• Title/Summary/Keyword: Fluid Therapy

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Intestinal pseudo-obstruction as the initial presentation of systemic lupus erythematosus in a 13-year-old girl (장 가성 폐쇄로 진단된 전신 홍반 루푸스 1예)

  • Cho, Ky Young;Khil, Tae Young;Ahn, Hye Mi;Lee, Sun Wha;Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.655-659
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    • 2008
  • Intestinal pseudo-obstruction (IPO) is a rare and poorly understood manifestation of systemic lupus erythematosus (SLE), especially in children. The characteristic clinical feature of IPO is obstruction without an identifiable obstructive lesion. The authors a 13-year-old girl whose first symptom of SLE was IPO. The patient presented with a 3-day history of nausea, bilious vomiting, abdominal distention, and no bowel movement. Simple abdominal radiographs revealed mild dilatation with partial air-fluid levels in the small intestine. Abdominal CT and methylcellulose small bowel studies showed massive ascites, engorgement of the small mesenteric vessels, pleural effusion, and diffuse bowel wall thickening of the gastric antrum, duodenum. and jejunum. The delayed passage of contrast for 15 days after the methylcellulose small bowel studies was suggestive of decreased bowel motility. Laboratory findings were positive for ANA, anti-double-stranded DNA, anti-Smith and lymphopenia. After 10-day treatment with high-dose corticosteroids, the symptoms improved. IPO associated with SLE should be considered in the differential diagnosis for patients presenting with symptoms of intestinal obstruction. Early recognition of IPO in SLE and appropriate therapy are important for prevention of complications and unnecessary surgery. This case raises awareness among pediatricians that although rare, IPO can be the presenting symptom of SLE in children.

Development of a Frequency Dependent Type Apex Locator with Automatic Compensation (자동 보정 주파수 의존형 근관장 측정기의 개발)

  • Kim, Deok-Won;Nam, Gi-Chang;Kim, Yeong-Ju;Lee, Seung-Jong
    • Journal of Biomedical Engineering Research
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    • v.19 no.6
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    • pp.595-602
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    • 1998
  • Among the apex locators, the frequency dependent type is more accurate and convenient to use than others, But the accuracy of the apex locator is still influenced by the presence of various electrolytes used in root canal treatments. In this study, we have developed a frequency dependent electronic apex locator minimizing the influence of the electrolytes on the measurement of root canal lengths. It was also confirmed that two frequencies of 500Hz and 100kHz are optimal for the measuring impedance compare with commercial product used(400Hz and 8kHz)a and there were no differences in accuracy among the three different types of the waveforms; sinusoidal, triangular, and rectangular waves(p>0.05). Impedance ratio of the two different frequencies represents the position of the file in root canal, and the voltage difference of two signals represents the status of the fluid in the root canal. As a result of compensation using the voltage differences, the errors were decreased on the average from +0.54mm to +0.18mm in $H_2O_2$ solution (p<0.01), and from -0.33mm to -0.01mm in NaOCl solution(p<0.01). The accuracies based on ${\pm}$0.5mm, in $H_2O_2$ and NaOCl solutions were improved with the automatic compensation from 71.1% and 91.1% to 82.2% and 100% respectively.

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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
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    • v.19 no.8
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    • pp.492-500
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    • 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.

The effect of calcium metaphosphate bone graft materials on bone regeneration (생분해성 Calcium Metaphosphate골이식재의 골조직재생효과에 관한 연구)

  • Chae, Han-seung;Lee, Yong-Moo;Yang, Seung-Min;Chun, Sung-Soo;Kim, Suk-Young;Ku, Young;Choung, Chong-Pyoung;Han, Soo-Boo;Choi, Sang-Mook;Rhyu, In-Chul
    • Journal of Periodontal and Implant Science
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    • v.33 no.1
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    • pp.13-26
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    • 2003
  • Periodontal regeneration therapy with bone-substituting materials has gained favorable clinical efficacy by enhancing osseous regeneration in periodontal bony defect. As bone-substituting materials, bone powder, calcium phosphate ceramic, modified forms of hydroxyapatite, and hard tissue replacement polymer have demonstrated their periodontal bony regenerative potency. Bone-substituting materials should fulfill several requirements such as biocompatibility, osteogenecity, malleability, biodegradability. The purpose of this study was to investigate biocompatibility, osteo-conduction capacity and biodegradability of $Na_2O$, $K_2O$ added calcium metaphosphate(CMP). Beta CMP was obtained by thermal treatment of anhydrous $Ca_2(H_2PO_4)_2$. $Na_2O$ and $K_2O$ were added to CMP. The change of weight of pure CMP, $Na_2O$-CMP, and $K_2O$-CMP in Tris-buffer solution and simulated body fluid for 30 days was measured. Twenty four Newzealand white rabbits were used in negative control, positive control(Bio-Oss), pure CMP group, 5% $Na_2$-CMP group, 10% $Na_2O$-CMP goup, and 5% $K_2O$-CMP group. In each group, graft materials were placed in right and left parietal bone defects(diameter 10mm) of rabbit. The animals were sacrificed at 3 months and 6 months after implantation of the graft materials. Degree of biodegradability of $K_2O$ or $Na_2O$ added CMP was greater than that of pure CMP in experimental condition. All experimental sites were healed with no clinical evidence of inflammatory response to all CMP implants. Histologic observations revealed that all CMP grafts were very biocompatible and osseous conductive, and that in $K_2O$-CMP or $Na_2O$-CMP implanted sites, there was biodegradable pattern, and that in site of new bone formation, there was no significant difference between all CMP group and DPBB(Bio-Oss) group. From this result, it was suggested that all experimental CMP group graft materials were able to use as an available bone substitution.

The effect of nutraceutical containing PRF-K2 on periodontal condition during maintenance phase (치주 유지관리기 환자에게 PRF-K2를 함유한 nutraceutical의 효과)

  • Kim, Yu-Kang;Chung, Hyun-Ju;Kim, Se-Won;Baek, Dong-Heon
    • Journal of Periodontal and Implant Science
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    • v.37 no.1
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    • pp.91-102
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    • 2007
  • The long term success of periodontal treatment is dependent upon the effectiveness of the main-tenance care program after active treatment. The purpose of this study was to evaluate whether nutraceutical containing PRF-K2 as natural product from plant and seaweed has beneficial effects on clinical parameters, gingival crevicular fluid (GCF) volume and GCF cytokine levels during main- tenance phase after periodontal treatment. Among the generally healthy and non-smoking. moderate to severe chronic periodontitis patients during maintenance phase in Department of Periodontics, Chonnam National University Hospital, twenty eight patients took nutraceutical containing PRF-K2 (Oscotec Inc. Cheonan, Korea) for 3 months as experimental group and sixteen patients received only maintenance care as control group. Clinical examination and GCF collection were performed at baseline, 1, 2 and 3 months of experiment. Total amounts and concentrations of GCF IL-1{\beta}, IL-1ra and $PGE_2$ were evaluated using ELISA kit. In probing pocket depth, experimental group showed the tendency of more reduction than control group after 3 months of experiment. Sulcus bleeding index (SBI) and GCF volume were significantly decreased in experimental group(p<0.05), whereas they were increased in control group. GCF IL-1{\beta} level tended to decrease in both experimental and control group and IL-1ra concentration tended to increase in experimental group and to decrease in control group. IL-1ra/IL-1{\beta} ratio tended to increase in experimental group and to decrease in control group during experimental period. GCF $PGE_2$ amount did not show any change in experimental group and tended to increase in control group. These results suggest that nutraceutical supplement which contain PRF-K2 could improve perio-dontal condition during maintenance phase after periodontal therapy.

Effects of Starvation and Perioperative Fluid Therapy on the Blood Glucose Concentrations during Anesthesia in Children (소아마취시 금식과 수액투여가 혈당농도에 미치는 영향)

  • Suh, Ill-Sook;Song, Sun-Ok;Park, Dae-Pal
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.89-93
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    • 1984
  • This study included 38 children patients of less than 4 years old and 18kg body weight. 93 After 8 hours of starvation, the children were divided into 2 groups: Group I received Hartmann's solution and Group II received Hartmann's dextrose solution. In both groups, the rates of infusion were 10ml/kg/hr before and during operation and blood samples were collected just before and 1 hr after induction of anesthesia, respectively. The results were as follows; 1) In the Group I, blood glucose concentration just before induction was decreased than control values that was checked at ward, and 1 hr values after induction was significantly increased than control values. 2) In the Group II, blood glucose concentration was increased just before and 1hr after induction than control values significantly respectively. 3) In the blood glucose concentration 1 hr after induction, difference between Group I and Group II was not significant. 4) In children, duration of starvation about 8 hrs did not significant influence on blood glucose concentration although dextrose was not administered.

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A Case of Brain Edema Complicated by Whole Lung Lavage to Treat Pulmonary Alveolar Proteinosis (폐포 단백증 치료를 위한 전폐세척술 후 발생한 뇌부종 1예)

  • Moon, Hee-Yong;Kim, Se-Kyu;Shin, Dong-Whan;Lee, Ki-Myung;Chang, Jung-Hyun;Kwak, Seung-Min;Lee, Hong-Lyeol;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.158-164
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    • 1994
  • Pulmonary alveolar proteinosis is a disease of unknown etiology characterized by the accumulation of PAS positive lipoproteinaceous material in the alveolar spaces sparing septum. The therapy which has enjoyed the greatest success is whole lung lavage. The authors reported here, a case of 44 year old male patient with pulmonary alveolar proteinosis, and this is the 7th case in Korea. The patient underwent whole lung lavage but expired due to brain edema complicated by the procedure. He complained exertional dyspnea and cyanotic lips, and presented fine inspiratory crackle at both lower lung fields, decreased arterial oxygen pressure, and diffuse infiltration at whole lung field. Light microscopic finding of lung tissue obtained by transbronchial lung biopsy revealed PAS positive amorphous, granular material filled in the alveolar spaces, and electron microscopy of bronchoalveolar lavage fluid concentrate showed many electron-dense multi-lamellated structures. To treat the disease, the authors tried whole lung lavage of left lung with $37^{\circ}C$ isotonic saline under general anesthesia. However, he expired due to brain edema probably due to dilutional hyponatremia complicated by the procedure, 11 days after the procedure. Whole lung lavage is known relatively safe, but fatal complication may occur like this case.

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Unresolving Pneumonia (치료에 대한 반응이 없는 폐렴)

  • Bang, Do Seok;Jung, In Sung;Kang, Ki Man;Park, Bum Chul;Yoon, Young Gul;Kim, Jae Su;Park, Yol;Lee, Sung Hoon;Hong, Young Chul;Ko, Kyoung Tae;Park, Sang Min;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.6
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    • pp.604-608
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    • 2004
  • A 47-year-old-man was admitted to the emergency department with dyspnea, right pleuritic pain, and high fevers for 3 days. He had a nonproductive cough that exacerbated the chest pain. A clinical examination revealed distressed and slightly tachypneic patient, with blood pressure of 110/90 mmHg, temperature of $39^{\circ}C$, pulse of 90 beats/min, respiratory rate of 24 breaths/min. A chest examination showed significantly diminished breath sounds in the right lung with dullness to percussion. Laboratory investigation demonstrated leukocytosis and a raised C-reactive protein. The results of arterial blood gas analysis revealed moderate hypoxemia. A radiograph and a CT scan of the chest showed extensive consolidation with multifocal low densities, and pleural effusion in the right lung. A diagnostic thoracentesis revealed straw-colored fluid, which was found to be a neutrophil-predominant exudate. At 7 days after admission, the clinical symptoms had not improved and the temperature was still $39^{\circ}C$ despite the aggressive therapy of community-acquired pneumonia. After comprehensive history taking, we realized then that he accidentally aspirated kerosene while siphoning from fuel tank to put into the boiler 3 days ago. Bronchoscopy with bronchial washings could be successful in establishing the diagnosis of hydrocarbon pneumonitis by demonstration of a high lipid-laden macrophage index. Thereafter, the symptoms and radiographic opacities gradually improved, and he was discharged several days later.

Rapid Detection of Lactobacillus Genus Inhabiting in Vagina of 20's Healthy Women Using Multiplex PCR (Multiplex PCR 분석을 통한 건강한 20대 여성의 질 내에 서식하는 Lactobacillus 속 유산균의 신속한 검출)

  • Oh, Cho-Rong;Cho, Hong-Bum
    • Korean Journal of Microbiology
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    • v.48 no.4
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    • pp.309-313
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    • 2012
  • The purpose of this study is to simultaneously detect and identify specific genus of Lactobacillus distributed in vagina of healthy women in their twenties by using multiplex primer. Vaginal fluid samples were taken from 166 women who were healthy and did not have vaginosis symptoms caused by bacterial infection. Six species of lactic acid bacteria belong to Lactobacillus genus that are known to inhabit in healthy vagina were selected to make a species-specific multiplex primer. Multiplex primer I was specified to selectively detect L. iners, L. crispatus, L. gasseri and multiplex primer II was specified to selectively detect L. acidophilus, L. jensenii, L. fermentum. L. crispatus (77%) was most frequently detected, and L. acidophilus (57%) and L. jensenii (57%) were relatively higher than others. Although the proportion of L. iners (59%) was a little higher than those of L. acidophilus and L. jensenii, this should be further validated in healthy women's vagina to be sure since they often appear in women having bacterial vaginosis and/or during the antibiotic therapy. Conclusively, the multiplex PCR technique using the species-specific primer could a useful tool to predict variation of vaginal health condition and process of recovery from vaginal disease.

The Factors Affecting the Use of Empirical Antibiotics in Febrile Infants from 1 Month to Less than 3 Months (30일 이상 90일 미만의 발열 영아에서 경험적 항생제 사용에 영향을 미치는 요소)

  • Byun, Joung-Hee;Song, Bo Kyung;Kim, Young A;Ko, Hoon;Yoo, Suk dong;Lim, Taek Jin;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.25 no.2
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    • pp.91-100
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    • 2018
  • Purpose: This study investigated the factors affecting the use of empirical antibiotics in febrile infants from 1 month to less than 3 months. Methods: We retrospectively reviewed the medical records of hospitalized previously healthy infants with fever in Pusan National University Children's Hospital from January 2010 to December 2016. Clinical features, laboratory findings and antibiotic therapy were analyzed. Respiratory viruses were identified by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) and were reported after 1-3 days. Enterovirus were identified by real time polymerase chain reaction (PCR) and were reported in several hours. Results: The 129 of 366 subjects used empirical antibiotics and 237 patients didn't used empirical antibiotics. Empirical antibiotics were used more frequently when the fever was longer before admission, respiratory symptoms and ill being appearances were present and C-reactive protein was elevated. The rate of readmission was low in the group not used empirical antibiotics. Most of the patients detected by enterovirus PCR in cerebrospinal fluid didn't used empirical antibiotics. The results of respiratory virus multiplex RT-PCR showed no difference in the use of empirical antibiotics. Conclusions: In our study, empirical antibiotic prescriptions were affected not respiratory virus multiplex RT-PCR but enterovirus PCR. If multiplex RT-PCR were reported more rapid turn around time, it will affect antibiotic use.