• Title/Summary/Keyword: 치료원칙

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Interventional Treatment of Chemical Pleuritis and Hemothorax Caused by Iatrogenic Internal Jugular Vein Perforation after Central Venous Port System Implantation: A Case Report (중심정맥포트 삽입 후 의인성 속목정맥 천공에 의한 화학적 늑막염과 혈흉의 중재적 치료: 증례 보고)

  • Do Woo Kim;Young Hwan Kim;Ung Rae Kang
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1459-1465
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    • 2020
  • The perforation of the intrathoracic internal jugular vein during the placement of an implantable central venous chemoport is a rare complication that is manifested by hemothorax or hemorrhagic shock. Furthermore, inappropriate instillation of a chemotherapeutic agent in the chemoport can cause chemical pleuritis, and the diagnosis of these complications prior to the instillation of chemotherapeutic agents and open thoracic surgery is mandatory. We report a patient with chemical pleuritis and hemothorax following an inappropriate instillation of a chemotherapeutic agent, through the perforated right internal jugular vein after placement of an implantable central venous chemoport. Treatment by embolization using coils and N-butyl cyanoacrylate, after percutaneous drainage, was successful.

Management Principles of Bilateral Vocal Fold Immobility (양측성 성대 마비의 치료 원칙)

  • Kim, Tae-Wook;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.2
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    • pp.118-125
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    • 2009
  • Bilateral vocal fold immobility (BVFI) is a challenging condition which may result from diverse etiologies including vocal fold paralysis, synkinesis, cricoarytenoid joint fixation, and interarytenoid scar. Most patients present with dyspnea and stridor, but sometimes with a breathy dysphonia. Careful history taking, laryngoscopic evaluation under general anesthesia or awaken status, laryngeal EMG, and imaging studies with CT and/or MRI are helpful for providing a precise diagnosis and planning appropriate managements. In children, congenital neurological disorder is one of the most common etiologies, and spontaneous recovery has been reported in more than 50% of cases. Therefore, observation for more than 6 months while securing the upper airway with tracheostomy if needed is a generally accepted rule before deciding any destructive procedure to be undertaken. In children with advanced posterior glottic stenosis, laryngotracheal reconstruction with rib cartilage graft should be considered. In contrast to children, BVFI most commonly occurs as sequalae of surgical complication in adults. Diverse static or dynamic procedures can be applied; posterior cordotomy, vocal fold lateralization, endoscopic or open arytenoidectomy, arytenoid abduction, and reinnervation, electrical laryngeal pacing, which need to be carefully selected according to each patient's needs and pathophysiology of BVFI.

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Rapidly Progressed Primary Choriocarcinoma of the Lung (급격히 진행한 원발성 폐 융모막 암종)

  • 장성욱;박정옥;이계영;이원애;류재욱;박성식;김삼현;서필원
    • Journal of Chest Surgery
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    • v.37 no.9
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    • pp.805-808
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    • 2004
  • A 69-year-old man was admitted due to blood-tinged sputum. The preoperative examination revealed 5${\times}$2.8cm sized nodular mass on left upper lobe of the lung. The patient underwent left upper lobectomy and radical Iymph node dissection under impression of lung cancer. Postoperative pathologic examination revealed as primary choriocarcinoma of the lung. The patient expired at postoperative 58 days despite meticulous postoperative care. We planned on immediate adjuvant chemotherapy but was delayed due to postoperative pneumonia and the choriocarcinoma progressed rapidly. Primary choriocarcinoma is an extremely rare clinical entity in lung cancer with no established therapeutic guidelines available. We report a case of the primary pulmonary choriocarcinoma which was diagnosed postoperatively.

Primary Hemangiopericytoma of the Lung -1 Case Report - (폐에 발생한 원발성 혈관주위세포종 -1례 보고-)

  • 최광민;김건일;신호승;박희철;홍기우
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.315-318
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    • 1998
  • Primary hemangioperiycytoma is quite rare tumor of the lung and arising from pericyte in external layer of capillaries. Most cases are developed in 4th and 5th decade, are asymptomatic, and have malignant otential. On chest radiography, primary pulmonary hemangiopericytoma shows lobulated, well demarcated, homogeneous soft tissue density. Microscopically, it consisits of numerous vascular spaces of variable size and shape separated by aggregates of tightly packed oval to spindle-shaped cells. Treatment of choice is surgical excision. We report a case of primary pulmonary hemangiopericytoma in a 16-year-old man who had well demarcated homogeneous mass in the superior segment of left lower lobe, but had no symptom. He had undergone left lower lobectomy. He has been followed up for 8 months but has no sign of relapse or metastasis yet.

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Delayed Bronchoplasty in Complete Transection of Left Main Bronchus after Blunt Trauma (외상성 좌측주기관지 절단환자의 지연수술 치험)

  • 김명천;이재영;조규식;박주철;유세영
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.182-185
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    • 1998
  • Recently, The non-penetrating injury of bronchus has been increased, especially by traffic accident. Early diagnosis and primary repair of bronchial injury not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. This report describes about a case of total collapse and consolidation of left lung with the complete transection of nearly bifurcated portion of left main bronchus , lasted for 2weeks after traffic accident. This was diagnosed by fiberbronchoscopy and 3-D chest computed tomography(CT). She underwent the sleeve resection and end to end anastomosis, and postoperative PEEP for 2 days, suctioning twice by fiberbronchoscopy, continue postural drainge and physiotherapy were applied. She had almost full expansion of the left lung at discharge.

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The comparative study on the metabolism of water-diseases and its' fundamental rule of treatment - Based on the formation of Dongeubogam - (수액질환(水液疾患)의 병기(病機) 및 치료원칙(治療原則)에 대한 비교고찰 - "동의보감(東醫寶鑑)"의 편제(編制)를 중심으로 -)

  • Back, Sang-Ryong
    • Korean Journal of Oriental Medicine
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    • v.9 no.1
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    • pp.65-79
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    • 2003
  • Many of the diseases that occur in a life being are either closely related to water, or they occur by loss or deterioration of water metabolism. There are six parts of study on this subject in ${\ulcorner}$Dongeubogam${\lrcorner}$. The parts are, the part of Jinaek the part of Dameum the part of Sobyeon the part of Bujong the part of Changman and the part of Seub. In these parts, it mentions loss of perspiration, abnormal urination, edema, abdominal dropsy, formation of abnormal body fluid and intrusion of dampness into the body and etc as the abnormal water metabolism. Loss of perspiration and urination is a process of eliminating the dampness in the body. Perspiration would be the abnormality of yanghwa[陽化]. Urination would be the loss of eumhwa[陰化]. Eum[飮] is the fluid accumulated in the body that failed to go through the process of Cihwa[氣化]. Dam[痰] is formed when the body fluid is heated by the smoking-fire. Meanwhile, the dampness occurs when the water penetrates into the bones, muscles and joints. Edema and abdominal dropsy are both outcomes of accumulated body fluid. Edema is the liquified body fluid congested on the surface or the peripheral ends of the body. Abdominal dropsy is congestion of fluid, that lost the characteristic of blood due to blood deterioration, in the abdominal part.

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Extraction of an Infected Permanent Pacemaker Lead Using Cardiopulmonary Bypass - 2 case reports - (체외 순환을 이용한 감염된 영구 심박동기 도선의 제거 - 2예 보고 -)

  • Oh, Tak-Hyuck;Kim, Gun-Jik;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.86-88
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    • 2010
  • Implanting a pacemaker is the most often used intervention for treating bradycardia. The most commonly used pacemaker is the intracardiac pacemaker, yet it can have many complications. An infected pacemaker can spread to systemic infection and the condition of the patient can quickly get worse, so if an infected pacemaker is suspected, then the pacemaker must be removed. Apart from the use of interventional methods such as a loop or a weight, we can take a more aggressive approach by using extracorporeal circulation for removal of the pacemaker. We report here on two cases in which extracorporeal circulation was used to remove the infected pacemakers.

Bleomycin Sclerotherapy of Lymphatic Maformation in Head and Neck (Bleomycin을 이용한 선천성 림프관기형의 경화요법)

  • 성명훈;장선오;정종우;김진영
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.108-108
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    • 1993
  • Cystic hygroma is a congenital anomaly of the lymphatic system for which the exact pathogenetic mechanism remains to be elucidated. It is filled with lymphatic fluid and commonly present in the cervical area in either single isolated or multiple form. It is usually innocuous without any pain but may be life-threatening when it is large enough to compromise the airway or interfere with swallowing. Since spontaneous regressions rarely occur, it requires surgical removal. However, this may be rendered difficult in multiple forms and in those with extensive infiltration into the surrounding tissue. This is a presentation of 10 pediatric patients with cystic hygroma who have been successfully treated by sclerotherapy using bleomycin at the authors' department.

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Treatment of soft Tissue Sarcoma by General Orthopedic Surgeon Rather than Orthopedic Oncologist (골연부조직 종양 전공자가 아닌 일반 정형외과 전문의에 의해 치료된 연부조직육종)

  • Lee, Soon-Hyuck;Park, Jong-Hoon;Park, Sang-Won;Choi, In-Chung;Han, Seung-Beom;Lee, Suk-Ha;Kim, Ho-Joong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.75-80
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    • 2007
  • Purpose: To investigate the quality of training hospital based treatment, we evaluated the soft tissue sarcoma treatments afforded by general orthopedic surgeon rather than orthopedic oncologist. Materials and Methods: We reviewed the details of 25 patients with pathologically confirmed soft tissue sarcoma who registered in our hospital between July 1997 and 2006 September. We evaluated initial diagnoses, the surgical treatment (including adjuvant therapy) and the follow up method used and related these to the principles of soft tissue sarcoma treatment. Results: The study cohort comprised 16 men and 9 women of mean age of 50.2 years. A diagnostic biopsy was performed in 9(36%) cases before definitive surgical treatment. Wide excision was performed in 13(52%) cases. For the 12 cases in which the grade of sarcoma was estimated, adequate surgical treatment with adjuvant therapy was performed only in 4(33.3%) cases. In addition, an adequate follow up schedule was adopted in only 4(16%) of the 25 study subjects. Conclusion: Unexpectedly, many cases of soft tissue sarcoma were treated inadequately even in a training hospital. An intensive education program on the treatment of soft tissue sarcoma is necessary for all orthopedic surgeons.

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Removal of Entrapped Pacemaker Electrode - One Case Report - (올가미를 이용한 영구 심박조율기 유도전극의 제거 -1 례 보고-)

  • 이인규;성시찬;우종수
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.668-670
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    • 1999
  • The most important indication for the removal of the lead-electrode system is the presence of an infection. When an infection occurs, the entire pacemaker system including the impluse generator and lead-electrode system should be removed. The entrapped electrode can be removed by a continous traction, by the use of forceps, snares or baskets, by the use of a locking stylet or a dilator sheath, and by an operation. We report a case that underwent a removal of an entrapped transvenous pacemaker electrode by the use of snaring technique.

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