• Title/Summary/Keyword: cases report

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Interstitial Lung Disease Associated with Polymyositis: Response to Cyclophosphamide and Prednisolone Combination Treatment (Cyclophosphamide와 Prednisolone 병합요법에 치료반응을 보인 다발성근염에 동반된 간질성폐질환 1예)

  • Moon, Jong-Ho;Park, Jun-Young;Lee, Sang-Moo;Kim, Hyeon-Tae;Uh, Soo-Taek;Chung, Yeon-Tae;Kim, Yong-Hoon;Park, Choon-Sik;Lee, Kyung-Soo;Kang, Dae-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.197-202
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    • 1993
  • Polymyositis (PM) is a inflammatory connective tissue disease involving predominantly skeletal muscles, characterized by symmetrical, proximal muscle weakness, inflammation, and frequently, degeneration. Interstitial lung disease in association with PM occurs in 5~10% of cases and carries an especially grave prognosis. Although the cause of lung involvement in PM is not known, the underlying pathologic process in the lung is an immune mediated inflammation of alveolar structures, alveolitis. It is of interest, therefore, that cyclophosphamide, an immune modulating agent, has been reported to be effective in the treatment of PM. We report a case of corticosteroid resistant PM associated with interstitial lung disease, successfully treated with cyclophosphamide. A 37-year-old female was presented with 8 months duration of cough, exertional dyspnea, and muscle weakness. She had typical symptoms, physical findings, and elevated muscle enzyme levels in serum with characteristic findings of muscle biopsy. She also had typical interstitial lung disease pattern on chest X-ray and high resolution CT with restrictive pattern on pulmonary function test. The findings of transbronchial lung biopsy was compatible with interstitial lung disease. She failed to respond to corticosteroid initially. Subsequently steroids and cyclophosphamide were given with excellent clinical improvement.

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A Case of Spontaneous Hemothorax Due to Rupture of Pseudoaneurysm in Type 1 Neurofibromatosis (신경섬유종증에 동반된 가성동맥류 파열로 발생한 자연 혈흉 1예)

  • Kim, Sun-Jong;Jeong, Hoon;Lee, Sung-Soon;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.1
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    • pp.122-126
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    • 2001
  • A non-traumatic, spontaneous hemothorax is rare. The most common causes are coagulopathy, due to anticoagulation treatment, and cancers with a metastasis to the pleural surface. Other unusual causes include thoracic endometriosis, ruptured aortic aneurysm, pulmonary arterio-venous malformation, coagulopathy, Osler-Rendeu-Weber syndrome, Ehlers-Danlos syndrome et cetera. A type 1 neurofibromatosis(Von Recklinghausen's disease) is an autosomal dominant disease that is characterized by multiple skin tumors(neurofibroma) and abnormal skin pigmentation(caf$\acute{e}$-au-lait spots). Some are accompanied by vasculopathy, and are present with a spontaneous hemothorax. Such cases are unusual but fatal. We have recently experienced a case where a young male patient with neurofibromatosis initially presented with hypovolemic shock due to a spontaneous hemothorax. Later, aortography revealed that the cause of the hemothorax was a rupture of a pseudoaneurysm of the right internal mammary artery and as a result, an embolization was performed. Here we report this case with a review of the appropriate literature.

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Mediastinal Lymphangioma in Adults : Three Case Reports (성인에서 발생한 종격동 림프관종 3례)

  • Kim, Kyung Chan;Koh, Won-Jung;Kwon, O Jung;Lee, Byoung-Hoon;Hwang, Jung Hye;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Joungho;Ko, Young Hyeh;Kim, Jhingook;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.3
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    • pp.303-310
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    • 2003
  • Background : Lymphangioma of the mediastinum is an uncommon benign tumor of lymphatic origin that is most often seen in children, is very rare in adults and is frequently discovered incidentally on chest x-ray exams. While radiology (CT and MRI) may suggest the diagnosis and allow an assessment of the operative difficulties, the histology of the surgical specimen is required for precise diagnosis. Complete resection is the only treatment; however, in some patients resection was incomplete because of the infiltrating character of these tumors, leading to recurrence. We report three cases of mediastinal lymphangioma with a review of the literature.

Implant-retained overdentures with pre-fabricated bar attachment system in edentulous patients (무치악 환자에서 기성 조립식 bar를 이용한 임플란트 피개의치 증례)

  • So, Na-Young;Hong, Young-Gi;Ha, Seung-Ryong
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.1
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    • pp.41-48
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    • 2016
  • Edentulous patients with severe alveolar bone resorption have trouble with using traditional complete denture. In order to overcome these problems, implant-retained overdenture was developed. SFI-bar$^{(R)}$ system can save time and cost compared to other existing bar systems which need complicated laboratory procedures because it can be adjusted directly in a patient's mouth. A 55-year-old male, who had experienced a fractured lower old implant-retained overdenture, wanted a durable and painless denture. The fractured Locator$^{(R)}$ attachments were removed and edentulous mandible was restored with SFI-bar$^{(R)}$. A 77-year-old female with a medical history of the Parkinson's disease and severely absorbed alveolar bone of mandible, wanted to wear a retentive mandibular denture without pain. After placing two implants in front of mental foramen, two adaptors were connected to two implants and a tube bar was connected to the adaptors. A female part fitted to the bar was attached to the new denture. These clinical reports describe two-implant-retained overdenture using the SFI-bar$^{(R)}$ system in mandibular edentulous patients. Since the patients were satisfied esthetically and functionally during 2 years' observation, we would like to report cases.

Fixed prosthodontic rehabilitation of maxillary posterior teeth using functionally generated path technique and intraoral digital scan: Case report (Functionally generated path technique 및 구내 디지털 스캔을 이용한 상악 구치부의 고정성 보철 수복 증례)

  • Kim, Sung-Ho;Lee, Jonghyuk;Choi, Yu-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.3
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    • pp.228-238
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    • 2020
  • In order to deliver fixed partial denture to a patient successfully, dentist must take into many considerations beforehand. Patient's occlusal pattern should be fully understood before delivering any type of prosthesis, whether it's canine guidance or group function occlusion. In order to do so, movement of mandible should be recorded precisely. Introduced by Meyers in 1933, functionally generated path technique (FGP) has been successfully used to record mandibular movement with various materials, such as wax, and utilize it in fabricating precise prosthesis. In the following cases, patients showed secondary caries or endodontic-periodontic lesion on maxillary molars. Root canal treatment and subgingival curettage were done for each patient. Since the long term prognosis of each tooth was questionable, lateral force should be minimized. In order to do so, FGP technique was used to record mandibular movements precisely. Instead of using conventional plaster impression, intra-oral scanning of wax tracing was done to fabricate prosthesis efficiently. After delivery of fixed partial denture, favorable outcome was obtained.

Long-term Follow-up Study of Sternocostoclavicular Hyperostosis (흉골늑골 쇄골간 과골증의 장기추시결과)

  • Kim, Jeung-Il;Suh, Keun-Tak
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.103-111
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    • 2006
  • Purpose: Sternocostoclavicular hyperostosis (SCCH) is a disease of unknown etiology, which is characterized by periosteal reaction and endosteal hyperossification of the sternum, clavicles and upper ribs as well as ossification of the surrounding soft tissue. SCCH is a well recognized but uncommon condition which is important differential diagnosis to consider to avoid misdiagnosis and to differentiate the condition from malignant process. But few studies have reported long-term clinical result of SCCH. We report long-term clinical result of SCCH. Materials and Methods: From 1986 to 2000, 17 cases of SCCH were followed up over two to 14 years. We evaluated the radiologic, pathologic and clinical results. Results: Four men and thirteen women were studied. The age when first symptom appeared were raged from17 to 60(average-48.7) There are no specific bacteriological, serological or histological finding. Usually a permanent increase in the erythrocyte sedimentation rate is found. The radiological examination showed the signs of proliferate destructive arthritis in most case. The majority of patients respond to NSAIDs and antibiotics. Conclusion: Sternocostoclavicular hyperostosis is uncommon benign condition, but important condition in the differential diagnosis of inflammatory or malignant process of this joint.

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Resection and Reconstruction for Liposarcoma Involving Popliteal Fossa and Antero-lateral Compartment of Lower Leg - A Case Report - (하퇴 슬와부 및 전외측 구획을 침범한 지방육종 환자의 절제 및 재건술 - 증례보고 -)

  • Won, Ho-Hyun;Hong, Youn-Seok;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.69-74
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    • 2009
  • Soft tissue sarcomas of popliteal fossa are rare, accounting for less than 5% of all soft tissue sarcomas of the extremities. In an extracompartmental space such as the popliteal, cubital fossa and inguinal space, where major vessels and nerves traverse, performing resections with wide margin is difficult and sometimes marginal margin is inevitable for limb salvage. For popliteal tumor resection, posterior approach would be a classic method. For tumors with small size and not adherent to surrounding structures, tumor is easily resected by this approach and dissection of nerve sheath or adventitia of vessel. On the contrary, tumors of large size and infiltrating the posterior structure of knee joint may show difficulty in en-bloc resection itself. These cases were candidates for amputation. Furthermore, tumors involving both popliteal fossa and anterior compartment usually had no choice but to have an amputation to prevent local recurrence. We regarded soft tissue sarcoma showing this kind of presentation as bone tumor having extraosseous mass. We performed wide en-bloc resection of proximal tibia and fibula along with sarcoma involving both compartment on liposarcoma of 47-year old man.

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Submentoplasty for esthetic improvement of the neck-lower facial region : Two cases report (하안면과 경부의 심미성 증진을 위한 지방흡입술을 동반한 Submentoplasty 술식: 증례보고)

  • Park, Young-Ju;Nam, Jeong-Hun;Song, Jun-Ho;Yeon, Byung-Moo;Kim, Da-Young;Ahn, Jang-Hun;Gang, Tae-In;Kang, Hae-Jin;Kim, Jun-Hyun
    • The Journal of the Korean dental association
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    • v.47 no.11
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    • pp.750-757
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    • 2009
  • Purpose : The purpose of this study is to evaluate the clinical availability of submentoplasty for esthethic improvement of the cervico-facial region of patients with obtuse chin-neck angle. Materials and methods : Case 1. We evaluate the changes of submental line length and chin-neck angle of 35-year-old woman with skeletal Class III and mandibular excess with excessive submental fat before and after surgery: Bilateral sagittal split ramus osteotomy(BSSRO) setback(5mm), Mandibular Angle Reduction, Reduction Malarplasty and Submentoplasty. In this case, It was done simultaneously with orthognathic surgery. Case 2. The changes of submental line length and chin-neck angle of 20-year-old man with skeletal class III and maxillary defiency were evaluated before surgery, at first surgery : Lefort I osteotomy(6mm posterior Impaction), BSSRO setback(9mm), Paranasal Augmentation and at second surgery: genioplasty(6mm advanced) with submentoplasty. In this case, submentoplasty and advancement genioplasty were done after 2 months post-operative periods. Results : Case 1. In case of the Skeletal Class III mandibular excess with submental fat deposit, It showed the improvement of submental angle and length of submental line after simultaneous submentoplasty. Submental angle is changed from $177^{\circ}$ (pre-op) to $151^{\circ}$ (post-op) and submental line length is changed from 8mm(pre-op) to 36mm(post-op). Case 2. The improvement of submental angle and length of submental line after delayed submentoplasty was aquired in case of the skeletal class III maxillary defiency. Submental angle is changed from $154^{\circ}$ (pre-op) to $161^{\circ}$ (first surgery) and to $153^{\circ}$ (second surgery) and submental line length is changed from 25mm(pre-op) to 19mm(first surgery) and to 23mm(second surgery). Conclusion : The results suggest that Submentoplasty is useful surgical procedure for esthethic improvement of the cervicofacial region of patients with obtuse chin-neck angle.

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Development of a Prototype Patient Monitoring System with Module-Based Bedside Units and Central Stations: Overall Architecture and Specifications (모듈형 환자감시기와 중앙 환자감시기로 구성되는 환자감시시스템 시제품의 개발: 전체구조 및 사양)

  • Woo, E.J.;Park, S.H.;Jun, B.M.;Moon, C.W.;Lee, H.C.;Kim, S.T.;Kim, H.J.;Seo, J.J.;Chae, K.M.;Park, J.C.;Choi, K.H.;Lee, W.J.;Kim, K.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.05
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    • pp.315-319
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    • 1996
  • We have developed a prototype patient monitoring system including module-based bedside units, interbed network, and central stations. A bedside unit consists of a color monitor and a main CPU unit with peripherals including a module controller. It can also include up to 3 module cases and 21 different modules. In addition to the 3-channel recorder module, six different physiological parameters of ECG, respiration, invasive blood pressure, noninvasive blood pressure, body temperature, and arterial pulse oximetry with plethysmogaph are provided as parameter modules. Modules and a module controller communicate with up to 1Mbps data rate through an intrabed network based on RS-485 and HDLC protocol. Bedside units can display up to 12 channels of waveforms with any related numeric informations simultaneously. At the same time, it communicates with other bedside units and central stations through interbed network based on 10Mbps Ethernet and TCP/IP protocol. Software far bedside units and central stations fully utilizes gaphical user interface techniques and all functions are controlled by a rotate/push button on bedside unit and a mouse on central station. The entire system satisfies the requirements of AAMI and ANSI standards in terms of electrical safety and performances. In order to accommodate more advanced data management capabilities such as 24-hour full disclosure, we are developing a relational database server dedicated to the patient monitoring system. We are also developing a clinical workstation with which physicians can review and examine the data from patients through various kinds of computer networks far diagnosis and report generation. Portable bedside units with LCD display and wired or wireless data communication capability will be developed in the near future. New parameter modules including cardiac output, capnograph, and other gas analysis functions will be added.

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Reoperation for Hemorrhage Following Open Heart Surgery with Cardiopulmonary Bypass A Report of 81 cases (개심술후 출혈로 인한 응급 개흉술 81례의 임상적 고찰)

  • 오중환
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.753-758
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    • 1985
  • Hemorrhage is an important complication after operation with cardiopulmonary bypass and sometimes necessitates a further emergency operation. Between July, 1962 and June, 1985, reoperation for hemorrhage was carried out on 81 patients [3.1%] out of a total 2634 patients who had previously undergone cardiopulmonary bypass surgery at the Department of Thoracic and Cardiovascular Surgery, Yonsei University Medical Center. There were 38 males and 43 females, with an average age of 25 years [ranging 6 months to 60 years] and an average body weight of 38 kg [ranging 5 to 77 kg].There were 43 patients of cyanotic heart disease, 32 patients of acquired valvular heart disease, 4 patients of coronary artery occlusive disease, 2 patients of ascending aorta aneurysm and annuloaortic ectasia. The average amount of blood loss in the case of cyanotic heart disease was 71.7140ml/kg, in acyanotic heart disease 45.16.3ml/kg, in acquired heart disease, 56.514.4ml/kg and in coronary artery occlusive disease, 50.618.7ml/kg during first post operative day. But there was no statistical difference [p>0.05]. The mean blood loss below 10 years old was 70.412.1 ml/kg. Those below 10 years old were believed to bleed more than any other group. But there was also no statistical difference [p>0.05]. Indications for reoperation were continued excessive blood loss [74%], cardiac tamponade or hypotension [23%] and radiological evidence of a large hematoma in the thorax and pericardium [2%]. Average bypass time was 2.10.1 hours [ranging 30 minutes to 5 hours]. The interval between operation and reoperation was as follows; less than 12 hours in 49 patients [60%], 12 to 24 hours in 20 patients [25%], 24 to 48 hours in 8 patients [10%], more than 48 hours in 4 patients [5%]. The commonest sites for bleeding were chest wall [36%], heart [34%], aorta [12%], pericardium [6%], thymus [5%] and others [6%]. But no definite source was found in ll patients [31%]. Twenty seven out of 81 patients [31%] had wound problems and 5 patients [6%] were expired. [Mean SEM]. In conclusion, in order to decrease the amount of blood loss after open heart surgery with cardiopulmonary bypass, shortening of bypass time and bleeding control at the wire suture site during chest wall closure were important. If the amount of blood loss was over 45 ml/kg or 8 m/kg/hour, reoperation should be considered as soon as possible. After operating, careful wound dressings were applied to prevent wound problems.

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