• Title/Summary/Keyword: constrictive

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Subxiphoid Pericardial Drainage of Pericardial Effusions (심낭삼출액에 대한 검상하 심낭배액술)

  • 오삼세;장우익
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.693-700
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    • 1997
  • To assess the effectiveness of subxipoid pericardial drainage for the treatment of pericardial effusion, we reviewed 80 cases of subxiphoid pericardial drainage between January 1986 and December 1995. There were 39 males and 41 females with ages ranging from 20 to 80 years. The diagnosis of pericardial effusion was made by echocardiography. The procedure was carried out under general anesthesia in 50(62.5%) and under local anesthesia in 30 patients(37.5%). Among the 33 p tients with malignant pericardial effusion, cytology was positive .in 14 of 31(45%), and pericardial biopsy showed malignancy in 7 of 29 patients(24%). Among the 27 patients with tuberculous pericardial effusion, the diagnosis was confirmed by histology of pericardial biopsy in 12 patient or bacteriologic culture in 1 patient. The operative mortality was 17.5% (14180 patients) and all the mortality occurred in the malignant group. There were no operation-related mortality Sixty six patients were followed from 9 days to 5 years; mean follow-up was 452 days. Recurrent pericardial effusions, necessitating further surgical intervention, occurred in 6 (7.5%) patients. Constrictive pericarditis developed later in 4 patients(5%) and two of them had undergone complete pericardiectomy. In summary, subxiphoid pericardial drainage allowed safe and efficient drainage of pericardial effusions with sampling for cytology and pericardial biopsy, and had an acceptable morbidity and mortality.

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A Study for Development of Ratio Beale Measuring Pain Using Korean Pain Tersm (통증어휘를 이용한 통증비율척도의 개발연구)

  • 이은옥;윤순녕;송미순
    • Journal of Korean Academy of Nursing
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    • v.14 no.2
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    • pp.93-111
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    • 1984
  • The main purpose of this study is to develop a ratio scale measuring level of pain using Korean pain terms. The specific purposes of this study are to identify the degree of pain of each pain term in each subclass: to classify each subclass in terms of dimensions of pain; and to analyze factors of the Korean pain ratio scale clustering together. One hundred an4 fifty eight pain terms which were originally identified as representative terms and their synonyms were used for data collection. Fifty eight nursing professors ana sixty one medical doctors who have contacted with patients having pain were asked to rate the weight of each pain term on a visual analogue scale. Subclasses in which ranks of pain terms were same f s findings in two previous studies were 1) thermal 3 am 2) cavity pressure, 3) single stimulating pain, 4) radiation pain. and 5) chemical pain. Subclasses in which ranks of pain terms were confused were 1) incisive pressure, and 2) cold pain. Subclasses in which one new pain term was added were 1) inflammatory-repeated pain, 2) punctuate pressure, 3) constrictive pressure, 4) fatigue-related pressure, and 5) suffering-relate4 pain. Subclasses in which two new pain terms were added were 1) traction pressure, 2) peripheral nerve pain, 3) dull pain, 4) pulsation-related pain, 5) digestion-related pain, 6) tract pain, and 7) punishment-related pain. Subclass in which 3 new pain terms were included was fear-related pain. Rating scores of 5 words in 4 subclasses were significantly different between the normal group and the extreme group of subjects in terms of subjective rating. Only one word among 6 words was that newly added to the scale. Rating scores of 12 words in 9 subclasses were significantly different between doctor group and nursing professor group. Among these 12 words, only 3 were those newly added to the scale. In comparison of these 12 words, mean scores of the nursing professors were always 7 to 16 points higher than those of the medical doctors. In the analysis of judgement of subjects in terms of dimensions of pain terms, subclasses of dull pain, cavity pressure, tract pain and cold pain were suggested to be included in the miscellaneous dimension. As a result of factor analysis of the ratings given to 96 pain words using principal components analysis without iteration and with varimax rotation limiting the number of factors to 4, factors of severe pain (factor I) mild-moderate pain (factor II) , causative pain (factor III) and temperature-related pain(factor IV) were extracted with the factor loading above 0.388. When the pain words were re-arranged on the bases of factor loading above 0.368, number of factors decreased to only first two factors. Maximum score of pain word in factor II was 46.17 and the minimum score of the factor I was 45.36. Further studies are needed to identify the validity, reliability, sensitivity and practicability of this ratio scale using patients having various sources of pain.

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Preparation of High Spin Five-Coordinate Iron(II) Complexes of 1,4,8,11-Tetraazacyclotetradecane and High Spin Six-Coordinate Iron(II) Complexes of 1,5,8,12-Tetraazadodecane (1,4,8,11-테트라아자사이클로테트라데칸의 높은 스핀 다섯배위철(II) 착화합물과 1,5,8,12-테트라아자도데칸의 높은 스핀 여섯배위철(II) 착화합물의 합성)

  • Myunghyun Paik Suh
    • Journal of the Korean Chemical Society
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    • v.24 no.2
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    • pp.139-145
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    • 1980
  • High spin iron(II) complexes of 1,4,8,11-tetraazacyclotetradecane (cyclam), a macrocyclic ligand, and 1,5,8,12-tetraazadodecane (3,2,3-tet), a noncyclic ligand, have been prepared. The reaction of low spin $[Fe(cyclam)(CH_3CN)_2](ClO_4)_2$ with chloride ion in methanol produces high-spin $[Fe(cyclam)Cl]ClO_4$. Although $[Fe(cyclam)(CH_3CN)_2](ClO_4)_2$ is low spin, $[Fe(3,2,3-tet)(CH_3CN)_2](ClO_4)_2$ isolated in the present study is high spin. This difference is explained in terms of the smaller constrictive effect exerted by the noncyclic ligand than the cyclic ligand. The isolation of $[Fe(cyclam)Cl]ClO_4$ provides evidences against the current view that the presence of either unsaturation or substituents on the macrocyclic ligands is necessary for the successful preparation of high spin five-coordinate iron (II) complexes. Reactions of $[Fe(cyclam)Cl]ClO_4\;and\;[Fe(3,2,3-tet)(CH_3CN)_2](ClO_4)_2$ with carbon monoxide yield low spin six-coordinate $[Fe(cyclam)Cl(CO)]ClO_4\;and\;[Fe(3.2,3-tet)(CH_3CN)(CO)](ClO_4)_2$, respectively.

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A Case of Tuberculous Pericardial Abscess Mimicking Thymic Carcinoma (악성 흉선종으로 오인된 결핵성 심낭농양 1예)

  • Park, Ji-Young;Park, Seung-Ah;An, Young-Hwan;Jang, Gil-Su;Kim, So-Yeon;An, Jeung-Sun;Hong, Eun-Young;Lim, Soo-Young;Kim, Kun-Il;Seo, Jin-Won;Park, Sung-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.4
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    • pp.347-351
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    • 2011
  • We report here an unusual case of pericardial tuberculoma that was misdiagnosed as thymic carcinoma on an imaging study. A 48-year-old woman was referred for evaluation of an anterior mediastinal mass. Computed tomography (CT) scans of the chest displayed cystic masses mimicking thymic carcinoma at the anterior mediastinum. Pericardiotomy and surgical drainage of the cystic masses were done, and pathologic examination of the excised pericardial specimen showed a chronic granulomatous inflammation with necrosis, compatible with tuberculosis. Acid-fast bacilli were also identified in the specimen. After treatment with anti-tuberculosis drugs and steroids, the patient showed clinical improvement. Although tuberculous pericarditis usually presents as pericardial effusion or constrictive pericarditis, it can also present as a pericardial mass mimicking thymic carcinoma on CT. Therefore, we suggest that tuberculous pericardial abscess should be included in the differential diagnosis of a mediastinal mass in Korea, with intermediate tuberculosis prevalence.