• 제목/요약/키워드: Day surgery

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변연절제 및 국소 피판술을 시행한 말기 암환자의 욕창에 대한 한의학적 치료 1례 (Korean Medicine Treatment for Pressure Injury in Terminal Stage Cancer Patients with Debridement and Local Flap: A Case Report)

  • 송주연;문지성;민선우;김학겸;김영지;안립
    • 대한한방내과학회지
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    • 제41권3호
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    • pp.478-486
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    • 2020
  • Objectives: Pressure injury is a common symptom of end-stage cancer, which impact quality of life. This case study reports on use of traditional Korean medicine in an end-stage cancer patient with pressure injury after debridement and local flap. Methods: A pressure injury with debridement and a local flap was treated using herbal medicine, a carbon arc, acupuncture, dressing, and cooperation in plastic surgery. Pressure injury was followed up with photographs. Results: On the 22nd day of treatment (26 days after the debridement and local flap), redness, swelling, and the condition of pressure injury were all improved. Moreover, the condition of the pressure injury was good without dressing. Conclusions: These results show that traditional Korean medicine may have a positive effect on a pressure injury and improve the quality of life of cancer patients. However, further study is needed to confirm these findings.

흉부 종괴로 오인된 선천성 식도열공 탈장 1례 (A Case of Cogenital Esophageal Hiatal Hernia Simulating Chest Mass)

  • 노혜미;문은경;이동철;임혜경;유재홍;설지영;김종철
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제2권2호
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    • pp.211-216
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    • 1999
  • 식도열공 탈장은 그 형태에 따라 진단 및 치료가 지연될 경우 반복되는 구토, 빈혈, 영양실조, 출혈, 감돈, 위궤양, 급성 위팽만 등의 합병증이 발생하여 치명적일 수 있다. 저자들은 심한 탈수와 영양 실조를 주소로 내원한 10개월 남아에서 단순 흉부촬영에서 우측 흉부 종괴로 오인되었으나 선천성 식도열공 탈장과 위의 회전에 의해 상부 위장관 바륨조영술에서 우측 흉강내에 위가 위치한 것처럼 보였던 경우로 탈장 정복술과 위식도 역류방지술을 시행한 후 상기 증상이 호전된 제 3형의 선천성 식도열공 탈장 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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신경계 중환자의 욕창발생에 관한 연구 (A Study on the Pressure Ulcers in Neurological Patients in Intensive Care Units)

  • 임미자;박형숙
    • 기본간호학회지
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    • 제13권2호
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    • pp.190-199
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    • 2006
  • Purpose: To provide basic data and to identify the risk of pressure ulcers among neurological patients in ICU. Method: The participants in the study were on 78 neurological patients in the ICU of 3 hospitals. Data were collected every other day from 24 hours after admission, for up to 40 days or until discharge. The total period of data collection was 3 months. The risk assessment scales used for pressure ulcer were the Cubbin & Jackson(1991) scale and the National Pressure Ulcer Advisory Panel(1989) skin assessment tool. Results: There was a significant relationship between having a pressure ulcers and weight, skin condition, mental status, respiration, hygiene and hemodynamic status compared to not having a pressure ulcer. The incidence rate of the pressure ulcer was 28.2%(n=22). Of these patients the mean number of hospitalization days until pressure ulcer development was 5.2 days. The most common pressure ulcer site was the coccyx(39.3%). Based on a cut-off point of 24, 9 patients with risk scores <24 on admission also showed risk score for development of pressure ulcers, 10 patients with pressure ulcer scores ${\geq}24$ were older, hospitalized for a longer time, had low serum albumin, low hemoglobin, diabetes mellitus and surgery. Conclusion: In order to make the Cubbin & Jackson risk assessment scales more useful, there is a need to determine the reliability of the upper cut-off point 24. The result also showed a need to assess other risk factors and for early identification of at-risk patients in order to provide preventive care from admission to discharge.

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Update on infantile hemangioma

  • Jung, Hye Lim
    • Clinical and Experimental Pediatrics
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    • 제64권11호
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    • pp.559-572
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    • 2021
  • The International Society for the Study of Vascular Anomalies classifies vascular anomalies into vascular tumors and vascular malformations. Vascular tumors are neoplasms of endothelial cells, among which infantile hemangiomas (IHs) are the most common, occurring in 5%-10% of infants. Glucose transporter-1 protein expression in IHs differs from that of other vascular tumors or vascular malformations. IHs are not present at birth but are usually diagnosed at 1 week to 1 month of age, rapidly proliferate between 1 and 3 months of age, mostly complete proliferation by 5 months of age, and then slowly involute to the adipose or fibrous tissue. Approximately 10% of IH cases require early treatment. The 2019 American Academy of Pediatrics clinical practice guideline for the management of IHs recommends that primary care clinicians frequently monitor infants with IHs, educate the parents about the clinical course, and refer infants with high-risk IH to IH specialists ideally at 1 month of age. High-risk IHs include those with life-threatening complications, functional impairment, ulceration, associated structural anomalies, or disfigurement. In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. Oral propranolol, a nonselective beta-adrenergic antagonist, is the first-line treatment for IHs at a dosage of 2-3 mg/kg/day divided into 2 daily doses maintained for at least 6 months and often continuing until 12 months of age. Topical timolol maleate solution, a topical nonselective beta-blocker, may be used for small superficial type IHs at a dosage of 1-2 drops of 0.5% gel-forming ophthalmic solution applied twice daily. Pulse-dye laser therapy or surgery is useful for the treatment of residual skin changes after IH involution.

Mirror Syndrome Resulting from Metastatic Congenital Neuroblastoma to Placenta

  • Park, Sung Hyeon;Namgoong, Jung-Man;Ko, Kyeong Nam;Kim, Chong Jai;Lee, Pil-Ryang;Jung, Euiseok;Lee, Byong Sop;Kim, Ki-Soo;Kim, Ellen Ai-Rhan
    • Perinatology
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    • 제29권4호
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    • pp.189-194
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    • 2018
  • Congenital neuroblastoma is a rare disease. Placental metastasis is extremely rare and poor prognosis has been reported in neonates. Mirror syndrome could occur in mother with placental metastasis with possibilities of hypertension and edema. We report a case of detection of left suprarenal mass in fetus at $31^{+5}weeks^{\prime}$ gestation. Mother presented with palpitation, edema, headache, and hypertension. Maternal 24 hours urine vanillylmandelic acid (VMA) and normetanephrine (NME) level at 34 weeks' gestation were elevated. Consequently, emergent cesarean section was done. Based on abdominal ultrasonography and whole body magnetic resonance imaging, left adrenal tumor with liver metastasis was suspected. Neuroblastoma was confirmed by liver and placenta biopsy. Chemotherapy was started with Pediatric Oncology Group 9243 at day 7 and changed into Children's Oncology Group 3961 due to cholestasis and poor response during 2nd cycle. Plasma exchange was done for aggravated direct hyperbilirubinemia. The baby expired at 73 days due to multi-organ failure. Maternal symptoms were completely resolved in 2 weeks after delivery along with normalization of the elevated level of VMA and NME. We report a first case of mirror syndrome in Korean mother and fetus resulting from metastatic congenital neuroblastoma to placenta.

Scutellaria baicalensis Inhibits Coxsackievirus B3-Induced Myocarditis Via AKT and p38 Pathways

  • Fu, Qiang;Gao, Lu;Fu, Xiao;Meng, Qinghua;Lu, Zhihong
    • Journal of Microbiology and Biotechnology
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    • 제29권8호
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    • pp.1230-1239
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    • 2019
  • Scutellaria baicalensis Georgi has been widely used in China for treatment of various diseases. This study investigated the effect of Scutellaria baicalensis Georgi extracts (SBE) against Coxsackievirus B3 (CVB3)-induced myocarditis in vitro and in vivo. In vitro, Hela cells and primary myocardial cells were infected with CVB3 and treated with SBE ($50-800{\mu}g/ml$) and ribavirin ($200{\mu}M$) for 48 h and then determined by CCK8 assay. Real-time PCR and western blotting assays were performed. In vivo, a myocarditis model was induced in male BALB/c mice by injecting CVB3 suspension intraperitoneally for three times, followed by treatment with SBE (400 and 200 mg/kg) and ribavirin (100 mg/kg) for 28 days. SBE ameliorated the cytotoxicity of CVB3 in Hela cells, especially at $400{\mu}g/ml$ (39.93% vs 65.67%, p < 0.05) without influencing cell growth and also significantly reduced CVB3 replication in primary myocardial cells. The levels of AKT, ERK, and p38 were increased after CVB3 infection. SBE could downregulate the expressions of AKT and p38. In vivo, the mortality rate from CVB3 reached to 66.67%, while 10.00% and 23.33% of this came after 400 and 200 mg/kg SBE treatment, respectively (p < 0.05). The CVB3 replication was obviously reduced after SBE administration from day 5. Similarly, the levels of AKT, ERK, and p38 mRNAs and proteins were increased, and SBE suppressed the expression of AKT and p38. Our study indicates that SBE is a promising potent antiviral agent against CVB3-induced myocarditis by inhibition of virus replication via depressing AKT and p38 expressions.

Changes of Bax, Bcl-2, CCR-2, MCP-1, and TGF-β1 genes in the left ventricle of spontaneously hypertensive rat after losartan treatment

  • Lee, Hyeryon;Kim, Kwan Chang;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • 제62권3호
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    • pp.95-101
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    • 2019
  • Purpose: Increased apoptosis was recently found in the hypertrophied left ventricle of spontaneously hypertensive rats (SHRs). Although the available evidence suggests that apoptosis can be induced in cardiac cells by various insults including pressure overload, cardiac apoptosis appears to result from an exaggerated local production of angiotensin in adult SHRs. Altered expressions of Bcl associated X (Bax), Bcl-2, chemokine receptor (CCR)-2, monocyte chemoattractant protein (MCP)-1, transforming growth factor $(TGF)-{\beta}1$, phosphorylated extracellular signal-regulated kinases (PERK), and connexin 43 proteins, and kallikrein mRNA were investigated to explore the effects of losartan on the SHR model. Methods: Twelve-week-old male rats were grouped as follows: control (C), SHR (hypertension: H), and losartan (L; SHRs were treated with losartan [10 mg/kg/day] for 5 weeks). Western blot and reverse transcription polymerase chain reaction assays were performed. Results: Expression of Bax, CCR-2, MCP-1, $TGF-{\beta}1$, PERK, and connexin 43 proteins, and kallikrein mRNA was significantly increased in the H group compared to that in the C group at weeks 3 and 5. Expression of Bax, CCR-2, MCP-1, $TGF-{\beta}1$, and connexin 43 proteins and kallikrein mRNA was significantly decreased after losartan treatment at week 5. PERK protein expression was significantly decreased after losartan treatment at weeks 3 and 5. Bcl-2 protein expression was significantly decreased in the H group compared to that in the C group at weeks 3 and 5. Conclusion: Losartan treatment reduced expression of Bax, CCR-2, MCP-1, $TGF-{\beta}1$, PERK, and connexin 43 proteins, and kallikrein mRNA in SHRs, along with decreased inflammation and apoptosis.

A Child of Severe Mycoplasma pneumoniae pneumonia with Multiple Organ Failure Treated with ECMO and CRRT

  • Hwang, Woojin;Lee, Yoonjin;Lee, Eunjee;Lee, Jiwon M.;Kil, Hong Ryang;Yu, Jae Hyeon;Chung, Eun Hee
    • Pediatric Infection and Vaccine
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    • 제26권1호
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    • pp.71-79
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    • 2019
  • 8세 남아가 호흡곤란과 기면증을 보이며 응급실에 내원하였다. 극도의 호흡부전을 보이고 있었고 고유량의 산소 공급을 함에도 불구하고 88-90%로 밖에 유지되지 않았고 단순 흉부 방사선 검사에서 전 폐야에 불투과도가 증가하였고 중등도의 흉수를 보였다. 마이코플라스마 폐렴 진단 하에 정맥 macrolide 를 포함한 항생제 치료를 시작하였으나 2병일 째 간, 신장에 다기관 부전 및 급성 호흡부전 증상을 보였다. 정맥-정맥 체외순환막성산소화기를 삽입하였고 지속적 신대체요법도 병행하였다. 18병일 째 성공적으로 체외순환막성산소화기에서 이탈하였고 저산소성 뇌 손상 없이 성공적으로 치료되었기에 본 사례를 보고한다.

Parent Perspectives of Diagnostic and Monitoring Tests Undertaken by Their Child with Inflammatory Bowel Disease

  • Ho, Shaun Siong Chung;Keenan, Jacqueline Ilene;Day, Andrew Stewart
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권1호
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    • pp.19-29
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    • 2021
  • Purpose: To assess parent perspectives of the current and potential future tests for their child with inflammatory bowel disease (IBD). Methods: New Zealand parents of a child with IBD were invited to complete an anonymous online survey. Experiences relating to their child's blood or faecal tests, medical imaging (abdominal ultrasound [US], abdominal computerised tomography [CT] and magnetic resonance enterography) and colonoscopy were collected. Perceived attitudes to potential future testing of urine, saliva, and breath, were sought. Results: Twenty-eight parents, 93% female completed the survey, and 86% were aged between 35 and 54 years. Baseline information was provided by parents for 27 of 28 children, 70.3% had Crohn's disease with a mean disease duration of 2.67 years. Blood tests were the most requested and completed tests, while CT was the least ordered and most refused test. Colonoscopy was rated as the least comfortable and generated the most worry. Explanation of test significantly improved parent's levels of understanding when their child had blood, faecal, imaging (US) or colonoscopy tests. Providing an explanation, test invasiveness and the impact of the blood results may have on their child's treatment significantly improved parents' comfort levels. However, explanation of colonoscopy generated a significant parental concerns. Saliva, urine and blood tests were chosen as the most preferred disease monitoring tests. Conclusion: Parents preferred any tests less invasive than colonoscopy for monitoring their child's IBD. Although providing explanation of their child's tests enhanced parents' understanding, it can also affect parents' levels of concern and comfort.

Dacryocystectomy for Chronic Dacryocystitis in a Beagle Dog

  • Jeong, Youngseok;Lee, Songhui;Kim, Su An;Woo, Sangho;Ko, Dumin;Seo, Kangmoon;Kang, Seonmi
    • 한국임상수의학회지
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    • 제38권3호
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    • pp.152-158
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    • 2021
  • A 3-year-old spayed female beagle dog was presented with epiphora, severe hemorrhagic and purulent ocular discharge in the right eye (OD). A reflux of the discharge through the other canaliculi, associated with signs of chronic inflammation, was observed on cytology. Dacryocystorhinography revealed retention of contrast media ventral to the lower punctum, indicating complete obstruction and the potential presence of radiolucent foreign body. Ocular discharge subsided after the first treatment, including flushing of the nasolacrimal duct and application of topical antibiotics and corticosteroids, but clinical symptoms of the dacryocystitis waxed and waned thereafter. Surgical treatment was delayed for 8 months due to Dirofilaria immitis infection, and topical treatment and monthly flushing were maintained. On the day of operation, a foreign body was released through the fistula, while flushing for disinfection under general anesthesia, just before the surgery. Dacryocystectomy was performed to remove necrotic tissue and residual foreign body around the nasolacrimal cyst. Upon histopathologic findings, the removed foreign body was considered to be a plant, and the nasolacrimal cyst was comprised of chronic active ulcerative inflammation and necrotic tissues. At the 1-week recheck, improvement of epiphora and ocular discharge and healing of the surgical site was noted. In conclusion, nasolacrimal duct foreign body can be considered in recurrent dacryocystitis, despite nasolacrimal flushing and topical medication. In this study, dacryocystectomy was curative without recurrence of dacryocystitis or epiphora.