• 제목/요약/키워드: chest tightness

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홧병클리닉을 방문한 환자들의 임상 증상과 MMPI 상의 성격 특징에 대한 연구 (Clinical Symptoms and Personality Characteristics on MMPI of Patients in Hwa-Byung Clinic)

  • 이유진;백경원;김하경;연규월;임원정
    • 정신신체의학
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    • 제16권2호
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    • pp.120-124
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    • 2008
  • 연구목적 : 본 연구는 홧병 클리닉을 방문한 환자를 대상으로 임상증상과 MMPI상의 성격특성을 조사해 보고자 하였다. 방법 : 2005년 12월부터 2006년 7월(7개월간)까지 이대 동대문 병원 내 가슴앓이 홧병 클리닉에 내원한 31명의 여성 환자($45.4{\pm}8.4$세)를 대상으로 호소하는 증상에 대해 반구조화된 면담을 실시하였고 신체적 검사를 시행하였다. 광고를 통해 모집된 31명의 여성 대조군($42.9{\pm}8.0$세)을 포함한 전체 대상군에게 MMPI를 완성하도록 하였다. 결과 : 홧병 클리닉 환자들이 호소한 주 증상은 31명 모두 가슴 답답함 혹은 통증을 호소하였으며, 소화기계 증상은 총 19명(61.3%)에서 있었다. 호흡기계 증상은 13명(41.9%)에서 관찰할 수 있었으며, 수면 장애는 12명 (38.7%)에서 있었다. 불안, 우울감 같은 정신과적 증상은 12명(38.7%)이 호소하였다. 8명(27.6%)의 환자에서 시행한 검사상 소화기계 질환이 진단되었다. 나이와 교육수준을 통제했을 때, 홧병 환자군에서 MMPI 소항목 척도 중 Hs(Hypochondriasis), D(Depression), Hy(Hysteria), Pt(Psychasthenia) 점수가 유의하게 높았다(p=0.001, p=0.049, p=0.000 and p=0.029, ANCOVA, respectively). 결론 : 본 연구에서 홧병 클리닉을 방문한 환자들은 다양한 신체 질환을 호소하였고, 27.6%의 환자에서 실제 신체질환이 진단되었다. 또한, 홧병클리닉 환자들의 성격 특징은 건강염려적이고, 우울하며, 스트레스에 미숙하고, 불안하였다.

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성인 20 세 이상 활로 4징증의 수술성적 (Surgical Correction of Tetralogy of Fallot in Adults over 20 Years of Age)

  • 정윤섭
    • Journal of Chest Surgery
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    • 제23권2호
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    • pp.253-259
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    • 1990
  • Between January, 1970 and August, 1989, a total of 81 patients whose age were more than 20 years of life, received total correction for tetralogy of Fallot. This report analyzed 70 patients among them and excluded the remaining 11 patients whose clinical data could not be found. Their mean age was 25.750.39 years[range 20 \ulcorner50]. The clinical manifestations were cyanosis and clubbing [64 pts], frequent URI[40 pts], anoxic spell [19 pts], infective endo-carditis[4 pts], brain abscess[3 pts], pulmonary tuberculosis[3 pts] and CHF, chest tightness, nephrotic syndrome, left hemiplegia, and tamponade. The types of right ventricular outflow tract obstruction were combined[46 pts], pure infundibular [21 pts] and pure valvular[3 pts]. Associated cardiovascular anomalies were PFO [27 pts], ASDi8 pts], LSVC[8 pts], aortic regurgitation [5 pts], right aortic arch, coronary artery anomalies, PDA and dextrocardia. Hospital mortality was 5.7%. The causes of death ware low cardiac output [2 pts], aggravation of CRF[1 pts] and brain damage[1 pts]. There was one late death because of residual intracardiac shunt and congestive heart failure. During the follow-up period, 16 patients were lost and the remaining 49 patients were asymptomatic and leading normal lives. Residual intracardiac shunt was detected in 5 patients with radionuclide single pass study but all of them had Qp / Qs ratio less than 1.5.

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거대상행핵대동맥루를 동반한 대동맥륜확장증 수술 치험: Cabrol씨 수술 1례 보 (Surgical correction in annuloaortic ectasia associated with ascending aortic aneurysm: one case report)

  • 곽문섭
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.753-761
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    • 1984
  • Most patients having annuloaortic ectasia are associated with marked dilatation of the sinuses of Valsalva and the aortic annulus as well as the huge aneurysm of the ascending aorta. A 19 year old male patient complaining of tightness on left posterior chest wall underwent cardiac angiography in which demonstrated annuloaortic ectasia with ascending aortic aneurysm and aortic insufficiency. The patient had corrective operation replacing the ascending aorta and aortic valve with a composite graft[Dacron prosthesis containing a Bjork-Shiley aortic valve] within the aneurysmal sac. The coronary orifices were anastomosed to the tubular Dacron prosthesis [30 mm in diameter] by means of a second smaller Gore-Tex tube [8mm in diameter]. The aneurysmal sac was trimmed by removing the redundant wall and then wrapped outer wall of the Dacron prosthesis. Postoperatively, mediastinal bleeding was temporarily observed in the operative day and satisfactory blood pressure was maintained with small dose of dopamine. One week later, large amount of serous effusion was drained out of the retrosternal space making partial disruption of the skin which was healed well by daily local dressing. The patient discharged in good condition on postoperative 29th day with no residual complications and is doing very well on the 4 months follow-up.

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승모판막 폐쇄부전을 유발한 기관지성 낭종 (Bronchogenic Cyst Causing Mitral Regurgitation)

  • 송종필;정승혁;강경훈;김병열;강경민
    • Journal of Chest Surgery
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    • 제32권1호
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    • pp.66-69
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    • 1999
  • 기관지성 낭종은 태아기에 원시전장으로부터 분화하는 비교적 드문 선천성 질환이며, 대부분 기관분기부, 양측 주기관지, 폐실질 그리고 종격동에서 발생한다. 40세 남자 환자로 호흡곤란과 흉부압박감을 주소로 입원하여, 컴퓨터 단층촬영 검사상 경계가 명확하고 크기가 7.2$\times$7.9 cm이며, 좌심방을 압박하는 균질의 종양이 발견되었고 심초음파 검사상 중등도의 승모판막 폐쇄부전을 보였다. 수술은 낭종을 완전히제거하였으며, 조직학적 검사상 기관지성 낭종으로 확진되었다. 추적관찰 결과 환자는 증상없이 잘 지내고 있었으며, 심초음파 검사상 승모판막 폐쇄부전은 경도로 호전되었다. 본 국립의료원에서는 승모판막 폐쇄부전증을 유발한 기관지성 낭종 1례를 치험하였기에 보고하는 바이다.

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대동맥판협착증에 동반된 우관상동맥의 석회성 색전증 (Fibrocalcific Embolism of Right Coronary Artery Combined with Aortic Valvular Stenosis)

  • 장성욱;박정옥;김영권;이명용;류재욱;박성식;서필원;김삼현
    • Journal of Chest Surgery
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    • 제36권11호
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    • pp.858-861
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    • 2003
  • 대동맥판막질환에 동반된 허혈성 심질환의 원인은 대부분 전신적인 동맥경화의 진행에 따른 것이며, 심한 석회화가 초래된 대동맥판협착증 환자에서 대동맥판막의 일부가 떨어져 나와서 관상동맥 색전증 및 협착을 유발시킨 예는 매우 드물다. 저자들은 흉부압박감을 주소로 내원한 73세 여자 환자에서 심초음파검사와 관상동맥조영술을 시행하여 중증 대동맥판협착증과 우관상동맥의 색전증을 진단하고 대동맥판치환술과 우관상동맥의 색전제거술 및 관상동맥성형술을 시행하였던 예를 치험하였다. 수술 후 우관상동맥 색전의 원인 물질이 대동맥판막으로부터 떨어져 나온 석회성 판막조직으로 판단되었기에 이와 관련된 문헌고찰과 함께 보고하는 바이다.

사지의 강직을 주소로 내원한 호산구성 근막염 환자 (A Case of Eosinophilic Fasciitis Presenting as Stiffness of all Limbs)

  • 허재혁;민주홍;권형민;김지영;조중양;이광우
    • Annals of Clinical Neurophysiology
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    • 제7권1호
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    • pp.46-48
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    • 2005
  • Eosinophilic fasciitis (EF), also known as Shulman syndrome, is an inflammatory disorder of unknown etiology. It usually presents with pain, swelling, and tenderness of the proximal aspect of the limbs, chest, or neck, with subsequent induration of the skin and subcutaneous tissues, in association with peripheral eosinophilia. EF is differentiated from scleroderma by the pattern of skin involvement and non-involvement of muscle. We report a case of progressive EF presented with tightness and stiffness in all limbs.

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염소 가스 중독에서 나트륨 중탄산염의 흡입치료 2례 (Two Cases of Sodium Bicarbonate Inhalation Therapy in Chlorine Gas Intoxication)

  • 이동훈;어은경
    • 대한임상독성학회지
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    • 제2권1호
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    • pp.49-53
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    • 2004
  • A chlorine gas is a common irritant and when exposed, it result in mild occular, oropharyngeal, or respiratory symptoms. In severe case, however, it may result in pulmonary edema, interstitial pneumonia, or respiratory failure. We report the case of 29-year-old and 46-year-old men is accidentally exposed to chlorine gas during cleaning water. The patients complained dyspnea, chest tightness, cough and both eye pain. During hospitalization, they were treated with inhalation of humidified oxygen, beta-adrenergic agonist and $2\%$ sodium bicarbonate. After several days, patients were discharged without respiratory symptoms and complication. In treatment of chlorine gas toxicity the inhalation of sodium bicarbonate is a possible initial therapy can improve respiratory symptoms in spite of lack of evidence.

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안심연료단지 주변지역 주민의 호흡기계질환에 대한 설문조사 및 건강검진 결과 분석 (A Study on the Results of Questionnaire Survey and Health Examination for Respiratory Disease among Residents in Briquette Fuel Complex in Ansim, Daegu)

  • 이관;임현술;김민기;민영선;이영현;김성우;최혜숙;안연순;사공준;유승도;김근배;윤미라
    • 한국산업보건학회지
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    • 제25권3호
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    • pp.355-365
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    • 2015
  • Objectives: This study was conducted to better understand the relationship between health effects and exposure to dusts from a briquette fuel complex in Ansim, Daegu, Korea. Methods: The subjects of this study consisted of 2,980 persons over 40 years old who had lived 20 years or more around a briquette fuel complex in Daegu. We conducted a questionnaire survey, and chest radiography was performed. In addition, chest computed tomography(CT) (335 cases) and pulmonary function test(PFT) (658 cases) were done. Pneumoconiosis was diagnosed if one of three radiologists determined(or suspected) pneumoconiosis. We also conducted in-depth interviews for pneumoconiosis cases. We defined the exposed group as subjects residing within a 500 meter radius from the walls of the briquette fuel complex, and the others were defined as the control group. Results: Subjects in the exposed and control groups are respectively 715(24%) and 2,265 cases(76%). Major respiratory symptoms in the exposed group such as sputum, dyspnea, chest tightness and wheezing were significantly higher than in the control group. By chest radiography, 173 cases of pneumoconiosis or suspicious pneumoconiosis were detected. By PFT, 62 cases(29.5%) of chronic obstructive pulmonary disease(COPD) among 210 asymptomatic subjects were detected. Finally, by chest CT we concluded 28 cases to be pneumoconiosis, and eight cases among them proved to be pneumoconiosis by environmental exposure. Conclusions: Through this study, we concluded that health outcomes such as respiratory symptoms, pneumoconiosis, and COPD were caused by continuous exposure to dusts from the briquette fuel complex. Policies to reduce environmental exposure are needed, and cases of environmental disease should be intensively followed up by the government.

학동기 농촌 아동의 폐기능 정상 예측치와 호흡기 증상에 민감한 폐기능 지표 (Normal Predicted Values of Pulmonary Function of the Primary School Children in Rural Area and Sensitive Index of Respiratory Symptoms)

  • 최병선;박정덕;홍연표;장임원
    • Journal of Preventive Medicine and Public Health
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    • 제28권3호
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    • pp.690-705
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    • 1995
  • Pulmonary function tests were conducted on 815 healthy primary school children (390 males and 425 female) in rural area using Collins Survey Spirometer (Warren E. Collins, Inc., U.S.A.) with X-Y Recorder. Respiratory symptoms(cough, sputum, sore throat, chest pain, chest tightness, dyspnea, coryza) were surveyed by the interviews. Multiple regression analysis and regression diagnostics were done for prediction equations of FVC, $FEV_1,\;PEFR\;and\;FEF_{25-75%}$. FVC, $FEV_1,\;PEFR\;and\;FEF_{25-75%}$ values in 3 groups of children classified by the number of symptom were compared each other through standard variable value. FVC, $FEV_1,\;PEFR\;and\;FEF_{25-75%}$ showed highly significant correlation with age, height and weight. Prediction equations for FVC, $FEV_1,\;PEER,\;FEF_{25-75%}$ are functions of height only in both male and female children aged between 6 and 12 years old. PEFR showed a significant difference related with the number of symptom in female. These results suggest that the PEFR is sensitive PFT parameter in this study.

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거연한간(居延漢簡)과 상한론(傷寒論)의 병증(病症) 비교 연구 (Comparative Study on Diseases and Symptoms between Shanghan-lun and Juyan Wooden Slips)

  • 하기태;정한솔;신상우
    • 동의생리병리학회지
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    • 제25권1호
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    • pp.19-28
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    • 2011
  • More than 30,000 Wooden Slips were excavated in the Juyan region in 1930s and 1970s. These slips recorded military actions of Juyan Frontier Fortress during Han dynasty, which is about BC 100 ~ AD 30. On the slips, there are many disease names and symptoms mentioned. We focused on a certain disease name, namely, Shnaghan(傷寒; injured by cold), which is the main subject of Shangha-lun(傷寒論). Looking closely into these Juan Wooden Slips, we found many articles recording Shanghan, including related diseases and symptoms, such as Shanghan(傷汗; injured by sweat), headache, fever and chills, immobilization of limbs, unacceptance of foods. And there are another Shanghan-related symptoms, such as inflation of upper-abdomen(心腹支滿), pain of upper abdomen(心腹痛), strain of both armpits(兩胠葥急), inflation of chest(胸脇支滿), tightness and fear in the chest(煩滿). Although they have no direct relationship with Shanghan, there are many symptoms, including the external wounds of waist, finger, thigh, back, breast and head, abscess of leg and elbow, sore throat, itching, leucorrhea, powerlessness of hands and legs(手足癃), visceral injury(傷臟), tinnitus, cold, warm and heat. Because the Wooden Slips are very short, with some characters even missing, we can not confirm the detail of the disease and symptoms. In addition, we will report about the herbal medicines and other treatments, which are recorded on the slips, by further research.