneventful.

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Predicting Factors for Positive Vaginal Surgical Margin Following Radical Hysterectomy for Stage IB1 Carcinoma of the Cervix

  • Sethasathien, Sethawat;Charoenkwan, Kittipat;Settakorn, Jongkolnee;Srisomboon, Jatupol
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권5호
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    • pp.2211-2215
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    • 2014
  • Background: To examine the incidence of positive vaginal surgical margins and determine the predicting factors following radical hysterectomy for stage IB1 carcinoma of the cervix. Materials and Methods: The clinical and histological data of 656 FIGO stage IB1 cervical cancer patients who had radical hysterectomy with bilateral pelvic lymphadenectomy (RHPL) from January 2003 to December 2012 were retrospectively reviewed and were analyzed for their association with a positive vaginal surgical margin. A p-value of < 0.05 was considered significant. Results: Thirty-five patients (5.3%) had positive vaginal surgical margins following RHPL; 24 (3.7%) for intraepithelial lesions and 11 (1.7%) for carcinoma. On multivariate analysis, microscopic vaginal involvement by high-grade squamous intraepithelial lesion and/or carcinoma (adjusted odd ratio (OR) 186.8; 95% confidence interval (CI) 48.5-718.5) and squamous histology (OR 8.7; 95% CI 1.7-44.0), were significantly associated with positive vaginal surgical margin. Conclusions: Microscopic vaginal involvement by HSIL and/or carcinoma are strong predictors for positive vaginal surgical margins for stage IB1 cervical cancer patients undergoing radical hysterectomy. Preoperative 'mapping' colposcopy or other strategies should be considered to ensure optimal vaginal resection.

Effects of Shoulder Abduction in Opposite Directions on EMG Activity in the Abdominal Muscles during Single Leg Raising in the Supine Position on the Foam Roller in Healthy Subjects

  • Yun, Sung-Joon;Kim, Moon-Hwan
    • The Journal of Korean Physical Therapy
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    • 제27권4호
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    • pp.270-274
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    • 2015
  • Purpose: The purpose of this study was to examine the electromyographic (EMG) activity of the abdominal muscles and to compare the activity ratios of the bilateral rectus abdominis (RA) to oblique abdominal muscles during shoulder abduction in opposite directions with single leg raising (SLR) performed in the supine position on a foam roller. Methods: Fifteen healthy subjects were recruited to the study. Each subject lay on the foam roller and performed left single leg raising with right or left shoulder $90^{\circ}$ abduction (Abd); performed in a random order. Surface EMG recordings of selected abdominal muscles (i.e., the RA, external oblique abdominis [EO], internal oblique abdominis [IO], and transverse abdominis [TrA]) were normalized to maximum voluntary isometric contraction. EO/RA and IO and TrA/RA ratios were determined with surface EMG. Data were analyzed by Independent t-test. The statistical significance level was p<0.05. Results: The results were as follows: (1) the right RA, left EO, and right IO and TrA muscle activities increased significantly at the left SLR with left Abd compared to the left SLR with right Abd (p<0.05); and (2) the ratio of right EO/RA activity increased significantly at the left SLR with right Abd compared to left Abd (p<0.05). Conclusion: These findings suggest that left SLR with left Abd on a foam roller is an appropriate exercise for activation of specific oblique abdominal muscles.

이상근 증후군 치험 1례 (A Case Report of the Piriformis Syndrome Treated by Caudal Steroid and Local Anesthetic)

  • 정창영;윤명하;임웅모;김별아
    • The Korean Journal of Pain
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    • 제8권1호
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    • pp.149-151
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    • 1995
  • Piriformis syndrome is a syndrome of low back and leg radiating pain thought to be due to a chronic contracture of the piriformis muscle that causes irritation of the sciatic nerve. The piriformis muscle is a flat pyramidal muscle, an external rotator and abductor of the hip, originating from the front of the sacrum and inner aspect of the sacroiliac joint, then passes laterally out of the sciatic notch to attach posteriorly to the greater trochanter of the femur, the sciatic nerve passes between the two bellies of the muscle. Mechanical irritation of the sciatic nerve by an inflammatory reaction of the piriformis muscle and its fascia at this pelvic level causes pain to radiate in the dermatomal regions of the nerve roots similar to that disk entrapment. diagnosis of piriformis syndrome is made primary on the basis of history and clinical examination. The incidence is considerably higher in women, with the reported ratio of women to men of 6:1. These patients frequently present with associated symptoms of pelvic pain and/or dyspareunia. Symptoms are usually unilateral but occasionally be bilateral. We had a 42 year-old woman patient with low back and left leg radiating pain and dyspareunia treated by caudal steroid and local anesthetic.

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