• Title/Summary/Keyword: 동반진단치료

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Analysis of Risk and Benefit of Open Lung Biopsy in Severe Immunocompromised Patients with Pulmonary Complications (폐합병증을 동반한 심한 면역저하 환자에서 폐생검술의 유효성 및 위험성에 대한 분석)

  • 이호석;이성호;김관민;심영목;한정호
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.539-546
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    • 2001
  • Background: Pulmonary complications in immunocompromised patients are often fatal. Empirical treatment is usually applied based on the clinical and radiological findings because of the risk of the aggressive diagnostic procedures such as open lung biopsy. However, recent advancements in operative procedures and perioperative management has decreased the procedure-related risks. We have prospectively analyzed the risks and benefits of the early application of open lung biopsy in such patients. Material and Method: Forty-two consecutive immunocompromised patients with critical pulmonary complications were included from June, 1996 to December, 1999. The definition of the immunocompromised is as those with chemotherapy and/or other modality for hematologic disorders, with usage of immunosuppressive drug after transplantation, with usage of steroid for more than 1 month, and with primary immunodeficiency disorders. The indication of open lung biopsy was those with no significant improvement after a week of aggressive application of empirical treatment or with rapidly aggressive process. The underlying disease included hematologic disorder(31 patients), post-transplantation(3 patients), chemotherapy for solid tumor(2 patients), and others(6 patients). Operations were done through thoracotomy(conventional or mini-) or VATS.

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Full mouth rehabilitation of deep bite patient with segmental osteotomy and orthodontic treatment (분절골절단술과 교정치료를 동반한 과개교합 환자의 완전구강회복 증례)

  • Chu, Seung-Sik;Cho, Woong-Rae;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.1
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    • pp.26-38
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    • 2015
  • Teeth wear and extrusion of antagonist are commonly observed in deep bite patient having severe vertical and horizontal overlap. These problems cause collapse of occlusal plane and abnormal anterior guidance. Without restoring harmonious occlusion, loss of multiple teeth and decreased masticatory function could not be prevented. To resolve problems associated with deep bite, multidisciplinary treatment including oral surgical, orthodontic and prosthetic treatment should be performed. This clinical report describes the results of increasing occlusal vertical dimension with a full-mouth restoration procedure. The treatment procedures include extraoral and intraoral examination, diagnosis, treatment planning, diagnostic wax-up, segmental osteotomy, orthodontic intrusion and prosthodontic rehabilitation. Full mouth rehabilitation with increasing occlusal vertical dimension can solve esthetic and functional problems.

Review of the Metabolic Syndrome (대사증후군의 개요)

  • Lee, Eun-Mi
    • The Journal of the Korean life insurance medical association
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    • v.26
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    • pp.13-20
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    • 2007
  • 대사증후군은 비만, 이상지혈증, 고혈압, 당뇨병이나 내당능 장애가 동반되어 나타나는 증후군이다. 근래 들어 우리나라도 점차 비만 인구가 증가함에 따라 대사증후군의 유병률이 빠르게 증가하는 추세를 보여. 대사증후군에 대한 간단한 개념 정리를 하였다. 먼저 대사증후군의 정의와 진단기준을 살펴보았다. 1998년 대사증후군을 명명하고 진안기준을 제시한 WHO 진단기준, NCEP-ATP III 진단기준, 인슐린 저항성 증후군의 진단기준을 살펴보고, 기타 인종에 따른 허리 둘레 기준 및 IDF 정의를 살펴 보았다. 또한 대사증후군과 관련된 여러 인자들도 다시 확인해보고, AHA/NHLBI 진단 기준도 살펴 보았다. 우리나라는 대부분 연구에서 NCEP-ATP III 기준을 적용하고 있는데, 그 내용은 복부 비만 허리둘레 남자 102cm 이상, 여자 88cm 이상, 중성 지방 150mg/dl 이상, HDL-콜레스테롤 남자 40mg/dl 미만, 여자 50mg/dl 미만, 혈압 130/85 mmHg 이상, 공복 혈당 110mg/dl 이상이다. 복부 비만의 경우는 2000년 제정된 WHO 서태평양 지역 기준인 남자 90cm, 여자 80cm 이상으로 적용하고 있다. 다음 치료의 기본 개념을 간단히 언급 하였는데, 가장 중요한 치료는 우선적으로 생활 습관의 개선을 꼽을 수 있으며, 기타 약물요법 및 인슐린 저항성 개선제 등이 있다. 우리나라 에서도 심혈관계 질환과 당뇨병이 점차 사망 원인의 우위를 차지 하고 있으므로 대사증후군을 초기에 진단하고 관리하는 노력이 매우 필요할 것으로 생각되며, 생명보험사도 대사증후군을 하나의 증후군으로 인식하여 대사증후군의 전반적인 이해가 필요할 것으로 생각된다.

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Lower Motor Weakness and Complex Regional Pain Syndrome of Lower Limb in the Patient of Frontotemporal Dementia: A Case Report (이마관자엽 치매 환자에서 나타난 하지 근력 저하와 복합부위 통증증후군에 대한 증례 보고)

  • Lee, Kwang Min;Noh, Se Eung;Joo, Min Cheol;Hwang, Yong;Kim, Ji Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.352-358
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    • 2017
  • Frontotemporal dementia, the second most common cause of early onset dementia, is a neurodegenerative clinical syndrome characterized by progressive deficits in behavior, executive function and language. Although motor symptoms in frontotemporal dementia are represented by motor neuron disease, parkinsonism and progressive supranuclear palsy syndrome, there have been no reports of motor weakness caused by the direct involvement of central motor nervous systems in frontotemporal dementia. Moreover, no association between clinical dementia groups and complex regional pain syndrome has been reported. We diagnosed a rare case with motor weakness and complex regional pain syndrome of lower limbs due to central nervous system lesion in a patient with frontotemporal dementia by magnetic resonance imaging, electrodiagnostic study and three phase bone scan. Following steroid therapy for complex regional pain syndrome, pain was improved. Functional improvement was noted after rehabilitation therapy, including functional electrical stimulation, muscle strengthening exercise and gait training during hospitalization. This case report suggests that rehabilitation therapy for motor weakness in frontotemporal dementia could be effective for improving overall function.

A Clinical Observation of Children with Urachal Anomalies (요막관 기형의 임상적 고찰)

  • Lee, Sang-Bae;Jung, Chang-Hyun;Kim, Kang-Sung;Ryu, Min-Hyuk;Lee, Dong-Jin
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.213-221
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    • 2005
  • Purpose : Urachal anomalies are rare but are known to develop several complications, especially infection. Moreover, uniform guidelines for management have not been presented because of the variable clinical characteristics of these anomalies. The purpose of this report is to review our experience with urachal anomalies and attempt to determine the optimal management. Methods : We retrospectively reviewed the records of fourteen children with a variety of urachal anomalies who had been treated from January 1996 to June 2005 at Dong Kang General Hospital. Results : The age distribution of the patients(mean age; 3.8 years) was six neonates, one infant, five preschool-age and two school-age children. The male to female ratio was 1:1. Six cases of urachal cyst, four cases of patent urachus, two cases of urachal sinus and two cases of urachal diverticulum were found. Three patients with patent urachus and one with urachal cyst had hydronephrosis. Other associated anomalies included an inguinal hernia in one patient with urachal sinus and a vesicoureteral reflux in one patient with urachal diver ticulum. As a first-line diagnostic tool, high-resolution ultrasound examination was performed in thirteen cases and computed tomography in one case. Surgical excision was performed in nine patients with urachal anomaly. Five cases out of six neonatal cases experienced spontaneous improvement during a three-month follow up period. Due to frequent infection of the umbilicus, surgical excision was performed on one neonate with urachal sinus. Conclusion : All patients with urachal anomalies should undergo investigation for associated anomalies. The neonate with urachal anomalies, especially patent urachus, do not require surgical excision unless the patient has multiple episodes of recurrent infection. (J Korean Soc Pediatr Nephrol 2005;9:213-221)

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Pediatric Hip Disease (I): Diagnosis and Treatment of Developmental Dysplasia of the Hip (소아 고관절 질환(I): 발달성 고관절 이형성증의 진단 및 초기 치료)

  • Kim, Hui Taek;Park, Yong Geon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.359-365
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    • 2020
  • Developmental dysplasia of the hip broadly includes inadequate development of the hip joint involving the acetabulum or proximal femur, or both. Although ultrasonographic studies in neonates have greatly lowered the frequency of neglected or operatively treated cases, its sensitivity is less than desired. Hip dysplasia without subluxation is commonly diagnosed incidentally and strongly related to degenerative arthritis in females after the 4th decade. Hip dysplasia with subluxation shows symptoms through various periods, depending on its severity, especially for women with onset during pregnancy. A complete physical examination and early treatment for neonates are extremely important for obtaining satisfactory outcomes. To avoid underdiagnosis and to serve appropriate treatment on time, the authors recommend examining any suspicious hips in infants under two years of age. The study will discuss the diagnosis and primary treatment of developmental dysplasia of the hip.

Treatment of patients with midline discrepancies using three-piece basal archwire (Three-piece basal archwire를 이용한 치열 정중선 불일치의 교정치료)

  • Kim, Seok-Jun;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.30 no.4 s.81
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    • pp.377-386
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    • 2000
  • At the finishing stage, the use of asymmetric elastics to treat mild skeletal and dental midline discrepancies often creates several side effects such as canted occlusal plane, tipped incisors and unesthetic results. This report presents the clinical cases with midline discrepancies, following a differential diagnosis, optimal mechanics, and considerations in treatment. Differential diagnosis and treatment mechanics with three-piece basal archwire can obtain predictable midline correction with minimal side effects.

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Clinical Observation of Congenital Urinary Tract Anomalies (소아 요로계 기형에 대한 임상적 고찰)

  • Chang Soo-Hee;Kim Sun-Jun;Lee Dae-Yeol
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.67-72
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    • 1997
  • Purpose : Congenital urinary tract anomaly is the most common anomaly in the childhood and progress to chronic renal failure and growth retardation. Therefore, early diagnosis arid treatment of urinary tract anomaly are important. Method : We reviewed medical records of 124 patients who had urinary tract anomalies on radiologic studies from Jan. 1986 to Dec. 1996. We analyzed demography and clinical characteristics of urinary tract anomalies. Results : 1) The age distributions were as follows ; 61 cases of 124 patients (49%) were under 1 year, 11 cases (8.8%) from 1 to 3 years, 20 cases (16%) from 4 to 6 years, 10 cases (8%) from 7 to 9 years, 9 cases (7.2%) from 10 to 12 years, 10 cases (8%) from 13 to 15 years, and 3 cases (2.4%) from 16 to 18 years. 2) Chief complaints in patients with urinary tract anomalies were fever, flank pain, prenatally diagnosed hydronephrosis, abdominal mass, dysuria and hematuria. 3) Of 124 patients, 68 cases(54.8%) were combined with urinary tract infection, and main causative organism was E.coli, and the most frequently associated anomaly was vesicoureteral reflux. 4) Most of the urinary tract anomalies were VUR, UPJ obstruction, congenital hydronephrosis and double ureter in order of sequence. 5) Whereas the frequency of simple urinary tract anomaly was 87.9%, that of complex anomaly was 12%. 6) Operative corrections were needed in 47 cases and 7 cases were progressed to renal insufficiency. Conclusion : We emphasize that early detection of urinary tract anomaly, appropriate treatment and regular follow-up are needed.

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A Case Report of Guillain-Barré Syndrome with Neutropenia Improved by Combined Korean Medicine Treatment (호중구 감소를 동반한 길랑바레 증후군에 대한 한의 복합 치료 증례보고 1례)

  • Jung, Eun-sun;Yoo, Ho-ryong;Kim, Yoon-sik;Seol, In-chan
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.21 no.1
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    • pp.57-66
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    • 2020
  • ■ Objectives This study reports a case of improvement in a patient with neutropenia after Guillain-Barré treatment through combined Korean medicine treatment. ■ Methods This patient was hospitalized for 22 days and was treated by herbal medicine, electroacupuncture, and physical therapy. Symptom improvement was evaluated through periodic clinical pathology examination, manual muscle test(MMT), yanagihara scale, and numeric rastic sclae(NRS). ■ Results The clinical symptoms and absolute neutrophil counts of this Guillain-Barré patient improved after the combined Korean medicine therapy treatment. ■ Conclusion This study suggests that Korean Medicine can be effective in reducing Guillain-Barre syndrome symptoms and improving intravenous immunogloubulin induced neutropenia, but more research is required to confirm these results.

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Transverse Colon Cancer with Duodenal Fistula (십이지장루를 동반한 횡행결장암 1예)

  • Seong Kyeong Lim;Seun Ja Park;Moo In Park;Won Moon;Sung Eun Kim;Sung-Uhn Baek
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.68-71
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    • 2014
  • A 57-year-old male visited our hospital due to a growing abdominal mass for 1 month. The patient was diagnosed as transverse colon cancer with duodenal fistula, and then was treated with neoadjuvant concurrent chemoradiation therapy (2 cycles of FOLFOX-4, 3-dimensional conformal radiation therapy: 3,000 cGy in 10 fractions). Despite the improvement of colon cancer and associated inflammation, the symptom of colonic obstruction was aggravated. Thus transverse colon segmentectomy was done. After surgery, he have received adjuvant 12 cycles of FOLFOX-4 chemotherapy. Now, he is currently being followed up in cure state.

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