• 제목/요약/키워드: Malignant obstruction

검색결과 94건 처리시간 0.019초

말기 암 환자의 장폐색성 복통에 대한 침구 및 족삼리 전침 치험 2례 (Acupuncture, ST-36 Electroacupuncture and Moxa Treatment of Abdominal Pain due to Bowel Obstruction in Cancer Patients : Case Report)

  • 김소연;최준용;박성하;권정남;이인;홍진우;한창우
    • 동의생리병리학회지
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    • 제28권2호
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    • pp.238-242
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    • 2014
  • Here we described 2 cancer patients treated by acupuncture for abdominal pain as a complication of bowel obstruction. The patient 1, 43-year-old man was treated with surgery, radiotherapy and chemotherapy for rectal cancer. Two years after surgery, he complained of acute abdominal pain due to small bowel adhesion band. Bowel obstruction and symptoms were not improved by conservative therapy like as fasting, keeping Levin tube, and fluid therapy. 4 months later, he could eat a little rice water, but ileus and abdominal pain persisted despite of applying opiod drug and patch. Got started on acupuncture, electroacupuncture(ST-36) and moxa treatment, pain was relived gradually. He could stop opioids 1 month later and ileus was improved after acupuncture therapy for 2 months. The patient 2, 65-year-old woman got hepatectomy, cholecystectomy, and chemotherapy with cholangiocarcinoma. 6 months after surgery, she got laparotomy again for biopsy of new mass around ascending colon. She started eating after gas passing, but felt abdominal distension. Diffuse paralytic ileus was diagnosed by abdominal X-ray, and she got started conservative therapy. During ST-36 electroacupuncture therapy, symptoms like abdominal pain and distension were improved and could stop opiod patch. But eating aggravated ileus again and clinical finding of mechanical bowel obstruction was appeared. Based on these cases, acupuncture and moxa therapy could be helpful for improving abdominal pain and ileus, but possibility of malignant bowel obstruction should be considered especially in cancer patients.

기관 및 기관지 폐색환자에서 굴곡형 기관지내시경을 이용한 냉동수술의 임상적용 (Clinical Appilication of Endobornchial Cryoablation That's Performed through Flexible Bronchoscope for Treating Tracheobronchial Ostruction)

  • 이성호;김광택;정재호;정원재;강문철;강은해;이은주;인광호
    • Journal of Chest Surgery
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    • 제41권4호
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    • pp.457-462
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    • 2008
  • 배경: 기관이나 기관분지부를 폐색시켜 호흡곤란을 유발하는 경우 기관 내경을 확보하기 위한 응급 시술이 필요하며 기관지 내시경을 이용한 레이저 소작술, 광역동치료 등의 치료가 사용된다. 냉동치료는 극저온으로 암을 얼려 암 조직의 괴사를 만들고 암을 제거하는 방법으로 본 연구에서 기관지내시경을 이용한 냉동수술의 임상적 유용성을 분석하였다. 대상 및 방법: 2005년 5월부터 2007년 5월까지 기관지내 종양으로 기관지 폐색을 일으킨 10명의 환자를 대상으로 분석하였다. 8명은 남자환자였고 평균연령은 $59.4{\pm}18.4$세였다. 양성종양이 3명, 악성종양이 7명이었고 폐색부위는 기관이 3명, 기관분지부가 3명, 기관지 4명이었다 시술은 굴곡형 기관지 내시경을 통하여 굴곡형 냉동수술기구를 넣어 기관지 폐색부위의 종양을 제거하였다. 냉동수술 1주 후, 1달 후에 각각 기관지내시경을 시행하여 시술의 성공률과 호흡곤란의 완화, 활동도의 호전, 시술의 합병증을 분석하였다. 결과: 10명의 환자 중 4명은 완전 관해되었고 6명은 불완전 관해를 보였다. 시술 후 합병증은 각혈(100%), 기침(5명) 등이 발생하였다. 각혈은 특별한 치료 없이 평균 4.9일($3{\sim}8$일)만에 호전되었다. 시술 후 모든 환자에서 호흡곤란의 완화와 활동도(performance scale)의 호전을 볼 수 있었다. 결론: 기관폐색은 말기암환자의 삶의 질 평가에서 중요한 부분을 차지하는 요소이다. 기관폐색의 재개통 방법 중 냉동수술은 간편하고 출혈이 적어 많은 양의 조직을 제거할 때 사용할 수 있는 안전한 방법으로 임상적용범위가 넓다. 본 임상경험에서, 기관 및 기관폐색 환자에서의 굴곡형 기관지 내시경을 이용한 냉동수술 방법은 효과적이며 안전한 방법이라 생각한다.

기도질환에서 실리콘 기도스텐트 치료 (Airway Stenting in Tracheobronchial Diseases : Silastic stenting)

  • 김호중
    • 대한기관식도과학회지
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    • 제10권2호
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    • pp.5-8
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    • 2004
  • Stenosing airway disease is classified as intraluminal obstruction, extrinsic compression, and malacia by the anatomical site of the lesion. Stenting therapy is indicated for symptomatic relief of life-threatening dyspnea caused by the last two types. Airway stents are made with metal mesh and/or silicone rubber, and currently more than 20 kinds of stent are available. Among many kinds of silicone stent, the Dumon stent is mostly widely used for benign and malignant airway stenoses, but general anesthesia and rigid bronchoscopy are needed for insertion. It can be removed when the stenosing airway disease subsides completely. In many clinical studies, most patients $(85-90\%)$ improved immediately after stenting, and procedure-related mortality was low $(<3\%)$ in experienced centers. Stent displacement, mucus impaction, and granulation tissue formation are potential complications. Stenting is one of many effective therapeutic modalities for stenosing central airway disease. Careful patient selection, experiences, and continuous development of new technology will bring better results.

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기관지에 발생한 양성 점액상피종 1례 보 (Mucoepidermoid tumor of the bronchus: one case report)

  • 송인석;조건현;이홍균
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.740-746
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    • 1984
  • Mucoepidermoid tumor arising from the bronchial tree as one of the bronchial adenoma is a extremely rare in incidence. And its clinical and histopathologic behavior has been reported as varying degree of benign to extremely malignant. Because symptoms are usually related to the bronchial obstruction or obstructive pneumonitis followed by endobronchial growth of tumor, frequently error is made in diagnosis of this tumor as entity of obstructive lung disease. We present a case of mucoepidermoid tumor with review of relevant literatures arising from the right middle lobe bronchus extending to intermediate bronchus in 47 years old housewife and was surgically removed by middle and lower Iobectomy.

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우하엽 기관지에서 발생한 점막 표피양 종양의 수술 치험 -1예 보고- (Mucoepidermoid Carcinoma of the Right Lower Lobe Bronchus - A case report-)

  • 김연수;김욱성;장우익;주미;류지윤
    • Journal of Chest Surgery
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    • 제37권11호
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    • pp.955-958
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    • 2004
  • 점막 표피양 선종은 드문 종양으로 원발성 악성 기관지 선종의 1%와 모든 폐종양의 0.2%를 차지한다. 이종양은 기관지 자극이나 폐쇄에 의한 증상을 나타낸다. 원격 전이는 드물기 때문에 완절 절제술이 최선의 치료법이다. 이 종양의 예후는 종양의 조직학적 악성도에 의한다. 저자들은 기침과 피가래의 증상을 보인 15세의 점막 표피양 종양환자를 경험하였다. 환자는 흥부 전산화단층 촬영과 기관지 내시경하 생검 후 개흉술을 시행하여 이엽절제술에 의한 완전한 종양 절제를 받았다.

Albers-Schonberg disease의 일례보고 (A CASE REPORT OF OSTEOPETROSIS)

  • 이상래;박상진;고강
    • 치과방사선
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    • 제7권1호
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    • pp.43-48
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    • 1977
  • The authors had observed a rare case of osteopetrosis from 8 years old male who had complained nasal obstruction at, Department of Dental Radiology, Kyung Hee University. In the serial roentgenograms the following results were revealed. 1. This osteopetrosis was considered to be malignant rather than benign. 2. In the skull, the greatest degree of radiopacity was found in the base. The pituitary fossa appeared to be small and posterior clinoid process revealed clubbing and thickening. 3. In the frontal and nasal bones were slightly enlarged with marked radiopacity and paranasal sinuses were obscured. 4. The maxilla was markedly affected and bony trabeculae were seen to be coarse and thickened but mandibular posterior segment slightly. 5. There were long retardation of the tooth eruption and physiologic resorption of the deciduous teeth, and tooth root revealed stunted and dwarfed appearance in the both jaws. 6. In this case, the thickened alveolar lamina dura was indistinguishable.

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심방점액종 -2례 보고- (Atrial Myxoma -2 Cases report-)

  • 심재영
    • Journal of Chest Surgery
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    • 제23권3호
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    • pp.501-506
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    • 1990
  • Cardiac myxomas are most common benign tumor and comprise approximately 50% of all primary cardiac neoplasms. They are intracavitary tumors occurring within any of the cardiac chambers, but they have a predilection for the atria and particularly the left atrium. Its are usually arise from the region of the limbus of the fossa ovalis. Clinically, they present with various manifestations due to obstruction to blood flow, embolization, and constitutional changes. Excision with the aid of cardiopulmonary bypass has been established as the treatment of choice for these histologically benign, but potentially malignant tumors and has generally produced good results [17]. We have experienced two cases atrial myxomas, one is left, the other is right and resected under established cardiopulmonary bypass, so we report these cases with the review of the literature.

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Unusual Tumors Obstructing the External Auditory Canal: Report of Two Cases

  • Kim, Chang-Hee;Lee, Hye Seung;Kim, Sung-Yong;Shin, Jung Eun
    • 대한청각학회지
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    • 제23권1호
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    • pp.59-62
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    • 2019
  • Primary tumors arising from the external auditory canal (EAC) are rare. We describe two cases of mass lesions within the EAC causing slowly progressive hearing loss without otorrhea or otalgia. Otoendoscopic examination demonstrated total obstruction of the EAC, and pure tone audiometry revealed conductive hearing loss. Based on the findings of the histopathologic examination, one patient was diagnosed with venous hemangioma that was treated using surgical resection, and the other patient was diagnosed with diffuse large B-cell lymphoma (DLBCL) that was treated using external-beam radiation therapy. Although primary tumors in the EAC are rare, both benign tumors such as venous hemangiomas and malignant lesions such as DLBCL should be considered as possible differential diagnoses of mass lesions in the EAC.

Unusual Tumors Obstructing the External Auditory Canal: Report of Two Cases

  • Kim, Chang-Hee;Lee, Hye Seung;Kim, Sung-Yong;Shin, Jung Eun
    • Journal of Audiology & Otology
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    • 제23권1호
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    • pp.59-62
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    • 2019
  • Primary tumors arising from the external auditory canal (EAC) are rare. We describe two cases of mass lesions within the EAC causing slowly progressive hearing loss without otorrhea or otalgia. Otoendoscopic examination demonstrated total obstruction of the EAC, and pure tone audiometry revealed conductive hearing loss. Based on the findings of the histopathologic examination, one patient was diagnosed with venous hemangioma that was treated using surgical resection, and the other patient was diagnosed with diffuse large B-cell lymphoma (DLBCL) that was treated using external-beam radiation therapy. Although primary tumors in the EAC are rare, both benign tumors such as venous hemangiomas and malignant lesions such as DLBCL should be considered as possible differential diagnoses of mass lesions in the EAC.

여러 간외담도 질환에서 삼차원적 자기공명 췌담관 조영술과 내시경적 역행성 췌담관 조영술과의 비교: 진단적 정확성을 중심으로 (Comparison of Diagnostic Accuracy of Three-Dimensional MR Cholangiopanceatography and ERCP in Various Extrahepatic Biliary Lesions)

  • 김경숙;이문규;김명환;이승규;김표년;오용호
    • Investigative Magnetic Resonance Imaging
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    • 제1권1호
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    • pp.148-153
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    • 1997
  • 목적: 다양한 간외담도질환에서 3차원적 자기공명췌담도조영술(MR cholangiopancreatography, MRCP)의 진단적 가치를 내시경적 역생성 췌담도조영술(ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY, ERCP)와 비교하여 알아보고자 하였다. 대상 및 방법: 간외담도질환이 의심되는 46명의 환자에 대하여 MRCP와 ERCP를 각각 시행하였다. MRCP는 reverse fast imaging with a steady-state free precession(reverse FISP:PSIF) 기법을 이용하여 얻어낸 후 MIP algorithm을 이용하여 재구성하였다. 담도확장여부와 폐쇄부위 진단에 대한 MRCP의 정확성을 ERCP를 최적기준으로 하여 평가하였다. 또한 악성 및 양성병변의 감별과 종합적인 진단정확도를 MRCP와 ERCP간에 비교하였다. 결과: MRCP의 담도확장여부 예측은 민감도 94.6%, 특이도 75.0%, 정확도 91.1%였다. 폐쇄부위 예측의 정확도는 87.0%였다. 악성과 양성병변의 감별에 있어 MRCP와 ERCP의 민감도, 특이도, 정확도는 각각 76.2%, 87.5%, 82.2%와 71.4%, 83.3%, 77.8%였다. 각각의 지롼에 대한 전체적 진단의 정확도는 MRCP가 60.0%, ERCP가 55.6%였다. 결론: 3D MRCP는 간외담도질환에 있어 ERCP와 비교하여 손색없는 진단적 가치를 가지며, 앞으로 ERCP를 대체할 수 있는 좋은 검사방법이라고 생각된다.

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