• Title/Summary/Keyword: 흉복부

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A Bile Duct Cancer Patient Whose Stent Shifted Significantly Over the Course of External Beam Radiotherapy (외부조사 방사선치료 기간 중 총담도 스텐트의 위치 변화가 컸던 사례)

  • Yun, Hyong-Geun
    • Radiation Oncology Journal
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    • v.29 no.2
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    • pp.121-126
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    • 2011
  • The author reports a bile duct cancer patient whose stent shifted significantly from right to left over the course of radiotherapy. The 80-year-old female patient had a short stature with thoracic kyphosis and mutiple spinal compression fractures. She was also emaciated and very lean. By comparing the weekly scanned computed tomography images, the author found her stent to have shifted by more than 4 cm from right to left over the course of external beam radiotherapy. The results of this case study suggest that for a very lean and emaciated kyphotic bile duct cancer patient, the possibility of large interfractional movement of the bile duct or stent during radiotherapy should be considered.

Clinical Application of Stent-graft in Thoracic Aortic Diseases (흉부 대동맥 질환에서 스텐트-그라프트의 임상적 적용)

  • Kim, Kyung-Hwan;Lee, Cheul;Chang, Ji-Min;Chung, Jin-Wook;Ahn, Hyuk;Park, Jae-Hyung
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.698-703
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    • 2001
  • Background: Endovascular stent-graft insertion in aortic diseases is now generally accepted as an attractive alternative treatment modality. We reviewed our clinical experiences of endovascular stent-graft insertion in thoracic aorta. Material and Method: Since 1995, we performed 8 cases of endovasclar stent-graft insertion. Preoperative diagnoses were aortic aneurysms in 4, traumatic aortic ruptures in 3, and ruptured aortic pseudoaneurysm in 1. All procedures were performed in angiography room with the guidance of fluoroscopy. The stent-graft device is a custom-made 0.35mm thickness Z-shaped stainless steel wires, intertwined with each other using polypropylene suture ligation. It is covered with expanded Dacron vascular graft. Result: All procedures were performed successfully. Follow-up studies revealed 2 minimal perigraft leakages. There was no significant leakage or graft migration. 2 patients expired due to multiple organ failure and fungal sepsis. Other survivors(6) are doing well. Conclusion: Endovascular stent-graft insertion is relatively saft and effective treatment modality in the managment of various types of aortic diseases. In may be an effective alternative in aortic diseases of great surgical risk.

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A Case of Cholethorax following Percutaneous Transhepatic Cholangioscopy (경피경간 담도내시경술 이후에 발병한 담즙흉 1예)

  • Park, Chan Sung;Lee, Soon Jung;Do, Gi Won;Oh, Ssang Yong;Cho, Hyun;Kim, Min Su;Hong, Il Ki;Bang, Sung Jo;Jegal, Yang Jin;Ahn, Jong-Joon;Seo, Kwang Won
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.131-136
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    • 2008
  • Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.

Is There a Need for Conventional Spine Radiographs Following a Negative Chest and Abdominal CT in Trauma Patients? (흉, 복부 전산화 단층촬영이 정상인 외상 환자에게 척추 단순촬영이 필요한가?)

  • Oh, Sung Chan
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.24-28
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    • 2009
  • Purpose: This was conducted to assess the need for conventional radiographs of the thoracolumbar spine for routine screening of trauma patients who revealed no spinal trauma on chest and abdominal computed tomography (CT). Methods: We performed a retrospective review of the medical records of trauma patients who underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. Results: Two hundred seventy-five trauma patients underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. In 274 of the cases, the thoracolumbar spine series was also negative. Conclusion: CT of the chest and abdomen is an adequate evaluation of the thoracolumbar spine in trauma patients who require routine thoracolumbar spine screening, making subsequent conventional radiographs of the thoracolumbar spine unnecessary.

How to Improve Image Quality for the Chest PA and the Simple Abdomen X-ray Examinations (흉, 복부 단순 X-ray 검사 시 영상의 질 향상 방법)

  • Cho, Pyong Kon
    • Journal of the Korean Society of Radiology
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    • v.7 no.3
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    • pp.165-173
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    • 2013
  • The purpose of this study is to examine how much the movement at X-ray examinations like breathing or the positioning affects the image during chest or abdomen X-ray examination so as to create an image containing information as much as possible. The study method adopted is doing the X-ray in each of the states including breathing (inspiration & expiration) and movement in the standing chest PA X-ray and simple abdomen X-ray among the kinds of examination selected the most in hospitals and then evaluating them by applying the standards of image evaluation for each region. According to the study result, about the standing chest PA X-ray, the images taken at inspiration contain more information than those taken at expiration or having subtle movement during the examination. About the simple abdomen X-ray, the images taken at expiration contain more information than those taken at inspiration or movement. The above study results imply that regarding general X-ray examination, information we can find from the images may differ significantly according to the region examined, examination purpose, or movement during the examination like breathing.

Treatment of Stomach Cancer Involving Esophagogastric Junction (식도-위 경계부위를 침범한 위암의 치료)

  • 이종목;백희종;박종호;임수빈;조재일
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.930-936
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    • 2001
  • Background: The origin site of carcinoma invading esophagogastric junction is variable. It may arise from squamous cell carcinoma of low esophagus, adenocarcinoma arising from Barrett's esophagus, adenocarcinoma of gastric cardia, or extension from proximal stomach cancer. In Korea, the majority of adenocarcinoma invading esophago-gastric junction seems to arise from proximal gastric carcinoma. Material and Method: We reviewed the data of surgically-resected gastric adenocarcinoma involving esophagogastric junction in KCCH between 1988 and 1999. Result: There were 212 cases. Male to female ratio was 156 to 56. Age distribution was between 22 and 78. Variable surgical approaches including median laparotomy, laparotomy with left or right thoracotomy, left thoracotomy, and thoracoabdominal approach were used. Postoperative pathologic stages were : Stage IA-7, IB-11, Ⅱ-25, ⅢA-73, ⅢB-34, and Ⅳ-57. Curative resection was performed in 199 patients, and total gastrectomy was performed in 200 patients. There were 77.4%(164 cases) with esophageal involvement, 74.1%(157 cases) with tumor involvement in the abdominal LN, and 8%(17 cases) with mediastinal LN metastasis. Operative mortality was 3.3%, and over-all 5 year survival rate was 35%. Conclusion: There are various surgical approaches and many things to consider for surgical resection, thoracic and abdominal approach may need for obtain proper resection margin and adequate lymph node dissection in stomach cancer invading esophagogastric junction.

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두한경(竇漢卿)의 "침경지남(鍼經指南) 표유부(標幽賦)"에 관한 연구(硏究)

  • Yu, Ho-Gyun;Kim, Yong-Jin
    • Journal of Korean Medical classics
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    • v.20 no.2
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    • pp.269-288
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    • 2007
  • "표유부(標幽賦)"포라료침구경락적기본이론화자오유주침법(包羅了鍼灸經絡的基本理論和子午流注鍼法) 유주팔법등침구임상이론(流注八法等鍼灸臨床理論), 역우기송(易于기송), 통과대차(通過對此)"표유부(標幽賦)"급역대주석가대(及歷代注釋家對) "표유부(標幽賦)" 주석적연구(注釋的硏究). 금득출여하결론(今得出如下結論): 1. "표유부(標幽賦)"중출현적두한경적학술사상(中出現的竇漢卿的學術思想), 시재계승(是在계承)"내경(內經)"화(和)"난경(難經)"적침구학(的鍼灸學), 이론적기본상(理論的基本上), 진일보발전이성적(進一步發展而成的). 대후세침구학적발전산생료중요적영향(對後世鍼灸學的發展産生了重要的影響). 2. 유우폐경적경기유운문혈수출(由于肺經的經氣由雲門穴輸出), 연경락순행체표(沿經絡循行體表), 우시사운문혈구유료통경행기적주치작용(于是使雲門穴具有了通經行氣的主治作用), 고이불설'혈출중부'(故而不說'穴出中府'), 이제출'혈출운문'(而提出'穴出雲門'), 저시두한경재침구이론방면적독도지외(抵是竇漢卿在鍼灸理論方面的獨到之外). 3. 소우침구보사(소于鍼灸補瀉), 인위수지보사법적작용중우호흡보사(인위手指補瀉法的作用重于呼吸補瀉), 제시료순(提示了循), 문, 제(堤), 안(按), 탄(彈), 염, 차, 반(盤), 추, 내(內), 동(動), 요(搖), 조(爪), 절적십사종침자보사수법(切的十四종鍼刺보瀉手法). 4. 제출침자전요관찰확인침구유무이상손상(提出鍼刺前要觀察確인鍼具有无이常損상), 시침전요냉침온난(施鍼前要냉鍼온暖), 시침시요예방절침화피부근육적손상(施鍼時要預防折鍼和皮膚筋肉的損傷), 제출좌수당중이다안침혈(提出左手當重而多按鍼穴), 우수경이서서염전자입적수법(右手경而徐徐捻轉자入的手法), 인위사용쌍수진침위호(인위使用쌍手進鍼위好). 5. 호침가관통경락기혈운행적통로(毫鍼可관通經絡氣血運行的通路), 여오행상응(與五行相應), 인이가평오장지한열(因而可平五臟之寒熱), 가조육부지허실(可調六腑之虛實), 유견사부정지공(有견邪扶正之功), 재구침중응용최위광범(在九鍼中응用最위광泛). 6. 제출침자시요관찰본신(提出鍼刺時要관察本神), 대우'본신'구체가간주시환자적'맥기'화'혈기'(對于'本神'具체可看做是患者的'脈氣'和'穴氣'), 종대적방면간가간주시환자적정신(종大的方面看可看做是患者的精神). 7. 제시료참조전후좌우지혈정확취혈적방법(提示了參照前後左右之血正確取穴的方法), 여참조주변경락확정경락적방법(여參照周邊經絡確定經絡的方法), 병강조요준조골도분촌화굴신수족관절적방법취혈재능취혈정확(병强調要遵照骨度分寸和屈伸手足關節的方法取穴才能取穴正確). 8. 소우두면오관(소于頭面五官).인후경항(咽喉頸項).흉복부(胸腹部), 요배부(腰背部), 부인(婦人) 소아(小兒) 사지등질환(四肢等疾患), 개소료침구치료적경험화심득(介沼了療鍼灸治療的經驗和心得), 제시료자오유주축일안시개혈침법여영구팔법등안시취혈침법(提示了子午流注逐日按時開穴鍼法여靈驅八法等按時取穴鍼法), 성위후세각종안시개혈침법적기초(成위後世各種按時開穴鍼法的基초).

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Surgical Correction of Thoracic Aortic Aneurysm Associated with Coronary Artery Disease A Case Report -A Case Report- (관상동맥질환을 동반한 대동맥류 수술치험 1례)

  • 우종수;서정욱
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.724-728
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    • 1997
  • We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms r vealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardiopulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.

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Effects of Hyeong points' Acupuncture of Three Foot-eum Collaterals on Abdominal Thermography of Healthy Human Beings (족삼음경(足三陰經) 형혈(滎穴) 자침(刺鍼)이 흉복부(胸腹部)의 체열변화(體熱變化)에 미치는 영향(影響))

  • Shin Jong-Keun;Kim Jae-Hyo;Park Sung-Sub;Park Kui-Jong;Kim Kyung-Sik;Sohn In-Chul
    • Korean Journal of Acupuncture
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    • v.20 no.4
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    • pp.1-16
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    • 2003
  • Objectives : This study was examined for effects of acupuncture of Hyeong points' Acupuncture of Three Foot-eum Collaterals on the abdominal thermography of health subject. Methods : The volunteers who participating in this study had taken rest for 20 - 30 minutes in room temperature $(23-25^{\circ}C)$ before the examination and informed them what to prohibit smoking, drinking and administration of drug for the previous day. The thermography of abdomen including a below part of the chest was taken using Infra-Red Imaging System (IR 2000, MEDI-CORE Co., Korea) by time interval of 15 minutes at 15 minutes before, just before and 15 minutes after, 30 minutes after and 45 minutes after acupuncture stimulation. Acupuncture was applied to the left Hyeong points' Acupuncture of Three Foot-eum Collaterals for 30 minutes. Results : The results showed that acupuncture of Hyeong points had more potencies of changes on all the ROIs of abdominal thermography than those of control group. Also, it was observed that the quantities of thermal changes following acupuncture of Hyeong points been increased comparing that of control group at all the ROIs (region of interest). Observed the thermography classified by ROI, however, it was failed that acupuncture of Hyeong points could modulate the specific areas concerning to the abdominal pathway of Three Foot-eum Collaterals. Conclusions : These results suggest that acupuncture of Hyeong points may modulate thermal distributions and changes of abdominal areas including the below of chest.

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A Study of Abdominal Syndrome in Jin Kui Yao Lue (금궤요략의 상견복증(常見腹證)에 관한 연구(硏究))

  • Hong, Mun-Yeup;Park, Sun-Dong;Park, Won-Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.1
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    • pp.51-76
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    • 1999
  • The subject of Abdominal syndrome in the field of Jin Kui Yao Lue takes a quarter of the whole research quantity, and has greatly contributed to the development of diagnoses due to the well-growth of syndrome differentiation through 'the differentiation of symptoms and signs based on prescriptions'-centered abdominal syndrome. Since then, while the diagnostic has been developed mainly in the field of pulse feeling and the inspection of the tongue, application of the abdominal diagnostic has not been continuously improved because of special historical and social environments. Recently, since interest in the differentiation of symptoms and signs based on abdominal syndrome has been raised by emphasis of Oriental diagnostic methods and. medical treatment which have led to the study of Abdominal Syndrome in Jin Kui Yao Lue. The following is the results of the study. 1. Jin Kui Yao Lue abdominal syndrome is categorized into all abdominal symptoms Epigastric symptoms, Hypochondrium symptoms, and Lower abdomen symptoms. 2. Subjective symptoms and Objective symptoms have been found in Abdominal syndrome, and Subjective symptoms have been more often than Objective symptoms. Both of the symptoms have been found more to co-exist in abdominal syndromes. 3. More cases of fullness of abdomen symptoms in All abdominal symptoms, a smaller number of cases in Taiyang disease, Yangming disease, disease involving all three yang, Tayin disease and Jueyin disease have been found, but there have not been found in Shaoyin disease. 4. More cases of Epigastric fullness and rigidity in Epigastric symptoms, Epigastric throbs in Palpitation symptoms, and sense of fullness-in-chest in Abdominal syndrome of chest and hypochondrium have been recognized. 5. Any regularity caused by abdominal symptoms has not been identified. 6. Diagnosis of the abdomen caused by abdominal symptoms has been identified in Epigastric fullness, Epigastric pain, Epigastric procrastination, Epigastric throb, fullness of abdomen and distension of lower abdomen.

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