• Journal of Chest Surgery
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• 제30권7호
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• pp.693-700
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• 1997

싣낭삼출액에 대한 검상하 심낭배액술의 임상적 효용성을 알아보기 위하여 1986년 1월부터 1995년 12월까지 10년간 서울대학교병원 흉부외과에서 검상하 심낭배액술을 시행 받았던 총 80명의 환자를 대상으로 임상 기록을 분석하였다. 남녀 구성은 남자 39명, 여자 41명이었으며, 연령은 20세에서 80세까지 분포하였고 평균 50$\pm$15세였다. 수술 전 모든 환자에서 심초음파 검사를 시행하여 심방삼출을 확인하였다. 50명(62.5%)의 환 자는 전신마취 하에 수술을 시행하였고 30명(37.5%)의 환자는 국소마취 하에서 수술을 시행하였다. 악성종양 에 의한 심낭삼출액은 33례(41.3%)였으며 이들 중 결과 확인이 가능했던 31례의 심낭액 세포검사와 29례의 심낭조직 생검 결과 각각 14례(45%)와 7례(24%)에서 양성이었다. 결핵성 심낭삼출액은 27례(33.8%)였으며 이 들 중 12례(44.4%)에서 확진이 가능했는데, 배양검사에서 결핵균이 자란 경우는 1례 뿐이었고, 조직생검에서 건락괴사를 동반한 만성 육아종성 염증소견이 확인된 경우는 12례였다. 수술사망은 14례(17.5%)였으며 모두 악성 심낭삼출 환자였다. 수술사망 환자 중 수술수기와 직접 연관되어 사망한 경우는 없 駭\ulcorner 수술사망 14례를 제외한 나머지 66명의 환자들에 대한 추적관찰 기간은 9일에서 5년까지로, 평균 452일이었다. 추적기간 중 심낭삼출의 재발로 다시금 심낭배액술이 필요했던 경우는 모두 6례(7.5%)였으며 그중 1례는 재수술 직후 갑작스런 심정지로 사망하였다. 만성 압박성 심낭염으로 이행되었던 경우는 4례(5%)였으며 이들 중 2명은 심낭절제술을 시행 받았다. 결론적으로 검상하 심낭배액술은 비교적 간편하고 안전하게 시행할 수 있으며, 심낭배액술시 시행하는 심낭액 세포검사와 조직생검을 통해 원인 진단에도 도움을 줄 수 있다고 생각된다.

• 대한간호학회지
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• 제14권2호
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• pp.93-111
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• 1984

The main purpose of this study is to develop a ratio scale measuring level of pain using Korean pain terms. The specific purposes of this study are to identify the degree of pain of each pain term in each subclass: to classify each subclass in terms of dimensions of pain; and to analyze factors of the Korean pain ratio scale clustering together. One hundred an4 fifty eight pain terms which were originally identified as representative terms and their synonyms were used for data collection. Fifty eight nursing professors ana sixty one medical doctors who have contacted with patients having pain were asked to rate the weight of each pain term on a visual analogue scale. Subclasses in which ranks of pain terms were same f s findings in two previous studies were 1) thermal 3 am 2) cavity pressure, 3) single stimulating pain, 4) radiation pain. and 5) chemical pain. Subclasses in which ranks of pain terms were confused were 1) incisive pressure, and 2) cold pain. Subclasses in which one new pain term was added were 1) inflammatory-repeated pain, 2) punctuate pressure, 3) constrictive pressure, 4) fatigue-related pressure, and 5) suffering-relate4 pain. Subclasses in which two new pain terms were added were 1) traction pressure, 2) peripheral nerve pain, 3) dull pain, 4) pulsation-related pain, 5) digestion-related pain, 6) tract pain, and 7) punishment-related pain. Subclass in which 3 new pain terms were included was fear-related pain. Rating scores of 5 words in 4 subclasses were significantly different between the normal group and the extreme group of subjects in terms of subjective rating. Only one word among 6 words was that newly added to the scale. Rating scores of 12 words in 9 subclasses were significantly different between doctor group and nursing professor group. Among these 12 words, only 3 were those newly added to the scale. In comparison of these 12 words, mean scores of the nursing professors were always 7 to 16 points higher than those of the medical doctors. In the analysis of judgement of subjects in terms of dimensions of pain terms, subclasses of dull pain, cavity pressure, tract pain and cold pain were suggested to be included in the miscellaneous dimension. As a result of factor analysis of the ratings given to 96 pain words using principal components analysis without iteration and with varimax rotation limiting the number of factors to 4, factors of severe pain (factor I) mild-moderate pain (factor II) , causative pain (factor III) and temperature-related pain(factor IV) were extracted with the factor loading above 0.388. When the pain words were re-arranged on the bases of factor loading above 0.368, number of factors decreased to only first two factors. Maximum score of pain word in factor II was 46.17 and the minimum score of the factor I was 45.36. Further studies are needed to identify the validity, reliability, sensitivity and practicability of this ratio scale using patients having various sources of pain.

• 대한화학회지
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• 제24권2호
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• pp.139-145
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• 1980

마크로사이클리간드인 1,4,8,11-테트라아자사이클로테트라데칸 (cyclam)과 비환형 리간드인 1,5,8,12-테트라아자도데칸 (3,2,3-tet)의 높은 스핀철(Ⅱ) 착화합물이 합성되었다. 낮은 스핀인 $[Fe(cyclam)(CH_3CN)_2](ClO_4)_2$는 메탄올속에서 염소이온과 반응하여 높은 스핀인 $[Fe(cyclam)Cl]ClO_4$를 생성한다. $[Fe(cyclam)(CH_3CN)_2](ClO_4)_2$는 낮은 스핀이지만 $[Fe(3,2,3-tet)(CH_3CN)_2](ClO_4)_2$는 높은 스핀을 가지며 이 차이는 비환형 리간드가 환형 리간드보다 압축효과가 작은 것으로 설명된다. $[Fe(cyclam)Cl]ClO_4$의 합성은 마크로사이클리간드가 불포화되어 있거나 치환체가 있어야 높은 스핀 다섯배위철(II) 착화합물의 합성이 가능하다는 지금까지의 전해에 반대되는 증거가 된다. $[Fe(cyclam)Cl]ClO_4$와 $[Fe(3,2,3-tet)(CH_3CN)_2](ClO_4)_2$는 일산화탄소와 반응해서 각기 낮은 스핀 여섯배위인 $[Fe(cyclam)Cl(CO)]ClO_4$ 와 $[Fe(3.2,3-tet)(CH_3CN)(CO)](ClO_4)_2$를 만든다.

• Tuberculosis and Respiratory Diseases
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• 제70권4호
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• pp.347-351
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• 2011

We report here an unusual case of pericardial tuberculoma that was misdiagnosed as thymic carcinoma on an imaging study. A 48-year-old woman was referred for evaluation of an anterior mediastinal mass. Computed tomography (CT) scans of the chest displayed cystic masses mimicking thymic carcinoma at the anterior mediastinum. Pericardiotomy and surgical drainage of the cystic masses were done, and pathologic examination of the excised pericardial specimen showed a chronic granulomatous inflammation with necrosis, compatible with tuberculosis. Acid-fast bacilli were also identified in the specimen. After treatment with anti-tuberculosis drugs and steroids, the patient showed clinical improvement. Although tuberculous pericarditis usually presents as pericardial effusion or constrictive pericarditis, it can also present as a pericardial mass mimicking thymic carcinoma on CT. Therefore, we suggest that tuberculous pericardial abscess should be included in the differential diagnosis of a mediastinal mass in Korea, with intermediate tuberculosis prevalence.