• Journal of Chest Surgery
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• 제23권2호
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• pp.333-341
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• 1990

aortoiliac pattern, Group II; femoropopliteal pattern and Group g; tibioperoneal pattern. A majority of patients belonged to group I [27 cases], 8 patients came under group II .and none in group g. Thirty patients underwent bypass operation with autogenous saphenous vein or synthetic graft with or without concomitant lumbar sympathectomy. Remaining 5 patients were operated on with sympathectomy only, Bypass procedures were anatomic bypass in 22 cases: aortoiliac artery bypass in 11 cases, femoropopliteal artery bypass in 10 cases, sequential femoropopliteal artery bypass in one case and extra-anatomic bypass in 8 cases, axillary-bifemoral artery bypass in one case and femorofemoral artery bypass in 7 cases. Postoperative complications which mainly composed of superficial wound infection[5 cases] which were treated without any significant sequel in all cases and thrombosis[2 cases]. Three patients died whose causes of death were acute renal failure in 2 cases and myocardial infarction in other, The overall patency, rate was 70Zo in 5 years. In conclusion, the clinical pattern and operative outcome were similar to he western pattern and all cases of death did not related to operative procedures and ischemic symptoms were relieved by bypass operations except several cases. I think and recommend that all patients suffering chronic arterial insufficiency by atherosclerosis obliterans ought to be managed with urgent and adequate operative procedure.

• Journal of Korean Neurosurgical Society
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• 제58권4호
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• pp.389-392
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• 2015

Brown tumors also called as osteoclastomas, are rare nonneoplastic lesions that arise in the setting of primary or secondary hyperparathyroidism. Parathyroid adenomas or hyperplasia constitute the major Brown tumor source in primary hyperparathyroidism while chronic renal failure is the leading cause in secondary hyperparathyroidism. Most of the patients with the diagnosis of primary hyperparathyroidism present with kidney stones or isolated hypercalcemia. However, nearly one third of patients are asymptomatic and hypercalcemia is found incidentally. Skeletal involvement such as generalized osteopenia, bone resorption, bone cysts and Brown tumors are seen on the late phase of hyperparathyroidism. The symptoms include axial pain, radiculopathy, myelopathy and myeloradiculopathy according to their locations. Plasmocytoma, lymphoma, giant cell tumors and metastates should be ruled out in the differential diagnosis of Brown tumors. Treatment of Brown tumors involve both the management of hyperparathyroidism and neural decompression. The authors report a very rare spinal Brown tumor case, arisen as the initial manifestation of primary hyperparathyroidism that leads to acute paraparesis.

• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.380-382
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• 2010

The authors present an extremely rare case of a pseudoaneurysm of the ulnar artery as a complication of a two-portal endoscopic carpal tunnel release (ECTR). A 70-year-old man with chronic renal failure and on maintenance hemodialysis with a left arteriovenous fistula presented with paresthesia of his right hand. A clinical diagnosis of right carpal tunnel syndrome was confirmed by ultrasonography and an electro physiologic study. He underwent two-portal ECTR, and the paresthesia was much improved. However, he presented to us one month after operation with severe pain, a tender mass distal to the right wrist crease and more aggravation of the paresthesia in the ulnar nerve distribution. Doppler ultrasound was performed and revealed a hypo echoic lesion 20 mm in diameter in the right palm, with arterial Doppler flow inside connected to the palmar segment of the ulnar artery. An ulnar artery pseudoaneurysm was diagnosed and treated by ultrasound-guided percutaneous thrombin injection. Transverse color Doppler ultrasound image showed complete thrombosis of the pseudoaneurysm and flow cessation after a total injection of 500 units of thrombin. The symptoms were also improved.

• Journal of Chest Surgery
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• 제41권6호
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• pp.799-802
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• 2008

흉쇄골관절은 전신의 골관절염 중 매우 드물게 이환되는 부위로 주로 마약 중독자, 당뇨병, 만성 신부전, 폐혈증 환자, 및 중심 정맥 혈관 삽입 후에 주로 나타난다. 초기에는 항생제 치료, 단순 절제 및 배농술 등의 방법으로 치유될 수 있으나, 치료 시기를 놓치면 골수염으로 진행되어 광범위 절제가 필요하다. 그러나 재발할 가능성이 있으므로, 본원 흉부외과에서는 혈류를 유지한 대흉근판을 빈공간에 메워 넣어 재발 가능성을 줄여보고자 하였다. 골수염을 동반한 흉쇄골 관절염 환자를 성공적으로 치료하였기에 이에 보고하는 바이다.

• 대한한의학방제학회지
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• 제17권2호
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• pp.195-201
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• 2009

Objectives : To evaluate the efficacy of herbal medicine on CRF, clinical study on one case of 48 year old male patient of CRF was performed. The patient complained of general weakness and anorexia, dizziness and both lower limb edema. Methods : According to the Differentiation of Symptoms(變證), the patient was classified as weakness(虛勞) prescribed Sipjeondaebo-tang(十全大補湯) as well as acupuncture and moxibustion. treatment. Change of BUN, Creatinine, Hgb, Albumin, VAS of weakness and urine volume was compared before and after treatment for 3 months. Results : After such treatments, the level of BUN and creatinine was decreased and the volume of urine was increased. Conclusion : Herbal medicine Sipjeondaebo-tang with acupuncture and moxibustion treatment would be efficient to the patient of CRF.

• 대한핵의학회지
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• 제21권1호
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• pp.55-60
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• 1987

$Digoxin^{(R)}$을 복용하고 있지 않는 각27명의 만성 신부전 환자 및 신생아의 혈청에서 Gammacoat $Digoxin^{(R)}$ kit와 Amerlex Digoxin $RIA^{(R)}$ kit를 이용하여 digoxin과 교차 면역반응을 보이는 내인성 물질(이하 DLI: Digoxin-like Immunoreactivity)을 측정하여 다음의 결과를 얻었다. 1) Gammacoat $Digoxin^{(R)}$ kit로 측정시 27명의 만성 신부전 환자중 12명에서 신생아의 경우는 27명 전원에서 측정 하한치 이상의 DLI가 검출된 반면, Amerlex Digoxin $RIA^{(R)}$ kit로는 1명을 제외한 양 군의 전원에서 DLI가 관찰되지 않았다. 만성 신부전 환자에서 Gammacoat $Digoxin^{(R)}$ kit로 측정된 DLI와 혈청 BUN/Creatinine 값 사이에는 유의한 상관 관계가 없었다. 2) 만성 신부전 환자 및 신생아의 pooled sera에 가한 digoxin의 수거율은 각각 49%, 40%였다. 3) 만선 신부전 환자 및 신생아의 pooled sera에서 측정되는 DLI의 희석 curve는 정상 희석 curve와 다르다고 할 수 없었다. 4) 만성 신부전 환자의 pooled sera에서 측정되는 DLI의 16%, 그리고 신생아의 pooled sera 에서 측정되는 DLI의 20%가 trypsin에 sensitive하였다. 5) 만성 신부전 환자의 pooled sera에서 측정되는 DLI의 56%가, 그리고 신생아의 pooled sera에서 측정되는 DLI의 경우는 전체의 20%미만이 methylene chloride로 추출되었다. 이상에서 만성 신부전 환자 및 신생아의 혈청에서는 방사면역 kit의 증류에 따라 DLI가 검출되며 그 실체를 알기 위해서는 더욱 연구가 필요하다고 할 수 있었다.

• Journal of Chest Surgery
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• 제24권4호
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• pp.397-403
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• 1991

From June 1987 to January 1991, 24 patients with moderate or massive pericardial effusion underwent subxiphoid pericardial window procedures for diagnosis and therapy. The patients` ages were ranged from 28 years to 71 years. The underlying diseases were chronic renal failure with long term hemodialysis in 3 cases, malignant lung cancer in 7 cases, stomach cancer in 2 cases, tuberculous pericarditis in 5 cases, pyogenic pericarditis in 2 cases, myxedema in one case, one metastatic squamous cell carcinoma from unknown origin and three of undefined etiology. Preoperative diagnoses of pericardial effusions were confirmed by echocardiogram in all cases. Subxiphoid pericardial drainages were performed under general[n=19] or local anesthesia[n=5]. Histological diagnoses were made from the inferior pericardial tissue in all cases except one. In this one case[tuberculous pericarditis], the subxiphoid pericardial approach was failed from intraoperative bleeding. There were two postoperative death, one[in malignant lung cancer] had postoperative ventricular tachycardia which result in cardiac arrest, and the other[unknown origin metastatic malignant effusion] had persistent tachyarrhythmia postoperatively and died on postoperative 5th days. Twenty three patients were followed up from 3 days to 9 months; mean follow-up day was 43 days. The preoperative and postoperative mean cardiothoracic ratio in chest x-ray were 0.69 and 0.52 respectively. Subxiphoid pericardial drainage may provide definitive diagnosis and treatment for pericardial effusions. The approach through subxiphoid pericardium under general or local anesthesia avoids the complications of pericardiocentesis and is effective for malignant pericardial effusion.

• 기본간호학회지
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• 제3권2호
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• pp.235-246
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• 1996

The purpose of this study was to discover the experience of hemodialysis which clients confronted hemodialysis at the same time as CRF diagnosis and to understand the nature and meaning of their crisis experience. The research subjects were 6 clients receiving hemodialysis in Seoul from Jan. 1996 to Jul. 1996. Data were collected by informal indepth interview and participant observation. Content Analysis(by Seaman & Verhonick, 1982; Woods & Catanzaro, 1988) was applied to collect similar contents and common experience in order to derivate concepts and categories for better understanding of their hemodialysis experience. As a result, 6 categories derivated to indentify their hemodialysis experience of the CRF clients-confronted hemodialysis at the same time as CRF diagnosis-were as follows: 1) The category of shocking crisis composed the concepts of shock, amagement and suffocation. 2) The category of denial composed the concepts of disease refusal and hemodialysis refusal. They repeatedly visited hospitals or didn't visit hospital in order to refuse disease, then depended on folk remedy or shamanistic method. 3) The category of severe anxiety composed the concepts of abandoned feeling, shame, resentment, neurosis and anger. 4) The category of depression composed the concepts of grief, suffering of unfairness, tearing, desire to death. 5) The category of powerlessness composed the concept of hopelessness. 6) The category of resigned acceptance composed the concepts of resignation and acceptance. In this study, the CRF clients who confronted hemodialysis at the same time as CRF diagnosis experienced six stages in accepting hemodialysis but these stages were mingled simultaneously and went on.

• 기본간호학회지
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• 제7권1호
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• pp.42-59
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• 2000

This study was done to analyze and develop the concept of coping in patients receiving hemodialysis. The Hybrid Model of concept development was applied to develop a conceptual structure of coping in patients receiving hemodialysis, which included a field study carried out using an in-dept interview with 18 patients in the hemodialysis room of one general hospital in Seoul. Data-analysis was done in three phases as suggested by the Hybrid Model. Finally, by summarizing the results from each case, the attributes of coping, its dimensions, definition and structure were outlined. According to the results of the study, a conceptual structure of coping which centers around stressors, stress-appraisal, strategy of coping and new definitions of coping in patients receiving hemodialysis was suggested : The coping of patients receiving hemodialysis is a process that deals with physical, emotional, inter-personal, and role stress caused by hemodialysis due to renal failure. It has a series of phases which include a phase that appraises the stressful situation based on past experience of chronic disease management, one's remaining rears, the extent of family support, the extent of economic dependency, inter-personal support. education and uncertainty, and a phase of developing coping strategies that con be affected by social support and self esteem. As a result of coping, patients adapt or not to the life situation of receiving hemodialysis.

• 보건교육건강증진학회지
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• 제18권1호
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• pp.17-33
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• 2001

The purpose of this study was to identify the major factors affecting performance in health promoting lifestyles in continuous ambulatory peritoneal dialysis(CAPO) patients. The subjects for this study were 98 CAPO patients living in Pusan city. The data for this study were collected from October 15th, 1999 to January 15th, 2000 by structured questionaries. Statistical analysis was done using SPSS softwares. The results were as follows: 1. The average score of performance in the health promoting lifestyles was 2.34. The variable with the highest degree of performance was self-actualization and nutrition, whereas the one with the lowest degree was exercise. 2. In the subscale of the health promoting lifestyles, especially educational level, marital state and CAPO period, there was significant differences between demographic variables and performance in the health promoting lifestyles. 3. The activity-related affect, situational influences, self-efficacy, and perceived barriers in the behavior-specific cognitions and affect have a significant correlation with performance in the health promoting lifestyles. 4. The most important variable that affects the performance in the health promoting lifestyles was situational influences, and the self-efficacy, perceived barriers, every monthly treatment cost, duration of chronic renal failure followed in order, activity-related affect. Those six variables accounted for 38.3% among the variables in health promoting lifestyles.