• 제목/요약/키워드: 말기 치료

검색결과 222건 처리시간 0.03초

급성 심근경색 후 좌심실류절제술을 받은 환자에서 재 좌심실용적감소술의 시행 (Redo-left Ventricular Volume Reduction Surgery in a Patient with Left Ventricular Aneurysm -1 case-)

  • 이삭;이창영;이교준;유경종
    • Journal of Chest Surgery
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    • 제38권1호
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    • pp.63-66
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    • 2005
  • 전벽의 급성심근경색에 의한 좌심실류가 있는 경우 수술적 전측심실내복원술(SAVER)은 좌심실의 무운동과 이상운동 구획을 분리하여 정상적인 좌심실 원형구조와 심근벽의 긴장도를 정상적인 수준으로 감소시켜 줌으로써 혈역학적 향상을 기할 수 있는 술식이다 저자들은 급성심근경색에 의한 좌심실류로 좌심실류절제술을 시행 받은 과거력이 있는 40세 남환에서 12년간에 걸친 remodelling의 결과로 진행된 말기심부전의 치료방법으로써 다시 수술적 전측심실내복원술을 시행한 후 만족할 만한 결과를 얻었기에 이를 보고하는 바이다.

하대정맥 필터 삽입 후 합병증으로 발생한 Phlegmasia Cerulea Dolens 1예 (A Case of Phlegmasia Cerulea Dolens as a Complication Caused by Placement of Inferior Vena Cava Filter)

  • 조영신;김종화;이호성;최재성;나주옥;서기현;김용훈
    • Tuberculosis and Respiratory Diseases
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    • 제65권3호
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    • pp.225-229
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    • 2008
  • 저자들은 폐색전증과 심부정맥 혈전증을 이전에 진단받았던 말기 전립선암환자에서 외상성 뇌출혈로 인해 항응고제 치료를 시행하지 못하여 하대정맥 필터를 삽입 후 하지 부종, 하지 맥압 소실, 급성 신부전 및 DIC 등으로 사망한 phlegmasia cerulea dolens 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

항암화학요법과 통합의학치료를 병행하여 부분 관해 된 간전이 동반 말기 췌장암 1례 (A Case Report of Partial Remission of End-stage Pancreatic Cancer Patient with Liver Metastasis Treated with Chemotherapy and Integrated Medicine Therapy)

  • 고은비;장권준;장주영;송미화;신광순
    • 대한한방내과학회지
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    • 제41권2호
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    • pp.166-176
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    • 2020
  • Objectives: This study reports on the effect of Integrative Medicine Therapy (IMT) on a patient with pancreatic cancer with liver metastasis. Methods: One pancreatic cancer with liver metastasis patient was treated using IMT in conjunction with Gemcitabine/Abraxane since September 2019. The cycle was repeated every four weeks for a total of 11 times. At the same time, the patient was treated with IMT. Tumor size was measured by scanning with Computed Tomography (CT). Adverse events were evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After treatment with Gemcitabine/Abraxane and IMT for eight months, the size of the body and tail of the cancer tumor and several hepatic metastatic regions decreased (partial response, [PR]), size, and number of multiple nodules in both lungs decreased. No evidence of newly developed metastatic lesions was found. The patient has maintained a good treatment outcome and has shown prolonged overall survival. Conclusions: This case demonstrates that treatment with IMT may have substantial benefits for patients with end-stage pancreatic cancer.

인대 불안정성이 동반된 말기 족근 관절염 환자의 자가 인대 재건술과 인공관절 치환술의 치료 결과 (End Stage Ankle Arthritis with Ankle Instability Patients Treatment Results Using Autograft Ligament Reconstruction with Total Ankle Arthroplasty)

  • 최재혁;김정렬;김동현;정우철;윤정로;여의동;이경태
    • 대한족부족관절학회지
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    • 제14권1호
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    • pp.47-52
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    • 2010
  • Purpose: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. Materials and Methods: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. Results: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average $8.2{\pm}0.9$ (range, 7~10) to $2.7{\pm}1.7$ (range, 0~6) and the AOFAS score improved from $46.4{\pm}14.6$ points (range, 23~69) to $80.1{\pm}9.3$ points (range, 65~95) at final follow-up. Anterior draw test improved $15.2{\pm}3.4$ mm (range, 12~23 mm) to $8.8{\pm}2.6$ mm (range, 6~13mm), varus stress test improved from $13.9{\pm}4.6^{\circ}$ (range, $10-18^{\circ}$) to $6.2{\pm}4.7^{\circ}$ (range, $2-18^{\circ}$) at final follow up. Conclusion: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.

팔 흔들기가 정상인의 보행에 미치는 영향 (The Effect of Arm Swing on Gait in Healthy Adults)

  • 정화수;최수희;박선자;오혜진;조화영
    • 디지털융복합연구
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    • 제12권11호
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    • pp.451-459
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    • 2014
  • 본 연구는 정상 성인의 팔 흔들기 종류에 따른 보행 시 운동역학적인 변화를 알아보기 위해서 실시하였다. 정상 성인 대학생 45명을 대상으로 정상 팔 흔들기, 한 팔 흔들기, 두 팔 움직임 없음 보행, 인위적인 팔 흔들기의 4가지 팔 흔들기 종류에 따라 실험을 진행하였다. 이들의 운동역학적인 변화를 알아보기 위해 3차원적 관절 운동역학적 변화 검사인 6-camera Vicon MX motion analysis system을 통해 보행 변수를 측정하였다. 팔 흔들기에 따른 운동역학적인 매개 변수들인 각 관절에서 보행속도, 엉덩관절 일률, 말기 디딤기의 수직 지면반발력에서 유의한 차이를 보였다(p<.05). 이러한 연구결과는 팔 흔들기 종류에 따라서 정상인과 환자들의 치료와 평가를 위한 지침으로서 임상에서 사용할 수 있을 것으로 생각된다.

의료인의 윤리적 이슈, 윤리적 딜레마와 윤리교육 요구도 조사 (Survey on Ethical Issues, Ethical Dilemma, and Needs for Ethics Education in Healthcare Providers)

  • 제남주;박미라;방설영
    • 디지털융복합연구
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    • 제18권10호
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    • pp.285-296
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    • 2020
  • 본 연구는 다양한 규모의 의료기관에 근무하는 의료인을 대상으로 Ethical Issues in Clinical Practice 도구로, 윤리교육 요구에 대한 내용을 조사하여 추후 윤리교육 프로그램 개발에 도움이 되는 기초자료를 제공하고자 시도되었다. G도에 소재한 의료기관의 의료인 149명을 대상으로 자료수집 하였다. IBM SPSS WIN/21.0을 이용하여 t-test, ANOVA, Pearson correlation coefficient, Multiple regression을 사용하였다. 윤리교육 필요성은 말기치료결정 이슈(r=-.22, p=.007), 환자간호 이슈(r=-.28, p<.001)와 역상관관계가 있었다. 대상자의 윤리교육 필요성에 가장 영향을 미치는 요인은 환자간호이슈(β=-.246, p=.035)이었고, 그 다음으로 불교(β=.208, p=.010)이었다. 수정된 설명력은 13.4%이었다(F=5.596, p<.001). 윤리교육 프로그램 내용을 구성할 때 대상자의 요구도를 반영하여 환자간호 이슈 내용과, 대상자의 종교를 반영한 맞춤형 프로그램 마련이 필요하며, 윤리교육 프로그램 개발에 도움이 되는 기초자료로 활용될 수 있을 것이다.

말기암 환자의 통증치료를 위한 지주막하강내 카테터 거치와 피하 이식형 약제 주입기 삽입 - 증례보고 - (Intrathecal Catheter and Subcutaneous Access Port Implantation in Pain Management for Terminal Cancer Patient - A case report -)

  • 서귀주;정진용;김호영;노운석;김봉일;송석영
    • The Korean Journal of Pain
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    • 제20권2호
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    • pp.240-245
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    • 2007
  • It is important to treat cancer-related pain in cancer patients to ensure the life quality of the patient, as well as to improve their life span. It has been estimated that at least 5% of cancer patients have pain refractory to medical treatment. Therefore, the need for epidural or intrathecal analgesia with opioids and local anesthetics is indicated if systemic treatment has failed. Intrathecal catheter placement and implantation of the injection port for administration of opioids and local anesthetics may improve pain relief in patients who are unresponsive to epidural routes. Although intrathecal implantation has several complications, similar infection rates have been reported between intrathecal and epidural administration. In addition, intrathecal administration showed better outcomes, including improved pain control, lowered daily doses, and an improvement in the level of drowsiness experienced when compared to epidural administration. We report here a case in which a terminal cancer patient was treated using an intrathecal catheter and subcutaneous port. The patient had cancer-related pain that could not be controlled by epidural opioid administration. Based on the results presented here, we suggest that intrathecal implantation is a feasible long term pain management method for intractable cancer pain patients.

변연절제 및 국소 피판술을 시행한 말기 암환자의 욕창에 대한 한의학적 치료 1례 (Korean Medicine Treatment for Pressure Injury in Terminal Stage Cancer Patients with Debridement and Local Flap: A Case Report)

  • 송주연;문지성;민선우;김학겸;김영지;안립
    • 대한한방내과학회지
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    • 제41권3호
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    • pp.478-486
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    • 2020
  • Objectives: Pressure injury is a common symptom of end-stage cancer, which impact quality of life. This case study reports on use of traditional Korean medicine in an end-stage cancer patient with pressure injury after debridement and local flap. Methods: A pressure injury with debridement and a local flap was treated using herbal medicine, a carbon arc, acupuncture, dressing, and cooperation in plastic surgery. Pressure injury was followed up with photographs. Results: On the 22nd day of treatment (26 days after the debridement and local flap), redness, swelling, and the condition of pressure injury were all improved. Moreover, the condition of the pressure injury was good without dressing. Conclusions: These results show that traditional Korean medicine may have a positive effect on a pressure injury and improve the quality of life of cancer patients. However, further study is needed to confirm these findings.

만성 신부전으로 진행된 비만 연관 사구체병증 1례 (Obesity Related Glomerulopathy Progressed to Chronic Renal Failure)

  • 안정희;윤정림;문경철;구자욱
    • Childhood Kidney Diseases
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    • 제14권1호
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    • pp.94-99
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    • 2010
  • Obesity-related glomerulopathy (ORG)는 단백뇨를 보이는 비만아에서 신장 조직학적 소견상 사구체 비대, 국소 분절성 사구체 경화 소견이 관찰되고 기저막 비후, 국소 간질조직 증식, 중등도의 발 돌기 소실 등을 보이는 질환으로 정의된다. 특발성 국소분절 사구체경화증과 비교하여 신증후군이 적으며 콜레스테롤 상승이 적고, 병의 진행이 느리다는 점에서 차이가 있다고 알려져 있으며, 체중감소를 통해 신장 기능이 회복될 수 있다고 알려져 있다. 본 증례의 9세된 비만아는 임상증상과 신장 조직검사에서 ORG로 진단되어 치료하였으나, 지속적인 체중 증가와 단백뇨로 말기 신부전으로 진행하여 소아 ORG 환아에서는 드문 경과를 취하여 이를 보고하는 바이다.

Pembrolizumab과 통합의학치료로 호전된 뇌전이 동반 말기 비소세포성 폐암 환자 1례 (A Case of End-stage non-small cell Lung Cancer Patient with Brain Metastasis Treated with Pembrolizumab with Integrative Medicine Therapy)

  • 서한길;진용재;송미화;김인태;박지혜;정준석;조성규;신광순
    • 대한암한의학회지
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    • 제23권2호
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    • pp.11-25
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    • 2018
  • Objective: The purpose of this study is to report the case of a patient with non-small cell lung cancer (NSCLC) with Programmed cell death protein 1 (PD-1) mutation treated by Integrative Medicine Therapy (IMT). Methods: A patient with metastatic NSCLC received pembrolizumab 200mg intravenously for every 3 weeks from July 2017. Repeat cycle every 3 weeks since July 2017. The patient has been treated with Integrative Medicine Therapy (IMT) since December 2016. The tumor size was measured by computed tomography (CT) and magnetic resonance imaging(MRI). Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After combined treatment, the extent of proximal portion of primary tumor in the left lower lobe was decreased and disease status was stable radiologically. No evidence of newly developed metastatic lesions in the brain since May 2017. The patient did not experience any adverse event according to NCI-CTCAE ver. 5.0. Conclusion: This case study suggests that Integrative Medicine Therapy (IMT) may contribute to tumor response, in conjunction with Pembrolizumab on the treatment of patients with NSCLC.