• Title/Summary/Keyword: 컴퓨터단층촬영검사

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Surgical Treatment of Acute Necrotizing Klebsiella Pneumonia -Two cases report- (급성 괴사성 클렙시엘라 폐렴의 외과적 치료 -2례 보고-)

  • 류경민;김삼현;박성식;류재욱;최창휴;박재석;서필원
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.484-488
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    • 1999
  • Massive lung gangrene is a rare but very rapidly progressing fatal complication of lobar pneumonia. Etiologic agents are Klebsiella pneumoniae, Pneumococcus and Aspergillus, etc. Chest X-ray shows firm consolidation of the involved pulmonary lobe and bulging fissure due to the volume expansion of involved lung. CT-scan shows extensive lung parenchymal destructions with multiple small cavitary lesions. Recommended treatment is the early surgical intervention combined with antibiotics. Without surgical intervention, lung gangrene is known to progress toward sepsis, multiorgan failure, and high mortality. We report two cases of rapidly progressing massive lung gangrene by Klebsiella pneumonia treated by the resectional surgery.

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A Case about Cyclosporine Treatment of Kimura's Disease Associated with Steroid Dependant Nephrotic Syndrome (스테로이드 의존형 신증후군과 동반된 기무라병에서 cyclosporine 치료 경험)

  • Do, Young-Sun;Kim, Hak-Yong;NamGoong, Mee-Kyung
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.271-277
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    • 2009
  • Kimura's disease is a chronic inflammatory disorder of unknown etiology. A 14 year old boy suffering from steroid dependant nephrotic syndrome, was presented with relapsing painless subcutaneous masses on the left buccal area. Blood analysis showed increased IgE and eosinophilia. During 4 years follow up, he was been treated by low dose steroid and short term cyclosporine. Consequently, frequent relapses of subcutaneous masses and nephrotic syndrome has been relieved. Cyclosporine treatment combined with steroid may be useful for preventing frequent relapse of Kimura's disease.

Primary Leiomyosarcoma of the Left Lower Posterior Chest wall with Lung Metastasis - One Case Report - (폐 전이를 동반한 원발성 흉벽 평활근육종 - 1례 보고 -)

  • 김대현;김범식;박주철;조규석
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.764-767
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    • 2002
  • An unusual case of primary leiomyosarcoma at the left lower posterior chest wall with metastasis to the right lung parenchyme is presented. The patient was a 43-year-old man who was asymptomatic but a slow growing hard mass was noted at the left lower posterior chest wall. The chest computed tomography showed a tumor at the left lower posterior chest wall with multiple metastasis to the right lung. The left lower posterior chest wall mass was examined by percutaneous needle aspiration and it was revealed as rhabdomyosarcoma histologically. En bloc resection to the left lower posterior chest wall tumor and metastasectomy to the multiple nodules in the right lung were done and pathological examination finally revealed primary leiomyosarcoma at the left lower posterior chest wall with multiple metastasis to the right lung. Chemotherapy was scheduled as adjunctive measure.

Descending Necrotizing Mediastinitis Caused by Yeast -A case report- (이스트에 의한 하행 괴사성 종격동염 -치험 1예-)

  • 윤영철;김성룡;전희재;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.386-389
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    • 2004
  • Descending nectorizing mediastinitis (DNM). represents a virulent form of mediastinal infection requiring prompt diagnosis and treatment to reduce the high morbidity mortality associated with this disease. Intr. avenous broad-spectrum antibiotic therapy alone is not efficient without adequate surgical drainage of the cervical and mediastinal collections, extensive debridement and excision of necrotic tissue, and wide mediastino-pleural irrigation. A 38-year-old man admitted via emergency room with painful left neck swelling and uncontrolled high fever. Chest computed tomogram showed left paratracheal abscess descending into the superior and anterior mediastinum. Transcervical mediastinal drainage was performed with 26 Fr. chest tube and left paratracheal drainage was performed with Penrose drain in urgency. Culture and sensitivity test grew Yeast. The drains removed via gradually shortening on day 39 after surgery.

A Female Infant with Segmental Multicystic Dysplastic Kidney (분절형 다낭성 이형성신 영아 보고 1례)

  • Lee, Jun Ho;Kim, Moon Kyu
    • Childhood Kidney Diseases
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    • v.17 no.1
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    • pp.25-28
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    • 2013
  • There have only been 35 pediatric cases and one adult case reported on segmental multicystic dysplastic kidney (MCDK) from our search in PubMed, including 19 cases detected antenatally. There is little documentation of segmental MCDK, particularly concerning its natural history. Segmental MCDK can be presented atypically, making diagnosis more difficult. We report an another case with segmental MCDK. Multicystic abdominal mass detected on antenatal sonogram in this infant was diagnosed as segmental MCDK by renal ultrasonography and computed tomography. If a definitive diagnosis of segmental MCDK can be made on imaging, surgery is not required for a diagnostic biopsy.

A Case of Pyogenic Liver Abscess Caused by Staphylococcus epidermidis in a Healthy Child (건강한 소아에서 발생한 Staphylococcus epidermidis에 의한 화농성 간농양 1례)

  • Gwak, Ji Hye;Eem, Yeun Joo;Choi, Ui Yoon;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.20 no.1
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    • pp.36-40
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    • 2013
  • Staphylococcus epidermidis is a normal inhabitant of skin, throat, mouth, vagina, and urethra. It is not usually pathogenic, particularly in immunocompetent hosts. This report describes a case of a pyogenic liver abscess caused by Staphylococcus epidermidis in a healthy 12-year-old boy. He was admitted to Seoul St. Mary's Hospital with intermittent fever for 6 days. Findings on abdominal computed tomography (CT) showed a mass measuring $7.0{\times}6.5$ cm in the right hepatic lobe. Culture of the abscess resulted in growth of Staphylococcus epidermidis as a causative organism. The patient was successfully treated with intravenous administration of antibiotics and percutaneous drainage of the abscess.

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Middle Lobe Syndrome Caused by Occult Foreign Body in the Bronchus Intermedius -A case report- (중간기관지 내 잠복이물에 의할 중엽증후군 -1예 보고-)

  • Lee Seung-Jin;Oh Jae-Yoon;Lee Cheol-Sae;Lee Kihl-Rho;Lee Seock-Yeol
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.498-501
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    • 2006
  • Occult bronchial foreign body is that long-standing foreign body lodge in bronchial tree. A 63-year-old male was admitted our hospital complaining of a cough. Chest computerized tomography and bronchoscopy showed collapse of right middle lobe and foreign body in the bronchus intermedius. After open thoracotomy and bronchotomy, foreign body was removed and collapsed middle lobe was ventilated. Herein we report a case of middle lobe syndrome caused by occult foreign body in the bronchus intermedius.

Mediastinal Lymphangioma - A case report - (종격동 림프관종 - 1예 보고 -)

  • Kim, Dae-Hyun;Kim, Soo-Cheol;Cho, Kyu-Seok
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.392-394
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    • 2007
  • A 14-year-old male patient was admitted for an abnormal chest X-ray. A chest computed tomogram showed a cystic mass in the anterior mediastinum and spleen, $14\times14cm$ and $2\times2cm$ in size respectively. Complete removal of the mediastinal lesion was achieved by a median sternotomy. The final histologic diagnosis of the lesion was cystic lymphangioma. There was no evidence of tumor recurrence until a postoperative period of 14 months.

Pseudoaneurysm of Tibioperoneal Trunk of Tibial Artery Caused by Minor Blunt Trauma (경한 둔상에 의하여 발생한 경골 동맥의 경골비골동체의 가성동맥류)

  • Suh, Seung-Pyo;Hwang, Seok-Ha;Hong, Sung-Ha;Kim, Jae-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.431-435
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    • 2020
  • Pseudoaneurysm which is usually caused by high energy trauma or penetrating injury results in serious complications if the diagnosis is delayed. The authors experienced a 63-year-old patient who slipped on the stairs with simple contusion and skin laceration. But, he was finally diagnosed with pseudoaneurysm of tibioperoneal trunk of tibial artery on magnetic resonance imaging and 3-dimensional computed tomography angiogram performed in two weeks due to aggravation of the symptoms. To the best of my knowledge, pseudoaneurysm of tibio-peroneal trunk caused by minor blunt trauma has not been reported till now in Korea. So we report this case with a review of the relevant literature.

Spatial Relationship of the Left Ventricle in the Supine Position and the Left Lateral Tilt Position (Implication for Cardiopulmonary Resuscitation in Pregnant Patients) (앙와위와 좌측 기울린위치에서의 좌심실의 공간적 관계 변화. 임신부 심폐소생술 측면에서)

  • Yun, Jong Geun;Lee, Byung Kook
    • Fire Science and Engineering
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    • v.27 no.5
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    • pp.75-79
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    • 2013
  • Application of the left lateral tilt position has been recommended during cardiopulmonary resuscitation (CPR) of pregnant patients. However, the left lateral tilt could displace the left ventricle (LV) besides the gravid uterus and may compromise the cardiac pump mechanism of CPR. Thus, we investigated the effect of left lateral tilt on the spatial relationship between the anterior-posterior axis (AP axis), which represents the direction of sternal displacement during CPR, and the LV. We retrospectively reviewed the medical records and multidetector computed tomography (MDCT) scans of 90 patients who underwent virtual gastroscopy using MDCT. Virtual gastroscopy was performed with the patient both in the left lateral tilt position and in the supine position. On an axial image showing the maximal area of the LV, the angle between the AP axis and the LV axis ($Angle_{AP-LV}$), the shortest distance between the AP axis and the mid-point of LV cavity ($D_{AP-MidLV}$) and the shortest distance between the AP axis and the LV apex ($D_{AP-Apex}$) were measured. In the supine scans, the LV was situated on the left side of the AP axis in 87 patients (96.7%). On the left lateral tilt scans, the mean tilt angle was $43.4{\pm}11.0^{\circ}$. $D_{AP-MidLV}$ and $D_{AP-Apex}$ were significantly longer in the left lateral tilt position (p<0.001), but $Angle_{AP-LV}$ was comparable between the positions. This study indicates that the left lateral tilt position may compromise the cardiac pump mechanism of chest compression in pregnant cardiac arrest patients.