• 제목/요약/키워드: Clinical cases

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clinical analysis of childhood empyema (소아 농흉의 임상적 고찰)

  • 김범식
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.385-390
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    • 1986
  • Empyema is a severe infection encountered in the pediatrics. With advance of the antibiotics and chemotherapeutics, there was a marked decrease in number of empyema. Empyema complicated by staphylococcal pneumonia in infant and children has been distressing problem, and the management of this complication has been discussed repeatedly in the past. In Korea, tuberculous empyema is also troublesome. If empyema is localized within thick capsule, tube thoracostomy and closed drainage alone is unacceptable, and early open thoracotomy to eliminate the empyema has proved good result. A clinical analysis of 39 patients with thoracic empyema was done. They were managed surgical intervention at Dept. of Thoracic & Cardiovascular Surgery at Kyung-Hee University Hospital from Jan. 1974 to December, 1984. 1. Age and sex distribution, infancy 9, early childhood 11. late childhood 9, puberty 10. The male to female ratio was 21:18. 2. The highest seasonal incidence was winter [21 cases]. 3. Cardinal symptoms were cough [76%], fever and chill [66%], and dyspnea [40%]. 4. The location of the empyema was right in 27 cases [69%] and 12 cases in left side. 5. The most frequent lesion to predisposing factor was pneumonia [67%]. 6. The commonest organism was Staphylococcus aureus in 15 [38%] cases, and Mycobacterium tuberculosis in 10 cases [26%]. 7. The surgical treatment was performed in all patients. The surgical procedure was closed tube thoracostomy in 25 cases [64%], decortication in 7 cases [18%], pulmonary resection in 4 cases [10%], and decortication with curettage in 2 cases. 8. One patient died from sepsis complicated by lymphoma and in one patient bronchopleural fistula was developed postoperatively.

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A Clinical Study on Primary Lung Cancer (폐암의 임상적 고찰)

  • Lee, Jeong-Cheol;Lee, Jong-Tae;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.140-147
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    • 1986
  • A clinical study was made on 72 cases of primary lung cancer operated in the department of thoracic & cardiovascular surgery, Kyungpook national university hospital from January 1975 to May 1985. The ratio of male to female was 13.4: I and mean age was 53. Histologically, squamous cell carcinoma comprised 72.2% of 72 operated cases. Before admission to our hospital, the erroneous diagnoses were made at local clinics on the 43 cases[59.7%] and a large percentage of them was diagnosed as pulmonary tuberculosis. And then, total of 56 cases received inadequate treatment or delayed the operation. For the location of the tumor, right to left ratio is 1.2:1 and the right upper lobe was most often involved [23.6%]. Operation was performed on the 72 cases and resection on the 59 cases[8.2%]. Postsurgical staging showed that stage III was found most frequently [59.4%] and T,N,M, was 28% of total cases. Two common surgical complications were bleeding in 7 and acute respiratory failure in 6 cases, and these 6 cases of acute respiratory failure were all died. On the basis of these experiences, we conclude that aggressive effort is needed for the early accurate diagnosis and adequate treatment of lung cancer.

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Treatment of Osteochondritis Dissecans of the Talus (거골 박리성 골연골염의 치료)

  • Hahn, Sung-Ho;Yang, Bo-Kyu;Yi, Seung-Rim;Chung, Shun-Wook;Lee, Dong-Ho;Lee, Chul-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.190-194
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    • 2002
  • Purpose: We present our experience about the clinical aspect and treatment modalities of ostechondritis dissecans of the talus. Material and Method: This study included 35 patients, 38 cases diagnosed as ostechondritis dissecans of the talus that were proved by clinical and radiologic finding. The methods of treatment were conservative (2 cases), multiple drilling (1 case), excision (1 case), excision, curettage & multiple drilling (23 cases), curettage & bone peg fixation (2 cases), curettage & bone graft (2 cases), and autogenous osteochondral transfer(Mosaicplasty) (7 cases). Results: Of the 38 cases, 30 cases were associated with a history of trauma (17 cases of medial lesion, 13 cases of lateral lesion), and 9 cases of which had major trauma history and 21 cases, minor repetitive trauma history. According to O'Farrel grading system, 21 cases (55%) had good results, 11 cases (29%) had fair results, and 6 cases (16%) had poor results. Of the medial lesion 16 cases had good results, 6 cases, fair results, and 2 cases, poor results. Of the lateral lesion 5 cases had good results, 5 cases, fair results, and 4 cases, poor results. Conclusion: There were fair or good results in 84% of patients with surgical treatment. Curettage and multiple drilling reveals a good result in medial lesion in grade I, II, III and lateral lesion in grade I, II. Autogenous osteochondral transfer(Mosaicplasty) is considered for the cases in grade III, IV(medial and lateral), lesion exceeds 1Cm of size and poor result with another treatment modality.

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An App-based Evolving Medical Nomogram Service System (앱기반 진화 의료 노모그램 서비스 시스템)

  • Lee, Keon-Myung;Hwang, Kyoung-Soon;Kim, Wun-Jae
    • Journal of Korea Entertainment Industry Association
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    • v.4 no.4
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    • pp.72-76
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    • 2010
  • Clinical nomogram is a graphical representation of numeric formula, constructed from clinical cases database of followed patients' treatment, which is used for medical predication. For a clinical nomogram to contribute patient care, it is required to accumulate as many as clinical cases and to extract medical prediction knowledge. It needs to be equipped with an effective method to build medical nomogram with high predication accuracy. It is desirable for medical nomogram to be accessible at patient care point. This paper proposes a medical nomogram service system architecture which takes into account the above-mentioned issues. The proposed system architecture includes a web-based database subsystem to maintain and keep track of clinical cases. On the periodic basis, a new clinical nomogram is reconstructed for the updated clinical database. For the convenient use of patient care practice environment, an app-based program is provided which makes prediction based on the most recent clinical nomogram constructed in the service system. The proposed method has been applied to a clinical nomogram service system development for recurrence and survival prediction in bladder cancer patients.

Clinical Observation on Voice Disorder (음성장애에 대한 임상적고찰)

  • 이종원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.7.2-8
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    • 1979
  • The tests related to air usage are valuable for evaluating phonatory function of clinical cases having glottic incompetence. Measurement of mean air flow rate, maximum phonation time and phonation quotient are important test for voice disorder. Stroboscopy is very useful for clinical evaluation of abnormality in the mode of vocal cord vibration. Author obtained following clinical result from 56 cases of laryngeal disorders in Kurume medical school in Japan. 1) Unilateral laryngeal lesions, are 35 cases (62.5%) and bilateral laryngeal lesions are 21 cases (37.5%). 2) Sex ratio is 39 cases (69.8%) of male and 17 cases (30.2%) of female. 3) In maximum phonation time below 10 seconds are 26 cases (46.4%) and above 10 seconds are 30 cases (53.6%). 4) In phonation quotient below 300 ml/sec are 33cases (58.9%). and above 300ml/sec are 23 cases (41.0%). 5) In mean air flow rate below 300ml/sec are 37 cases (66.1%) and above 300ml/sec are 19 cases (33.9%). 6) Symmetry of vibratory movement of the vocal cord, regularity of vibration, amplitude of vibration, wave on the mucosa and glottic closures are observed by stroboscopic examination. 7) Postoperative voice test and stroboscopic examination revealed good result in compare pre-operation with post-operation.

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A Clinical Analysis of Surgically Treated Myasthenia Gravid (중증 근무력증환자에서 흉선절제술의 효과 및 임상적 고찰)

  • 민경석;조유원
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.73-78
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    • 1996
  • From June 1989 to May 1994, 23 patients with myasthenia gravis underwent thymectomy in the Department of Thoracic Surgery, Asan Medical Center. For the evaluation of the effect of thymectomy, clinical analysis including age and sex distribution, preoperative disease severity, duration of the symptoms, thymic pathology, and postoperative clinical improvement was performed. The mean follow-up period was 15 mon hs(range : 5∼60mon1hs). The effectiveness of thymectomy according to the postoperative symptoms and drug dose was graded as follow : a) complete remission in 5 cases (21.7%), b) clinical improvement with dose reduction in II cases (47.9%), c) clinical improvement without dose reduction in 3 cases(13.0%), 4) unchanged in 2 cases (8.8%), e) early death in 1 case(4.3%) and f) recurrence in 1 case(4.3%). According to the preoperative disease stage by Modified Osserman classification, 6(66.7%) of the 9 patients in stage I and 13 (92.9%) of 14 patients in stage II were clinically improved after thymectomy. although there was no significant statistical differences between these two groups (p> 0.05). According to the thymic pathology, 4 (100%) of 4 cases with normal thymus were clinically improved. Ten (90.9%) of 11 cases with thymic hyperplasia and 5 (62.5%) of 8 cases with thymoma were clinically improved, but there was no significant statistical differences in these three groups (p> 0.05 . The thymectomy resulted in dramatic clinical improvement in 19 (82.5%) out of 23 patients. According to the preoperative disease stage by Modified Osserman classification or the thymic pathology, there was no significant statistical differeneces in the effect of thyinectomy (p> 0.05).

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Clinical Analysis of Atypical and Malignant Meningiomas : A study of 52 Cases (비정형성 및 악성 뇌수막종의 임상분석 : 52례 연구)

  • Park, Hong-Jun;Gwak, Ho-Shin;Hwang, Sung-Kyun;Kim, Jeong Eun;Lee, Sang Hyung;Jung, Hee-Won;Kim, Dong Gyu;Cho, Byung-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1103-1107
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    • 2001
  • Objective : Atypical and malignant meningiomas(AM, MM) are known to be rare and show aggressive behavior. Limited data are available concerning the clinical features, effectiveness of surgical removal and role of radiation therapy with AM, MM. The authors report our experience of AM, MM, with respect to clinical features. Methods : Twenty-four cases of AM and 28 cases of MM, who were operated between 1988 and 1999 were retro-spectively studied review of medical records and radiological findings. These were compared with control group of 24 cases of menigiomas manifestating usual clinical course, which are selected arbitrarily among operative cases between Apr. 1999 and Dec. 1999. Mean follow-up periods were 26(1-91) months for AM and 23(1-62) for MM. Authors analyzed the prognostic factors for survival, and statistical analysis were accomplished by Kaplan-Meier method and log-rank test. Results : Differences of clinical features between control groups and these atypical and malignant meningioma group were not significant. However, the location of MM was frequent in non-basal area(p<0.01). In AM, there were 4 patients of recurrence, and 3 patients of mortality. Among mortality cases, only one patient died of tumor progression, the other patients died of other causes. The survival at 2 year and 5 year in this group were 88% and 74% respectively, and in MM, 11 patients died due to tumor progression and 2 had spinal metastasis. The survival at 2 year and 5 year were 72% and 20%, respectively. For extent of resection, total removal(Simpson grade 1 or 2) was less often achieved in MM compared with AM(50% vs. 83%). Extent of resection of tumor and postoperative radiation therapy did not affect survival in both AM, MM. Conclusions : Clinical behavior of AM showed more benign than that of MM. Prognostic factor for survival is not related extent of resection of tumor and postoperative radiation therapy. However, further investigation with long-term follow-up and additional cases is mandatory.

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Clinical Report of 2 Postherpetic Neuralgia Cases Diagnosed and Treated as Ganwoolqiche (간울기체(肝鬱氣滯)로 변증시치한 대상포진 후 신경통 환자 치험 2례)

  • Choi, Cheol-Hong;Park, Sun-Young;Ko, Kyung-Mo;Hwang, Sun-Yi;Jee, Seon-Young;Chung, Dae-Kyoo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.21 no.3
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    • pp.207-214
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    • 2008
  • Objective : This study report the effect of traditional medical treatment on postherpetic neuralgia(PHN) 2 cases. Methods : We observed 2 PHN cases diagnosed Ganwoolqiche and prescribed herbal medication (Soyosan-Gagambang & Punsimgieum-Gamibang) for each case. Results : Both cases showed efficient clinical results, especially for the pains. Conclution : In this study, operated traditional medical treatment on PHN cases and could find good progress after treatment.

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The Results of Treatment for Tarsal Tunnel Syndrome Associated with Calcaneus Fracture (종골 골절과 연관된 족근관 증후군의 치료 결과)

  • Lee, Woo-Chun;Kim, Yoo-Mi
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.84-87
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    • 2006
  • Purpose: To review the results of surgical decompression for tarsal tunnel syndrome associated with calcaneus fractures. Materials and Methods: Six tarsal tunnel syndromes in five patients were surgically decompressed at our hospital with followed up of average 26.0 months (range, $12{\sim}36$ months). All patients were male and average age at surgery was 50.0 years (range, $33{\sim}69$years). All five cases developed after calcaneus fractures including one bilateral case. Clinical results were assessed according to the criteria of Pfeiffer and Cracchiolo. Results: The result was good in three cases, fair in one case and poor in two cases. Four cases in four patients were satisfied with the result of treatment. Conclusion: Clinical results of surgical treatment for tarsal tunnel syndrome associated with calcaneus fracture of the foot or ankle was improved and maintained in four of six cases.

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Hyperplastic conditions of the mandibular condyles

  • Nah Kyung-Soo
    • Imaging Science in Dentistry
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    • v.33 no.4
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    • pp.207-209
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    • 2003
  • Purpose: To evaluate the clinical and radiographic features of unilateral hyperplastic mandibular condyles for some useful preliminary diagnostic recommendations. Materials and Methods : Clinical records, radiographs and histologic diagnoses of 35 cases with asymmetric mandibular condyles due to apparent unilateral condylar hyperplasia were evaluated retrospectively. Results: Among 35 cases, 28 were true hyperplastic conditions of condyles whereas the remaining 7 were unilateral internal derangement occurring on the short side. 17 of the 28 hyperplastic condyles showed a mass or irregular radiographic shadow with histologic diagnosis including osteochondroma and osteoma. Only 5 of these cases showed facial asymmetry. 2 out of the 17 cases showed hyperplastic round shaped irregular condyles consistent with ankylosis and their histologic diagnoses were osteochondromas. 11 of the 28 cases showed smooth enlargement of condylar head with elongation of the neck causing facial asymmetry, but histologic diagnoses were not available because the surgical operation conserved the condyles. Conclusion: The hyperplastic conditions of the mandibular condyles include not only true hyperplasia, osteochondroma, osteoma, and ankylosis, but also unilateral internal derangement occurring on the short side.

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