• 제목/요약/키워드: Fluid therapy

검색결과 409건 처리시간 0.021초

원인불명의 극심한 식욕부진(食慾不振)을 호소한 고령 환자 치험례 (Case of an Old-Age Patient with Ill-defined Severe Anorexia)

  • 정기용;하유군;백종우;최유경;김동우;박종형;전찬용
    • 동의생리병리학회지
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    • 제22권1호
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    • pp.256-261
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    • 2008
  • Anorexia is a common symptom in the elderly patients. Causes of anorexia in the elderly are very diverse and multifactorial. Causes include physiological changes associated with aging, mental disorders such as depression, anorexia tardive, dementia, medical diseases such as cancer(lung and gastrointestinal cancer), benign gastrointestinal disorders, cardiac disorders, pulmonary disease, thyroid disorders, infection. Medications such as digoxin, theophylline have also been implicated in the problem. No cause is found in about one quarter of patients. Management is directing at treating causes and providing nutritional support. In Oriental medicine, the appetite has close relation to Biwi. The main cause of anorexia is the insufficiency of Biwi. The physiology of Biwi is that Bi sends clarity(food essence) upward and Wi sends digested food downward. Specially if the physiologic function of Wi is disordered by various factors, Wi cannot send digested food downward. As a result, the anorexia can present by the disorder of Wi function. We experienced a case of an 74 years old female patient with ill-defined severe anorexia differentiated as Wijoongheohan. The patient was managed with fluid therapy and Jeonghyangsiche-tang. The anorexia and other symptoms improved continuously during hospitalization.

외상성 폐낭종의 외과적 치료 (Surgical Treatment of Traumatic Pulmonary Cyst -A case report-)

  • 오성철;이성주;김창희;채성수
    • Journal of Chest Surgery
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    • 제29권5호
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    • pp.577-580
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    • 1996
  • 외상성 폐낭종은 비관통성 흉부외상후 발생되는드문공동성 폐 병변이다. 병 발생은공기와 액성 물 질을 함유하는 폐 실질의 좌상이다. 진단은 외상후 폐낭종이 발생될 수 있다는 인식에 기초를 두며, 다른 유사한 질환과 감별이 중요하다. 일단 외상성 폐장종이 진단되면, 치료는 입원후 필요시 호흡을 보조하 면서, 외과적 관찰을 하는 것이 원칙이다. 그러나 감염이 합병되고, 보존적 요법과 적합한 항생제 치료 에도 불구하고 낭종의 크기가 줄지 않는 경우, 수술적 치료를 요하다. 저자들은 최근 19세 남자 환자에서 외상성 폐낭종을 치험하였기에, 관련 문헌의 고찰과 함께 보고하 고자 한다.

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방사성핵종 복막촬영술을 이용한 복수에 동반된 수흉의 감별 진단 (Radionuclide Peritoneal Scintigraphy in Patients with Ascites and Pleural Effusion)

  • 이재태;이규보;황기석;김광원;정병천;조동규;정준모
    • 대한핵의학회지
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    • 제24권2호
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    • pp.279-285
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    • 1990
  • Simultaneous presence of ascites and pleural effusion has been documented in patients with cirrhosis of the liver, renal disease, Meigs' syndrome and in patients undergoing peritoneal dialysis. Mechanisms proposed in the formation of pleural effusion in most of the above diseases are lymphatic drainage and diaphragmatic defect. But sometimes, hepatic hydrothoraxes in the absence of clinical ascites and pleural effusion secondary to pulmonary or cardiac disease are noted. It is not always possible to differentiate between pleural effusion caused by transdiaphragmatic migration of ascites and by other causes based soly on biochemical analysis. Authors performed radionuclide scintigraphy after intraperitoneal administration of $^{99m}Tc-labeled$ colloid in 23 patients with both ascites and pleural effusion in order to discriminate causative mechanisms responsible for pleural effusion. Scintigraphy demonstrated the transdiaphragmatic flow of fluid from the peritoneum to pleural cavities in 13 patients correctly. In contrast, in 5 patients with pleural effusion secondary to pulmonary, pleural and cardiac diseases, radiotracers fail to traverse the diaphragm and localize in the pleural space. Ascites draining to mediastinal lymph nodes and blocked passage of lymphatic drainage were also clarified, additionaly. Conclusively, radionuclide peritoneal scintigraphy is an accurate, rapid and easy diagnostic tool in patients with both ascites and pleural effusion. It enables the causes of pleural effusion to be elucidated, as well as providing valuable information required when determining the appropriate therapy.

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아토피피부염에 대한 Lactobacillus 혼합배양액의 임상 증례 (The Case Study of Lactobacillus mixture culture fluid on Atopic dermatitis)

  • 조을화;김태근;홍수정;정도연;황성연;안성훈
    • 대한한의학회지
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    • 제36권3호
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    • pp.135-143
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    • 2015
  • Objectives: Recently lactic acid formulation was known as the adjuvant therapy on atopic dermatitis(AD) symptoms because of little side effects. In this study, it was studied that Lactobacillus mixed culture appliment was effective on not on AD symptoms. Methods: The case-photos 30-40 times of AD symptoms from case were observed with literatures. The case-photos were acquired with environmental AD dermatitis experience program which is conducted in SUNCHANG RESERCH INSTITUTE OF HEALTH AND LONGEVITY from 2014.01 to 2014.08. Experience applicants were limited the oral administration and chemical external administration. Results: Lactobacillus mixed culture appliment was effective because of the mitigation or disappearance of AD primary symptoms like pruritus, erythema, edema, effusion, dry skin, scaly, scab etc. AD symptom degree was dependent on lactobacillus mixed culture appliment times, and classified as Reaction Period (RAP), Reduction Period (RDP), Efection Period (EP), Reproduction Period (RPP) on a single mixed culture appliment time. And AD symptoms which were appeared in RPP were classified as Rebound Period (RBP), Effection Period (EP), Subclinical Period (SCP). Conclusions: Lactobacillus mixed culture appliment is considered to be useful for AD symptoms and is estimated to be effective by different mechanism with oral administration or steroid ointment application. Lactobacillus mixed culture appliment is expected to induce a synergistic effects on AD symptom reliefs with the other oral administration.

전립선 암에서 Bicalutamide 사용으로 생긴 간질성 폐질환 1예 (Bicalutamide-induced Interstitial Lung Disease)

  • 김양균;김이형;이재진;최천웅;유지홍;박명재;강홍모
    • Tuberculosis and Respiratory Diseases
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    • 제68권4호
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    • pp.226-230
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    • 2010
  • Androgen deprivation therapy, which is the standard treatment for metastatic prostate cancer, includes nonsteroidal antiandrogenic drugs, such as flutamide, nilutamide and bicalutamide. Of them, bicalutamide rarely induces interstitial pneumonia. We report a case of bicalutamide-induced interstitial pneumonia. A 68-year old male diagnosed with prostate cancer and multiple bone metastases presented with dry cough and low grade fever for 3 days. He had taken bicalutamide (50 mg/day) for 13 months. High resolution computed tomography revealed ground glass opacity in his right upper lung. The laboratory studies showed no eosinophilia in the serum and bronchoalveolar lavage fluid. Despite the use of antimicrobial agents for 2 weeks, the extent of the lung lesions increased to the left upper and right lower lung. He had no environmental exposure, collagen vascular disease and microbiological causes. Under the suspicion of bicalutamide-induced interstitial pneumonia, bicalutamide was stopped and prednisolone (1 mg/kg/ day) was initiated. The symptoms and radiologic abnormalities were resolved with residual minimal fibrosis.

개에서 Norepinephrine 분비 갈색세포종 증례1 (A Case of Norepinephrine Secreting Pheochromocytoma in a Dog)

  • 최을수;김동훈;김현욱;최지혜;장재영
    • 한국임상수의학회지
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    • 제26권3호
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    • pp.268-272
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    • 2009
  • An-11-year-old male Shih-tzu was admitted to emergency care unit of Haemaru Referral Animal Hospital with signs of dyspnea, anuria and depression. There were abnormalities on complete blood count and serum chemistry included leukocytosis with mild left shift, mild azotemia, and increased ALT activity. Fluid therapy(0.9% saline, 40 ml/hr) and antibiotics were immediately initiated. The patient began to vomit after 5 hours' rest and pale mucous membrane, bradycardia, and hypertension were noted. Abdominal ultrasonography revealed enlarged left adrenal gland and thrombus in caudal vena cava(CVC). Result of ACTH stimulation test was normal. Cytology of ultrasound-guided FNA smears showed numerous naked nuclei, which was suggestive of adrenal medullar tumor. Concentrations of 24 hour urine metanephrine and normetanephrine was moderately increased compared to those of a control dog. Adrenal mass was surgically removed, and biopsy of the CVC mass was obtained. After surgery the patient began to recover but the dog acutely developed cardiopulmonary arrest and died. On histopathology the adrenal mass and biopsy of the CVC mass were consistent with pheochromocytoma. On electron microscopic view norepinephrine specific granules were found in the cytoplasm of tumor cells.

건성안(乾性眼)에 대한 침료법(鍼療法)의 문헌적(文獻的) 고찰(考察) (Book research into acupuncture treatement for dry eye)

  • 권도희;김용석;최도영
    • Journal of Acupuncture Research
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    • 제17권3호
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    • pp.10-24
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    • 2000
  • 1. Objectives : Millions of people throuout the world are affected by some form of dry eye disorder. I made researches for more effective treatments for dry eye. 2. Methodes : I refered to occidental and oriental medical records. 3. The results were as follows : Common symptoms of dry eye are dryness, burning, irritation, grittiness, itching, fatigue of eye, photophobia, congestion, mattering and tear. Treatments of dry eye are to clear away heat and fire, remove dampness, replenish Um and promote production of body fluid, tonify the blood and replenish Ki. Acupunctre and moxibustion therapy of dry eye are as follows: Very busy points of traditional regular acupuncture are Sangsong, Chanjuk, Sajukkong, Chongmyong, Sabaek, Tongjaryo, Taeyang, Pungji, Tuimup, Paekoe, Un-gyo, Chonjong, Hapkok, Yangbaek, Kansu, Yanggye, Imup, Chok-samni, Taechung, Kwangmyong, Yang-gok, Uihui, Chohae, Haenggan. Less busy points of it are Oyo, Kuhu, Sungup, Konmyong, Konmyongl, Konmyong2, Sangmyong, SanghaChongmyong, Shinmyong, Osang, Shinjong, Yonghyang, Yaemyong, Chon-yu, Chon-ju, Kwallye, Naebi, Noeho, Tuyu, Mokchang, Ponshin, Shinhoe, Yepung, Okchim, Pungbu, Kokchon, Kollyun, Nae-gwan, Tae-nung, Samumgyo, Sokolkong, Shinsu, Um-gyo, Igan, Chongok, Choktaek, Kyonjungsu, Kokchi, Kongchoe, Kyuum, Kihae, Taekolkong, Taedon, Pino, Pisu, Sabong, Samgan, Kokchi, Shinmun, Shinmaek, Shimsu, Yangno, Aengmun, Yolgyol, Oegwan, Wijung, Chang-gan, Chungjo, Chungdo, Chigu, Chium, Chollyo, Tongni, Pungmun, Haryom. Very busy points of ear-acupuncture are Kan, Bi, Shin, An, Less busy points of it are Shim, Pye, Naebunbe, Mok1, Mok2, Shinmun, Ichom. Useful points of bleeding by needle are Taeyang meridian, Yangmyong meridian, Chono, Chonjong, Paekoe, Sangsong, Chanjuk, Sajukkong, nasal cavity. Useful points of moxibustion are Inchung, Huaryo, Shinchu, Pungmun, Kansu, Shimsu, Kokchi, Kongchoe, Sohae.

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부산지역 방문간호사업 실태에 관한 연구 (A Research on Actual Conditions of Visiting Nursing Program on Busan)

  • 김영숙;박정란;박형숙;이윤미
    • 가정∙방문간호학회지
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    • 제11권1호
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    • pp.23-32
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    • 2004
  • Purpose: The purpose of this research is to give basic data about a way of connection to individual centers and vitalization of visiting nursing program on Busan. Method: The research is done with survey for eight hospitals. sixteen public heath centers, forty-six social welfare centers to be practised visiting nursing program on Busan for actual condition of that. Results: 1. The average nursing career is below 5-10 years. But visiting nursing career is below 3 years(70%) in hospital. public, public heath center, and heath center. 2. Hospitals coverage of visiting nursing service is city as a whole. Whereas public heath center and social welfare center covered some local area. 3. Client of visiting nursing service possess in order of alone lived elderly, person in uncomplete movement, a disabled person, and a chronic disease person. 4. The main service in visiting is patient assessment, basic nursing activity, and treatment nursing activity with medication care, B.P check, dressing, bedsore care, catheter care and exchange, fluid therapy. Particularly, the hospital runs parallel to basic care and treat care in 100%. The social service center has 65.0% in a patient assessment and basic nursing activity. 5. The concern about services connecting with other center is very high. Conclusion: Actual conditions of visiting nursing program on Busan, which is presented in this study. The results of this study will become the pillar of visiting nursing program planning and application.

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구강악안면영역의 치성감염으로 인한 근막간극 감염에 대한 회귀적 연구 (THE RETROSPECTIVE STUDY OF INTRAFASCIAL INFECTION FROM ODONTOGENIC INFECTION IN ORAL AND MAXILLOFACIAL REGION)

  • 김성혁;이재훈
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권1호
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    • pp.42-49
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    • 2007
  • Infections in oral and maxillofacial region are relativley common and self-limiting, but in some cases, infections spread to adjacent hard and soft tissue and to cause any complication, even threaten life. So we made retrospective study of patients with interfascial infection who had been hospitalized and been treated by surgical treatment in Dankook university about 10 years. We reviewed the charts of patient with interfascial infection from 1995 to 2005. The result were as follows: 1. In gender & age distribution, male(54.2%) & fouth decade were most frequently. 2. The most common cause of infection was dental caries(55.2%) and the most of involving teeth was lower posterior teeth(44.1%). 3. Submandibular space is most frequently involving space and most infection involved mainly one space. 4. The patients with systemic disease were 38.2%. Diabetic mellitus was 87.2% of systemic diease. The admission period was 19.5 days in systemic disease. 5. The most microorganism in culture was Streptococcus Viridans(36.2%) in all patient. Klebsiella Pneumoniae was found most in Diabetic Mellitus. 6. The patient were mainly treated I&D on admission day. Of them 5(1.1%) patients were received tracheostomy. 7. Serum albumin, CRP and body weight are associated with Nutritional Risk Index(NRI). High risk patient group according to NRI classification showed higher rate of complications & mortality. 8. The patients with complication were 28(6.7%) persons. 4(0.9%) patients were expired. Nutritional Risk Index was helpful to predict the prognosis. When interfascial infection starts to spread, we must pay attention to airway management. Fluid therapy with nutritional may support to healing of wound.

Microbiological and clinical effects of enamel matrix derivative and sustained-release micro-spherical minocycline application as an adjunct to non-surgical therapy in peri-implant mucosal inflammation

  • Faramarzi, Masumeh;Goharfar, Zahra;Pourabbas, Reza;Kashefimehr, Atabak;Shirmohmmadi, Adileh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권4호
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    • pp.181-189
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    • 2015
  • Objectives: The purpose of this study was to compare the microbial and clinical effects of mechanical debridement (MD) alone or in combination with the application of enamel matrix derivative (EMD) and sustained-release micro-spherical minocycline (MSM) for treatment of peri-implant mucosal inflammation (PIMI). Materials and Methods: Subjects with at least one implant with PIMI were included and divided into control and two different test groups. In all three groups, MD was performed. In the MSM group, following MD, MSM was placed subgingivally around the implants. In the EMD group, after MD, EMD was placed in the sulcus around the implants. Sampling of peri-implant crevicular fluid for microbial analysis with real-time polymerase chain reaction and recording of probing depth (PD) and bleeding on probing (BOP) were performed prior to as well as two weeks and three months after treatment. Median values and interquartile range were estimated for each variable during the various assessment intervals of the study. Results: In all groups, at two weeks and three months, the counts of Porphyromonas gingivalis decreased significantly compared to baseline. Levels of P. gingivalis were significantly reduced in MSM (P<0.001) and EMD (P=0.026) groups compared to the control group. Also, clinical parameters improved significantly at two weeks and three months. Reduction of PD was significant in MSM (P<0.001) and EMD (P<0.001) groups. The decrease in BOP in the MSM, EMD, and control groups was 60%, 50%, and 20%, respectively. Conclusion: The use of MSM and EMD can be an adjunctive treatment for management of PIMI and improves clinical parameters and reduces P. gingivalis burden three months after treatment.