• Title/Summary/Keyword: 내과질환

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A Case of Tracheal Hamartoma (기관내 과오종 1예)

  • Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;HwangBo, Bin;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Sung, Sook-Hwan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.383-388
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    • 1999
  • Background: Tracheal hamartoma is a very rare cause of upper airway obstruction. Its clinical features can mimic medical conditions, such as bronchial asthma, chronic bronchitis, and so on. Case; This report presents the case of a 65 year old man whose major symptom was dyspnea. We found a tumor in his distal tracheal lumen, and the tumor was removed with success using rigid bronchoscope. The tumor was histologically proven to be a hamartoma, and his symptoms were much improved. Conclusion: It is important to distinguish it from other conditions because medical management is often not helpful. Surgical correction-with or without thoracotomy-is inevitable.

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Inpatient Dental Consultations to Pediatric Dentistry in the Yonsei University Severance Hospital (연세대학교 세브란스 병원 내 입원한 환자의 소아치과 의뢰 현황)

  • Joo, Kihoon;Lee, Jaeho;Song, Jeseon;Lee, Hyoseol
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.2
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    • pp.145-151
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    • 2014
  • The goal of this study was to describe dental consultation of pediatric inpatients to the department of pediatric dentistry at Yonsei University Severance Hospital. 391 dental consultations at Yonsei University Severance Hospital referred to pediatric dentistry in the year 2012 were included in this study. Consultations were categorized according to patients' gender, age, chief complaint, referred department and diagnosis. 288 patients (166 males and 122 females) with an average age of 5.9 were referred to the Department of Pediatric Dentistry. 129 cases (33.1%) from Department of Rehabilitation Medicine, 80 cases (20.5%) from Pediatric Hematology- Oncology, 51 cases (13.0%) from Pediatric Cardiology, and 44 cases (11.3%) from Pediatric Neurology. Chief complaints were ranked from oral examination (39.7%), dental caries (14.0%), pre-operative evaluation (12.8%) and others (33.5%); including oral pain, trauma, tooth mobility, orthodontic treatment, self-injury, fabrication of obturator and etc. Dental consultations should be encouraged as dental care and treatment could affect the control of systemic diseases of admitted patients. Pediatric inpatients have been referred to pediatric dentistry for not only comprehensive oral exam but also various chief complaints. The most frequent dental diagnosis made and treatment performed were dental caries and non-invasive/preventive care respectively.

A Case Report : TMJ Osteoarthritis in a Patient with Renal Osteodystrophy (턱관절의 골관절염을 동반한 신성골이영양증 환자 증례보고)

  • Lee, Gi-Ho
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.247-253
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    • 2013
  • Renal osteodystrophy(RO) is characterized by skeletal changes in patients with renal disease and developed as a result of alterations in the metabolism of calcium, phosphate and secondary hyperparathyroidism. Bony changes in the craniofacial region include decreased bone density, radiolucent lesions(brown tumors), depletion of cortical bone and loss of lamina dura, but such changes rarely occur in the temporomandibular joint(TMJ). We report an uncommon case of bony changes and pain of both TMJs in a patient with RO. A 41-year-old man with RO came to our clinic due to TMJ pain and sounds. Occlusal change was also reported. Radiographs revealed degenerative changes of the both condyles. The patient had medical history of renal cancer therapy and hemodialysis. The patient was diagnosed with TMJ arthritis of RO and referred for systemic management through medication of calcium and vitamin D and parathyroidectomy. At 15-month follow-up, most of TMD symptoms disappeared and second radiographs revealed that bone density and cortical thickness of the mandible increased and the skeletal outline of the both condyles became relatively clear. As bony changes may begin in the early stage of the renal disease, dentists should be alert to detect the sign of the disease. In addition, it is important to differentiate TMJ arthritis of systemic cause because the treatment protocol is quite different.

COPD Patients with Hypercapnic Respiratory Failure : Response to Therapy and Determinant of Intubation (만성폐쇄성폐질환 환자의 고탄산혈증성 호흡부전 : 치료 반응 및 기도삽관의 결정인자)

  • Song, So-Hyang;Kim, Chi-Hong;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.462-472
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    • 2001
  • Background : The determinants of intubation and the response to therapy in COPD patients with hypercapnic respiratory failure were retrospectively reviewed. Methods : This study involved a review of 132 episodes of hypercapnic respiratory failure($PaCO_2\;{\geq}\;50\;mmHg$ and $pH\;{\leq}\;7.35$). The time frame for resolution or the time to intubation of patients who were admitted between 1996 and 1999 was analyzed. Results : Out of 132 hypercapnic episodes, 49(37%) required intubation. A comparison was made with the 83 cases that responded to treatment. Patients requiring intubation had a greater severity of illness, which included a higher APACHE II (Acute Physiology and Chronic Health Evaluation II) score ($20{\pm}5$ vs $14{\pm}4$ ; p<0.01), a higher WBC, a higher serum BUN, and greater acidosis (pH, $7.23{\pm}0.11$ vs $7.32{\pm}0.04$ ; p<0.01). Those with the most severe acidosis(pH<7.20) had the highest intubation rate(87%) and shortest time to intubation($2{\pm}3\;h$). Conversely, those with an initial pH 7.31 to 7.35 were less likely to be intubated(20%), and had a longer time to intubation($97{\pm}121\;h$). The patients with a pH 7.21 to 7.25($4.1{\pm}2.9$ day) required longer period of time to respond to medical treatment than patients with a pH of 7.31 to 7.35($2.2{\pm}3.1$ day). Of those patients requiring intubation, half(55%) were intubated within 8 h of admission, and most (75%) within 24 h. Of those patients responding to treatment medical therapy, half(52%) recovered within 24 h and most (78%) recovered within 48 h. Conclusion: Respiratory acidosis at the initial presentation is associated with an increased likelihood of intubation. This should assist in deciding help with the decision whether to treat patients medically, institute noninvasive ventilation, or proceed to intubation.

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A Comparative Study Concerning the Psychopathologies between the Patients with Peptic Ulcer and Those with Essential Hypertension - Focused on Medically-Ill Out Patients - (소화성 궤양과 본태성 고혈압 환자의 정신병리에 관한 비교 연구 - 내과외래환자를 중심으로 -)

  • Choi, Hyun-Kyoung;Kim, Chan-Woo;Lee, Dong-Gun;Kwak, Chung-Whan;Park, Seung-Ken;Park, Hee-Ouk;Ok, Jong-Whan;Kim, Jeong-Gee
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.149-158
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    • 2003
  • Objectives: The authors studied the anxiety, depression and psychological characteristics of medical out-patients, which are diagnosed as peptic ulcer disorder and essential hypertension. We also examined the state of psychiatric consultation. Methods: The subjects were composed of 56 patients with peptic ulcer disorder, 44 patients with essential hypertension and 116 controls. STAI, BDI and SCL-90R was administered to all subjects. Chart review, telephone interview and Self report questionnaire of etiology and severity of illness, drug compliance and so forth were performed in disease groups. Results: Considerable depression was noticed in 39.3% among the patients with peptic ulcer disorder, 27.7% in hypertension and 12.1% in control group by BDI. State anxiety was noticed in 44.6% among the patients with peptic ulcer disorder, 54.5% in hypertension and 18.1% in control group by State anxiety. Trait anxiety was noticed in 42.9% among the patients with peptic ulcer disorder, 34.1% in hypertension and 25.8% in control group by Trait anxiety. The higher SOM, BDI, STAI, the lower drug compliance and rapport. Psychological problems are considered of the most important etiology in 48.2% of peptic ulcer group and 45.7% of hypertensive group. But psychiatric consultation is made only in 1.8% of peptic ulcer group and 2.3% of hypertensive group. Conclusions: Anxiety and depression are common phenomena in medical outpatients. In comparison with the normal control group, peptic ulcer group showed significantly higher trait anxiety and depression and hypertensive group higher state anxiety. These characteristics are related to the drug compliance and doctor-patient relationship. These results suggested the needs of active psychiatric consultation.

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Psychiatric Preparation of Surgery (수술전 환자들의 정신과적 문제)

  • Chang, Sung-Man;Lee, Sang-Won
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.1
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    • pp.3-7
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    • 2009
  • Psychiatric disorders are quite common in surgical patients. However, surgeons are less likely to refer patients to psychiatrists than other physicians, who also have a tendency to under-recognize psychiatric disorders among their patients. Therefore, a large proportion of psychopathology in surgical patients is either undiagnosed or misdiagnosed and not optimally treated, if treated at all. This column focuses on common psychiatric issues that generally arise in surgical patients and reviews psychiatric issues specific to specialized surgical settings and patients (eg, burn units, obesity surgery).

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Insomnia in Medical Illnesses:The Secondary Insomnia (내과적 질환에 동반된 불면증:이차성 불면증)

  • Lim, Se-Won;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.11-16
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    • 2005
  • Sleep can be easily disrupted by variety of conditions. Most of medical illnesses could be a primary condition causing secondary insomnia. The common underlying mechanism of secondary insomnia is presumed to be stress effects on sleep. The assessment and treatment of secondary insomnia are often complicated. Establishing an causal inference between primary condition and insomnia is the key to assessment. However, it can be difficult even for experienced clinicians due to diagnostic ambiguity of secondary insomnia. Therefore, through medical evaluation and integrative understanding of primary condition is essential to manage secondary insomnia properly. Although treatment have been usually focused on the primary medical illnesses per se, nonpharmacologic interventions, such as sleep hygiene, might be effective in many cases.

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Detection of SNPs involved in the development of complex diseases with the boolean algebra (부울 대수를 이용한 복합질환의 중요 SNP 찾기)

  • Sangseob Leem;SeunghyunKim;Kyubum Wee
    • Proceedings of the Korea Information Processing Society Conference
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    • 2008.11a
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    • pp.722-725
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    • 2008
  • 복합질환(complex disease)의 원인과 작용 모델을 찾기 위해 여러 가지 통계적인 방법들과 기계 학습(machine learning)의 방법 등이 사용되고 있다. 소수 SNP의 작용모델을 찾는 방법은 많이 알려져 있지만 다수 SNP의 작용 모델을 효과적으로 찾는 방법은 거의 연구되어 있지 않다. 본 연구에서는 원인 SNP들의 작용을 부울 식(boolean expression)으로 나타내고, 유전 알고리즘(genetic algorithm)을 이용하여 예측 정확도가 높은 부울 식을 구성하였으며 실제 자료와 생성된 자료에 대하여 제안한 모델의 성능을 측정하였다.

The rationale for management of oral appliance in TMD patients (턱관절 질환 구강장치 치료의 원칙 : 그 부작용과 예방)

  • Lim, Hyun-Dae
    • The Journal of the Korean dental association
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    • v.57 no.4
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    • pp.241-247
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    • 2019
  • Etiology of temporomandibular disorders is multifactorial origin and complex. therefore, reversible and conservative treatment is recommended in the initial approach of TMD. oral appliances are widely used to manage TMDs, while their mechanisms of action and its effects remain controversial and unclear. The purpose of this paper was to review information regarding the types, designs, and materials of occlusal appliances and the rationale for the continued use of OS for the management of TMDs.

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The Past, Present and Future of Korean Research in Psychosmatic Medicine (한국 정신신체의학연구의 과거와 현재 그리고 미래)

  • Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.9-13
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    • 2012
  • Psychosomatic medicine is a part of medicine which is to find the effect of psychological, behavioral, and medical factors on the human body and disease. In the early $20^{th}$ century, the idea of psychogenesis had been developed and resulted in the concept of psychosomatic disease which was believed to be caused by psychological factors. However a multifactorial model of illness developed and it allowed illness to be viewed as a result of biopsychosocial interactions. The following have been highlighted by consultation-liaison psychiatry. Psychosomatic medicine has addressed stress and psychiatric factors which affect the etiology, course, and treatment of medical disorders. Moreover it contributes the growth of other related disciplines such as psychoneuroendocrinology, psychoimmunology, behavioral medicine, health psychology and quality of life research. Nowadays, psychosomatic field becomes enlarged because medical and surgical departments have been developed rapidly, and research methods and tools have brought forth rapid progress and advance in medical science. Therefore the author reviews the past and present psychosomatic researches and suggests the future of psychosomatic research in Korea.

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