• Childhood Kidney Diseases
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• 제18권2호
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• pp.132-136
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• 2014

결절성 경화증은 과오종의 발생을 특징으로 하는 유전질환으로, 피부, 뇌, 심장, 눈, 폐, 구강, 신장 등의 다양한 장기들을 침범한다. 신장에서 관찰 가능한 다양한 병변들은 발생 빈도와 사망률이 높기 때문에 주의를 필요로 하며, 신장 증상의 이른 발생 시기를 고려하여 소아 연령에서부터 적절한 진단과 관리가 중요하다. 저자들은 소아 연령에서 발생한 거대 혈관근육지방종, 신세포암, 신경색, 신낭종, 그리고 신결석증 등이 동반된 결절성 경화증 4례를 경험하였기에 보고하는 바이다.

• 한국정보통신학회논문지
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• 제21권9호
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• pp.1761-1770
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• 2017

대뇌혈류증가 치료는 뇌경색에 가장 중요한 치료방법중 하나이다. 기존의 대뇌혈류증가 치료가 침습적으로 행해져옴에 따라 다수의 합병증을 유발할 수 있다는 문제점이 제기되고 있다. 따라서 이러한 문제점을 보완하기 위해 최근에는 비침습적 대뇌혈류증가 장치가 등장하였다. 하지만 현재 구현된 비침습적 대뇌혈류증가 장치는 속도와 정확성이 떨어지는 문제점이 제기되고 있다. 본 논문에서는 기존의 구현된 비침습적 대뇌혈류증가 장치의 단점을 보완하고자 다른 방식으로 시스템을 구현하여 대뇌 부위로 가는 혈류량을 우회적으로 증가시켜 최종대뇌 손상부위를 최소화 하는 것으로 목표로 한다. 본 논문에서 구현한 시스템은 사지압박을 진행함과 동시에 사지의 혈류지수를 측정하여 혈류지수가 일정 수치 이하로 떨어지는 압력을 찾아 사지압박을 통해 대뇌부위로 가는 혈류량을 우회적으로 증가시켜 혈류증강 치료를 실시한다. 이는 기존의 침습적 대뇌혈류증가 치료와 비교하여 합병증의 우려가 없고, 최종실험 결과 혈류량을 20% 이상 증가시키기에 환자에게 선택적으로 사용될 수 있다.

• 대한중풍순환신경학회지
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• 제12권1호
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• pp.1-7
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• 2011

Objectives : The purpose is to discuss the clinical applications of Orungsan(Goreisan: 五苓散) as an alternative management for increased intracranial pressure in the field of neurosurgery in Japan. Methods and Results : Attention has focused on Kampo medicine(traditional Japanese medicine) for some cerebral disease including chronic subdural hematoma(CSDH) and cerebral infarction in Japan. Orungsan and one of its classes, Sirungtang(Saireto: 柴苓湯) are well known their effects on brain edema. After some studies of Orungsan has the anti-edemic effects by the inhibition of aquaporin, this herbal medicine has been used widely in the neurosurgery field in Japan. It is high time to think about where we are and we go ahead for the progress and the integration in medicine. We have reviewed the studies using Orungsan or Sirungtang, that was reported at the 20th annual meeting of 'the Japan society for Kampo medicine and neurological surgery' was held on November 5, 2011 in Tokyo. Fifteen studies related with Orungsan or Sirungtang were reported among all 32 studies at the meeting. Orungsan in ten, and Sirungtang in five among 14 studies contained specific clinical case. In the aspects of disease, thirteen papers were related with SDH, including CSDH(11), SSDH(1), aneurism clipping for SDH prevention(1), and one was acute cerebral infarction and one was multiple metastatic brain tumor. In the report style, case control study was 7(mostly retrospective), and the case report was 8. Conclusions : Orungsan may be plausible to be an alternative method to reduce brain edema after SDH and other brain injury in the field of neurosurgery.

• 대한족부족관절학회지
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• 제11권1호
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• pp.107-110
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• 2007

Synovial chondromatosis is an uncommon non-neoplastic condition of the joints, forming multiple cartilaginous nodules in the synovium. The lesion usually tends to involve large joints, and the occurrence in the small joint of foot is very rare. We would like to report a case of synovial chondromatosis which was confused with Freiberg infarction in the 1st metatarsophalangeal joint of the foot.

• Journal of Chest Surgery
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• 제20권1호
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• pp.139-147
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• 1987

in general rapid and complete resolution of pulmonary emboli, even massive, is the natural history. However, rarely, the emboli do not resolve but rather became fibrotic organization and densely adherent to the arterial wall, therefore, may lead to significant clinical disability. In patients with chronic pulmonary embolism, medical management usually has little effect and only surgical treatment can offer improvement. The case was 30-year-old man who had admission to the Hanyang University Hospital due to fall-down from 11th floor 407 days before operation and then transferred to our department for surgical management under the diagnosis of chronic pulmonary embolism, Pulmonary angiogram demonstrated multifocal thromboembolism with infarction and lung scans showed no improvement in spite of anticoagulant and thrombolytic therapy. At median sternotomy for pulmonary artery thromboembolectomy, the well organized and multiple septic emboli could be removed by gallstone forceps. But reoperation of left upper lobectomy was performed because of the repeated hemoptysis and suspicious pulmonary arterio-bronchial fistula 19 days postoperatively. Despite of ventilatory support and drug treatment, the patient died due to right heart failure associated with cor pulmonale 27 days after first operation. Discussion of the operative and perioperative problems are offered.

• Journal of Yeungnam Medical Science
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• 제5권1호
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• pp.167-172
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• 1988

저자들은 뇌교경색의 원인이 되는 것으로 생각되는 $1{\frac{1}{2}}$증후군 1례를 경험하였기에 문헌고찰도 함께 하였다.

• 동국한의학연구소논문집
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• 제8권1호
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• pp.107-116
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• 1999

이 실험의 목적은 소속명탕(小續命湯)에 대하여 KCN(potassium cyanide)으로 유발된 혼수시간과 생존시간을 측정하여 전뇌허혈(全腦虛血)에 미치는 영향을 관찰하고, 또한 MCA occlusion 유발시 뇌부종율(腦浮腫率)과 뇌허혈면적(腦虛血面積)을 측정하여 국소뇌허혈(局所腦虛血)에 미치는 영향을 실험연구하였다. 1. 전뇌허혈 유발실험에서 유의성있는 KCN 유발 혼수시간의 단축, 치사량의 KCN에 대한 생존시간의 연장 효과가 나타났다. 2. 국소 뇌허혈 유발실험(MCA occlusion)에 미치는 효과에서는 뇌허혈면적과 뇌부종율이 대조군에 비하여 유의성있게 감소하였다.

• 대한핵의학회지
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• 제21권2호
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• pp.167-174
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• 1987

Among noninvasive approaches for the evaluation of left ventricular performance, radionuclide ventriculography (RVG) has been shown to be of particular values. Phase analysis, recently introduced as more objective means for evaluating the temporal sequence of systolic ventricular wall motion than cine image of RVG comprises a pixel by pixel Fourier transformation of the time activity curve of a multiple gated acquisition equilibrium blood pool study. To examine the regional wall motion of ventricles in myocardial infarctions, we evaluated the phase image and histogram constructed for each ventricle by total phase angle range and full width of half maximum (FWHM). This study consisted of 7 normal subjects and 23 subjects with acute myocardial infarction. Contrast ventriculography and coronary angiography was performed in all partients with myocardial infarction. And we compared the result of phase analysis with cine image of RVG and examined the interrelationship between phase analysis and contrast ventriculography with coronary angiography. The results were as follows; 1) The total phase angle range and FWHM of LV phase histogram in myocardial infarction ($86^{\circ}\;and\;32^{\circ}$, repectively) were wider than those in normal control ($38^{\circ}\;and\;18^{\circ}$, respectively p<0.01). 2) RV phase angle range and FWHM in patients with right coronary artery (RCA) occlusion ($79^{\circ}\;and\;37^{\circ}$, respectively) were wider than those in normal control ($39^{\circ}\;and\;18^{\circ}$, respectively p<0.001) and the patients without RCA occlusion ($52^{\circ}\;and\;19^{\circ}$, respectively p<0.01). 3) Phase analysis was more sensitive (95%) than cine image of RVG (70%) for the detection of regional wall motion abnormality of LV.

• Investigative Magnetic Resonance Imaging
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• 제18권3호
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• pp.263-268
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• 2014

신경매독은 스피로헤타(spirochete)인 Treponema pallidum에 의한 뇌와 척수의 드문 감염증이다. 저자들은 53세 남자환자에서 시신경, 삼차신경, 안면신경, 전정와우신경, 중뇌동맥, 후뇌동맥, 척수와 척수막을 침범한 복합적인 수막혈관성, 수막척수염 형태의 신경매독을 경험하여 이를 보고하고자 한다. 본 증례를 통해 뇌수막염과 더불어 뇌신경염, 뇌혈관염이 있고 수막척수염을 동반하는 복합적인 중추신경계 이상 소견이 있어 임상적인 진단이 어려운 경우 신경매독을 감별진단으로 고려하여 영상 소견을 바탕으로 한 빠른 진단이 필요함을 강조하고자 한다.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.12-17
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• 2011

Purpose: A rib fracture secondary to blunt thoracic trauma continues to be an important injury with significant complications. Unfortunately, there are no definite treatment guidelines for severe multiple rib fractures. The purpose of this study was to evaluate the result of early operative stabilization and to find the risk factors of surgical fixation in patients with bilateral multiple rib fractures or flail segments. Methods: From December 2005 to December 2008, the medical records of all patients who underwent operative stabilization of ribs for severe multiple rib fractures were reviewed. We investigated patients' demographics, preoperative comorbidities, underlying lung disease, chest trauma, other associated injuries, number of surgical rib fixation, combined operations, perioperative ventilator support, and postoperative complications to find the factors affecting the mortality after surgical treatment. Results: The mean age of the 96 patients who underwent surgical stabilization for bilateral multiple rib fractures or flail segments was 56.7 years (range: 22 to 82 years), and the male-to-female ratio was 3.6:1. Among the 96 patients, 16 patients (16.7%) underwent reoperation under general or epidural anesthesia due to remaining fracture with severe displacement. The surgical mortality of severe multiple rib fractures was 8.3% (8/96), 7 of those 8 patients (87.5%) dying from acute respiratory distress syndrome or sepsis. And the other one patient expired from acute myocardial infarction. The risk factors affecting mortality were liver cirrhosis, chronic obstructive pulmonary disease, concomitant severe head or abdominal injuries, perioperative ventilator care, postoperative bleeding or pneumonia, and tracheostomy. However, age, number of fractured ribs, lung parenchymal injury, pulmonary contusion and combined operations were not significantly related to mortality. Conclusion: In the present study, surgical fixation of ribs could be carried out as a first-line therapeutic option for bilateral rib fractures or flail segments without significant complications if the risk factors associated with mortality were carefully considered. Furthermore, with a view of restoring pulmonary function, as well as chest wall configuration, early operative stabilization of the ribs is more helpful than conventional treatment for patients with severe multiple rib fractures.