• Title/Summary/Keyword: Fluid therapy

Search Result 406, Processing Time 0.027 seconds

Cranial Vena Cava Syndrome in a Retriever Dog Receiving CPN through Central Venous Catheter

  • Oh, Sangjun;Kang, Jinsu;Kim, Bumseok;Kim, Namsoo;Heo, Suyoung
    • Journal of Veterinary Clinics
    • /
    • v.39 no.5
    • /
    • pp.253-257
    • /
    • 2022
  • A 5-year-old castrated male Golden Retriever dog weighing 15 kg presented with evidence of intestinal intussusception. The patient had cachexia and severe dehydration before being referred to our department. Ultrasound imaging revealed a target sign indicative of intestinal intussusception. Emergency surgery was performed shortly after diagnosis. After a successful surgery, the patient was hospitalised for postoperative care. Initial treatment was aimed at the reversion of dehydration and the provision of adequate nutrition. Fluid therapy and central parenteral nutrition were administered via the peripheral and central venous catheters, respectively. Ten days postoperatively, swelling and edema were observed in the head and neck. Ultrasound and computed tomography confirmed complete blockage of the cranial vena cava due to thrombosis, which consequently obstructed both the left and right jugular veins. For treatment, dalteparin and tissue plasminogen activator were administered. However, the patient lost all of its vital function on the daybreak of postoperative day 11. Venous thrombus formation secondary to central parenteral nutrition application via the central line is a rare but possible complication. Veterinarians who are concerned about taking care of patients receiving CPN through the central line should keep the possibility of venous thrombus formation in mind.

Glycine induces enhancement of bactericidal activity of neutrophils

  • Kang, Shin-Hae;Ham, Hwa-Yong;Hong, Chang-Won;Song, Dong-Keun
    • The Korean Journal of Physiology and Pharmacology
    • /
    • v.26 no.4
    • /
    • pp.229-238
    • /
    • 2022
  • Severe bacterial infections are frequently accompanied by depressed neutrophil functions. Thus, agents that increase the microbicidal activity of neutrophils could add to a direct antimicrobial therapy. Lysophosphatidylcholine augments neutrophil bactericidal activity via the glycine (Gly)/glycine receptor (GlyR) α2/TRPM2/p38 mitogen-activated protein kinase (MAPK) pathway. However, the direct effect of glycine on neutrophil bactericidal activity was not reported. In this study, the effect of glycine on neutrophil bactericidal activity was examined. Glycine augmented bactericidal activity of human neutrophils (EC50 = 238 μM) in a strychnine (a GlyR antagonist)-sensitive manner. Glycine augmented bacterial clearance in mice, which was also blocked by strychnine (0.4 mg/kg, s.c.). Glycine enhanced NADPH oxidase-mediated reactive oxygen species (ROS) production and TRPM2-mediated [Ca2+]i increase in neutrophils that had taken up E. coli. Glycine augmented Lucifer yellow uptake (fluid-phase pinocytosis) and azurophil granule-phagosome fusion in neutrophils that had taken up E. coli in an SB203580 (a p38 MAPK inhibitor)-sensitive manner. These findings indicate that glycine augments neutrophil microbicidal activity by enhancing azurophil granule-phagosome fusion via the GlyRα2/ROS/calcium/p38 MAPK pathway. We suggest that glycine could be a useful agent for increasing neutrophil bacterial clearance.

A Study on the Relationship Between Length of Time and Contamination in Open Intravenous Solutions (정맥주사용 수액의 개방후 시간경과에 따른 오염도에 관한 실험연구)

  • 김일원
    • Journal of Korean Academy of Nursing
    • /
    • v.16 no.1
    • /
    • pp.67-80
    • /
    • 1986
  • The use of intravenous solutions for fluid replacement has become an integral part of patient care, This widespread use of intravenous solutions has increased the risk of contamination that can lead to septicemia and phlebitis. The literature regarding contamination of in use intravenous solutions recommends a standard 24-hour time limit on the use of these fluids. But the desings of these studies did not incorporate a time variable related to contamination. In other studies, however, time was a manipulated variable: but data regarding the onset of contamination were conflicting. Because published reports conflict with regard to a time standard related to the use of intravenous therapy, additional empirical data are needed upon which to base the standards of care regulating use of intravenous therapy. This study investigated rate of contamination in simulated in-use intravenous solutions to obtain data from which to recomend a standard time period for the administration of intravenous solutions. In this study samples were drawn from 60 bottles of 5% D/W solution at predetermined time intervals over 48 hours and samples were inoculated to Thio-glychollate Broth. After 10 days' culturing in that Broth, samples were cultured on blood agar plates for 18∼48 hours to determine the rate of contamination. was found at all time Period, regardless of the presence or absence of nurse's gloving in the preparation of fluids, the location in which the experimentations were performed, the contamination level of surrounding air, or the length of time during which solutions were opened. Data from this study support the use of a 48-hour time period on which to base the standard involved in ready-to-use simple intravenous solutions without additives. In emergency departments and critical care areas where intravenous solutions are prepared in advance, the suggested time standard supported by the data generated from this study is 48 hours, not 24 hour. Data from this study support a 24-hour time standard for changing in-use intravenous solutions when the contamination results from the manipulation of intravenous infusion system by hospital personnel, or from some other exogenous sources during administration. Because contamination that does occur within 48 hours in intravenous solutions must be introduced from some exogenous sources, further empirical studies based on the identification of sources of contamination and factors that affect the rate of contamination, are needed to investigate the currently employed standard of intravenous therapy and to provide the patient with more efficient and safer intravenous thereapy.

  • PDF

A Case of Interstitial Pneumonitis developed by Interferon-${\alpha}$ Treatment for Chronic Hepatitis C (만성 C형 간염 환자에서 Interferon-${\alpha}$를 투여중 발생한 간질성 폐렴 1예)

  • Yoon, Jong Goo;Ahn, Joong Hyun;Ko, Seung Hyeon;Lee, Hyun Seoung;Kwon, Soon Seog;Kim, Young Kyoon;Moon, Hwa Sik;Park, Sung Hak;Song, Jeong Sup
    • Tuberculosis and Respiratory Diseases
    • /
    • v.43 no.4
    • /
    • pp.637-644
    • /
    • 1996
  • Interstitial pneumonitis associated with interferon alpha therapy for chronic hepatitis C was first describe6 in 1994 by Kazoo et al In Japan. The mechanism of interstitial pneumonitis developed by interferon alpha was still unknown but immunologic, allergic of direct lung toxicity were suggested. We experienced a case of interstitial pneumonitis developed during interferon alpha therapy for chronic hepatitis C in a 52-year-old male patient. He was treated with 6 million units of interferon alpha intramuscularly 3 times per week for 4 weeks and noted progressive dyspnea and cough. These symptoms were subsided after 6 weeks' discontinuation of interferon alpha therapy. And so, he was retreated with 3 million units of interferon alpha 3 times per week for 8 weeks and felt dyspnea again. He was admitted to our hospital for further evaluation of progressive dyspnea. Arterial blood gas(ABG) values were $PaO_2$ 90.7 mmHg and $PaCO_2$ 31.9 mmHg, and antinuclear antibody(ANA) was negative. A chest X-ray film revealed diffuse reticulo-nodular shadows in bilateral lung fields, suggesting a diagnosis of interstitial pneumonitis. A marked increase in lymphocyte count and suppressor T cell were observed in bronchoalveolar lavage(BAL) fluid. Lymphocyte stimulation test with interferon alpha was positive. Interstitial pneumonitis was confirmed by transbronchial lung biopsy. After discontinuation of interferon alpha, we gave oral steroid in the condition that clinical symptoms were being improved gradually.

  • PDF

A comparative study on between Shanghanlun(傷寒論) and Sa-sang constitutional medicine(四象醫學) in Pathogenesis (상한론(傷寒論)과 사상의학(四象醫學)의 병기(病機)에 대한 비교연구(比較硏究) - 동의수세보원(東醫壽世保元) 변증론(辨證論)을 중심(中心)으로 -)

  • Lee, Kwang-Young;Park, Chan-Kuk
    • Journal of Korean Medical classics
    • /
    • v.11 no.1
    • /
    • pp.676-718
    • /
    • 1998
  • After a comparative study on between Shanghanlun(傷寒論) and Sa-sang constitutional medicine(四象醫學) in Pathogenesis, I got a conclusion like this. Sa-sang consitutional medicine(四象醫學) changed the directions to the medicine in the center of personality from the medicine in the center of Shanghanlun(傷寒論)'s demonstration, devided the personality of people by the size of Organ system(臟腑) into 4types of Tae-eum, Yo-yang, Tae-yang, Yo-eum(太少陰陽), and explains all the course of physiology, pathology, diagnosis, therapy of the body on the point of constitutional view. Comparing the features of two medicines, Shanghanlun(傷寒論) and Sa-sang constitutional medicine(四象醫學), Shanghanlun(傷寒論) devided the diseases into the three type of eum-yang based on eight principal syndroms(八綱原理), in accordance with evidence of illness, pulse and studied the therapy, Shanghanlun(傷寒論) set up the basis of medicine which is based on overall of symptoms and signg(辨證論治醫學). Sa-sang constitutional medicine(四象醫學) distinguished the image(象) which is devided by the size of inherited Organ system(臟腑), refered to the symptom of diseases(病症) and decided the therapic directions. So Sa-sang constitutional medicine(四象醫學) gave more accuracy to the therapy by subdeviding the process of differenciation of case(辨證) into 2 steps of differenciation of image(辨象) and differenciation of case(辨證). In view of etiologic factor, Shanghanlun(傷寒論) regarded it as a invading of pathogenic factors(邪氣), so Shanghanlun(傷寒論) has the medical theory of pathogenic factors(邪氣). But Sa-sang constitutional medicine(四象醫學) regarded it as a disorder of the genuine energy(正氣)'s movements(升降緩速), so Sa-sang constitutional medicine(四象醫學) has the medical theory putting first of genuine energy(正氣). But Shanghanlun(傷寒論) also recognized the constitutional difference basically and Sa-sang consitutional medicine(四象醫學) devided the constitution into Tae-eum, Yo-yang, Tae-yang, Yo-eum(太少陰陽) and explained the food-air-fluid metabolism(飮食-氣液之氣病證) as cold-hot, cool-warm and devided the the symptom of diseases(病症) into the interior and the exterior(表裏) as the up-down, slow-fast movements of eum-yang and insufficiency and excessiveness is between them. In the end, Sa-sang constitutional medicine(四象醫學) has the theory of eight principal syndroms(八綱原理) faithfully which is the theory of differenciation of case(辨證理論) of Shanghanlun(傷寒論). Therefore Shanghanlun(傷寒論) made a lot of influence on originating Sa-sang constitutional medicine(四象醫學), Sa-sang constitutional medicine(四象醫學) is the theory which is based on existing medical theory including Shanghanlun(傷寒論) and composed the new medical theory to the constitutional point of view. Sa-sang constitutional medicine(四象醫學) enriched the medical theory and developed the clinical medicine so it has the historical value in the medicine.

  • PDF

The Study on Wound Healing in Rabbit Skins by Low-intensity Laser Irradiation (저강도 레이저 조사에 의한 가토 피부의 상처 치유에 관한 연구)

  • 김식현;전진석
    • Biomedical Science Letters
    • /
    • v.6 no.2
    • /
    • pp.119-129
    • /
    • 2000
  • The skin is an organ that has many important roles, including protection against infection, regulation of temperature and fluid loss, and sensory function. Injury to the skin, wound repair normally involves: (1) balanced activity of inflammation, (2) the re-epithelial phase and (3) the matrix formation of remodeling phase. Thus, skin wound healing is a finely controlled biological process involving a series of complex cellular interactions. Laser therapy is being implemented with increasing frequency in medicine. Low intensity laser is one that is capable of producing an energy density so low that any biologic alterations are the result of direct irradiation effect, not thermal events. This study was designed to evaluate the efficacy of low intensity laser therapy on skin wound healing in rabbits. A total of 10 male rabbits (New Zealand White Rabbit), age 8 weeks were used. Skin wound were surgically created dorso-lateral on the flank of 10 rabbits (2$\times$2 cm/damage areas). The experimental animals were treated with 5Hz (830 nm wave length) low-intensity laser (MILTA-01 Model) daily for 10 min (1.6 J/$cm^2$) for 12 days. Control animals were sham treated with the laser head. Laser irradiation animals showed a complete remodeling of the epithelial layer, a positive repair of connective tissues, and enhanced the wound closure rate over time as compared to the control animals. Especially, laser irradiation groups improved fibroblast activity, cellular content, granulation tissue formation, and collagen deposition which is resulted in improving the tensile strength of the wound. These findings suggest that laser photostimulation could accelerate healing of open wound in rabbits, and may be benefit in the treatment of open wound, including decubitis ulcers.

  • PDF

Diagnostic Significance of the Serologic Test Using Multiple Antigens of Mycobacterium Tuberculosis by ELISA (다양한 특이결핵항원을 이용한 결핵항체 검사(ELISA)의 진단적 유용성)

  • Kim, Dae-Yun;Choi, In-Hwan;Park, Seung-Kyu;Cho, Shang-Rae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
    • /
    • v.47 no.6
    • /
    • pp.757-767
    • /
    • 1999
  • Background: Diagnosis by smear and/or cultures of the Mycobacterium tuberculosis from body fluid or biopsy specimen is "Gold standard". However the sensitivity of the direct microscopy is relatively low and culture of mycobacteria is time consuming. Despite an explosion in the techniques of rapid identification of mycobacteria by molecular genetic means, it is laborious and expensive and then rapid, inexpensive serodiagnosis is interested in diagnosis of tuberculosis. But sensitivity and specificity of known serologic antigen is not full sufficient level and then new antigen develop and combination cocktails of new developed antigens by ELISA are needed. Method: To compare the efficacy of different mycobacterial specific antigen and to assess the applicability of the combination of several different antigens in the diagnosis of tuberculosis, five ELISA tests derived 14KDa, 16KDa, 19KDa, 23KDa, 38KDa were evaluated in 57 active pulmonary patient and 24 inactive post-therapy follow up patient and 48 normal control. Results: The optical densities of ELISA test with 14KDa, 16KDa, 19KDa, 23KDa, 38KDa were significantly higher in active tuberculosis cases than in normal control(P<0.001, P<0.001, P<0.027, P<0.001, P<0.001) and those with 16KDa, 38KDa were significant higher in active tuberculosis cases than in inactive post-therapy follow up cases(P<0.01. P<0.001) and those of 14KDa, 16KDa, 23KDa, 38KDa were significant higher in inactive post-therapy follow up cases than in normal control(P<0.008. P<0.01. P<0.006. P<0.001). The sensitivity of 14KDa, 16KDa, 19KDa, 23KDa, 38KDa in active pulmonary patient cases was 42.1%, 43.9%, 15.8%, 28.0%, 70.2%, respectively and the specificity of 14KDa, 16KDa, 19KDa, 23KDa, 38KDa in active pulmonary patient cases was 95.8%, 95.8%, 91.7%, 89.6%, 93.8%, respectively. The sensitivity and specificity of combination 38KDa with 16KDa was 87% and 93.7%. Conclusion: The sensitivity and specificity of new antigens for serodiagnosis of the tuberculosis still remains limited at around 70%, which makes its a poor diagnostic tool for disease confirmation. A combination of cocktail antigens provided by cut-off value adjustment for serodiagnosis of tuberculosis some improved diagnostic yield than single antigen serologic test.

  • PDF

Clinical Indices Predicting Resorption of Pleural Effusion in Tuberculous Pleurisy (결핵성 늑막염에서 삼출액의 흡수에 영향을 미치는 임상적 지표)

  • Lee, Joe-Ho;Chung, Hee-Soon;Lee, Jeong-Sang;Cho, Sang-Rok;Yoon, Hae-Kyung;Song, Chee-Sung
    • Tuberculosis and Respiratory Diseases
    • /
    • v.42 no.5
    • /
    • pp.660-668
    • /
    • 1995
  • Background: It is said that tuberculous pleuritis responds well to anti-tuberculous drug in general, so no further aggressive therapeutic management is unnecesarry except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who need later decortication due to dyspnea caused by pleural loculation or thickening despite several months of anti-tuberculous drug therapy. Therefore, we want to know the clinical difference between a group who received decortication due to complication of tuberculous pleuritis despite of anti-tuberculous drug and a group who improved after 9 months of anti-tuberculous drug only. Methods: We reviewed 20 tuberculous pleuritis patients(group 1) who underwent decortication due to dyspnea caused by pleural loculation or severe pleural thickening despite of anti-tuberculous drug therapy for 9 or more months, and 20 other tuberculous pleuritis patients(group 2) who improved by anti-tuberculous drug only and had similar degrees of initial pleural effusion and similar age, sex distribution. Then we compared between the two groups the duration of symptoms before anti-tuberculous drug treatment and pleural fluid biochemistry like glucose, LDH, protein and pleural fluid cell count and WBC differential count, and we also wanted to know whether there was any difference in preoperative PFT value and postoperative PFT value in the patients who underwent decortication, and obtained following results. Results: 1) Group 1 patients had lower glucose level{$63.3{\pm}30.8$(mg/dl)} than that of the group 2{$98.5{\pm}34.2$(mg/dl), p<0.05}, and higher LDH level{$776.3{\pm}266.0$(IU/L)} than the group 2 patients{$376.3{\pm}123.1$(IU/L), p<0.05}, and also longer duration of symptom before treatment{$2.0{\pm}1.7$(month)} than the group 2{$1.1{\pm}1.2$(month), p<0.05}, respectively. 2) In group 1, FVC changed from preoperative $2.55{\pm}0.80$(L) to postoperative $2.99{\pm}0.78$(L)(p<0.05), and FEV1 changed from preoperative $2.19{\pm}0.70$(L/sec) to postoperative $2.50{\pm}0.69$(L/sec)(p<0.05). 3) There was no difference in pleural fluid protein level($5.05{\pm}1.01$(gm/dL) and $5.15{\pm}0.77$(gm/dl), p>0.05) and WBC differential count between group 1 and group 2. Conclusion: It is probable that in tuberculous pleuritis there is a risk of complication in the case of showing relatively low pleural fluid glucose or high LDH level, or in the case of having long duraton of symptom before treatment. We thought prospective study should be performed to confirm this.

  • PDF

Implication of Quantitative Culture of Bronchoalveolar Lavage Fluid in the Diagnosis of Ventilator Associated Pneumonia in Patients with Antimicrobial Therapy (항생제 사용 중 발생한 기계 호흡기 관련 폐렴에서 기관지 세포 세척술의 진단적 의미)

  • Chang, Yoon-Soo;Ahn, Chul-Min;Chung, Byung-Chun;Kim, Hyung-Jung;Kim, Seong-Kyu;Lee, Won-Yong;Shin, Jeung-Su
    • Tuberculosis and Respiratory Diseases
    • /
    • v.49 no.1
    • /
    • pp.72-81
    • /
    • 2000
  • Backgrounds : Authors evaluated the quantitative culture of bronchoalveolar lavage fluid(BALF) in patients who were being treated with antimicrobial agents and the characteristics of isolated microorganism. Method : A prospective study was done with 25 patients under mechanical ventilation and antimicrobial treatment in ICU and NCU of Yongdong Severance Hospital from Apr. to Sep. 1999. Patients were classified into two groups: control group (n=5) and patients with VAP (n=20). The threshold of quantitative culture of BAL fluid in the diagnosis of VAP was $10^4$ cfu/ml. Results : 1) In gram staining of BALF, one patient in the control group and four in the VAP group showed positive results. Quantitative culture of BALF showed no organisms in the patients in the control group and in 9 VAP patients. Therefore the overall sensitivity was 43.8%. 2) Frequency of isolated organisms cultured above diagnostic threshold was in the following order: E. cloaclae, S. aureus, K. pneumoniae, and A. baumani. S. aureus and Staphylococcus coagulase(-) were a11 resistant to oxacillin. Seven out of 10 isolated G (-) organisms were suspected to be organisms producing extended spectrum $\beta$-lactamase (ESBL). 3) The concurrence between gram staining of sputum aspiration and that of BALF was only in 1 case. And the concurrence of culture results was observed in 3 cases. Conclusion : The sensitivity of gram staining and quantitative culture of BALF from patients under antibiotic therapy and the concordance rate between conventional tracheal aspiration and BAL were low, facts which were important in interpretation the data. Since the frequency of drug resistance organisms was not different from that of foreign data, antibiotics must be prudently selected and used.

  • PDF

A study on the theory of "Pyong-Yeol-Byong (評熱病論)" in 33th chapter of "SoMon (素問)" Yellow Emperor's Nei-Ching (黃帝內經) (황제내경(黃帝內經) 소문(素問) 평열병론(評熱病論)에 대(對)한 연구(硏究))

  • Moon, Hee-Seork;Hong, Won-Sik
    • Journal of Korean Medical classics
    • /
    • v.3
    • /
    • pp.399-443
    • /
    • 1989
  • In this thesis, I intend to study the translational and clinical interpretation through the syndrom of "Pyong-Yeol-Byong", and reached the following conclusions. 1. Eum-Yang-Kyo (陰陽交)' 1) Meaning: "Eum" means "Essential and vital energy" "Yang" means "Evil factor affecting health" and "Kyo" means "cross-struggle." 2) Location of disease: Heat evil enter Hyeol-Bun (血分) 3) Pathogenesis: Heat evil invade Eum-Bun (陰分) and struggles with Health energy, therefore Eum-Chung (陰精) is exhausted and Heat-evil doesn't disapper, it damage Eum and exhaust fluid. Reach fever, rapid pulse raving and unable to take meal, not controled by sweating and sceach death. 4) Particularity of Syndrome: Heat enter Hyol-Bun, and Evil factor is enough and Health energy is insufficient, so that reveal the symptoms of high fever, delirium with coma, unable to take meals. 5) Therapy: It clears Gi-Bun heat evil (氣分熱邪) by Gypsum, Rhizoma Anemarrhenae, Flos Lonicerae, Fructus Forsythiae, Fructus Gardeniae, Radix Scutellanae Rhizoma Coptidis, and cools Blood by Cornu Rhinoceri Asiatici, Radix Rehmanniae, Cortex Moutan Radicis, Dae-Chung-Yob (大靑葉) Radix Arnebiae Seu Lithospermi. 2. Poong Gweol (風厥) 1) Meaning: Poong means wind-evil, Gweol means reversing up. 2) Location of disease: Disease complexes with TaeYang (太陽) in outer part, and with So-Eum (少陰) in inner part. 3) Pathogenesis: Tae-Yang-Gyeong (太陽經) accept wind-evil and So-Eum-Gyeong (少陽經) Kidney Energy reverse up so that fidgetiness not resolves by sweating. 4) Particularity of Syndrome: There are outer symptoms of fever, hydrosis with inner symptoms of fidgetinessis. 5) Therapy: Reduce Jok-Tae-Yang (足太陽) and Supply Jok-So-Eum (足少陰) by accupuncture, so cure Poong Gweol and make balance between Yeong (營) and Wi (衛). 3. Scrofula coused by wind-evil (勞風) 1) Meaning: It means accepting wind evil rest less. 2) Location of Disease: It locates lung 3) Pathogenesis: Because of accepting wind-evil restless, he take scrofula with damaging lung. 4) Particularity of disease: It is lung disease of aversion to wind and shiver, nape-stiffiness, dim eyesight, cough, disphea, vomitting sputum, if one camnot vomit sputum, he died by damage of lung. 5) Therapy: The period of therapy is different by age or strength of health energy, so I think must prevent Eum deficiency and clear fever no reduced in lung. 4. Shin-Poong (腎風) 1) Meaning: It means taking edema by accepting wind-evil, because the kidney controls water. 2) Location of Disease: It is that wind-evil envade kidney. 3) Pathogenesis : Water evil of kidney with wind-heat rises up to face, reach edema, puffines s of the lower eyelid, floating pulse, bombus, yellowish urine, hydrosis and hand-heating, drymouth and excessive thirsty, walkless by heaviness, menstrual disfunction, restless and unable to take meals, unable to lie flat, heavy cough if lie flat, and accepting wind-evil by deficiency of kidney function, so the function of dredging the water passage is not smooth, symptom of water and symptom of wind reveal together. 4) Therapy: Remove wind-heat, promote diuresis to eliminate tile wetness-evil, supplement the dificiency of kidney's Eum. Finally, we can know that later Fever Disease Medicime (溫病學) is affected to the theory of "Pyong Yeol Byong" in 33th Chapter of SoMoon (素問).

  • PDF