• Title/Summary/Keyword: 이학적 검사

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Clinical Study of Vascular Injuries (혈관 손상의 임상적 고찰)

  • Chung, Sung-Woon;Kim, Young-Kyu
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.480-484
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    • 2007
  • Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

Clinical Results after Repair of Rotator Cuff Tear in Patients with Accompanying AC Joint Pathology: Clinical Comparison of Non-operative Treatment (회전근개 파열과 동반된 견봉 쇄골 관절 병변이 회전근개 봉합술 후 결과에 미치는 영향: 비수술적 치료를 통한 임상적 비교)

  • Yoo, Moon-Jib;Seo, Joong-Bae;Lee, Dae-Hee;Kim, Sung-Jin
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.86-90
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    • 2012
  • Purpose: We studied the need for distal clavicle resection by comparing rotator cuff tear patients who underwent non-surgical treatment with and without acromioclavicular joint pathology. Materials and Methods: 45 cases that had been under follow up care for at least 9 months after receiving rotator cuff repair in our hospital between Jan. 2005 and Jun. 2011 had been studied. Acromioclavicular joint pathology group and control group were classified by physical examination and MRI findings. The temporal changes in shoulder joint abduction, internal and external rotation strength, ASES and KSS score of the two groups were measured and analyzed. Results: The acromioclavicular joint pathology complicated rotator cuff injury group's strength measurements for abduction, internal rotation, external rotation were each 8.05 (${\pm}4.54$), 11.33 (${\pm}6.05$), 10.24 (${\pm}5.27$) preoperatively and improved to 13.26 (${\pm}5.50$), 17.51 (${\pm}6.80$), 15.60 (${\pm}5.37$) post operatively while the KSS score and ASES score were each 49.07 (${\pm}15.28$) and 48.65 (${\pm}13.27$) preoperatively, improving to 84.48 (${\pm}10.96$) and 84.65. (${\pm}9.86$). The measurements for the group without complicating acromioclavicular pathology are as follows. The strength for abduction, internal rotation, external rotation was each 6.42 (${\pm}3.11$), 7.59 (${\pm}4.81$) and 7.93 (${\pm}4.49$) preoperatively, improving to 15.85 (${\pm}7.35$), 19.18 (${\pm}9.14$), 16.95 (${\pm}5.70$) post operatively, while the KSS score and ASES score each went from 42.12 (${\pm}6.43$) and 41.37 (${\pm}7.42$) to 83.44 (${\pm}6.30$) and 83.17 (${\pm}7.01$) respectively. The measurements for the two groups, however, did not show a statistically significant difference (p>0.05). Conclusion: Analysis of the rotator cuff injury groups with and without AC joint pathology showed that both groups had improved strength, ASES and KSS scores with no statistical difference difference among the groups. As such, it thought that conservative treatment is an acceptable alternative to distal clavicle resection.

Clinicopathological Correlation of Intralobar Pulmonary Sequestration (내엽성 폐격리증의 임상적 특성과 조직병리학적 소견의 연관성)

  • Cho, Hyun-Min;Shin, Dong-Hwan;Kim, Kil-Dong;Lee, Sak;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.356-362
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    • 2003
  • Background: Intralobar and extralobar pulmonary sequestrations have been considered as congenital lesions that occur at different stages of embryonic life. However, most cases of intralobar pulmonary sequestration (IPS) seem to have an acquired origin, as they are absent in infants and associated anomalies are relatively, uncommon among them. Material and Method: The cases of 25 patients who were diagnosed as IPS after surgical resection from December, 1985 to July, 2002 were included in this study. The medical records wire retrospectively reviewed and the clinical characteristics were age at operation; gender; symptoms at presentation; presence of congenital anomalies; combined diseases; preoperative studies and diagnosis; location of the lesion; method of surgical resection; origin, size and numbers of aberrant artery; histopathological findings; and postoperative complications. Result: There were 17 (68%) female patients and 8 (32%) male patients, their ages ranged from 1 to 57 and mean value was 23 years old. Though 14 patients (56%) complained of respiratory symptoms such as pneumonia and recurrent respiratory infections, a large number of patients (44%) were asymptomatic or had chest pain only when the lesion was discovered. Only 8 patients (32%) were diagnosed as pulmonary sequestration preoperatively and 8 (32%) were suspected as mediastinal or lung tumor, 5 (20%) were congenital or acquired cystic lung disease, and 4 (16%) were lung abscess or bronchiectasis, respectively. The majority of aberrant arteries (86.4%) confirmed during the operation were originated from thoracic aorta and 2 were thoracic and abdominal aorta, 1 was abdominal aorta, respectively. The younger patients (less than 10 years old) had more other congenital anomalies (30% vs 6.7%) but the proportion of congenital IPS was not significantly different (10% vs 6.7%, p>0.05) compared with elder patients. Histopathologically, almost all lesions showed chronic inflammation, cystic changes and similar pleural adhesions regardless of age. Conclusion: The large portion of the patients with IPS (44%) was clinically asymptomatic or presented non-respiratory symptoms at diagnosis and likely to be diagnosed as mediastinal or lung tumor especially in elder patients. Though the younger patients had more other congenital anomalies, most cases of IPS proved to be acquired lesions in terms of the histopathlogical findings and the proportion of congenital evidences.

Postoperative Complications After Arthroscopic Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft (자가 슬개건을 이용한 전방 십자 인대 재건술의 수술 후 합병증)

  • Zhu, Fang Zhen;Yoo, Moon-Jib;Kim, Myung-Ho;Park, Hee-Gon;Bahng, Seung-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.122-127
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    • 2008
  • Purpose: Evaluation and analysis of the incidence of postoperative complications after arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft. Materials and Methods: We reviewed 172 cases of arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft in anterior cruciate ligament tear without meniscal injury. We performed Lysholm knee score and KT-2000 testing, simple radiograph, physical examination as evaluation factor. Also, around knee pain, swelling, limitation of motion, patellofemoral crepitation, paresthesia and pain on kneeling were evaluated. Results: The average follow up period was 49.8 months. In 172 patients, 148 males and 26 femlaes were evaluated. The average age was 34.4 years. The Lysholm knee score improved from 51.9 points preoperatively to 90.8 points at final follow up. Clinical outcome was excellent in 83%, good in 11%, fair in 4% and poor in 2%. There were many cases of complications, 24 cases (14%) of around knee pain, 12 cases (7%) of swelling, 45 cases (26.2%) of patellofemoral crepitation, 52 cases (30%) of donor site paresthesia, 65 cases (38%) of pain on kneeling, 10 cases (5.8%) of limitation of motion at extension, 13 cases (8%) of limitation of motion at flexion and 2cases (1.2%) of patellar fracture. Conclusion: Although arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone had good clinical results, many complications were noted. Some factors in surgical technique were suspected to be related to the complications and long term follow up will be necessary to further evaluated.

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Comparison of Results of ACL Reconstruction According to the Fixation Materials (Metal & Bioabsorbable Interference Screw and RIGIDfix) (금속, 흡수성 간섭 나사못 및 RIGIDfix를 이용한 전방 십자 인대 재건술의 결과 비교)

  • Lim Hong Chul;Wang Joon Ho;Rho Young Jin;Hwang Jin Ho
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.206-214
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    • 2003
  • Purpose : To analysis each clinical results after arthroscopic ACL reconstruction with using variable fixatives which are metallic and bioabsorbable interference screw, and RIGIDfix. Therefore, We reported the clinical reliability and safty of ACL reconstruction using RIGIDfix. Materials and Methods : We evaluated the results of arthroscopic ACL resconstruction with patellar tendon autograft among three groups, of which group 1 is used metal interference screw for 44 patients, group 2 used bioabsorbable interference screw for 47 patients, group 3 used RIGIDfix for 42 patients. We compared the clinical results by physical examination (anterior drawer test, Lachman test and pivot shift test), Lysholm score and KT-2000 arthrometer and compared the radiological results by measurement of tunnel and fixatives position and widening and by MRI findings. We analyzed the results by SAS 8.2 Ducan. Tukey and paired t-test Results : Physical instability was in 5 cases, which group 2 had 4 cases and group 3 had 1 case. Lysholm score improved from 59.8. 64.4, 61 to 90.1, 92.3. 92. KT-2000 arthrometer instability improved from 9.20, 10.2, 9.5 to 1.43. 1.62. 2.00 (p=0.478). Radiologically, all cases had excellent tunnel position and cyst change was observed the 8 cases in the group 2, but, all 20 cases 2nd MRI had signal change of peri-fixatives. But, no correlation of clinical results. Conclusion : No statistical difference of clinical instability was found among three groups. And femoral tunnel changes were much observed in group I, II than III. We considered the RIGIDfix has much advantages because the short operation time, better fixation position and much bone contact surface. But, further long term follow up study was needed.

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Thallium-201 SPECT in the Evaluation of Postoperative Tumor Recurrence on the Chest Wall in Lung Cancer (폐암 수술 후 흉벽의 종양 재발 검출에 있어 Tl-201 폐 SPECT의 유용성)

  • Ryu, Young-Hoon;Kim, Hyung-Jung;Ahn, Chul-Min;Kim, Se-Kyu;Paik, Hyo-Chae;Lee, Doo-Yun;Chung, Kyung-Young;Yune, Min-Jin;Park, Sang-Jung;Moon, Sung-Wook;Kim, Sang-Jin;Lee, Jong-Doo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.542-549
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    • 2002
  • Purpose : The purpose of our study was to assess the usefulness of the Tl-201 SPECT for the detection of the postoperative tumor recurrence on chest wall. Methods: 28 patients including 14 with suspected recurrence of tumor in the chest wall on postoperative chest cr scan, 10 with postoperative pleural effusion which proved benign on radiologic, cytologic and laboratory findings, and 4 with chronic tuberculous empyema as control group were included. All patients underwent SPECT 30 minutes and 4 hours after intravenous injection of 111MBq of Tl-201. Tumor uptake was visually graded by two interpreters and scored as follows : no uptake:0, similar to contralateral lung: 1, higher than contralateral lung but less than heart:2 and similar to heart:3. Results : Markedly increased (grade 3 or 2) Tl-201 uptake was noted in patients with suspected recurrence of tumor in the chest wall (13/14) whereas no (8/10) or minimal (2/10) uptake along the collapsed lung in patients with postoperative benign pleural effusion. In two patients, Tl-201 SPECT revealed additional recurrent tumor mass lesions that were barely perceptible on chest cr scan. Patients with chronic tuberculous empyema showed relatively smoothly marginated increased uptake along the chest wall 4/4), but lesser in degree (grade 1 or 2), when compared to recurrent tumor uptake. Conclusion : Tl-201 lung SPECT seems to be useful to detect postoperative tumor recurrence on chest wall and to differentiate malignant from benign pleural effusion and may provide additional information to the morphologic data obtained by CT.

Acetabular Labral Tear in Sports Injury (스포츠 손상에서의 비구순 파열)

  • Hwang Deuk-Soo;Rhee Kwang-Jin;Kwon Youk-Sang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.15-20
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    • 2002
  • Purpose: The purpose of this study is to evaluate diagnosis and treatment of acetabular labral tears in sports injuries. Materials and Methods: From March 1995 to January 2000, We treated 15 patients with acetabular labral tear by sports injuries. There were 6 men and 9 women. Mean age was 41 years old. Running injuries are 5 cases, fighting 3, aerobic exercise 3, swimming 2, climbing 1, bicycle 1. For conservative treatment, we performed medication and observation at least for 1 year. For the patients with arthroscopic surgery, we performed Harris Hip Score (pain and function) preoperatively and postoperatively at 6, 12 months, and evaluated patient’s pain by JOA pain scoring system and postoperative subjective satisfaction. Results: The mean score of HHS improved 15 points with conservative treatments and 32 points with hip arthroscopy. In 4 cases of conservative treatment, there was 1 scale improvement of JOA pain scoring system. In arthroscopic partial labrectomy, all cases were improved to more than 2 scale. Conclusion: We considered that acetabular labral tears occurred associated with sports injuries. So it is important to be interested in enthusiastic diagnosis and appropriate treatment for hip pain caused by sports injuries, especially about acetabular labral tears.

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Phonetic improvement by adjusting the shape of the anterior palate of the maxillary complete denture: a case report (상악 총의치 전방 구개 부위 형태 조정을 통한 발음개선 증례)

  • Yoon, Myeong Ah;Lee, HagYoung;Kim, Jee Hwan
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.37-43
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    • 2022
  • Patients tend to return to normal pronunciation patterns after fitting new dentures. However, for some patients, it takes a long time to adapt the new complete denture. In this case, the patient came to the hospital at the address of wanting to remake dentures due to wear and tear. After diagnosis through clinical and radiological examination, the maxillary complete denture and mandibular removable partial denture were remade. The patient complained whistling /s/ sound at the first check-up after placement of the new denture. The anterior palatal area of polished surface of the new maxillary complete denture was concave comparing to old denture, and this was the cause of the whistling /s/ sound. A tissue conditioning material was applied to the maxillary complete denture and patient made /s/ sound. The tissue conditioning material was replaced with self-curing type denture base resin, and the patient was immediately satisfied with clear /s/ sound. As an objective assessment, palatogram and speech analytics software was applied. In this case, a patient who received denture treatment complaining of difficulty in pronunciation underwent immediate denture repair, which resulted in patient satisfaction and improved pronunciation through objective evaluation.

Clinical Estimation of Corrected State with Change in Vertex Distance (정점간거리 변화에 따른 교정상태의 임상 평가)

  • Kim, Jung-Hee;Lee, Hak-Jun
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.1
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    • pp.25-30
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    • 2010
  • Purpose: This study was conducted to estimate the changes of corrected diopter and corrected visual acuity with the change in vertex distance. Also we aimed to provide basic data for refraction test. Methods: Using the trial lens, we measured the corrected diopter and corrected visual acuity after performing binocular balance test. We measured the changes of corrected diopter and corrected visual acuity in change of vertex distance. We analyzed statistical significance and relations between vertex distance and corrected diopter and corrected visual acuity. Results: There was no difference in corrected diopter with the change of vertex distance within -1.00D, but the corrected diopter increased with it over - 1.25D. In particular, the change of diopter was largest when the vertex distance increased 15 mm. At over 11.00D, there was large changes of diopter with the changes of vertex distance at 5 mm, 10 mm and 15 mm. On correlation analysis between the vertex distance and the corrected diopter, there was strong correlation (r=0.999 at 5 mm increase of vertex distance, r=0.982 at 10 mm increase and r=0.957 at 15 mm increase) and also there was significant (p<0.01). At the change of visual acuity in increased of vertex distance, the range of a decrease in visual acuity was large when the changes of vertex distance was largest. On correlation analysis between the vertex distance and the corrected visual acuity, there was strong correlation (r=0.969 at 5 mm increase of vertex distance, r=0.985 at 10 mm increase and r=0.994 at 15 mm increase) and also there was significant (p<0.01). Conclusions: The vertex distance was very important at the refraction test and at wearing spectacle. On correlation analysis between the vertex distance and the corrected diopter, and the corrected visual acuity, there was strong correlation and statistically significant. Therefore, the vertex distance should be kept at the refraction using trial lens, and the best fitting was made not to slipping forward, and so we suggested regular refitting of spectacle and the managing method of spectacle were educated to the spectacle wearers.

Safety Evaluation of Ethanol Extract from Unripe Fruit of Bitter Melon (Momordica Charantia L.) in Sprague-Dawley Rats (랫드를 이용한 여주 추출물의 안전성 평가)

  • Ryu, Hyeon Yeol;Lee, Somin;Ahn, Kyu Sup;Yong, Yeon;Kim, Hye Jin;Kim, Seong-Eun;Lee, Hak Sung;Hong, Su-Young;Kim, Hyun-Kyu;Hwang, In Guk;Song, Kyung Seuk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.4
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    • pp.490-500
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    • 2017
  • This study was performed to evaluate repeated dose oral toxicity upon administration of the test substance 1,2-benzisothiazolin-3-one for 90 days and to determine NOAEL (no observed adverse effect level) and target organs in Sprague-Dawley rats. Single, 2-week repeated, and 13-week repeated oral dose toxicity studies were conducted in Sprague-Dawley rats. The dose levels of groups were 1,250, 2,500, and 5,000 mg/kg/d. All dose groups were compared with the vehicle control group. The animals were observed for clinical signs and weekly body weight. Urinalysis, hematology, and serum biochemistry analyses were conducted. Subsequently, animals were sacrificed and subjected to histopathological examination. For the result, NOAEL of ethanol extract from unripe fruit of bitter melon had an optimal dose of 5,000 mg/kg/d and acceptable daily intake up to 3,000 mg/man. There was no target organ detected. Therefore, bitter melon, which contains a variety of bioactive substances, could be widely used as a health functional food ingredient.