• 제목/요약/키워드: recurrence symptoms

검색결과 481건 처리시간 0.025초

악성늑막삼출증의 흉강경 탈크늑막유착술 (Thoracoscopic Talc Pleurodesis of Malignant Pleural Effusion)

  • 손동섭;기양수
    • Journal of Chest Surgery
    • /
    • 제31권3호
    • /
    • pp.266-270
    • /
    • 1998
  • 악성늑막삼출증 환자에서 임상증상을 호전시켜 삶의 질을 향상시키기 위한 여러 방법이 시도되고 있으나 어려운 점이 많다. 이전에 늑막유착을 위해 많이 사용하던 tetracycline은 생산이 중단되어 더 이상 사용하지 못하고 있다. 본 연구는 악성 늑막 삼출증 환자에서 흉강내에 탈크를 분무하여 늑막 유착의 효과을 연구함에 목적을 두고 전향적으로 조사하였다. 1995년 3월 부터 1997년 3월 까지 15명의 환자에서 흉강경을 이용하여 4 gm의 무균적이고 석면이 들어 있지 않은 100% 탈크을 분무하여 수술전과 수술후(평균 101일, 범위 25∼233일) 임상적, 방사선학적 비교 관찰하여 다음과 같은 결과을 얻었다. 1. 환자는 남자 6례, 여자 9례로 여자가 많았으며, 평균연령이 55.1세(범위 31∼74세)이었고, 원발성 종양은 폐암이 10례 유방암이 2례 간암, 위암, 미확인 선암이 각각 1례였다. 2. 수술전 늑막수에서 세포진 검사 양성률은 36%이었고 흉강경하 조직검사의 양성률은 100%였다. 3. 임상적으로 탈크 분무후 증상호전이 94%에서 관찰되었다. 4. 흉부 x-선 촬영상 술후 한달에서 94%의 늑막수의 재발이 없었다. 5. 술후 합병증으로는 창상감염과 호흡부전이 각각 1례씩 있었다. 결론적으로 악성늑막삼출증 환자에서 흉강경을 사용해 흉강내에 탈크을 분무하여 늑막유착을 유도하는 것이 매우 효과적인 방법으며 환자 선택에 있어 수술후 폐의 재팽창이 중요한 인자가 된다

  • PDF

식도암의 외과적 치료 (Surgical Treatment of Esophageal Cancer)

  • 이재덕;이계선
    • Journal of Chest Surgery
    • /
    • 제29권7호
    • /
    • pp.753-758
    • /
    • 1996
  • 대전 을지병 원 흉부외과에서는 1987년 1월부터 1994년 12월까지 8넌 동안 식도암으로 진단된 25명의 환자에 대 해서 수술적 치료를 시 행하였다. 24례가 남자 환자였고 1례는 여자 환자였다. 연령 분포는 40세에서 74세까지 였고 평균연령은 60.4세 였다. 가장 흔한 증상은 연하곤란(92.0 %)이었고, 그외 전신 쇠약감(28.0 %), 흥골하 통증(16.0 %), 체중감소(16.0%) 순이었다. 식도암의 발생부위는 상부 1132례, 중부 l1317례, 하부 if)6례이 었다. 외과적 치료는 개흥을 통한 식도절제 및 식도 위 문합술 14례, 개흥을 통한 식도절제 및 식도 결장 위 문합술 5례, 개흥을 통한 식도절제 및 공장간치술 2례, 위루술 4례이 었다. 술후 합병증은 문합부누출 3례, 농흉 3례, 창상감염 2례, 무기폐 2례, 늑막삼출 1례, 애성 1례, 기흥 1례, 공장 이식편 괴사 1례, 흡인성 폐렴 1례이었다. 수술후 사망환자는 3례 있었다. 사망원인은 흡인성 폐렴 1 례, 패혈증과 호흡부전 각각 1 례이었다. 평균 생존기간은 9.75개월 이었고, 식도암의 재발은 3례에서 있었다.

  • PDF

좌측 주기관지 및 기관에 발생한 선양낭포성암 2례 (Two Cases of Adenoid Cystic Carcinoma of the Left Main Bronchus and Trachea)

  • 조영복;이학준;김기범;정진홍;이관호;이현우;김미진
    • Journal of Yeungnam Medical Science
    • /
    • 제13권2호
    • /
    • pp.347-359
    • /
    • 1996
  • 기관이나 주기관지에서 발생한 선양 낭포암은 서서히 진행하며 조기진단이 어렵고 특징적인 임상적 증상이나 소견이 없어 만성적인 호흡기 질환과의 감별 진단이 힘들어서 질환이 상당히 진행된 후에야 발견되는 수가 많고 원격전이가 많으며 또한 대부분 재발하는 특성이 있으므로 치료후 10년이상의 세심한 추적관찰이 필요하다. 저자들은 선양낭포암이 좌측 주기관지에 발생한 58세 여자 환자와 기관후벽에 발생한 25세 여자 환자를 각각 경험하였기에 보고하는 바이다.

  • PDF

Antifungal Activity of Silver Salts of Keggin-Type Heteropolyacids Against Sporothrix spp.

  • Mathias, Luciana Da Silva;Almeida, Joao Carlos De Aquino;Passoni, Luis Cesar;Gossani, Cristiani Miranda David;Taveira, Gabriel Bonan;Gomes, Valdirene Moreira;Vieira-Da-Motta, Olney
    • Journal of Microbiology and Biotechnology
    • /
    • 제30권4호
    • /
    • pp.540-551
    • /
    • 2020
  • Sporotrichosis is a chronic and subacute mycosis causing epidemiological outbreaks involving sick cats and humans in southeastern Brazil. The systemic disease prevails in cats and in humans, with the symptoms restricted to the skin of immunocompetent individuals. Under these conditions, the prolonged treatment of animals and cases of recurrence justify the discovery of new treatments for sporotrichosis. This work addresses the antifungal activity of silver salts of Keggin-type heteropolyacid salts (Ag-HPA salts) such as Ag3[PW12O40], Ag6[SiW10V2O40], Ag4[SiW12O40] and Ag3[PMo12O40] and interactions with the antifungal drugs itraconazole (ITC), terbinafine (TBF) and amphotericin B (AMB) on the yeast and mycelia forms of Sporothrix spp. Sporothrix spp. yeast cells were susceptible to Ag-HPA salts at minimum inhibitory concentration (MIC) values ranging from 8 to 128 ㎍/ml. Interactions between Ag3[PW12O40] and Ag3[PMo12O40] with itraconazole and amphotericin B resulted in higher antifungal activity with a reduction in growth and melanization. Treated cells showed changes in cell membrane integrity, vacuolization, cytoplasm disorder, and membrane detachment. Promising antifungal activity for treating sporotrichosis was observed for the Ag-HPA salts Ag3[PMo12O40] and Ag3[PW12O40], which have a low cost, high yield and activity at low concentrations. However, further evaluation of in vivo tests is still required.

유방암 생존자들의 자가관리에 대한 현상학적 연구: 비약물적 접근방법을 중심으로 (The phenomenological study of self-management intervention among breast cancer survivors: Non-pharmacological approaches)

  • 허석모;허나래
    • 한국산학기술학회논문지
    • /
    • 제17권12호
    • /
    • pp.270-284
    • /
    • 2016
  • 본 연구는 현상학적 방법을 적용하여 유방암 생존자들의 비약물적 추후 관리 경험에 대한 본질적 구조와 의미에 대해 심도 있게 파악하는 것을 목적으로 한다. 이번 연구에서 총 참여자는 10명으로 S시 E병원 외래에 정기적으로 내원하는 유방암 생존자로 수술, 화학요법, 방사선요법을 완료한 자들이었다. 자료수집 기간은 2014년 8월부터 2015년 2월까지로 수집된 자료는 심층면담 후 Colaizzi의 방법 적용하여 분석하였다. 연구결과, 7개의 주제와 16개의 하위범주가 도출되었다. 7개의 주제는 '1. 증상을 완화하기 위해 용이한 방법을 적용함, 2. 변화된 신체 상태를 위해 움직이려 함, 3. 재발 방지를 위해 특정 식용 작물을 섭취함, 4. 건강을 유지하기 위한 식생활 양식이 있음, 5. 보완대체요법에 대해 항상 예의주시함, 6. 주치의 처방외 필요한 치료가 있음, 7. 자연친화적인 환경에서의 삶을 지향함' 이었다. 이번 연구는 유방암 생존자들이 치료 후에 일상생활에서 어떻게 추후관리를 하는지 심도있게 파악하는 데 도움을 줄 것이다. 나아가 본 결과는 향후 유방암 생존자들에게 실제 관리 양식에 근거한 실행 가능한 지침과 프로그램을 제공하는데 있어 기초자료로써 제공될 것이다.

Clinical Outcomes of Basaloid Squamous Cell Carcinoma of the Esophagus: A Retrospective Analysis of 142 Cases

  • Zhang, Bai-Hua;Cheng, Gui-Yu;Xue, Qi;Gao, Shu-Geng;Sun, Ke-Lin;Wang, Yong-Gang;Mu, Ju-Wei;He, Jie
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권3호
    • /
    • pp.1889-1894
    • /
    • 2013
  • Background: Basaloid squamous cell carcinoma of the esophagus (BSCCE) is a rare and distinctive tumor with no standard treatment. This study aimed to explore treatment in relation to prognosis of the disease. Methods: A total of 142 patients with BSCCE that underwent treatment in our hospital from March 1999 to July 2010 were retrospectively analyzed. All patients received surgery, 42 postoperative radiotherapy and 28 patients chemotherapy. Results: There were 26 patients included in stage I, 60 in stage II, 53 in stage III and 3 in stage IV. The clinical symptoms and macroscopic performances of BSCCE did not differ from those of typical esophageal squamous cell carcinoma. Among 118 patients receiving endoscopic biopsy, only 12 were diagnosed with BSCCE. The median survival time (MST) of the entire group was 32 months, with 1-, 3- and 5-year overall survival (OS) of 81.4%, 46.8% and 31.0%, respectively. The 5-year OS of stage I and II patients was significantly longer than that of stages III/IV, at 60.3%, 36.1% and 10.9%, respectively (p<0.001, p=0.001). The MST and 5-year OS were 59.0 months and 47.4% in patients with tumors located in the lower thoracic esophagus, and 27.0 months and 18.1% in those with lesions in the upper/middle esophagus (p=0.002). However, the survival was not significantly improved in patients undegoing adjunctive therapy. Multivariate analysis showed TNM stage and tumor location to be independent prognostic factors. Furthermore, distant metastasis was the most frequent failure pattern, with a median recurrence time of 10 months. Conclusion: BSCCE is an aggressive disease with rapid progression and a propensity for distant metastasis. It is difficult to make a definitive diagnosis via preoperative biopsy. Multidisciplinary therapy including radical esophagectomy with extended lymphadenectomy should be recommended, while the effectiveness of radiochemotherapy requires further validation for BSCCE.

암 환아 부모의 경험에 대한 질적 연구 (The Experience of Parents Whose Child is Dying with Cancer)

  • 조영숙;김수지
    • 대한간호학회지
    • /
    • 제22권4호
    • /
    • pp.491-505
    • /
    • 1992
  • The purpose of this research was to understand the structure of the lived experience of parents of a child terminally ill with cancer The research question was “What is the structure of the experience of parents of a child terminally ill with cancer\ulcorner” The sample consisted of 17 parents of children admitted to the cancer units of two university hospitals in Seoul. The unstructured interviews were carried out from October 10, 1991 through January 10, 1992. They were audio-recorded and analysed using Van Kaam's method. Parents ascribed the cause of the cancer to the mother's emotional imbalance during pregnancy, the mother's stress, failure to observe religious rites, food, the parent's sin, misfortune and pollution. The theme clusters were tension, fear and depression experienced during pregnancy, stress that children suffer from abusive parents, failure to observe religious activites, bad luck, and sins committed during a previous life. When the child suffered a recurrence of cancer, the parents experienced negative emotions, nervousness, sorrow. depression and death. The theme clusters were feelings of despair, helplessness, regret, guilt, insecurity, emptyness and apathy. The long struggle with cancer resulted in the loss of economic security, loss of psychological and physical well being, and social withdrawal. The theme clusters were the economic burden of medical cost, giving up treatment, debt, limited medical insurance coverage and blood transfusion. The loss of psychological well being included stress, lack of support systems, inability to carry out responsibilities, lack of trust of the medical ten family breakdown, inappropriate expression of emotion and not disclosing the diagnosis to the child. Physically the parents suffered fatigue, insomnia, loss of appetite, loss of weight, dizzness, headache, psychosomatic symptoms, and increased consumption of liquor and cigarettes. Social withdrawal was manifested by taking time off from work to look after the child, decrease of outside social activities and feelings of isolation. Influences on family life were spousal conflicts, negative response of siblings, separation of the family members and economic hardship. The theme clusters were blaming a spouse for the cause of the illness and disagreements, maladjustment, lonliness, hostility and depression of siblings. The high price of medical care over the long period was a major factor influencing the life of the family. Positive experiences during the child's long illness were the strengthening of support systems and religious beliefs and financial help from social organizations. The support of one's spouse primarily helped to overcome the stress of the long illness. In addition, support was received from parents of other children with cancer and from nurses and religious leaders. The nurse, by providing empathetic support, should be a person with whom parents can express their feelings and share their experiences.

  • PDF

새기형(鰓畸形, Branchial Anomalies) - 대한 소아외과학회 회원을 주 대상으로 한 전국 조사 - (Branchial Anomalies in Korea - A Survey by the Korean Association of Pediatric Surgeons -)

  • 박우현;권수인;김상윤;김성철;김신곤;김우기;김인구;김재억;김현학;박귀원;박영식;박주섭;송영택;안우섭;오남근;오수명;유수영;이남혁;이두선;이명덕
    • Advances in pediatric surgery
    • /
    • 제2권2호
    • /
    • pp.119-128
    • /
    • 1996
  • The survey on branchial anomalies was conducted by Korean Association of Pediatric Surgeons. A total of 173 cases were reported, which were managed by 36 members and cooperators during the three years from January 1, 1993 through December 31, 1995. The following results were obtained by retrospective analysis of the 173 cases of branchial anomalies. The presenting symptoms were cervical mass in 101 cases, pit with or without discharge in 71, cervical abscess in 47 and respiratory difficulty in 3. The average age of the patients with cervical abscess was 52 months. Seventy(79%) of 89 patients with branchial anomalies and a cystic mass had their first clinical manifestations by 1 year of age, while 40(51%) of 78 patients with only a branchial cyst had their first clinical manifestation in first year of life. Radiologic studies were carried out in 77 patients (43%). The preferred diagnostic modalities were ultrasonography(47 patients), simple neck radiogram(19) and CT scan(17). Preoperative diagnosis was correctly made in 156(91%) of 173 patients. Seventeen patients were incorrectly diagnosed as thyroglossal duct cyst in 5 patients, cystic hygroma in 4, dermoid cyst in 3, and lymphadenopathy in 3. There were no remarkable difference in sex and laterality of presentation but bilateral lesions were found in 9(5%) patients and unusual locations of the anomalies were the manubrium, left subclavicular area, median cervial area, preauricular and parotid area. There were 78(45%) patients with cyst, 52(30%) patients with sinus, 35(20%) patients with fistula and 8(5%) patient with skin tag. Embryological classification was possible in only 64(37%) patients. The 2nd branchial anomaly was present in 50(78%), the 1st branchial anomaly in 10(18%), and the 3rd or 4th branchial anomaly in 4(6%). Histopathological study of the lining epithelium(N=134) is recorded that 45% were lined with squamous epithelium, 17% with respiratory epithelium, 6% with. squamous and respiratory epithelium, 14% with inflammatory change. Lymphoid tissue was common(62%) in the wall of the lesions. Twelve(7%) of 158 patients had postoperative complications including wound complication, recurrence and facial nerve palsy.

  • PDF

상완 신경총에 발생한 신경초종의 수술적 치료 결과 (Surgical Outcomes of Schwannoma Occurred at the Brachial Plexus)

  • 이혁진;이영호;공현식;이승환;이준오;노영학;김강욱;백구현
    • Archives of Reconstructive Microsurgery
    • /
    • 제19권1호
    • /
    • pp.1-6
    • /
    • 2010
  • Schwannoma of the brachial plexus region is very rare. There has not been general agreement in terms of surgical outcome from limited number of studies. We analyzed surgical outcomes from 11 cases of schwannomas which occurred in the brachial plexus. From February 2000 to August 2009, 11 patients with schwannomas of the brachial plexus region were surgically treated by a single surgeon. We retrospectively reviewed the medical records and MRI of our cases, and evaluated the neurologic deficit and the recurrence of tumors after surgery. All the cases were proven histologically as schwannomas. The mean age of the patients was 52.6(36~67) years old, 4 of them were male and 7 were female. The tumor was located in the left side in 9 patients, and right in 2. The mean postoperative follow-up was 24.7(6~78) months. Initial presentation was usually painless, palpable mass. The mass was located in various level of the brachial plexus such as root, trunk, cord, or terminal branch level. The size of mass was from $1.5{\times}1.5{\times}0.5$ cm to $11.0{\times}10.0{\times}6.0$ cm. Eight of 11 patients showed no neurologic deficit. Three patients showed postoperative neurologic deficit; two of them had transient sensory deficit, and one of them had weakness of flexor pollicis longus and 2nd flexor digitorum profundus. There were no recurrences. The schwannoma of the brachial plexus region should be considered as a curable lesion with an acceptable surgical risk of injury to neurovascular structures. With precise surgical techniques, these tumors can be removed to improve patient's symptoms with minimal morbidity.

  • PDF

타액선 악성선상낭종과 조직학적 등급과의 관계 (Histologic Grade of Adenoid Cystic Carcinoma Arising from Salivary Glands - Clinical Review of 66 Cases -)

  • 박윤규;박성길;이삼열;오성수;이혜경
    • 대한두경부종양학회지
    • /
    • 제7권2호
    • /
    • pp.129-136
    • /
    • 1991
  • This is a clinical, retrospective review of 66 cases of the Adenoid cystic carcinoma who were treated at the Department of Surgery, Presbyterian Medical Center, Chonju during the past 20 years from January, 1971 to December, 1990. The results were obtained as follows; 1) The most common malignant tumor in the minor salivary gland was adenoid cystic carcinoma and it's incidence was 57.6% (38 cases). 2) The most common site of adenoid cystic carcinoma in the major salivary gland was parotid gland with the incidence of 22.7% (15 cases). 3) The peak age of patients with adenoid cystic carcinoma was 5th decade(30.3%) and others' peak age except adenoid cystic carcinoma was 6th decade(35.9%). 4) The duration of symptoms of adenoid cystic carcinoma patient was less than one year in the minor salivary gland, comprising 21 cases(55.3 %) and more than one year in 18 cases(64.9 %) of the major salivary gland carcinoma. 5) According to histologic grades of 66 cases of adenoid cystic carcinoma, Grade I was 15 cases and Grade II 19 cases, Grade III 5 cases. Other 27 cases were undetermined. 6) The incidence of cervical lymphnode metastasis of 39 cases of adenoid cystic carcinoma classified into histologic grades was 0% in Grade I, 10.5% in Grade II and 20% in Grade III. 7) The incidence of nerve invasion confirmed histologically was 20% in Grade I, 63.2% in Grade II and 100% in Grade III. It was significant(p<0.01). 8) The local recurrence rate was 26.7% in Grade I, 47.4% in Grade II and 60% in Grade III. The lung was the commonest site for distant metastasis comprising 14 cases among 19 cases in which distant spread occurred. 9) 5 year determinate disease-free survival rate according to the histologic grade was 57.1% in Grade I, 27.3% in Grade II and 25.0% in Grade III. 10) The determinate 5-year survial rate of adenoid cystic carcinoma was 71.4% in the only curative surgery group, 70.6% in the combined treatment group of surgery and postoperative irradiation, 66.7% in the combined treatment group of surgery with postoperative irradiation and chemotherapy, and 33.3 % in the non-curative treatment group. 11) The average size of tumor was 3.6cm in Grade I, 4.8cm in Grade II and 4.5cm in Grade III.

  • PDF