• Title/Summary/Keyword: 폐쇄성 내만

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Mitral Insufficiency due to Isolated Cleft Mitral Valve in Anterior Mitral Leaflet - A case report- (단독 승모판막 전소엽 열구로 인한 승모판막폐쇄부전 -1예 보고-)

  • Ko Moo Sung;Kwon Oh Choon;Ahn Wook Su;Lee Sub;Bae Chi Hoon;Park Ki Sung
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.319-322
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    • 2005
  • A 45 year-old man who suffered with palpitation and dyspnea for 3 years visited our hospital. He was dianosed as mitral insufficieny due to isolated cleft mitral valve in anterior mitral leaflet on the basis of transthoracic echocardiogram In our case edges of the cleft were relatively thin and smooth. The entire length of the cleft was sutured with 5-0 Prolene? interrupted sutures. We report a case of direct suture repair in a patient with isolated cleft in anterior mitral valve leaflet.

Bronchiolitis Obliterans Organizing Pneumonia as the First Manifestation of Polymyositis (다발성근염의 선행증상으로 나타난 폐쇄성 세기관지염 기질화 폐렴)

  • Lee, Jong-Hoon;Son, Choon-Hee;Jeong, Won-Tae;Lee, Ki-Nam;Lee, Young-Hoon;Choi, Pil-Jo;Jeong, Jin-Sook;Lee, Chang-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.89-95
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    • 1999
  • Bronchiolitis obliterans organizing pneumonia (BOOP) preceding polymyositis is rare. In this report, a 40-year-old patient with fever, chillness, generalized myalgia and progressive exertional dyspnea, had bilateral interstitial infiltrates on chest radiograph. High-Resolution CT showed subpleural and peribronchial distribution of airspace consolidation. Open lung biopsy was consistent with BOOP. Prednisolone therapy led to improvement, but during tapering of prednisolone for 3 months to 30 mg, he complained of weakness of both lower legs. One month later, prednisolone was tapered to 15 mg a day, fever. chillness and generalized myalgia were recurred. He complained of weakness of both arms. The creatine kinase (CK) with MM isoenzyme, lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) were elevated. Anti-Jo1 antibody was positive. Vastus lateralis muscle biopsy was compatible with polymyositis. After injection of methylprednisolone for 1 week, the patient became afebrile, the dyspnea resolved, the pulmonary infiltrates decreased, and the muscle strength improved. The serum CK, LDH, AST levels declined significantly. Patients with idiopathic BOOP should have follow-up for the possible development of connective tissue disorders including polymyositis.

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Osteoporosis in Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환에서의 골다공증에 관한 연구)

  • Kim, Seong-Ja;Lee, Young-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.90-96
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    • 1999
  • Background : Osteoporosis has been reported in patients with chronic obstructive pulmonary disease, but this association is not well established. This study was undertaken to determine whether the prevalence of osteoporosis was increased in patients with chronic obstructive pulmonary disease and we examined the relationship of corticosteroid administration with osteoporosis. Method: Subjects were 23 patients with chronic obstructive pulmonary disease and 20 control patients. We reviewed hospital records and measured bone mineral density using dual-energy x-ray absorptiometry(Lunar. USA). Results: Mean bone mineral density(BMD) of spine in COPD group was $0.683{\pm}0.154 g/cm^2$ and $0.971{\pm}0.212g/cm^2$ in controls(p<0.01). But there was no significant difference in femoral neck BMD. There were seventeen cases of osteoporosis and six cases of osteopenia in COPD group and three patients of osteoporosis and one case of osteopenia in controls. But, there was no significant correlation between disease duration of COPD and spinal T score(r=-0.395, p>0.05). Ten patients were received corticosteroid in COPD group. Spinal T score in steroid receiving patients were $-3.82{\pm}0.94(SD)$ and $-2.82{\pm}0.97(SD)$ in not having steroid patients(p<0.01). Cumulative dose of corticosteroid was associated with spinal T score(r=-0.424, p<0.05) and duration of corticosteroid administration also associated with spinal T score(r=-0.457. p<0.05). Spinal BMD of patients not having corticosteroid in COPD group(n=13) were significantly lower than that of controls($0.71{\pm}0.13 g/cm^2$ and $0.97{\pm}0.21 g/cm^2$, p<0.01). Conclusion : Prevalence of osteoporosis is increased in patients with chronic obstructive pulmonary disease. Especially patients who are receiving corticosteroid have high risk of osteoporosis or osteopenia and need for preventive management.

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A Case of Imperforate Hymen with Acute Urinary Retention (급성 뇨 폐색을 동반한 처녀막 폐쇄증 1례)

  • Choi, Lim;Cho, Sea-Eun;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.86-89
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    • 2011
  • Imperforate hymen is, with an incidence of 0.1%, a rare female anomaly, which can appear with symptoms such as lower abdominal pain, primary amenorrhea, dysuria, anuria, caused by retention of menstrual blood after the onset of menstruation. Generally urinary retention is caused by psychological conditions, drug effect, infection or congenital anomaly causing acute urinary obstruction. We experienced a patient with symptoms of acute urinary retention, suggesting acute urinary obstruction. The cause for the retention turned out to be an imperforated hymen, which should therefore be mentioned in the literature as a possible cause in cases suspected of urinary retention.

Intracardiac Repair of the Coronary Sinus Laceration during Retrograde Cardioplegia - A case report- (역행성 심정지 중 발생한 관상정맥동 파열의 심장내 복구의 치험 -1예 보고-)

  • 김시훈;양경아;김상익
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.861-864
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    • 2004
  • Coronary sinus injuries related to the use of retrograde cardioplegia are rare and have potentially lethal complications. This report describes a case of coronary sinus laceration during retrograde cardioplegia in an old patient with mitral valve regurgitation, endocarditis, and left ventricular hypertrophy, and tells the details of the method of intracardiac repair.

Cavitating Adenocarcinoma and Soluamous Cell Carcinoma in the Same Lobe of the Lung (동일 폐엽내 발생한 공동화 선암과 펀평세포암)

  • 유지훈;김관민;김진국;심영목;한정호
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.153-156
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    • 2002
  • Synchronous primary lung cancers in the same lobe are rare. Cavitating adenocarcinoma as single lung lesion is unusual. We experienced cavitating adenocarcinoma and squamous cell carcinoma in the same lobe of the lung. The patient was a 74-year-old male with chief complaints of hemoptysis. CT scan showd a central mass in right upper lobar bronchus, obstructive pneumonia, and lung abscess in the right upper lobe. Pathologically, the central mass was a 2.3$\times$1$\times$1 cm sized squamous cell carcinoma, and lung abscess was revealed as a 37272 cm sized adenocarcinoma. The patient was discharged without any specific problem after right peumonectomy.

A Case Report on Treatment of Obstructive Sleep Apnea Patient Using Intraoral Removable Appliance (구강내 장치를 이용한 수면 무호흡 환자의 치료 증례)

  • Kang, Kook-Jin;Oh, Kang-Seob;Lee, Si-Hyung
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.210-215
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    • 1998
  • OSA(Obstructive Sleep Apnea) is a condition with repeated obstruction of the upper airway while sleeping. This obstruction of the upper airway may result if sleep-induced physiologic change in muscle activity is superimposed on various structural defects of the upper airway. Macroglossia, micrognathia, retrognathia, and decreased airway lumen have all been implicated in OSA. There are a variety of surgical and nonsurgical treatment modalities currently available for OSA. Recently the uvulopalatopharyngoplasty has achieved widespread use, but success rates vary and long-term effects are still unknown. Current nonsurgical treatment methods can be cumbersome and uncomfortable with variable responses. For this case. we diagnosed as OSA by using polysomnographic analysis and cephalometric analysis, and delivered intraoral removable appliance which is more conservative, reversible and easy to use for patient. And we got results that Apnea Index(AI) decreased from 14.4 to 3.1, Total Respiratory Disturbance Index(Total RDI) decreased from 18.1 to 7.0 and removal of chronic headache in daytime.

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Management of complications of oral appliance therapy for snoring and obstructive sleep apnea (코골이 및 폐쇄성 수면무호흡증의 구강내 장치 치료시 부작용 및 관리)

  • Jo, Jung-Hwan
    • The Journal of the Korean dental association
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    • v.57 no.5
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    • pp.270-278
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    • 2019
  • Oral appliances therapy is becoming increasingly recognized as a successful treatment for snoring and obstructive sleep apnea(OSA). Compared with continuous positive airway pressure(CPAP), the gold standard therapy for OSA, oral appliance therapy are less efficacious for severe OSA but are more acceptable and tolerable for patients, which in turn, may lead to a comparable level of therapeutic effectiveness. Nevertheless, the various side effects of oral appliance therapy, such as, increased salivation or dryness, pain or discomfort in the teeth or gums, occlusal discomfort in the morning, temporomandibular disorders, dental and occlusal changes may cause discontinuation of treatment or changes in treatment plan. Therefore, oral appliance therapy should be provided by a qualified dentist who can evaluate oral tissues, occlusion, and temporomandibular joints, and prevent and manage the possible side effects.

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Changes of Sputum Matrix Metalloproteinases and Tissue Inhibitor of Matrix Metalloproteinase-1 by Antibiotic Treatment in Acute Exacerbation of Chronic Bronchitis (만성 기관지염의 급성 악화에서 항생제 투여에 의한 유도객담 내 Matrix metalloproteinase와 Tissue inhibitor of matrix metalloproteinase의 변화)

  • Yoon, Hyoung-Kyu;Ahn, Joong-Hyun;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyung;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.420-430
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    • 2002
  • Background : Excessive extracellular matrix (ECM) deposition by airway inflammation is presumed to play an important role in the pathogenesis of worsening airflow obstruction (Ed- acceptable three-word noun) seen during acute exacerbations of chronic bronchitis. Although many proteases can cleave ECM molecules, matrix metalloproteinases (MMPs) and their inhibitors are likely to be the physiologically relevant mediators of ECM degradation. Objectives ; The purpose of this study was to demonstrate that antibiotic treatment can change airway MMPs and TIMP-1 concentrations/levels by controlling airway inflammation in acute exacerbation of chronic bronchitis. Methods : We studied 40 patients, all of whom had an acute exacerbation of chronic bronchitis. The patients were treated with two different antibiotics, moxifloxacin and clarithromycin, in a double-blind manner for 7 days. Sputum samples were induced and collected before and after antibiotic therapy. We measured the sputum concentration of MMP-1,-9, TIMP-1, IL-8 and secretory leukocyte proteinase inhibitor (SLPI) in sputum supernatants by ELISA method. Results : There was no difference after antibiotic treatment in the sputum concentrations of MMP-1,-9, TIMP-1, IL-8 and SLPI between the patients treated with moxifloxacin and those treated with clarithromycin. But the sputum concentrations of TIMP-1, and SLPI, and the TIMP-1/MMP-1 ratio were significantly reduced by the antibiotic therapy. There were significant positive correlations between sputum TIMP-1 levels and IL-8 levels (p<0.01, r=0.751), and between the sputum TIMP-1/MMP-1 ratio and IL-8 levels (p<0.01, r=0.752). The sputum SLPI levels were significantly elevated by antibiotic treatment and were negatively correlated with sputum TIMP-1 levels (p<0.01, r=-0.496) and TIMP-1/MMP-1 levels (p<0.01, r=-0.456). Conclusion : The study shows that the worsening of airway inflammation in acute exacerbation of chronic bronchitis is associated with an imbalance between the concentrations/levels of TIMP-1 and MMPs. Antibiotic treatment can prevent progression of airway narrowing in acute exacerbation of chronic bronchitis by modulation of the protease and anti-protease imbalance.

A study on the temperature inside clothing as fundamental data for development of the heat energy harvesting clothing (인체 전력에너지 수확의류 개발을 위한 의복내 온도 측정의 기초적 고찰)

  • Yang, Jin-Hee;Cho, Hyun-Seung;Park, Sun-Hyung;Lee, Joo-Hyeon
    • Science of Emotion and Sensibility
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    • v.16 no.1
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    • pp.125-132
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    • 2013
  • Recently, the consciousness of energy crisis is rapidly growing and sustainable eco-friendly energy sources are becoming issue. Therefore the portable electronic device requires new energy sources for providing continuous power supply and the power energy harvesting system of the human body that enables the power-harvesting research requests anytime, anywhere. One of the sources for energy harvesting is heat energy, which is the difference in temperature of the body and the surrounding environment. We tried to analyze the temperature difference between the environmental temperature and the temperature inside clothing according to the structure of the closed portion. And we examined the temperature difference between the environmental temperature and the temperature inside clothing according to the material of the clothing. The analysis showed that we have been able to get different results at parts of the body in the temperature inside clothing according to the structure of clothing. In upper torso of the chest and back, the temperature inside clothing of 'closed structure' was higher than the temperature inside clothing of 'opened structure'. In the section of arm and leg, it was reduced the difference of temperature inside clothing between 'closed structure' and 'opened structure'. It was particularly noticeable in the section of leg. The results of analysis of the difference between the environmental temperature and the temperature inside clothing according to the material of the clothing, in both cases of the two materials, 'closed structure' was higher than the 'opened structure' in the difference value between the environmental temperature and the temperature inside clothing. There was a difference according to the material in the section of leg. In this study, we outlined the basic guidelines for developing heat energy harvesting clothing by exploring the structure and material of clothing suitable for the heat energy harvesting.

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