• Title/Summary/Keyword: 수술 후 감염

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Rofecoxib: New Drug Profile

  • 한국임상약학회
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.3
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    • pp.140-144
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    • 2000
  • Reofecoxib는 용량 의존적으로 cyclo-oxygenase-2를 선택적으로 억제한다. 골관절염 환자를 대상으로 하여 이중맹검, 무작위, Western Ontario and McMasters Universi-ties Osteoarthritis Index를 이용하여 평가한 결과, rofecoxib 12.5, 25 mg는 신체적 기능을 크게 향상시키는 것으로 보여졌다. 또한 diclofenac (50 mg, 1일 3회), ibuprofen (800 mg, 1일 3회), nabumetone(1500 mg, 1일 1회)와 유사한 임상효과를 나타내었다. Rofecoxib는 원발성 월경곤란증과 수술 후 치통에 효과적으로 억제하였으며 naproxen sodium과 ibuprofen과 같은 진통 효과를 보였다. Rofecoxib는 안전성 면에서 우수하며 가장 흔한 부작용은 설사, 두통, 오심과 상기도 감염증이다. Rofecoxib 12.5, 25, 50 mg/day를 투여한 골관절염 환자에게서 위장관계 부작용(천공, 궤양, 출혈)은 ibuprofen, diclofenac, nabumetone을 투여한 환자보다 훨씬 낮은 발생빈도를 나타내었다.

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CMV Bronchiolopneumonia Presenting as a Cystic Lesion in the Lung (낭종성 폐질환으로 오인된 거대세포바이러스(CMV) 세기관지폐렴)

  • 조현민;이기종;정경영
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.285-288
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    • 2003
  • Cytomegalovirus (CMV) pneumonitis leading to inflammation and obstruction of the tracheobronchial tree may cause the cystic changes in the lung. We performed segmentectomy of lung under the diagnosis of congenital cystic lung disease in an infant of 2 weeks presenting severe respiratory failure. Histology and serology confirmed congenital CMV bronchiolopneumonitis.

치료용 레이저를 이용한 대상포진 (Herpes Zoster)치료 19례에 대한 보고

  • 배성동
    • The Journal of Korean Physical Therapy
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    • v.2 no.1
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    • pp.123-125
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    • 1990
  • 문헌에 의하면 대상포진의 원인은 바이러스에 대한 세포성 면역이 저하될 때, 또는 악성종양 등으로 면역억제제 치료를 받아서 2차적으로 면역이 저하될 때 체내에 잠재해 있던 바이러스가 재활되어 발병하는 것으로 추정하고 있다. 본 저자도 이에 대하여 의견을 같이하고 있는데 노령층의 $60\~70$대 여자환자수가 압도적으로 많았다는 점과, $20\~39$세 사이의 청${\cdot}$장년층에서는 단1명의 대상자가 없다는 점뿐 아니라, 본 대상자중 11세의 소녀는 7세때 뇌종양 수술을 2차례에 걸쳐 실시한 후 면역제제를 계속적으로 사용하는 있는 점 등은 문헌의 발병원인과 상당히 일치하였다. <전파 양식> 비말 감염 (droplet infection)으로 전파되며, 수두와 달리 전염성이 높지 않다. <잠복기> 잠복해 있던 바이러스가 언제 재활할지 알 수 없으므로 불명이다. 그러나 본조사에서는 대상포진에 대한 병력을 가진 사람이 없었고, 발생 원인을 본인 자신도 모르고 있었다. <합병증> Ramsay Hunt의 증후에 의하면 합병증은 외이도의 수포, 안면신경마비, 혀의 2/3부분의 미각상실, 간혹 청각 및 평행장애를 일으킨다고 한다. <치료> 대상포진의 대증요법으로 calamine lotion Burrow solution의 wet dressing 진통제 및 cytosine arabinoside나 adenosine arabinoside와 같은 항히스타인제, 최근에는 Acyclovir가 많이 사용되고 있는 것으로 알려졌다.

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Seven Cases of Severe Esophageal Stricture (고도의 식도 협착증 7 예)

  • 김기주;김호성;조중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.5.2-5
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    • 1982
  • With the improvement of living standard and socioenvironmental change, esophageal stricture due to acetic acid, Hcl, insecticides and lye has led to decrease remarkably. Esophageal stricture has decreased because of immediate treatment and adequate management. However there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. The authors recently have experienced seven severe cases of esophageal stricture. All six patients were treated with 18-51 French Sippy esophageal dilating bougie. One patient was transfered to thoracic surgery department due to complete esophageal obstruction. Case 1. A 23 year old housewife who ingested Hcl for suicide. After Witzel's operation, she visited to dilate esophageal first constriction stircture due to swallowing difficulty postoperation 2 months later. We were treated successfully. Case 2. A case of esophageal stricuture in the second and third physiologic constriction part. The patient was 51 years old man who ingested lye accidently, and was dilated by bougination. Case 3. The patient was 43 year-old man who ingested acetic acid as a mistake and was treated inadequately at hopsital. Inspite of treatment, esophageal stricture developed at the third physiologic part. We are trying to dilate the esophagues now. Case 4. The patient was 55 year-old woman who had ingested Hcl for the purpose of suicidal attempt. 2 months later gastroduodenal anastomoisis due to pyloric region stenosis, the first physiologic constriction stricture was dilated successfully. Case 5. The patient was 41 year-old woman who ingested Hcl for suicide 4 months ago. There was indwelled orogastric tube for 1 month but esophageal stricture developed at the first and 3rd constriction part. She was treated by using a bougination. Case 6. An athlete 21 year old man, ingested acetic acid 2 spoonful per 3 days by purpose in order to soften the bone for last 14 months. There was complete esophageal obsturction in esophagogram and transferred to the thoracic surgery department. Case 7. A 3 year-old girl was ingested lye at a accident. She had a bougination for 16 months under the general anesthesia for dilation due to whole irregular esophageal stricture. She developed lower esophageal perforation, but healed eventually.

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Isolated Sphenoid Sinusitis with Nontypeable Haemophilus influenzae Bacteremia in a Healthy Child (균혈증을 동반한 비피막형 인플루엔자균에 의한 접형동 부비동염 소아 1례)

  • Seok, Min Jeong;Choi, Kyu Young;Shin, Saeam;Cho, Ky Young
    • Pediatric Infection and Vaccine
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    • v.27 no.1
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    • pp.62-68
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    • 2020
  • Acute bacterial sinusitis is one of the most common diseases in children, and 5-13% of patients with viral upper respiratory infection experience secondary bacterial sinusitis as a complication. Isolated sphenoid sinusitis is rarer than frontal, maxillary, and ethmoid sinusitis. However, it presents potentially devastating complications, such as cranial nerve involvement, brain abscess, and meningitis, owing to its anatomical location. Nontypeable Haemophilus influenzae (NTHi) commonly causes acute bacterial sinusitis but rarely causes bacteremia, particularly in immunocompetent patients. We present a rare case of a 14-year-old boy with bacteremia due to isolated sphenoid sinusitis caused by NTHi.

The Risk Factors Influencing the Postoperative Mortality of the Patients with an Abdominal Aortic Aneurysm (복부대동맥류 환자에서의 수술 후 사망의 위험인자 분석)

  • Lee, Seong-Kwang;Jun, Hee-Jae;Park, Kyung-Taek;Yoon, Young-Chul;Han, IL-Yong;Lee, Yang-Haeng;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.655-662
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    • 2010
  • Background: Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized as an option to achieve a cure. We retrospectively analyzed over a 6 year period the surgical outcomes, the complications and the mortality-related factors for patients with abdominal aortic aneurysms. Material and Method: We analyzed 36 patients who underwent surgery for abdominal aortic aneurysms between May 2001 and June 2005, and between April 2007 and November 2009. The indications for surgery were rupture, a maximal aortic diameter > 50 mm, and medically intractable hypertension or pain. Result: The mean patient age was $69.67{\pm}6.97$ years (range: 57 to 84 years). Thirty two patients (88.9%) were males and 4 patients (11.1%) were females. Extension to the iliac artery existed in 28 patients (77.8%). Thirteen patients (36.1%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $73.7{\pm}13.3$ mm (60 to 100 mm). Surgery was performed by a midline laparotomy and 10 patients (27.8%) underwent emergency surgery. The mortality rate was 8.3%; the mortality rate for the patients with ruptured aneurysms was 23.1 % and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included wound infection (3 cases), sepsis (2 cases), renal failure (2 cases) and pneumonia (1 case). Unstable vital signs, pre-operative transfusion, ruptured aneurysm, emergency surgery, comorbidity (DM and syncope) and complications (sepsis and renal failure) were the statistically significant mortality-related factors (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have high mortality, but the unruptured cases are repaired with relative safety. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, an elective operation of the unruptured aneurysms could decrease the procedure's morbidity and the inconvenient for repeat evaluation with good surgical results.

Comparative Study of Sterilization by Gamma-ray and Electron-Beam (감마선, 전자선에 의한 멸균 비교분석)

  • Jeong, Kyeonghwan;Park, Changhee
    • Journal of the Korean Society of Radiology
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    • v.14 no.5
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    • pp.537-543
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    • 2020
  • The elderly population in the modern society is growing rapidly due to advance medical technology and minimally invasive surgery. Therefore, as the tendency to use medical device is increasing, pathogenic infection is a concern. Therefore, the first aim of modern medicine is infection prevention in medical place. Recently, patient implants are increasing using 3D printing. Hydroxyapatite is used as a representative material. And, there haven't had currently absorbed dose standard for sterilization of hydroxyapatite discs. Escherichia coli and Streptococcus mutans contaminated on the surface of hydroxyapatite discs were irradiated at each absorbed dose of 0, 0.5, 1.0, 3.0, 5.0 kGy using Gamma-ray of cobalt and Electron-beam of linear accelerator. Then, the number of bacteria was measured in the sample by the decimal dilution method. After sterilization, a non-parametric testing method was performed to compare the survival of Escherichia coli and Streptococcus mutans. As a result, Escherichia coli was sterilized at 1 kGy or more and Streptococcus mutans at 3 kGy or more on absorbed dose. It is considered possible to perform sterilization at a lower value than the recommended absorbed dose of radiation sterilization.

Bilateral Intralobar Pulmonary Sequestration with Horseshoe Lung A near suggestion about the treatment of pulmonary sequestration (마제상폐를 보이는 양측성 엽내형 폐격리증의 외과적 치료 -폐격리증치료에 대한 새로운 제안-)

  • 박종빈;김용희
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.226-230
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    • 1997
  • This is a case report of surgical management of a bilateral intralobar pulmonary sequestration with horseshoe lung presenting with frequent U I with productive sputum. Simple chest X-ray showed pneumonic consolidation and infiltration on both lower lobes, and chest CT revealed multiple cystic lesions compatible with pulmonary sequestration. The aortography demonstrated two anomalous systemic arteries arising from the thoracic aorta just above the diaphragm to both sequestrums. Left lower lobectomy was performed through the left thoracotomy with ligations and divisions of the both systemic feeding arteries to the left and right sequestrum, and division of the isthmic portion of horseshoe lung without removal of right sequestrum. The patient was discharged on the postoperative loth day and followed-up till now without any sequelae and symptoms of residual right sequestration. The recent follow-up chest CT 5 months after the operation revealed spontaneous regression of the residual right sequestrum. Authors would suggested that only division of aberrant artery to sequestrum without lobectomy may be applied in uncomplicated ca e of intrapulmonary seqilestration.

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Surgical Treatment of Prosthetic Valve Endocarditis after Reconstruction of the Intervalvular Fibrous Trigon -A case report- (판막간 섬유체 재건을 시행한 후 발생한 인공판막 심내막염의 수술적 치유 -1예 보고-)

  • Choi, Seon-Uoo;Kim, Wook-Sung;Min, Ho-Ki;Kang, Min-Woong;Lee, Young-Tak;Park, Pyo-Won
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.755-758
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    • 2008
  • We report here on a case of performing a redo-operation for a 65-years-old male patient who had prosthetic endocarditis after reconstruction of the fibrous skeleton due to infective endocarditis 8 years earlier. An aortic annular abscess with a 1cm sized subvalvular abscess and mobile mitral valve vegetation with destruction of the fibrous skeleton was shown on the preoperative echocardiography. An emergency operation was performed due to heart failure. Reconstruction of both the aortic and mitral annuli and the fibrous skeleton was done by using two separate bovine pericardial patches and then mechanical valves were implanted. The postoperative echocardiography shows no paravalvular leakage. The patient has been followed up with no symptoms.

Endobronchial Leiomyoma - A case report - (기관지내 평활근종 -1례 보고-)

  • 김한용;황상원;이연재;유병하;안종운;김병헌
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.725-729
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    • 1998
  • Endobronchial leiomyoma is extremely rare and accounts for less than 2% of benign tumors of the lower respiratory tract. Leiomyomas are predominantly found in the young and the middle aged : of the average age being 35 years for bronchial and lung parenchymal lesions and 40.6 years for tracheal lesions. The symptom depends on the location of the tumor, its size, and changes in the lung distal to the lesion. A 37-year-old woman was admitted to our hospital complaining of coughing. Bronchoscopy revealed complete obstruction of the right main bonchus at the carina by an oval-shaped, nonulcerative, smooth, and pinkish-tan tumor with a broad margin and extended to the left main bronchus. A biopsy was performed and showed a benign spindle cell tumor. A right pneumonectomy was performed because of chronic infection, and the lung could not expanded during aeration. The histological diagnosis of the resected specimen was leiomyoma. The postoperative course was uneventful.

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