• Title/Summary/Keyword: Fluid Management

Search Result 513, Processing Time 0.029 seconds

Drilling off the Petrosal Apex and Opening the Upper Wall of Meckel's Cave Are the Key Elements of Good Outcomes in the Treatment of Trigeminal Neuralgia Secondary to Petrous Apex Meningioma

  • Bai, Jie;Zhou, Yufan;Song, Gang;Ren, Jian;Xiao, Xinru
    • Journal of Korean Neurosurgical Society
    • /
    • v.65 no.3
    • /
    • pp.479-488
    • /
    • 2022
  • Objective : The surgical management of trigeminal neuralgia (TN) caused by petrous apex meningioma (PAM) is still a challenge because of the lesion's deep location and the surrounding complex structures. The authors describe the intradural anterior transpetrosal approach (ATPA) and its effect on the treatment of TN secondary to PAM. Methods : A retrospective analysis of 15 patients with TN secondary to PAM who underwent surgery via the intradural ATPA was conducted. The key techniques, which included drilling off the petrosal apex (PA) and opening the upper wall of Meckel's cave (MC), are described in detail. Results : Total removal of the tumor and complete pain relief (Barrow Neurological Institute I) were achieved in all 15 patients without significant morbidity. Five patients developed new facial numbness postoperatively, which disappeared within three months after surgery. The postoperative magnetic resonance imaging showed temporal lobe swelling in three patients, but no clinical symptoms. One patient had cerebrospinal fluid leakage and was managed with bed rest and temporary lumbar drainage. One patient had an intracranial infection and was treated with antibiotics. By the last follow up, no patients had pain relapse or/and tumor recurrence. It is worth noting that the vascular compression at the root of the trigeminal nerve was found in one patient during the operation. Conclusion : Our experience suggests that drilling off the PA and opening the upper wall of the MC are key elements for a good outcome of the treatment of TN secondary to PAM. The intradural ATPA has the advantages for both tumor resection and pain relief.

A Case of the Large Colon Impaction in an Adult Donkey (성숙한 당나귀의 큰잘록창자 폐색 증례)

  • Yang, J.;Park, Y.S.
    • Journal of Practical Agriculture & Fisheries Research
    • /
    • v.20 no.2
    • /
    • pp.117-123
    • /
    • 2018
  • The purpose of this report is to describe the diagnosed case of a large colonic impaction in an adult donkey. An adult female donkey (Equus africanus asinus; 6-years-old) was admitted to the Equine Hospital of Jeju Race Park with signs of anorexia, which had started 1 day previously. Clinical examination revealed: weak gut sounds, dehydration, and severe abdominal distension, but normal respiratory and heart rates and no signs of pain. Transrectal palpation identified an impaction in the colon. The patient was treated with nasogastric siphonage, fluid therapy, and nonsteroidal anti-inflammatory drugs. Over the course of a day, her condition worsened; she started trembling, could not stand, and 2 hours later she died. Upon necropsy, a vast amount of ingesta was found in the large colon, particularly in the left ventral colon. The cecum and small colon were normal. Eleven days prior to presentation, the stable management and diet of the donkey had changed. We suspect that the change of feed, reduced water consumption, and lack of exercise precipitated the illness. However, the exact cause of the sudden death of the donkey requires further investigation.

Diagnosis and Management of Lymphoplasmacytic Rhinitis in a Cat (림포형질세포성 비염에 이환된 고양이의 진단과 치료)

  • Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
    • /
    • v.28 no.4
    • /
    • pp.438-441
    • /
    • 2011
  • A 7-year-old castrated, domestic shorthair cat was presented with a 2-year history of chronic nasal discharge and sneezing. Upon presentation, bilateral mucopurulent nasal discharge and stertorous respiration were marked. Physical examination revealed a tachypnea. Oral examination was unremarkable and chest radiology was normal. Findings of nasal cytology and skull radiology were not specific and further imaging technique, endoscopic examination and histopathology was performed for a definite diagnosis. Fluid, and/or soft tissue opacity was found in bilateral nasal cavity, nasopharyngeal regions and right side tympanic bulla through the CT scan. No evidence of neoplasia was revealed. A rigid rhinoscopy, flexible bronchoscopy and otoscopy was used for the visualization of the lesions and tissue biopsy biopsy was performed for histopathology. On histopathological examination, the nasal mass consisted mainly of large numbers of plasma cells and lymphocytes. And the final diagnosis was lymphoplasmacytic rhinitis based on histopathologic examination. Long term management with oral cyclosporine (5 mg/kg, BID) was safe and successful in this cat. This is the first case report described clinical and diagnostic characteristic features of feline lymphoplasmacytic rhinitis and its clinical outcome using oral cyclosporine in Korea.

Endoscopic Management of Pineal Region Tumors with Associated Hydrocephalus (수두증을 동반한 송과체 부위 종양에 대한 내시경적 치료)

  • Kim, Jeong Hoon;Ra, Young Shin;Kim, Joon Soo;Ahn, Jae Sung;Kim, Chang Jin;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
    • /
    • v.30 no.5
    • /
    • pp.575-580
    • /
    • 2001
  • Purpose : In general, pineal region tumors are managed by using microsurgical approach or stereoctactic biopsy. However, in selected cases endoscopic approach to pineal lesions might prove to be as effective as microsurgery and less invasive. We report an alternative surgical strategy for managing certain patients with pineal neoplasms that allows treatment of the symptomatic hydrocephalus as well as tumor biopsy under direct vision in the same sitting. Materials and Methods : Twenty-two patients with pineal region tumors with associated hydrocephalus were treated in one session by endoscopic third ventriculostomy and endoscopic tumor biopsy at our institution from October 1996 to January 2000. All patients were retrospectively evaluated. Results : There was no operative mortality. There was one cause of significant bleeding during biopsy, but was controlled endoscopically, and the patient recovered completely without neurologic deficit resulting from intra-operative bleeding. The symptoms related to increased intracranial pressure(ICP) have resolved in all patients, and the need for a shunt is completely eliminated. Histological diagnosis was achieved in 21 of the 22 patients by this procedure. A biopsy was not obtained in one patient. Although this pineal region tumor was seen endoscopically, this could not be biopsied because of technical difficulties in working around an enlarged massa intermedia. The lesions included fourteen germinomas, three mixed germ cell tumors, and one each of the followings: pineocytoma, pineoblastoma, pineocytoma/pineoblastoma(intermediate type), meningioma, and low grade glioma. Five of the 22 patients subsequently underwent formal microsurgical tumor removal. Additional chemotherapy or radiotherapy could then be initiated according to the histological diagnosis. Conclusion : We consider that endoscopy affords a minimally invasive way of reaching three objectives by one-step surgery in the management of pineal region tumors with associated hydrocephalus : 1) cerebrospinal fluid(CSF) sample for analysis of tumour markers and cytology, 2) treatment of hydrocephalus by third ventriculostomy, and 3) several biopsy specimens can be obtained identifying tumors which will require further open surgery or adjuvant radiation and/or chemotherapy. However, complications and morbidities should be emphasized so as to be avoided with further technical experience.

  • PDF

Effects of insect growth regulators(IGRs) on vitellogenesis in insect (곤충의 난황형성에 대한 곤충성장조절제의 작용)

  • Lee, Hee-Kwon;Lee, Jong-Jin;Kim, Moo-Key;Lee, Hoi-Seon
    • The Korean Journal of Pesticide Science
    • /
    • v.5 no.4
    • /
    • pp.11-19
    • /
    • 2001
  • This review discusses the effects and roles of insect hormones and insect growth regulators (IGRs) on vitellogenesis in adult insects. Insect vitellogenesis is regulated by hormones such as juvenile hormone (JH), ecdysteroids, and neurosecretory hormones (ovaryecdysteroidogenic hormone : OEH) released by neurosecretory cells, diet, and other elements(male specific protein of sperm fluid). In the fat bodies, the vitellogenins are synthesized by the stimulation of JH released by corpus allatum (CA) and ecdysteroids produced by follicle cells with the ovary in most insects. Furthermore, vitellogenins are released into the hemolymph, transported to the ovarioles by carrier protein, and incorporated into oocytes for the developing ovary. Of IGRs, juvenile hormone and its mimics such as methoprene and pyriproxifen appear to have pharmacological effects such as membrane lysis, destruction of salivary grand and midgut epithlial cells, fat body cells, and ovarian tissue, and also anti-juvenile hormone such as precocenes I and II appear to have specific cytotoxicity such as inhibition of corpus allatum and oocytes development. These results suggest that IGRs may be useful as agents for integrated pest management.

  • PDF

Awareness and performance about nosocomial infection management; a early stage nurse in small and medium hospitals (병원감염관리에 관한 인지도와 수행도 - 중소병원 초보간호사를 중심으로 -)

  • Kim, Jung-Mi;Choi, Young-Sil
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.19 no.8
    • /
    • pp.492-500
    • /
    • 2018
  • This study was conducted to identify the degrees of awareness and performance of hospital infection control of early stage nurses working in medium and small sized hospitals. This survey was conducted for 15 days from Sep. 15 to Sep. 30, 2017. Data were then analyzed by SPSS Win 22.0 to determine the mean and SD, as well as to conduct t-tests, ANOVA, and Scheffe's test. The result were as follows: 1. There were significant differences in awareness of hospital infection according to urinary tract infection, respiratory infection, and disinfection of contaminated goods managements with age. 2. There were significant differences in performance of hospital infection according to hand washing (working department), fluid therapy (education need p<0.001), urinary tract (position), and respiratory infection management (position p<0.001). 3. The mean score of awareness and performance regarding hospital infection were significantly different (all items p<0.001). According to these results, systematic education for improving awareness and performance regarding hospital infection control by nursing staff in medium and small sized in hospitals should be conducted. In addition, organizational efforts to increase the number of early stage nurses and improve the usability of personal infection control devices should be encouraged.

Prediction of water quality change in Saemangeum reservoir by floodgate operation at upstream (상류제수문 방류조건에 따른 새만금호의 수질변화 예측)

  • Kim, Se Min;Park, Young Ki;Lee, Dong Joo;Chung, Mahn
    • Journal of Korea Water Resources Association
    • /
    • v.50 no.6
    • /
    • pp.373-386
    • /
    • 2017
  • This study simulated water quality item and flow rate of subbasin for Saemangeum watershed using Soil and Water Assessment Tool (SWAT) model and Environmental Fluid Dynamics Code (EFDC) model which simulate hydraulic and water quality in three-dimensions. The simulated values corresponded to observed value well. The result of simulation for floodgate operations at the M3 and M5 points, it exceeds water quality standard and at the M3 and D3 points, change of range for concentration is too wide, and upstream of Saemangeum reservoir is sensitive to inflow flow rate. Compared to the annual average concentration for observed station according to the discharge conditions, improvement of water quality for upstream was apparently compared to the downstream. Range of influence for change of water quality presented that maximum discharge condition, the influence range is 22 km in the direction of the Saemangeum downstream from the Mankyung bridge, and 15 km in the downstream direction of saemangeum in the Dongjin bridge. This study result demonstrated that floodgate operating at upstream has significant influence on water quality management of Saemangeum reservoir and it needs to be considered in plans of water quality management for Floodgate operation on Saemangeum reservoir.

A Study on a Method for Composing a Portfolio for REITs Investment Using Markowitz's Portfolio Model (마코위츠 포트폴리오 모형을 사용한 리츠 투자 포트폴리오 구성방법에 관한 연구)

  • Lee, Chi-Joo;Lee, Ghang;Won, Jong-Sung;Ham, Sung-Ili
    • Korean Journal of Construction Engineering and Management
    • /
    • v.11 no.2
    • /
    • pp.54-63
    • /
    • 2010
  • Domestic construction companies suffer from the difficulty in financing in the wake of economic slump at home and abroad. In the periods of this economic slump, which hit the nation REITs, the facilitator of fluid financing and the stimulating of construction economic, has increasingly been expanded since its introduction in 2001. But, REITs relatively falls behinds any other nations, in terms of its growth speed and marketing volume. The purpose of this research thesis is to suggest the method for composing a portfolio using Markowitz portfolio selection models for stimulating REITs. Main contents are as follows. First, the thesis made the comparative analysis on profit increase in REITs investment in application of models by Markowitz and REITs derivatives from 2007/07/03 to 2008/07/21 during investment analysis periods. The result showed that total profits by Markowitz model amounted to about 10 percent higher than average profits of REITs derivatives. Second, this thesis made the analysis on sensitivity of data-gathering and portfolio change periods of the existing profits, in order to measure the both periods and yield optimum profits. The six month data-collecting periods of profits accounted for some 16% higher profits than profits of REITs derivatives. In case when the two week periods of portfolio change accounted for some 11% higher profits than profits of REITs derivatives.

Radiation Therapy In Management Of Primary Non-Hodgkin's Lymphoma Of Central Nervous System (원발성 중추신경계 림프종에 대한 방사선치료)

  • Hong, Seong-Eon
    • Radiation Oncology Journal
    • /
    • v.12 no.1
    • /
    • pp.33-42
    • /
    • 1994
  • From 1982 to 1991, sixteen Patients with primary non-Hodgkin's lymphoma of the central nervous system(CNS) were seen at Kyung Hee University Hospital. The most common subtypes were large, noncleaved cell lymphoma and immunoblastic lymphoma of B cells. Lesions most commonly involved were the parietal lobes and/or deep nuclei. Positive cerebrospinal fluid cytology was rare at initial presentation. Sixteen patients were treated with surgical biopsy or resection followed by whole brain radiotherapy at a median dose of 40 Gy(range=30-50 Gy) with variable boost doses. Of 16 patients who underwent surgery and postoperative radiotherapy, fourteen patients died between 2 and 49 months following treatment, and two are alive with no evidence of disease at 8 and 22 months. The 1-and 2-year survival rates were 55.6$ \% $ and 34.7$ \% $, respectively with 12 months of median survival. Patterns of failure were analyzed in eleven patients of total 16 patients. Failure at the original site of involvement was uncommon after radiotherapy treatment. In contrast, failure in the brain at sites other than those originally invovled was common in spite of the use of whole brain irradiation. Failure occurred in the brain 11/16(68.7$ \% $), in spinal axis 4/16(25.0$ \% $). The age, sex, location of involvement within CNS, numbers of lesion, or radiation dose did not influence on survival. The authors conclude that Primary CNS lymphoma is a locally aggressive disease that is poorly controlled with conventional radiation therapy. The limitation of current therapy for this disease are discussed, and certain promising modality should be made in regarding the management of future patients with this disease.

  • PDF

Physicochemical properties of chitosans produced from shrimp shell under the different conditions and their influences on the properties of Kakdugi during storage (제조조건이 다른 새우껍질 chitosan의 물리.화학적 성질 및 깍두기의 보존성에 미치는 영향)

  • Kim, Kwang-Ok;Kang, Hyen-Jun
    • Journal of the Korean Society of Food Culture
    • /
    • v.9 no.1
    • /
    • pp.71-77
    • /
    • 1994
  • This study was undertaken to investigate the physicochemical properties of chitosans produced from chitins which were prepared from shrimp shell under the 4 different conditions(HCl concentration : 1 N, 4 N and reaction temperature $0^{\circ}C,\;20^{\circ}C$). The effects of chitosan on the properties of Kakdugi during storage also were examined. Viscosity of chitosan was markedly different$(313.1{\sim}98.8\;cps)$ depending on the production conditon. Chitosan solution showed pseudoplastic property. The infrared(IR) spectrums of chitosans prepared under the conditions of this study were very simillar, and the degree of deacetylation of chitosan was relatively high$(92{\sim}96%)$ independent of the extraction conditions of chitin. As the storage period was extended, markedly lower pH and higher titratable acidity were resulted in all the groups. Throughout the storage period, pH and titratable acidity of kakdugies with chitosan were higher and lower, respectively than those of control. Viscosity of kakdugi juice was significantly different among the groups and as the storage period increased, the juice viscosity decreased. At the eighth day of storage, the juice of control group was more viscous than those of kakdugies containing chitosan. Throughout the storage period the numbers of total microorganisms and of microorgarnisms of Leuconostoc genus in control kakdugi tended to be higher and lower, respectively than those in kakdugies containing chitosan. The growth of Lac. plantarum was slightly lower in kakdugi containing chitosan C produced at low HCl concentration and high temperature compared to the others.

  • PDF