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Clinical Analysis on the Closed Thoracostomy -2341 cases (폐쇄식 흉강 삽관술에 대한 임상적 고찰)

  • Kim, Cheon-Seog;Kim, Yeun-Gue;Park, Jin;Lee, Kyong-Woon
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.991-1000
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    • 1997
  • Closed thoracostomy with UWSD* which is the most utilized procedure in chest surgery applies general thoracic disorders, trauma and after-thoracic surgery. The University hospital was involved on operating 2341 cases of closed thoracostomy with UWSD except chest tubing after-thoracic surgery for a full six years from January, 1991 to December, 1996. The rate of men and women out of the total 2341 cases was 3.5 : 1, the distribution by age showed that men were 36.6 $\pm21.0$ years old, women were $47.0\pm20.2$ years old and so that the total were 40.0 $\pm$ 20.5 years old. As for indication, spontaneous, secondary and traumatic pneumothorax were the most common, in addition to hemothorax hemopneumothorax, hydrothorax, hydropneumothorax, empyema, chylothorax. The most indwelling period of chest tubing is between eight and fourteen days for 974 cases and the average is 13.7 $\pm$ 6.3 days, The average drainage amount immediately after thoracostomy was 537 $\pm$ 88m1, and in 694 cases(46.0%), the drain amount was 201 ~ 500 ml. The rate of right and left tubing was 52.4 47.6, in 2071 cases(88.5%), the thoracostomy was the first chance and 2210 cases(94.4%) were treated with a single tube drainage. Almost all the patients complained of tube site pain, besides tube site infection, intercostal neuralgia, loss of tube function by the pleural adhesion, intrathoracic infection, incomplete reexpansion of defective lung, hemorrhage caused by the rupture of a blood vessel, subcutaneous emphysema, lung parenchymal rupture, diaphragmatic and intraabdominal trauma, reexpansionary pulmonary edema of one side lung and cellulitis were relapsed. 84.6% of all patients recovered with only clo ed thoracostomy and the rest of patient needed additional some necessary managements and so on to have successful results. There were two deaths(0.1%), caused by reexpansionary pulmonary edema, the cellulitis were complicated by thoracostomy with UWSD on an empyema patients to come to death(due to sepsis). t UWSD = under water seal drainage

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Diagnostic Approach to a Patient with a Pleural Effusion Including Ultrasound-guided Paracentesis Performed by a Medical Resident (내과 전공의가 시행한 초음파 이용 흉수천자를 포함한 흉수의 진단적 접근)

  • Lee, Yun Young;Choi, Won Je;Yu, Chang Min;Suh, Seong O;Kim, Eun Sil;Ahn, Seok- in;Chung, Jun-Oh;Park, Sang Joon;Kim, Yun Kwon;Kim, Soyon;Kim, Young Jung;Lee, Se Han;Heo, Heon
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.439-444
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    • 2008
  • Background: A patient with a pleural effusion that is difficult to safely drain by a "blind" thoracentesis procedure is generally referred to a radiologist for ultrasound-guided thoracentesis. But such a referral increases the cost and the patient's inconvenience, and it causes delay in the diagnostic procedures. If ultrasound-guided thoracentesis is performed as a bedside procedure by a medical resident, then this will reduce the previously mentioned problems. So these patients with pleural effusions were treated by medical residents at our medical center, and the procedures included bedside ultrasound-guided thoracenteses. Methods: We studied 89 cases of pleural effusions from March 2003 to June 2005. A "blind" thoracentesis was performed if the amount of pleural effusion was moderate or large. Bedside ultrasound-guided thoracentesis was performed for small or loculated effusions or for the cases that failed with performing a "blind" thoracentesis. Results: "Blind" thoracenteses were performed in 79 cases that had a moderate or large amount of uncomplicated pleural effusions and the success rate was 93.7% (74/79 cases). Ultrasound-guided thoracentesis by the medical residents was performed in 15 cases and the success rate was 66.7% (10/15 cases). The 5 failedcases included all 3 cases with loculated effusions and 2 cases with a small amount of pleural effusion. All the failed cases were referred to one radiologist and they were then successfully treated. If we exclude the 3 cases with loculated pleural effusions, the success rate of ultrasound-guided thoracentesis by the medical residents increased up to 83% (10/12cases). Two cases of complications (1 pneumothorax, 1 hydrohemothorax) occurred during ultrasound-guided thoracentesis. Conclusion: Ultrasound-guided thoracentesis performed as a bedside procedure by a medical resident may be relatively effective and safe. If a patient has a loculated effusion, then it would be better to first refer the patient to a radiologist.

Effects of Taeumin, Soeumin and Soyangin Prescriptions on the Adipocyte Induced by Gold Thioglucose in the Rat (태(太)·소음인(少陰人), 소양인(少陽人)의 처방(處方)이 Gold thioglucose로 유발(誘發)된 백서(白鼠)의 비만병(肥滿病)에 미치는 효과(效果))

  • Kim, Kyung-Yo
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.1
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    • pp.295-317
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    • 1996
  • It is researched to elucidate the effects of Taeumjowuitang(TE,太陰調胃湯), Sibimikwanjungtang(SE, 十二味寬中湯) and Yangkeogsanwhatang(SY,凉膈散火湯) on the obesity induced by gold thioglucose and the differentiation and growth of preadipocyte 3T3-L1 in the mouse. The result were as follows: 1. TE,SE and SY extracts improved the blood level of transaminase in the obese mouse induced by gold thioglucose. 2. TE,SE and SY extracts inhibited the increase of liver fat and body fat in the obese mouse induced by gold thioglucose. 3. TE,SE and SY extracts inhibited the increase of body weight in the obese mouse induced by gold thioglucose. 4. TE,SE and SY extracts inhibited the growth of undifferentiate preadipocyte 3T3-L1. 5. TE,SE and SY extracts showed inhibitory effect on the differentiation of preadipocyte 3T3-L1. The above results suggest that the TE,SE and SY extracts may be used on the obesity induced by the overgrowth and differentiation of adipocyte, and the accumulation of fat in liver and body.

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