• 제목/요약/키워드: sign and symptom

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Clinical Durability and Deflation of Saline-Filled Breast Implant in Breast Reconstruction (유방재건술에 사용된 식염수 보형물의 임상적 내구성과 누출)

  • Kim, Il-Kug;Lee, Jun-Ho;Kim, Yong-Ha;Kim, Tae-Gon;Lee, Soo-Jung;Kang, Soo-Hwan
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.808-814
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    • 2011
  • Purpose: Despite wide clinical use of breast implants, there is continued concern about the lifespan of these devices. The causes of explantation were infection, deflation of implant and patient's want. The deflation of saline-filled breast implant was related to strength and durability of implant shell. The purpose of this study is to evaluate the clinical durability of saline-filled breast implant through the analysis of duration until deflation occurred, causes, incidence and influencing factors. Methods: Retrospective analyses were conducted on clinical records for 19 cases of deflation of saline-filled breast implant from 201 cases of breast reconstruction with saline-filled implant between May 1995 and June 2011. The authors had been analyzed the causes of deflation, survival duration, symptom, sign, nipple excision, volume of implant, saline filling, method of reoperation, breast cancer stage and combined capsular contracture. Results: The causes of deflation were attributed to the cases that cannot be evaluated the causes in 15 cases, fall down in 1 case, mammography in 2 cases, accidental needle injury in 1 case. Mean survival duration was 4 years and 5 months. The duration of survival was less than 1 year for 5 cases, 1 year to 10 years for 10 cases, more than 10 years for 4 cases. The volume between 201 and 250 cc of deflated breast implant was rated as high by 14.0 percent. The deflation rate of underfilled implants was 11.4 percent, adequate filled implants was 9.3 percent. None of overfilled implant was deflated. The deflation of smooth surface implant was 5 of 152 cases. Textured implant was 14 of 49 cases. The capsular contracture of non-deflated breast implant was 28 of 182 cases and that of deflated breast implant was 6 of 19 cases. Conclusion: The patients who underwent saline-filled breast implant implantation should be informed that their implant could deflate. The analysis of clinical durability and causes of deflation in breast implant was important for the prediction and prevention of reopeation. The authors could suppose the causes of deflation of saline-filled breast implant through history, duration of survival, inspection of the shell of implant.

Behcet`s Syndrome with Aortic Aneurysm: A Case Report (Bechet`s 병과 합병된 상부대동맥류: 치험 1례 보고)

  • Gang, Jeong-Ho;Lee, Jeong-Ho;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.98-105
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    • 1977
  • A 36 year old blindman, engineer was admitted with chief complaints of hemoptysis, recurrent sore throat, pyoderma in genital organ, uveitis and thrombophlebitis for 10 years. Above the chief complaints were remission or exacerbation during hospitalization. Physicalexamination showed that left radial, ulnar & brachial pulse was not palpable. No bruit or murmur was obtained over the mass. Neurologic examination revealed no significant finding.On admission, chest P-A showed hen egg sized round & oval compact hazy density on left upper lung field. Bronchogram revealed no pathological finding and Lt. tomogram showed well define large,ovoid mass density in the superior mediastinum. Fluoroscopy finding showed nonpulsatile on left upper lung field. Pre-op. aortography was not taken, under the impression of lung Ca. rule out .sortie aneurysm, exploratory operation was performed through the 2nd intercostal space, Lt. It was performed that the mass was ascending sortie aneurysm of saccular type. Direct aneurysmectomy with multiple figure of eight suture were done without any prosthetic graft. Post-op. control I.V.C graphy showed completely obstruction sign. Postopcontrol aortography revealed good surgical result. Final, histopathological answered non-specific sortie aneurysm, saccular type. Post-op. courses were uneventful except mild neurologic disturbance with subclavian steal syndrome and associated with both lower leg pitting edema due to inferior vena cava obstruction. After op, 3 month later, discharged to home, with big systemic problem. Behcet`s syndrome reviewed with related literatures. The coexistence of mouth and genital ulceration with hypopyon mentioned by hippocrates and described by various workers in the early part of this century was first defined as a syndrome by Behcet in 1937. In 1937 Behcet described a chronic relapsing triple symptom complex of oral ulceration, genital ulceration, and ocular inflammation. The place of the syndrome as part of a systemic disorder in now clearer, and the under lying pathology appears to be a vasculitis. The disease runs a- chronic course, blindness being the greatest disability and control nervous system involvement a cause of death. Thrombophlebitis is fairly frequent, france et al [1951] giving an incidence of 25% and Dowling [1961] 12%, superficial thrombophlebitis migrans and thrombosis of large veins, including venae cavae [Thomas, 1947: Boolukos 1960] are recorded. Little attention has been paid to arterial involvement. Mishima et al. [1961] described resection cf an aortic aneurysm in a 38 year old man with Behcet`s syndorme. Mounsey in a clinicopathological conference described a case [Brit, med. J., 1966] of ruptured aortic aneurysm in Bechcet`s syndrome treated by aorto-iliac graft. Also, Shikano and Oshima et al [1963] recorded two aneyrysm of smaller arteries. Unfrequently, aortic aneurysm was presumed to be secondary to osteomyelitis of the lumber spine, though the possible association between aortic aneurysm and Behcet`s syndrome was raised. A further case is reported here, in which ascending aortic aneurysm with Behcet`s Ds. appeared to form part of this generalized disease. This is a case report of surgical experience of Behcet`s Ds. with ascending aortic aneurysm which had nearly all the typical clinical features. Above mentioned and was reviewed with related literatures.

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Comparison of the Depression and Anxiety between the Elderly in the Home for the Aged and Those in the Community (양로원 노인과 재가 노인의 불안과 우울에 관한 비교조사)

  • Seo, Ryo-Seok;Jung, Sung-Duk;Kim, Chang-Su
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.256-268
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    • 1992
  • This survey was conducted from January 1991 to May 1991. Two hundred arid eight residents in 4 government supported homes for the aged and two hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale(CADS) and somatization symptom check list(SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and un satisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.

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A Clinical Study on Patients of Low Back Pain by DITI (적외선 체열촬영을 이용한 요통환자의 임상적 관찰)

  • Jin, Jae-do;Han, Moo-Gyu;Lee, Jeong-Hoon;Lee, seung-woo;Han, Sang-Won
    • Journal of Acupuncture Research
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    • v.18 no.4
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    • pp.22-31
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    • 2001
  • Objective : This study is designed to evaluate the correlation between the data of DITI (Digital Infrared Thermographic Imaging) and the clinical symptoms in the patients with low back pain. Methods : Among the outpatients with back pain who visited to Department of Acupunture & Moxibustion, Tae gu Oriental Hopital of Kyung San University from January 2000 to August, we selected 115 cases that examined DITI. We evaluated the correlation between the data of DITI examination and the clinical symptoms (Distribution of Sex and Age, Duration of Disease, Main Sign, Grade of Clinical Symptoms, Diagnosis according to Symptoms(辨證),) in the patients with low back pain. Results & Conclusion : 1. The thermal changes in terms of the duration of disease : The acutest period has the highest thermal change. Also, the longer the duration of disease was, the higher the termal change was. It increased in the order of the acutest period, the less acute period, and the the chronical period. 2. Thermal changes due to the main symptom : The degree of thermal change was as follows (from the highest to the lowest): first, back and knee pain, second, back and leg pain, third, back and buttock pain, fourth, numbness of leg, and fifth, back and dorsum pain. 3. Thermal changes in terms of the grade of clinical symptoms : The more servious the symptoms were, the higher the thermal change was. It was increased in the order of Gr 1, Gr 2, Gr 3, and Gr 4. 4. Thermal changes depdning on symptoms diagnosis : Chwaseom(挫閃) has the highest temperature, $0.87{\pm}0.49^{\circ}C$. 5. Thermal changes before and after treatment : Before treatment, the average thermal change was $0.83^{\circ}C$ but after treatment, it was decreased to $0.38^{\circ}C$. For the above symptoms, if DITI is used, the diagnosis is easier based on the medical history of the patient who has back pain, and the degree of pain. However, if thermal change is soly used for diagnosis, it will be hard to determine the nature of sickness. Therefore, it should be folllowed by other supplementary examination.

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A Clinical Analysis of the Intestinal Atresia (선천성 장 폐쇄증의 임상적 분석)

  • Park, Jin-Young
    • Advances in pediatric surgery
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    • v.10 no.2
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    • pp.99-106
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    • 2004
  • Intestinal atresia is a frequent cause of intestinal obstruction in the newborn. We reviewed the clinical presentation, associated anomalies, types of atresias, operative managements, and early postoperative complications in 36 cases of intestinal atresia treated at the Department of Surgery, Kyungpook National University Hospital between January 1994 and February 2003. Location of the lesion was duodenum in 17 patients, jejunum in 11 patients and ileum in 8 patients. The male to female ratio was 1:1.4 in duodenal atresia (DA), 2.7:1 in jejunal atresia (JA) and 7:1 in ileal atresia (IA). The most common type was type III (41.1 %) in DA, and type I (52.6 %) in JA and IA. The most common presenting symptoms was vomiting(88.2 %) in DA, but in jejunoileal atresia, vomiting(89.4 %) and abdominal distension(89.4 %) were the most common sign and symptom. All cases of DA were diagnosed by plain abdominal radiography. There were 6 cases of DA with congenital heart disease, 3 cases of DA with Down syndrome and 3 cases of JA with meconium peritonitis. Segmental resection was performed in 13 cases, duodenoduodenostomy in 11 cases, membrane excision in 7 cases, jejunojejunostomy in 2 cases, gastroduodenostomy in 2 cases and ileocolic anastomosis in 1 case. There were 9 postoperative complications including 3 each of anastomotic leakage, wound infection, and intestinal obstruction 3 cases. The mortality rate for DA was 11.8 %(2/17). Both deaths in DA were attributed to congenital heart disease. The mortality rate for JA was 18% (2/11). Both cases died with sepsis and short bowel syndrome.

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Diagnosis and Treatment of Chronic Medial Ankle Instability (만성 내측 족관절 불안정성에 대한 진단 및 치료)

  • Kim, Jin-Su;Young, Ki-Won;Lee, Han-Sang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.37-41
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    • 2013
  • Purpose: We investigated the short term results of medial deltoid ligament repair after diagnosis of chronic medial ankle instability. Materials and Methods: 262 military patients with ankle instability symptom were evaluated between May 2007 and December 2009. We diagnosed 29 chronic medial ankle instability cases with medial drive through sign under arthroscopy, radiologic findings and physical exam, treated with deltoid talo-navicular band repair using anchor suture. We used the American orthopedic foot and ankle society ankle-hindfoot score (AOFAS), visual analog scale (VAS) and ankle functional satisfactory scores were carried out. Results: 29 patients (11.1%) has chronic medial ankle instability, mean AFOAS score, VAS was improved from 65.4(range; 43-83), 6.0(range; 4-10) to 82.0(range; 60-100), 3.2(range; 1-7). Patients satisfaction were excellent 13(44.8%), good 11(37.9%) and poor 5(17.2%). Two cases was recurred and revised with allo-tendinous reconstruction. Conclusion: We underwent surgery to repair the talo-navicular ligament for chronic medial ankle instability, and about 83% of satisfactory results were obtained.

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Responses of Medical Students to Using Smartphone Video at Clinical Performance Examination (표준화환자가 스마트폰 동영상으로 증상을 보여준 진료문항에 대한 의과대학생들의 반응)

  • Cho, Young Hye;Kim, Min Ji;Yeom, Jung Sook;Bae, Hwa-ok;Kim, Jae-Bum;Lee, Keunmi;Koh, Suk Bong;Seo, Ji-Hyun
    • Health Communication
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    • v.13 no.2
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    • pp.217-221
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    • 2018
  • Background: There are practical difficulties to show exact clinical symptoms such as seizure to medical students at Clinical Performance Examination (CPX). We developed a new CPX case of child's seizure on video using smartphone. Methods: A total of 356 $4^{th}-year$ students of five universities in Daegue-Gyeongbuk and Gyeongnam area took the clinical skill examination from June $13^{th}$ to $17^{th}$ in 2016. Among them, 72 students took the new CPX case in June $15^{th}$ and 71 students filled out the questionnaire on whether the new CPX with smartphone video is helpful, authentic, difficult, and necessary for other CPX. All the questions were measured on 5-Likert scale. Results: Mean score of the new CPX was 57.1, lower than the mean scores of the other 11 CPX cases, 62.8. For the question "Smartphone videos helped to solve the problem", 45 students (63.4%) answered 'Very much'. For the question "Is it realistic compared to other questions?" 30 students (42.3%) and 25 students (35.2%) answered 'Very much' and 'Much'. For the question "Is it difficult compared with other questions?" 18 students (25.4%) and 26 students (36.6%) answered 'Very much' and 'Much'. As for the question "I would like to have more tests using smartphone video", 26 students (36.6%) answered 'So and so'. Conclusion: A majority of students responded that video presentation was helpful and authentic to figure out the CPX, whereas they assessed smartphone video was more difficult compared with other CPXs. Further, students were negative toward using smartphone video for the other CPXs.

Risk factors and effect of screening for gastric cancer in a university hospital (한 대학병원 위암 환자의 위험요인과 조기검진 효과)

  • Lee, Tae-Yong;Min, Gyung Hun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.5
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    • pp.2914-2922
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    • 2014
  • To study the risk factors and effect of gastric cancer screening, case-control study was conducted. From June 2007 to December 2011, 580 newly diagnosed gastric cancer (342 advanced gastric cancer, 171 early gastric cancer) patients were enrolled at the department of general surgery in a university hospital. History of gastric examinations and possible risk factors were collected through interviews with structured questionnaire and reviewed medical chart. Comparing advanced cancer and early gastric cancer were analysed by chi-square test and logistic regression. The results showed that aged 70 and over (OR 2.393; 95%CI 1.329-4.310), Ex-smoker (OR 1.612; 95%CI 0.970-2.680), blood type A (OR 1.784; 95%CI 1.035-3.075), and H. pylori infection (OR 1.699; 95%CI 0.905-3.191) were important risk factors for advanced gastric cancer compared to early gastric cancer. Weight loss (OR 2.752; 95%CI 1.333-5.684) and indigestion (OR 1.574; 95%CI 1.069-2.319) were also important sign and symptom. Although the results cannot find effect of screening, national policies on early cancer detection must conduct.

Dental Management in a Patient with Turner Syndrome with Dental Anomalies : A Case Report (치아형태이상을 가진 터너 증후군 환자의 치과적 관리)

  • Lee, Haney;Shin, Seyoung;Kim, Jaegon;Lee, Daewoo;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.3
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    • pp.386-392
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    • 2018
  • Turner syndrome (TS) is a chromosomal disorder caused by monosomy of the X chromosome, with complete or partial absence of the second sex chromosome. Anomalies of root morphology have been found to occur more often in patients with TS, which make endodontic treatment challenging and requires special handling. The patients with TS may also have systematic problems such as cardiac or renal malformations, so in treating these patients it is important for clinicians not only to be aware of the characteristic intraoral findings, but also to make the patients have regular dental check-ups to prevent oral complications in advance. An 12-year-old girl who had been diagnosed with TS at the age of 10 years was referred due to discomfort in the bilateral mandibular premolar regions. Dens evaginatus and taurodontism were detected in all the mandibular premolars characteristically. The bilateral mandibular first premolars had three roots and the bilateral mandibular second premolars had periapical lesion with two roots. Due to the complexity of the root canal anatomy, root canal treatment were completed with a dental microscope to ensure adequate visualization. After 2 years of regular follow-up examinations, there were no clinical sign or symptom associated with the teeth, and no periapical lesion, was found. This case report describes the characteristic oral features and dental management of TS patients.

The Analysis on Clinical Characteristics of Out-Patients of Oriental Thyroid Clinic (한방병원 갑상선 클리닉 내원 환자들의 임상적 특성 분석)

  • Byun, Sang-Hyuk;Kim, Soon-Il;Kang, Ki-Hoon;Lee, Byung-Cheol;Ahn, Young-Min;Doo, Ho-Kyung;Ahn, Se-Young
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.213-220
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    • 2005
  • Objective : Thyroid diseases are one of the most common endocrine disorders. However, the first chosen-treatments including anti-thyroidal and hormone-supplement therapy in western medicines, sometimes have failed to improve abnormal thyroid hormone secretions and clinical symptoms. Therefore, there has been a growing expectation for Oriental Medicine to take the role of alternative therapy. However, there has been little analysis of clinical characteristics. In this study, clinical characteristics of thyroidal disease patients who visited Kyung-Hee oriental hospital from January to July 2004 were analyzed. Methods : A total 86 patients diagnosed as hyperthyroidism, hypothyroidism or thyroid nodule were selected. Clinical history, including sex, age, symptoms, disease duration and methods of previous therapy and thyroidal test, such as thyroid function test (TFT), thyroid scan and other thyroid examinations. Results : In distribution of onset age and sex, the patients who have visited oriental hospital with thyroidal diseases showed similar characteristics with typical patients. In clinical symptom, the most frequent clinical sign was fatigue in both hyperthyroidism and hypothyroidism, which differs from the classical characteristics of those diseases. Most patients complained the unresolved symptoms, some of which are attributable to abnormal thyroid hormone secretions, in spite of western therapy with anti-thyroidal and hormone supplement agents. Conclusions : In oriental therapy, it will be necessary to consider the unique clinical features of thyroidal diseases different from classical patterns, and this study suggests that oriental therapy is a good alternative method for patients whose first treatment with western agents failed. Furthermore, more public information to these patients about oriental medicine would be helpful to increase cure rates, and give various choices to patients with thyroid diseases.

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