• 제목/요약/키워드: pulmonary lesion

검색결과 393건 처리시간 0.087초

심방세동의 최신 외과적 치료 (Recent Advances in Surgery for Atrial Fibrillation)

  • 이동협;정태은
    • Journal of Yeungnam Medical Science
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    • 제22권1호
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    • pp.13-26
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    • 2005
  • Atrial fibrillation (AF) is the most common cardiac rhythm disturbance, which carries significant cardiovascular morbidity and mortality. The medical treatment for AF is cumbersome and unsatisfactory, which has highlighted the need to develop alternative treatments for AF. The recent discovery that AF is often initiated by atrial ectopic beats has resulted in treatments designed to target the ectopic sources, particularly those within the pulmonary veins. Building on the pioneering work of Cox et al., a recent reported series demonstrated the feasibility of treating patients undergoing cardiac surgery for other structural heart diseases with limited, left-atrial ablation lesion sets using alternative energy sources. As less complex modifications of the Maze procedure have been developed, a number of energy sources have been introduced to create of electrically isolating lesions within the atria. These sources have been used both endocardially in arrest heart procedures as well as epicardially in a beating heart setting. This review summarizes the recent advances in surgery for AF that will aid in the development of an effective, minimally invasive surgical procedure to cure patients with AF.

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A Case of Atypical Adenomatous Hyperplasia of Larger Than 2 cm

  • Park, Bo Mi;Cho, Min Ji;Lee, Hyun Seok;Park, Dong Il;Park, Myoung Rin;Kim, Ju Ock;Lee, Jeong Eun;Lee, Choong Sik;Jung, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • 제74권6호
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    • pp.280-285
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    • 2013
  • Atypical adenomatous hyperplasia (AAH) has been considered to be a precursor lesion of bronchioloalveolar carcinoma (BAC) and pulmonary adenocarcinoma. It usually coexists with BAC and/or an adenocarcinoma. Chest computed tomography reveals multiple well-defined nodules with ground-glass opacity. Usually, AAH does not exceed 10 mm in size. AAH with extensive involvement on one side of the lung field or one that is larger than 2 cm has not been previously reported. We herein report a case of a 71-year-old nonsmoking female with lung AAH of larger than 2 cm.

흉부외상 환자중 개흉술이 필요했던 53례에 관한 임상적 고찰 (Clinical Study of 53 Patients Requiring open Thoracotomy After Thoracic Injuries)

  • 김규만
    • Journal of Chest Surgery
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    • 제24권11호
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    • pp.1115-1124
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    • 1991
  • Recently the thoracic injuries have been markedly increasing due to the vast increase of traffic accident, industrial disaster, and incidental accident as well as the frequent use of the murderous weapons including gun or rifle. Because the thoracic injuries could involve the heart, lung, and great vessels, and would influence the lives, prompt diagnosis and adequate treatment are essential. Most of thoracic injuries can be managed with the conservative treatment and simple surgical procedure such as closed thoracostomy, but certain cases require open thoracotomy to preserve lives and to return to their normal environment. The authors have analysed the result of 53 cases of open thoracotomy after thoracic injuries mainly according to the patient`s chart review. The mean age was 33.4 years old and male to female ratio was about 5: l. Injury mechanisms that elicited thoracic trauma indicated for open thoracotomy were penetrating[47%] and non-penetrating[53%] injuries. The Most common type of the thoracic lesion was hemothorax with or without pneumothorax and diaphragm rupture was the second. 58\ulcornero of thoracic injuries were accompanied by abdominal injuries and 47% by bone fractures. 34 patients were operated within 24 hours after injury and their average elapsed time was 13.6 hour. The remained patients were operated after 24 hours and their average elapsed time was 7.8 days. 71 cases of operative procedures containing some overlappings were performed: diaphragm repair[28], bleeding control[12], pulmonary and cardiac repair[4 cases] Postoperative complication rate was 32.1% and operative mortality rate was 9.4%[5/53].

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대상포진후 신경통 치료중에 발생한 흉막 삼출액 (Pleural Effusion Followed by Multiple Intercostal Nerve Blocks in the Patient with Postherpetic Neuralgia)

  • 송정자;한영진;최훈
    • The Korean Journal of Pain
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    • 제5권2호
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    • pp.269-272
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    • 1992
  • 대상포진후 신경통은 통증 치료실에서 흔히 만나는 질환이지만 가장 치료하기 힘든 질환 중의 하나이다. 따라서 통증 치료를 담당하는 의사는 자기가 알고 모든 지식을 동원하여 환자를 치료하지만, 그 결과는 대개 만족스럽지 못하고, 또 뜻하지 않은 합병증을 당하여 당황하는 수도 있었다. 저자들은 폐 결핵등의 과거력을 가진 대상포진후 신경통 환자의 치료 도중에 반복적인 늑간신경 차단이 기여했으라라고 생각되는 흉막삼출액 발생을 경험하였기에 보고하는 바이다.

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폐양성 투명세포(당)종양 -1례 보고- (Benign Clear Cell ("Sugar") Tumor of the Lung -A Case Report-)

  • 이종국;서재정
    • Journal of Chest Surgery
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    • 제29권4호
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    • pp.461-465
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    • 1996
  • 본 교실에서는 최근 극히 드문 폐양성 종양인 투명세포(당)종양 1예를 경험하였다. 현재까지 구미에서 총 40례정도 보고되 었을 뿐이 며 국내 에서는 1례가 서울대 학교병 원에서 보고되 었을 뿐이다. 증례는 43세 남자로 검진시 단순흉부촬영 에서 이상 음영 소견이 지적되어 폐양성종양을 의심하여 우하엽 폐절제술을 시행하였다. 조직학적으로 종양세포들은 투명한 세포질을 가지며, 세포질간 경계가 뚜렷하였고 세포질 내에 당이 축적되어 있어 양성 투명새포종양으로진단하였으며,전자현미경 검사에서 종양세포들은 등근핵을 가지고 있으며 풍부한 세포질 내에는 자유형의 당원이 많이 관찰되었으나 기저판, 멜라닌소체, 층판소체 등은 관찰되지 않았다.

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폐종양으로 오인된 병소 (Lesion Mimicking Lung Tumor)

  • 고훈;조용선;이양덕;한민수;강동욱
    • Tuberculosis and Respiratory Diseases
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    • 제57권2호
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    • pp.197-200
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    • 2004
  • 흉부방선균증은 임상양상 및 방사선학적 소견이 폐의 기타 염증성 질환이나 악성암과 유사한 경우가 많아 감별진단에서 놓치기 쉬우나, 대부분 항생제 치료에 좋은 반응을 보이므로 조기진단을 위한 적극적 접근으로 심각한 합병증의 발생 및 불필요한 수술을 막아야 한다. 저자들은 폐암을 의심하여 시행한 검사도중 폐를 침범하는 방선균증을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

소아의 위장관 중복증 (Gastrointestinal Duplications in Childhood)

  • 김대연;김성철;김인구
    • Advances in pediatric surgery
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    • 제7권1호
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    • pp.26-30
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    • 2001
  • Gastrointestinal duplications are rare congenital malformation that may require surgical intervention in the neonate, infant, and occasionally the older child. Symptoms produced by duplications vary according to their location, size, type and histology. We report the clinical characteristics and the surgical results of 9 cases of the gastrointestinal duplications treated at at Asan Medical Center between 1989 and 2000. Five patients were boys and four were girls; age of patients ranged from 5 days to 10 years. Eight duplications were cystic and one was tubular. One involved the stomach; five were in the ileum, and two in the cecum. The most common presentation was intestinal obstruction. There was associated anomaly in one patient, pulmonary sequestration and double ureter. Ectopic gastric mucosa was found in two. All patients underwent surgical resection. There was no perioperative mortality or morbidity. Although gastrointestinal duplication is a rare entity. consideration of associated anomalies and being familiar with the anatomy and clinical features are required for adequate management. In cystic form. complete excision is recommended but planned surgery is required for long segment tubular lesion.

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폐로 전이한 악성 에나멜모세포종의 세침흡인 세포학적 소견 - 1예 보고 - (Fine Needle Aspiration Cytology of Malignant Ameloblastoma Metastasized to the Lung - A Case Report -)

  • 강윤경;박인애;임창윤;함의근;이상국
    • 대한세포병리학회지
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    • 제4권2호
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    • pp.166-170
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    • 1993
  • We describe the cytologic features of metastatic ameloblastoma which presented as multiple bilateral lung nodules. The patient was a 22-year-old male who had recurrent ameloblastoma of the mandible 7 years after the diagnosis of primary lesion. Fine needle aspiration of one of the pulmonary nodules revealed patchy arrangement of cell clusters with outer palisading columnar cells and inner irregular loose polygonal cells. Most of tumor cells had plenty cytoplasm and ovoid nuclei which lacked either pleomorphism or hyperchromatism. The cytologic findings corresponded with histologic features of the primary site which was also benign looking ameloblastoma.

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공동절개술과 근육충진술을 이용한 폐국균증의 수술 (Pulmonary Aspergilloma Treated by one Stage Cavernostomy and Myoplasty)

  • 안현성;김응중;신윤철;지현근;최광민
    • Journal of Chest Surgery
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    • 제34권9호
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    • pp.729-732
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    • 2001
  • 49세 남자 환자가 객혈을 주소로 입원하였다. 단순 흉부방사선 소견과 흉부단층촬영 소견에서 우측 폐첨부에 연부조직 덩어리가 있는 큰 공동이 관찰되었으며 또한 혈청진균검사상 국균증에 대해 양성이었다. 폐국균종 의심하에 폐우상엽절제술을 계획하였으나 폐첨부와 종격동 흉막의 심한 유착으로 페엽절제술이 불가능하여 공동절개술과 전거근을 이용한 근육충진술을 동시에 시행하였다. 환자는 수술직후 객혈이 멈추었고 특별한 합병증없이 술후 20일만에 퇴원하였으며 8개월간 추적관찰 중에 객혈의 소견은 없었다.

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자연 기흉의 임상적 고찰 -244례- (Clinical Evaluation of Spontaneous Pneumothorax -A Review of 244 Cases-)

  • 김병린
    • Journal of Chest Surgery
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    • 제27권4호
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    • pp.292-296
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    • 1994
  • From March, 1985, to June, 1993, 244 patients with 345 episodes of spontaneous pneumothorax treated at Koryo General Hospital were reviewed. Most of the patients were male, and the ratio of male to female was 8:1. The average age of the patients with spontaneous pneumothorax was 32.8 years old. The site of pneumothorax was revealed left side in 53.3%, right side in 42.6%, and bilateral in 4.1%. The cause of pneumothorax were shown primary spontaneous pneumothorax in 73.4%, and secondary spontaneous pneumothorax in 26.6%. The underlying pathologic lesion in secondary spontaneous pneumothorax showed pulmonary tuberculosis in 56patients[86.1%], COPD in 4patients[6.2%], bronchial asthma in 2patients[3.1%], lung cancer in 2patients[3.1%], and pneumoconiosis in a patient[1.5%]. The usual clinical symptomes were dyspnea, chest pain and chest discomfort. Recurrence rate was as follow; 2nd episode 33.6%, 3rd episode in 26.8%, and above in 4th episode in 18.2%. All the patient of pneumothorax was treated as following; Closed thoracostomy tube drainage in 127patients, bullectomy in 88patients, lobectomy in 5patients, wedge resection in 2patients, conservative treatment with oxygen therapy in 21patients, and video assisted thoracoscopic bullectomy in a patient. The course of treatment of all of the patients were smooth and uneventful.

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