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김정중,이석기,임진수,최형호 대한흉부외과학회 2004 Journal of Chest Surgery (J Chest Surg) Vol.37 No.12
Background: Malignant pleural effusion is a common clinical problem in neoplastic patients. With the diagnosis of a malignant pleural effusion, palliative therapy was done. One of the treatments was a chemical pleurodesis. Talc was the most commonly used a sclerosing agent, but the quality of patient's life was not improved. We was evaluated by other agents such as Viscum album for relief of malignant pleural effusion. Material and Method: From November 2001 to October 2003, 17 patients who underwent to chemical pleurodesis for the malignant pleural effusion. We compared the talc (group I: 10 patients) and Viscum album (group II: 7 patients). We analysed them retrospectively in term of various factors and results. Result: There were no significant differences between group I and group II in the sex ratio, mean age, origin of primary cancer and site, but, group I had higher successful rate (80%:71%) than group II. Group II had better length of chest tube stay after procedure, Karnofsky performance and recurrence than group I. The failed treatement group was related to the pleural fluid pH and interval of initial chemical pleurodesis after thoracostomy. Conculsion: Although the chemical pleurodesis with Viscum album was slightly lower than talc in the successful rate, there was an alternative method instead of the chemical pleurodesis with talc to improve the patient's quality of life in malignant pleural effusion. 배경: 악성 흉막 삼출액은 암환자에서 흔히 나타나는 임상 증상이며, 진단이 되면 보존적 요법으로 치료하는데, 가장 흔히 사용되는 방법은 화학적 흉막 유착술이다. 가장 보편적으로 사용되는 talc는 환자 삶 질을 향상시키는 못한다. 저자들은 악성 흉막 삼출액을 치료하는 다른 경화제인 Viscum album에 대하여 평가하였다. 대상 및 방법: 2001년 11월부터 2003년 10월까지 악성 흉막 삼출액으로 치료를 받은 17명을 대상으로 하였다. Talc group I (10명)과 Viscum album group II (7명)으로 나누어서 후향적으로 여러 가지 인자와 결과를 비교하였다. 결과: 성별, 연령, 원발성 종양 및 병변 부위는 양군 간에 차이는 없었지만, 성공률은 group I에서 더 높았고, group II에서는 시술 후 더 짧은 흉관 유지 기간, 더 높은 Karnofsky performance와 낮은 재발률을 보여 주었다. 치료가 실패한 경우는 흉막 삼출액 pH 및 흉강삽관술 시행 후 화학적 흉막 유착술 기간과 관련이 있었다. 결론: Viscum album을 이용한 화학적 흉막 유착술이 talc를 사용한 경우보다 성공률은 약간 낮았지만, 악성 흉막 삼출액 환자의 삶에 대한 질을 향상시킬 수 있기 때문에 선택된 경우에 대용 치료법이 될 수 있을 것 같다.
백관미 ( Kwan Mi Pack ),김상위 ( Sang We Kim ),이상도 ( Sang Do Lee ),김윤지 ( Yoon Ji Kim ),서철원 ( Cheol Won Suh ),김동관 ( Dong Kwan Kim ),송동은 ( Dong Eun Song ) 대한내과학회 2008 대한내과학회지 Vol.74 No.4
저자 등은 ADA가 증가되어 있는 편측성 흉수를 가진 환자에서 원발성 흉막삼출성 림프종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. A 78-year-old woman was referred to this hospital because of exertional dyspnea for 2 weeks. Although she was treated with anti-tuberculous medication under the assumption that she had tuberculous pleuritis, her dyspnea continued. Physical examination revealed diminished breath sounds over the left lung field. Chest radiography showed a large left pleural effusion. The pleural effusion revealed malignant cell-dominant exudates with a high adenosine deaminase level. Serological tests were negative for HIV. Computed tomography scan of the chest and abdomen showed pleural effusion, but no mass or pathological lymph nodes were detected. The biopsy specimen of the pleura was diagnosed as malignant B-cell lymphoma with plasmacytoid features, suggesting a possibility of primary effusion lymphoma. Polymerase chain reaction assay of tumor was positive for HHV-8 DNA. She underwent pleurodesis during Video-Assisted Thoracic Surgery, and her dyspnea subsequently improved.(Korean J Med 74:441-444, 2008)
미숙아에서 말초 유도 중심정맥관 삽입과 연관된 흉막삼출과 횡격막마비
장미선 ( Mi Sun Chang ),백상훈 ( Sang Hun Baek ),이명숙 ( Myung Sook Lee ),한영미 ( Young Mi Han ),성세인 ( Se In Sung ),유혜수 ( Hye Soo Yoo ),안소윤 ( So Yoon Ahn ),김은선 ( Eun Sun Kim ),장윤실 ( Yoon Sil Chang ),박원순 ( Won S 대한주산의학회 2012 Perinatology Vol.23 No.3
Pleural effusion and diaphragmatic palsy secondary to fluid extravasation after central line insertion in the neonate are rare complications. Here we report a case of right pleural effusion and diaphragmatic palsy caused by fluid extravasation associated with peripherally inserted central venous catheter in the preterm infant.
유방암에서 발생한 악성 흉막삼출에 대한 흉강 내 Paclitaxel 화학요법
이수정,박신영,최정은,전명훈,강수환 한국유방암학회 2010 Journal of breast cancer Vol.13 No.4
Malignant pleural effusion in breast cancer has been associated with poor prognosis. The response rate of local treatment has been very low and in some case, complications have resulted in death. We investigated the efficacy and safety of paclitaxel, as an intrapleural chemotherapeutic agent. From January 2006 to December 2009, ten breast cancer patients who had developed malignant pleural effusion were infused with intrapleural paclitaxel through a chest tube, which was clamped for 48 hours. The chest tube was maintained until drainage was reduced to less than 50-100 mL/day. The average time spent with a chest tube attached following intrapleural chemotherapy was 9.3 days. During the follow-up period, six patients had no recurrent pleural effusion and two received a second round of intrapleural chemotherapy following which no further pleural effusion recurred. There were no severe side effects except for mild toxicity. It is suggested that intrapleural paclitaxel chemotherapy may be superior to conventional local treatment and may represent an effective treatment modality with low toxicity.
농흉 및 합병된 부폐렴성 흉막 삼출 환자에서 Pigtail 도관 배액의 유용성
박정우 ( Park Jeong U ),유승민 ( Yu Seung Min ),설원종 ( Seol Won Jong ),백은기 ( Baeg Eun Gi ),이규훈 ( Lee Gyu Hun ),서준범 ( Seo Jun Beom ),정성환 ( Jeong Seong Hwan ),안창혁 ( An Chang Hyeog ),임영희 ( Im Yeong Hui ),박정웅 ( 대한결핵 및 호흡기학회 2003 Tuberculosis and Respiratory Diseases Vol.54 No.2
이주현 ( Joo Hyun Lee ),김태환 ( Tae Hwan Kim ) 대한내과학회 2011 대한내과학회지 Vol.81 No.2
Connective tissue diseases represent an heterogenous group of immunologically mediated inflammatory disorders including multiorgan involvement, can affect pleura with various frequencies. Rheumatoid arthritis and systemic lupus erythematosus represent the most common immunological diseases that affect the pleural cavity. The clinical presentation, frequency, prognosis and response to therapy vary, depending on the pattern of involvement as well as on the underlying connective tissue diseases. In this article, we will review the pleural effusion caused by connective tissue diseases. (Korean J Med 2011;81:154-160)