• Title/Summary/Keyword: 상처감염

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Histological Changes in the Normal Tissues of Rat after Local Application of the Holmium-166-Chitosan Complex attached to Biodegradable Solid Material (생분해성 고형물에 흡착시켜 실험동물에 국소 투여한 홀미움- 166-키토산 복합체의 투여량, 기간 및 부위에 따른 조직의 괴사 정도와 양상)

  • Lee, Jong-Seok;Jeon, Dae-Geun;Cho, Wan-Hyung;Lee, Soo-Yong;Oh, Jung-Moon;Kim, Jin-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.190-199
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    • 2003
  • Purpose: The aim of this study was to find out a clinically appliable method to insert a biodegradable solid material containing holmium-166-chitosan complex into the surgical field, and to evaluate the histological changes in the normal tissues after ${\beta}$ -ray irradiation from holmium-166 according to the dose, period and type of tissues. Materials and Methods: 3.0 mCi, 50 ${\mu}l$ of the liquid state $^{166}$Ho-chitosan complex was attached to the absorbable gelatin sponge. The radiation activity measured by dose caliberator was 1.5 mCi. These $^{166}$Ho-chitosan complex containing absorbable gelatin sponges were inserted into the thigh muscles and over the femur bones of the Wistar rats. The cases were evaluated at 2 weeks after insertion, and 4, 6 weeks with respect to the histological changes of the soft tissues and bone, the depth of the tissue necrosis, and the changes of the $^{166}$Ho-chitosan complex containing absorbable gelatin sponges. Results: At 2 weeks, the muscles showed coagulation necrosis, degenerating myocytes, regenerating myocytes, intermuscular edema, and inflammatory cells. The necrosis depth was 3.3 mm. In the bones, there was no osteocyte in the lacuna of cortex (empty lacuna), marrow fibrosis, inflammation. The necrosis depth was 2.9 mm. At 4 weeks, in the muscle, calcification and increased fibrosis with necrosis depth by 3.3 mm were the additional findings. In the bone, marrow fibrosis with necrosis depth by 3.3 mm were detected. At 6 weeks, soft tissue shrinkage, increased fibrosis and granulation tissue formation, and nearly resolving inflammatory reaction were the findings. Conclusion: The local application of the $^{166}$Ho-chitosan complex attached to biodegradable gelatin material with surgery in the laboratory animals resulted in no mortality and morbidity, and satisfactory tissue necrosis. Holmium-166 can be applied to the treatment of the malignant tumor patients.

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Analysis on the cause of eosinophilia in a neonatal intensive care unit (신생아 집중 치료실에서 호산구 증가증 원인에 관한 분석)

  • Kim, Jeong Young;Im, Hyo Bin;Sung, Min Jung;Son, Sang Hee;Seo, Son Sang
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.28-32
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    • 2010
  • Purpose : Although eosinophilia is a common laboratory finding in many neonatal intensive care units (ICUs), its causative mechanisms remain obscure. We aimed to determine the causes of eosinophilia in the neonatal ICU environment. Methods : Serial eosinophil counts were determined weekly for 288 hospitalized, appropriately grown neonates. Infants were divided into four groups according to gestational age, and the incidence and etiologic factors of eosinophilia were retrospectively studied. Results : Absolute eosinophilia (>$700/mm^3$) was documented in 18% (52/288) of neonates. Twenty-two infants (42.3%) exhibited mild eosinophilia ($700-999cells/mm^3$), 27 (51.9%) exhibited moderate eosinophilia ($1,000-2,999cells/mm^3$), and 3 (5.8%) exhibited severe eosinophilia (>$3,000cells/mm^3$). Of the 288 infants studied, 54 suffered sepsis. Thirty of these 54 infants (55.6%) showed eosinophilia, and 22 out of the remaining 234 infants (9%) without sepsis showed eosinophilia, indicating that eosinophilia was more prevalent in the sepsis group (P <0.05). All 5 infants suffering from bronchopulmonary dysplasia showed eosinophilia, and 47 out of the remaining 283 infants (16.7%) without bronchopulmonary dysplasia showed eosinophilia. Thus, eosinophilia was more prevalent in the bronchopulmonary dysplasia group (P<0.05). Furthermore, increased prevalence of eosinophilia was associated with respiratory distress syndrome, ventilator use, blood transfusion, and total parenteral nutrition (P<0.05). Conclusion : Our results suggest that eosinophilia is influenced by sepsis and bronchopulmonary dysplasia, although it can also occur idiopathically at birth. Moreover, the potential role of eosinophils in conditions such as wound healing and fibrosis in sepsis or chronic lung disease may be a cause of eosinophilia.

Results of the Reconstruction of Anterior Cruciate Ligament with Freshfrozen Achilles Allograft and of the Second-look Arthroscopy (신선 동결 동종 아킬레스건을 이용한 전방 십자인대 재건술 후 2차 관절경소견)

  • Yoo, Jae-Doo;Kim, Sung-Il
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.111-116
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    • 2007
  • Purpose: To assess the clinical results of ACL reconstruction with a fresh frozen Achilles allograft, retrospectively and the findings of the graft in second look arthroscopy. Materials and Methods: Twenty-eight ACL reconstructions using fresh frozen Achilles tendon allograft were included in this study between March 1999 and February 2003. The average age was 31.2 years old and the average follow-up was 16.6 months(range: 12-26 months). The clinical evaluation was done by KT-1000 arthrometer, Lysholm knee score, range of motion, Lachman and pivot-shift test. Results: In the last follow-up of Lachman test, 21 cases showed normal, 5 cases grade 1, 2 cases grade 2 and 1 case grade1. The results of pivot-shift test data, 23 cases(82.1%) were normal, 4 cases(14.3%) grade 1, 1 case(3.6%) grade 2. The mean maximum side-to-side difference was improved from 6.75mm preoperatively to 2.46mm in the last follow-up. Lysholm knee score was improved from 73.5 preoperatively to 91.6 in last follow-up. Re-rupture of the ACL graft was found in one case and one case of wound infection in the tibial incision was found. The 6 cases showed the good synovialization of the ACL graft. Conclusion: The anterior stability was restored with ACL reconstruction using fresh frozen Achilles allografts and the good synovialization was found in the second-look arthroscopy

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Education Need of the Visit ing Health Service Workers in Gwangju and Jeollanam-do Public Health Facilities (일부 공공보건기관 방문보건요원의 교육요구도 조사)

  • Kim, Young-Lak;Kim, Shin-Woel;Chung, Eun-Kyung;Choi, Jin-Su
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.51-64
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    • 2002
  • This study was aimed to provide the basic data for the development of effective educational program by reflecting the opinions of the visiting health service workers. The subjects were 144 visiting health service workers in Gwangju and Jeollanam-do area who responded the mail questionnaire. The data were collected from June to July, 2001 using questionnaire composed of the education need, knowledge by subjective appraisal, and experience of education. The major findings of this study were as follows: 1. The number of respondents who received at least one education within recent three years were 43(29.9%) at the central level, 57(39.6%) at the provincial level and 53(36.8%) at the district level. The satisfaction with education was higher at the central level than at the provincial and district level. 2. Knowledges by subjective appraisal on the 'chronic degenerative diseases management' and 'health promotion' was relatively high. while that of 'rehabilitation' was low. 3. The knowledge by subjective appraisal of visiting health service was related with experience of education and license status. The knowledge was higher in registered nurses than in nurse aids. The curricula related to increased level of knowledge of visting health service workers were 'elderly health care', 'rehabilitation' and 'psychiatric-mental health nursing' educations at the central level 'continuing education for the community health practioners' and 'psychiatric-mental health education' at the provincial level and 'elderly health care', 'rehabilitation' 'psychiatric-mental health' and 'acute diseases control' educations at the district level. 4. The respondents preferred elderly health management as the contents of education, officer group education as the method of education, province(30.4%) as the main body of education, exercise and practice as the form of education, 2-3 times per year as the frequency of education, and 3-5days as the period of education. The findings of this study could suggest that future education program should be planned to increae the knowledge level of visiting health service workers by reflecting their educational need.

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Laparoscopy Application to Determine Estrous Cycle in Korean Black Goats (복강경을 이용한 한국흑염소의 성주기 판정)

  • Yang, H.S.;Jang, S.K.;Yong, H.W.;Cho, J.K.;Shin, S.T.
    • Journal of Embryo Transfer
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    • v.22 no.1
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    • pp.69-74
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    • 2007
  • This study was performed to determine the estrous cycles by macroscopic observation of the ovarian changes using the laparoscopy and to make use of these results for embryo transfer in Korean black goat (Copra hircus aegagrus). Laparoscopic examinations of the ovaries were performed from 2 days after $CIDR^(R)$ removal to 22 days after ovulation. The serial morphological changes of follicles and corpus luteum (CL) were observed. CL was classified corpus hemorrhagicum(CH), corpus luteum (CL) and corpus albicans (CA) by its maturation and regression. On the day before ovulation (Day 0), Graafian follicles (GF) were found on one or both ovaries. On the day (Day 1) and $2^{nd}$day (Day 2) of ovulation, and ovulation depression (OD) and an early stage corpus hemorrhagicum $(CH_1)$ were observed at the site of GF, respectively. On Days 3 to 4, more developed and enlarged corpus hemorrhagicum $(CH_2\;and\;CH_3)$ arised from the ovulation of the GF with well vascularization. On Days 5 to 6, it was identified that mature corpus luteum $(CL_3)$ was grown on the ovary, and fully developed CL with adjacent follicles were occupied most part of the ovary on Days 17 and 18. Then the size of CL was diminished, and completely luteal regression $(CL_1\;or\;CA)$ with new large follicle was identified on Days 20 and 22. From these results, the 4 stages of the estrous cycle in Korean black goats were 1) estrus (Day 0) for 1 day, 2) metestrus $(Day\;1{\sim}4)$ for 4 days (stage of CH development), 3) diestrus $(Day\;5{\sim}16/17)$ for 12 or 13 days (luteal stage), and 4) proestrus $(Day\;17/18{\sim}20/22)$ for 4 or 5 days (stage of luteal regression and follicular growing). Laparoscopy for observation of ovarian changes was invasive than laparotomy. Additionally, it had advantages of reduced adhesion and quick operation time. It was considered that laparoscopic examination of ovarian changes will be useful for embryo transfer in the Korean black goats.

Minimal Skin Incision with Full Sternotomy for Congenital Heart Surgery (최소 피부 절개술을 이용한 선천성 심장 질환 수술)

  • Park, Choung-Kyu;Park, Pyo-Won;Jun, Tae-Gook;Park, Kay-Hyun;Chae, Hurn
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.368-372
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    • 1999
  • Background: Although there have been few reports about minimal skin incision for the repair of congenital heart lesions, minimizing an unsightly scar is a particularly important factor in growing children. We have adopted a technique that permits standard full sternotomy, conventional open chest cardiopulmonary bypass, aortic cross-clamping, left atrial vent, and antegrade cardioplegia with minimal surgical scar. Material and Method: With minimal skin incision and full sternotomy, 40 patients with congenital heart disease underwent open heart surgery from April 1997 through September 1997. Defects repaired included 30 ventricular septal defects, 4 atrial septal defects, and 1 sinus Valsalva aneurysm in 35 children(M:F=17: 18), and 3 Atrial septal defects, 1 ventricular septal defect, and 1 partial atrioventricular septal defect in 5 adults(M:F=1:4). Midline skin incision was performed from the second intercostal space to 1 or 2 cm above the xiphoid process. For full sternotomy, we used the ordinary sternal saw in sternal body, and a special saw in manubrium under the skin flap. During sternal retraction, surgical field was obtained by using two retractors in a crossed direction. Result: The proportion of the skin incision length to the sternal length was 63.1${\pm}$3.9%(5.2∼11cm, mean 7.3cm) in children, and 55.0${\pm}$3.5%(10∼13.5cm, mean 12cm) in adults. In every case, the aortic and venous cannulations could be done through the sternal incision without additional femoral cannulation. There was no hospital death, wound infection, skin necrosis, hematoma formation, or bleeding complication. Conclusion: We conclude that minimal skin incision with full sternotomy can be a safe and effective alternative method for the repair of congenital heart diseases in children and adults.

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The Learning Curve of Laparoscopy-assisted Distal Gastrectomy (LADG) for Cancer (학습곡선을 기준으로 한 복강경 보조 원위절제술에 대한 결과)

  • Kim, Kab-Choong;Yook, Jeong-Hwan;Choi, Ji-Eun;Cheong, Oh;Lim, Jeong-Taek;Oh, Sung-Tae;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.232-236
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    • 2008
  • Purpose: Laparoscopic surgery for gastric cancer was introduced in the past decade because it was considered less invasive than open surgery, and this results in less postoperative pain, faster recovery and an improved quality of life. Several studies have demonstrated the safety and feasibility of this procedure. We examined the outcome of performing laparoscopic surgery for gastric cancer over the last two year. Materials and Methods: From April 2004 to December 2006, 329 patients with gastric adenocarcinoma underwent a laparoscopy-assisted distal gastrectomy with lymph node dissection. The data was retrospectively reviewed in terms of the clinicopathologic findings, the perioperative outcomes and the complications. Results: The total patient group was comprised 196 men (59.6%) and 133 women (40.4%). The mean BMI was 23.6 and the mean tumor size was 2.7 cm. The mean number of harvested lymph node was 22.7, and this was 18.6 before 30 cases and 23.1 after 30 cases, and the difference was significant (P=0.02). The mean operation time was 180.9 min, and this was than 287.9 min before 30 cases and 170.2 min after 30 cases. After 30 cases, there was a significant improvement of the operation time (P<0.01). The mean incision length after 30 cases was shorter than that before 30 cases (P<0.01). Postoperative complications occurred in 24 (7.3%) of 329 patients and there was no conversion to open surgery. Conclusion: Even though the LADG was accompanied by a difficult learning curve, we successfully performed 329 LADG procedures over the past 2 years and we believe that LADG is a safe, feasible operation for treating most early gastric cancers (EGC).

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