• Title/Summary/Keyword: chest tightness

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A Case of Esophageal Perforation due to Foreign Body (식도이물에 의한 식도천공 1예)

  • 홍기환;조규모;송기준
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.7.1-7
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    • 1983
  • Esophageal perforation occurred rarely, but it leads to a high mortality and morbidity. Main cause of esophageal perforation in Korea is instrumental perforation in patients with lye stricture of esophagus during diagnostic endoscopy or therapeutic bouginage. A case of 25-year-old male patient entered to outpatient clinic. Chief complaints were mild pain at swallowing, mild fever elevation and chest tightness with radiating pain to shoulder and interscapular region for 1 day. On the X-ray film with barium soaked cotton piece in esophagus, it was revealed that foreign body (fish bone) had been located on the level of 2nd vertebra with leakage of barium to mediastinum. The foreign body was removed with endoscopy in Dept. of otolaryngology, and cervical mediastinostomy was performed in Dept. of thoracic surgery.

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A Study on Clinical Records of King Hyeonjong's Queen, Queen Myeongseong, Focusing on Cases Recorded in the Seungjeongwon Ilgi (The Daily Records of Royal Secretariat of Joseon Dynasty 承政院日記) (현종 비 명성왕후의 복약 기록 연구 - 『승정원일기』의 의안을 중심으로 -)

  • Park, Jooyoung;Kug, Sooho;Kim, Namil;Cha, Wungseok
    • The Journal of Korean Medical History
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    • v.32 no.1
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    • pp.11-20
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    • 2019
  • Queen Myeongseong was the wife of King Hyeonjong, the 18th king of the Joseon Dynasty, and the mother of King Sukjong. The clinical records of Queen Myeongseong are summarized on the basis of the Seungjeongwon Ilgi (The Daily Records of Royal Secretariat of Joseon Dynasty 承政院日記) and reviewed through Donguibogam. Queen Myeongseong gave birth to one male and three female children in the time of the queen. She took Geumgaedangguihwan (金櫃當歸丸), Dalsaengsan (達生散), Antaeum (安胎飮) during her pregnancy and Gungguitang (芎歸湯) during postnatal care. Since 1669, chest tightness, sleeplessness, arm pain and numbness of arms had been appeared. Ondamtang (溫膽湯) and Dodamtang (導痰湯) were used but they were not effective. However, when her symptoms were regarded as a benign tumor due to cold and wetness, there was a difference in the use of Ohjuksan (五積散). In 1683, when king Sukjong was caught in a smallpox, she took care of him. She exorcised in the middle of winter to pray for her son's recovery, and died of the flu.

Giant Coronary Artery Aneurysm Presenting as a Calcified Mediastinal Mass a, Coronary Artery Fistula - A case report - (종격동 종양으로 오인된 거대관상동맥류와 관상동맥루 - 치험 1례 -)

  • Yoon, You-Sang;Lee, Cheol-Joo;Choi, Ho;Kang, Jun-Kyu;Choi, Jin-Wook;Kim, Hyung-Tae
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.787-791
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    • 2001
  • Coronary artery aneurysm is a rare disorder. It is defined as abnormal dilatation of coronary artery with diameter exceeding 1.5 times the adjacent normal segments. The incidence of coronary aneurysm is 2.6% in Caucasians and 0.25% in Asians. Over half of the former were associated with atherosclerotic coronary artery disease. However, 70 percents of the latter were nonobstructive coronary artery aneurysms. Coronary artery fistula is a rare disorder. It has been identified in only 0.2% of routine cardiac angiographic studies conducted over a 10-year period. The clinical spectrums are various, asymtomatic, asymptomatic murmur, dyspnea on exertion, fatigue, and congestive heart failure. The right coronary artery (56%) and left coronary artery(36%) are mainly involved in the origin site of congenital coronary artery fistula. The draining site of fistula are right ventricle(39%), right atrium(33%), and pulmonary artery(20%) and so on. This 54 years-old woman had intermittent chest tightness and an abnormal mediastinal shadow on chest roentgenogram and chest C-T examination, which was diagnosed as a mediastinal mass such as teratoma. We performed the operation under left anterolateral thoracotomy for mass excision. However, we knew the mass had the pulsating arterial blood flow through a fine needle puncture of the mass and that it was attached to the left ventricle. We believed the excision of mass on beating heart would be very dangerous. Therefore, we closed the wound without excising the mass. After several days, we performed an echocardiography and coronary angiography, We knew it was cardiac tumor. Incidentally, the patient had a tortuous coronary fistula from the right coronary artery to pulmonary trunk. Using cardiopulmonary bypass with moderate systemic hypothermia, the mass was resected and the fistula was clipped with surgical clips. Pathology of the specimen was a giant coronary arterial aneurysm.

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A Study of Adverse Health Symptoms of Spray Painters Using Isocyanates(HDI) (분사페인트에 의한 이소시안화물의 노출이 건강에 미치는 영향에 관한 연구)

  • Lee, So-Gil;Pisaniello, Dino;Lee, Nae-Woo
    • Journal of the Korean Society of Safety
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    • v.23 no.3
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    • pp.79-86
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    • 2008
  • In the manufacturing industries using HDI(hexamethylene diisocyanate) product hardeners, exposure to HDI is common to spray painters in terms of inhalation and dermal or ocular contact. Due to a lack of information for spray painters in automobile and furniture industries, a questionnaire survey was conducted for the prevalence of adverse health symptoms(33 spray painters and an unexposed group n = 91) to assess the importance of personal controls. Despite the small sample size, common health symptoms were reported, such as skin symptoms(dry cracked skin-61% and dermatitis/skin irritation-33%) and respiratory symptoms(phlegm-49%, asthma-21%). In addition, other adverse health symptoms were reported, such as skin rash(12%), cough(39%), shortness of breath with wheezing(30%), chest tightness and difficulty in breathing(30%). No significant eye symptoms were reported. It was founded that the adverse health symptoms reported in this study were related to poor personal work practices and inappropriate PPE use. Therefore, appropriate personal controls like PPE use, work practices, regular training and education are suggested to minimize the risk of health symptoms. In addition, medical examination will also be suggested for individual health effects.

Post Discharge Nursing Needs of Patients with Open Heart Surgery (개심술 환자의 퇴원후 간호요구에 대한 조사연구)

  • 김명희
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.664-677
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    • 1993
  • The purpose of this study was to provide basic data for the development of educational material in Korean for patient3 being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out -patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows ; 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used (91.0%) . The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many Patients didn’t know the importance of a low salt diet(57.8%), and did not get any education on low salt diet (66.7%). Gimchi was included as one of the most commonly ingested foods (77.8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1% ). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1% of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%) . Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns (57.7%) related to nursing. needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical discomfort including the following : memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51.1%), sleep disturbance(46.7%) and other symptoms in that order of frequency. Nursing needs related to physical condition were a concern for all of them. The viability and function of the replaced valve(53.3%) and weight gain(60.0%) were mal or concerns. 6. Looking at their psychoemotional condition it was found that 36 patients(80.0%) were emotionally unstable. The causes were physical discomfort(17 patients), insufficient knowlege of open heart surgery(6 patients), fear of death(6 patients), familial over protection(2 patients ) and lack of support (5 patients).

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Effect of Non-contact Korean Medical Treatment for Patients Recovering at Home with Positive Coronavirus Disease 2019 Diagnostic Test Results at a Local Public Health Center: A Retrospective Chart Review (지역 보건소에서 시행한 코로나 바이러스 감염증-19 진단 검사상 양성인 재택치료 환자의 비대면 한의진료 효과: 후향적 차트 리뷰)

  • Jeon, Chaeheun;Choi, Daejun;Kim, Gyeongmuk;Kim, Hyejin;Leem, Jungtae;Chi, Gyoo-yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.36 no.4
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    • pp.130-137
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    • 2022
  • Due to the coronavirus disease 2019 (COVID-19) pandemic, appropriate management of sequelae and treatment of infectious symptoms became increasingly important healthcare issues. Although the practice guidelines and treatment cases based on the East Asian traditional medicine have been reported, there are rare studies on the use of Korean medicine in Korea. Therefore, this study aimed to present the progress of non-contact Korean medical treatment for infected patients at a local public health center using retrospective chart review. A total of 18 patients were prescribed with 5 days of herbal decoction and medicine extract covered by the national health insurance. With the questionnaire form, the progression and improvement of symptoms before and after treatment were evaluated using the numerical rating scale (NRS), and the treatment satisfaction and opinions were obtained. The symptoms such as cough (5.56±2.23 to 2.89±2.14), sputum (6.11±1,75 to 3.28±2.47), sore throat (6.06±2.70 to 1.47±1.62), anorexia (5.56±2.63 to 1.94±2.21), nausea (3.75±1.71 to 1.17±1.11), diarrhea (3.40±2.63 to 1.50±1.51), chest tightness (4.93±2.46 to 2.29±2.30) and fatigue (6.44±1.79 to 2.67±1.88) all improved according to the NRS, and the satisfaction with herbal medicine treatment on a 5-point Likert scale was 4.24±0.90. No side effects and adverse reactions were reported. Thereupon non-contact Korean medical treatment can be concluded that it effectively reduces the COVID-19 infection mild symptoms in restrictive extent. Since the retrospective data does not include a control group, the more confirmative data is needed by multicenter and large-scale controlled clinical study afterwards.

The Effect and Side Effect of Dipyridamole in Myocardial SPECT (Dipyridamole 부하 심근 SPECT에서 Dipyridamole의 작용과 부작용)

  • Yang, Hyung-In;Lee, Dong-Soo;Yeo, Jeong-Suk;Bae, Sang-Kyun;Choi, Chang-Woon;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.203-209
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    • 1993
  • Dipyridamole is an agent that may be used to noninvasively evaluate coronary artery disease. The effect of dipyridamole infusion its generally related to its induced peripheral vasodilatory effect. In normal person, heart rate is generally increased slightly while blood pressure decrease, but the achieved double product and related myocardial oxygen consumption have no significant change. The purpose of this study is to examine the effect and side effect of dipyridamle, and to compare different response to dipyridamole among the patients. We evaluated 847 patients who underwent dipyridamole stress myocardial SPECT. 93.6% of them had induced hypotension, 0.9% showed no change of blood pressure, 5.5% had increased blood pressure. 8.3% had no change of pulse rate more than 10% of basal pulse rate. Among diabetes, 16.9% was not change of pulse rate, 6.7% in non-diabetes. There was no significant correlation between age and rate pressure product rest(RPPr), in patiens without perfusion defects on SPECT(y=7.1x+ 48.4 r=0.13 p>0.01). As increasing age, RPPs/RPPr was declined(y= -11.6x+68.9 r=0.17 p<0.01), similar results were obtained in patients with perfusion defect. The size of perfusion defect on myocardial SPECT have no correlation between RPPr and RPPs/RPPr. The side effects of dipyridamole included chest pain and chest tightness, headache, abdominal pain, dizzness, nausea, and dyspnea. As increasing age, dipyridamole-induced cardiac work at rest was increased, cardiac response to dipyridamole was decreased.

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Sick Building Syndrome in 130 Underground Workers (지하상가 근무자의 건강 장애에 관한 실태조사)

  • Joo, Ree;SaKong, Joon;Chung, Jong-Hak;Park, Sang-Whan;Kim, Dong-Hee;Kim, Dong-Min;Choi, Eun-Kyong;Cho, Hyun-Geon
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.325-340
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    • 1998
  • A cross-sectional study was conducted to evaluate the relationship between sick building syndrome(SBS) and the environmental factors affecting SBS on 130 underground workers and 60 controls. The study consisted of 1) a review of environmental condition 2) measurement of temperature, $O_2$, $CO_2$, CO, and formaldehyde and 3) a questionnaire survey of symptom prevalence and perception of environmental conditions using indoor Air Quality questionnaire recommended by National Institute for Occupational Safety and Health. Bronchitis and dust allergy were more prevalent in underground workers significantly(p < 0.05). Among the 18 symptoms related to the indoor air pollution, the experience rate of dry, itching or irritated eyes, sore or dry throat, chest tightness, tired or strained eyes and dry or itchy skin symptom was significantly different between the underground workers and controls. The diagnostic criteria of SBS was defined as at least 1 symptom is experienced 1-3 times a week during the last 1 month among 18 indoor air pollution related symptoms which can be relieved by moving out of the underground. Applying the criteria, the mean symptom score was significant higher in underground workers than controls significantly (p < 0.05). These resalts indicated that underground workers are under inappropriate ergonomic and physical condition and inadequate ventilation. Their experience rate of symptoms related to indoor air pollution and prevalence of SBS was significantly higher than controls. To reduce the prevalence of SBS of underground workers, the surveillance system of indoor air quality, restriction of using fuel in underground and legislative regulations for the environment are needed to establish a better indoor air quality. Early detection, treatment and prevention of SBS through medical attention is also needed.

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Formaldehyde Exposure in the Plywood Manufacturing Factory (목재 가공업소에서의 Formaldehyde폭로)

  • Ha, Myung-Wha;Kim, Doo-Hie;Lim, Hyun-Sul;Park, Sang-Hu
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.1 s.33
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    • pp.37-44
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    • 1991
  • In the plywood manufacturing factory established in 1979, female 3 workers who had exposed to adhesives containing formaldehyde for more than 48 months of duration suffered from eye, nasal, oral, throat and skin irritation and dyspnea as chief complaints. The actual level of the exposure to formaldehyde were not estimated when the exposed workers started to have above symptoms. The environmental monitoring of workplace was measured on April 25, 1990, and the concentration of formaldehyde revealed 0.2 ppm, however the exhaustive ventilatory system was already installed at that time. Twenty six subjects from entire factory were examined by questionnaire, physical examination and spirometry, etc. on August 22, 1990. Significant difference was observed in symptoms and signs of nasal, oral and throat irritation between the exposed group with longer duration and that with short duration. When the exposed group with longer duration was compared to the group of nonexposed, symptoms and signs of nasal, oral, throat and skin irritaion, chest tightness and dullness were significantly increased in the former group. The results of the spirometric test showed that the forced vital capacity and the forced expiratory volume at 1 second were decreased among the exposed group with longer duration but not significant.

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Study for Treatment Effects and Prognostic Factors of Bronchial Asthma -Follow Up Over 2 Years- (2년 이상 관찰중인 성안 기관지 천식환자의 치료 효과 및 예후인자에 관한 연구)

  • Choung, Bo-Young;Park, Jung-Won;Kim, Sung-Kyu;Hong, Chein-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.559-573
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    • 1997
  • Background : Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway responsiveness to a variety of stimuli. Method : Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of "Global initiative for asthma, Global strategy for asthma management and prevention" (NHLBI/WHO) with PFR(%) larger than 80%, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/WHO, group 5 (long term control group) : patients who were controlled for more than 2 years by step 1 or 2 treatment of NHLBI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC20 and peripheral blood eosinophil count, pulmonary function test, steroid doses and aggrevation numbers after treatment. Results : On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and initial pulmonary function was better. The long term control group required lower amounts of oral steroid. had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control Atopy, allergic skin test, sputum and blood eosinophil, total IgE, nonspecific bronchial responsiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was $20.3{\pm}9.7$ months and relapse did not occur. Conclusion : Patients who had asthma of onset age younger, shorter symptom duration, better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.

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