• 제목/요약/키워드: Fluid therapy

검색결과 409건 처리시간 0.029초

Collision Tumor Composed of Meningioma and Cavernoma

  • Weigel, Jens;Neher, Markus;Schrey, Michael;Wunsch, Peter H.;Steiner, Hans-Herbert
    • Journal of Korean Neurosurgical Society
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    • 제60권1호
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    • pp.102-107
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    • 2017
  • A true collision tumor is a rare entity composed of two histologically distinct neoplasms coinciding in the same organ. This paper reports a unique case of cerebral collision tumor consisting of two benign components. On the first hand, meningioma which is usually a benign lesion arising from the meningothelial cell in the arachnoidal membrane. On the other, cerebral cavernoma which is a well-circumscribed, benign vascular hamartoma within the brain. To our knowledge, there is no previously documented case of cerebral collision tumor consisting of two benign components. A 56-year-old Caucasian male suffered in 2002 from an atypical meningioma WHO $II^{\circ}$ located in the left lateral ventricle. Three years after the tumor extirpation, the patient suffered from a hematoma in the fourth ventricle due to a recurrently haemorrhaged cavernoma. In 2008, a recurrence of the tumor in the left lateral ventricle was discovered. Additionally, another tumor located in the quadrigeminal lamina was detected. After surgical resection of the tumor in the left lateral ventricle, the pathological examination confirmed the diagnosis of a collision tumor consisting of components of a meningioma WHO $II^{\circ}$ and a cavernoma. Postoperatively, no adjuvant treatment was needed and no tumor recurrence is discovered up to the present. A possible explanation for the collision of those two different tumors may be migration of tumor cells mediated by the cerebrospinal fluid. After 5-years of follow-up, there is no sign of any tumor recurrence; therefore, surgical tumor removal without adjuvant therapy seems to be the treatment of choice.

태음인 부종 환자의 건율제조탕 치험 1례 (A Case Study of Taeeumin Patient with Edema Treated with Gunyuljejo-tang)

  • 한수지;유준상
    • 사상체질의학회지
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    • 제33권3호
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    • pp.138-145
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    • 2021
  • Objectives Edema occurs in various disorders, such as heart failure, nephrotic syndrome, renal failure, liver cirrhosis, and cancer. The excessive accumulation of interstitial fluid in limb tissue will often manifest with ankle and knee swelling and lowers patient's quality of life. But the conventional treatment includes restricting dietary sodium and using diuretics. The purpose of this study is about significant improvement of a patient with edema who had suffered from dependent gait accompanied by mild pain, after treatment by herbal medicine based on SCM(Sasang constitutional medicine). Methods The pattern identification of the patient was diagnosed with a superficial disease of Taeeumin. So after the admission, Gunyuljejo-tang was used, almost two times per day during 2 weeks. Also, we applied acupuncture routinely every day and western medicine as needed. We measured the circumferences of Lt. thigh and followed up the bioelectrical impedance analysis and checked the appearance of lower limb. Results and Conclusions The therapy was effective, and the circumferences, which was 59.69cm at onset time, decreased to 52.07cm almost same to the healthy side of her thigh. There was no more edematous sign on the body, either. This case showed that management of Taeeumin's healthy energy(呼散之氣, the energy of exhalation) could be effective in treating edema.

Implementation of Enhanced Recovery after Surgery (ERAS) Program in Perioperative Management of Gastric Cancer Surgery: a Nationwide Survey in Korea

  • Jeong, Oh;Kim, Ho Goon
    • Journal of Gastric Cancer
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    • 제19권1호
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    • pp.72-82
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    • 2019
  • Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. Materials and Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. Results: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. Conclusions: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.

The impact of two doses of coenzyme Q10 on semen parameters and antioxidant status in men with idiopathic oligoasthenoteratozoospermia

  • Alahmar, Ahmed T
    • Clinical and Experimental Reproductive Medicine
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    • 제46권3호
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    • pp.112-118
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    • 2019
  • Objective: Oxidative stress contributes to male infertility, and antioxidants have been recommended for treating idiopathic oligoasthenoteratozoospermia (OAT). There is, however, a lack of agreement on the type, dosing, and use of individual antioxidants or combinations thereof. The purpose of this study was to compare the effects of two doses of coenzyme Q10 (CoQ10) on semen parameters and antioxidant status in men with idiopathic OAT. Methods: In this prospective study, patients with idiopathic OAT received 200 mg/day (n = 35) or 400 mg/day (n = 30) of CoQ10 orally for 3 months. All patients underwent semen analysis according to the fifth editions of the World Health Organization criteria. Total antioxidant capacity (TAC), catalase (CAT) activity, and superoxide dismutase (SOD) activity were measured both before and after treatment. Results: Treatment with CoQ10 (200 mg/day or 400 mg/day) resulted in a significant increase in sperm concentration from baseline ($8.22{\pm}6.88$ to $12.53{\pm}8.11million/mL$, p= 0.019; $7.58{\pm}5.41$ to $12.33{\pm}6.1million/mL$, p= 0.002, respectively), progressive motility ($16.54%{\pm}9.26%$ to $22.58%{\pm}10.15%$, p=0.011; $14.22%{\pm}12.85%$ to $26.1%{\pm}14.52%$, p= 0.001, respectively), and total motility ($25.68%{\pm}6.41%$ to $29.96%{\pm}8.09%$, p= 0.016; $23.46%{\pm}12.59%$ to $34.82%{\pm}14.17%$, p= 0.001, respectively). CoQ10 therapy also increased TAC (p= 0.009, p= 0.001, respectively), SOD activity (p= 0.004, p= 0.001, respectively), and CAT activity (p= 0.039, p= 0.024, respectively). Furthermore, antioxidant measures correlated significantly with seminal fluid parameters (r = 0.36-0.76). Conclusion: CoQ10 supplementation improved semen parameters and antioxidant status in men with idiopathic OAT, with a greater improvement shown in men who took 400 mg/day than in those who took 200 mg/day.

Intraventricular Antimicrobial Therapy for Intractable Ventriculitis: Two Case Reports

  • Lee, Ji Weon;Yoon, Yoonsun;Kim, Sang-Dae;Kim, Yun-Kyung
    • Pediatric Infection and Vaccine
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    • 제29권1호
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    • pp.46-53
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    • 2022
  • 뇌실염은 일반적으로 정맥 내 항생제를 통하여 치료하나, 불응성 뇌실염의 치료는 정맥 내 항생제 치료와 뇌실 내 항생제 치료의 병행이 요구되기도 한다. 이론적으로 항생제의 뇌실 내 투여는 정맥 내 단독 투여보다 뇌척수액에서 더 높은 항생제 농도에 도달할 수 있게 한다. 본 증례 보고는 기존의 전신 항생제 치료에 불응하는 폐렴 간균과 메티실린 내성 표피 포도상 구균에 각각 뇌실 내 겐타마이신과 반코마이신 투여를 통하여 뇌실염을 치료한 2례로서 이후에도 주요 합병증 등이 없어 이를 보고하는 바이다.

Spinal Epidural Lipomatosis Secondary to Hypothyroidism in a Siberian Husky Dog

  • Jeong, Ju-Young;Hwang, Tae-Sung;Song, Kun-Ho;Song, Joong-Hyun
    • 한국임상수의학회지
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    • 제39권5호
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    • pp.235-239
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    • 2022
  • A 10-year-old neutered male Siberian Husky presented with paraparesis and severe lethargy. On physical examination, the patient was unable to weight-bear and walk and exhibited significant muscle mass loss in both hindlimbs and generalized truncal alopecia with a dull coat of hair. On neurological examination, cranial lumbar vertebral pain, hind limb cross-extensor reflex, delayed hindlimb postural reaction, upper motor neuron bladder dysfunction, and total absence of cutaneous trunci reflex were identified. Computed tomography revealed diffuse idiopathic skeletal hyperostosis and spondylosis deformans of the cervical and thoracolumbar vertebrae. In addition, a generalized decrease in bone mineral density of the vertebrae was identified. Magnetic resonance imaging showed hyperplasia of the epidural fat compressing the spinal cord in the thoracolumbar region and concurrent mild multiple intervertebral disc herniations. No specific findings were observed in cerebrospinal fluid analysis. Blood analysis of thyroid function revealed decreased total T4 and free T4 levels, and increased TSH levels. The patient was tentatively diagnosed with spinal epidural lipomatosis (SEL) secondary to hypothyroidism. The patient was treated with levothyroxine, firocoxib, and gabapentin. Clinical signs gradually improved, and the patient showed normal ambulation 40 days after treatment initiation. SEL is extremely rare in dogs. To the best of our knowledge, this is the first case report of SEL secondary to hypothyroidism that was treated conservatively. Secondary SEL can be sufficiently managed by treating the underlying cause, if possible.

특이 과거력이 없는 소아에서 발생한 Streptococcus intermedius 화농 관절염 1예 (A Case of Septic Arthritis due to Streptococcus intermedius in a Healthy Child)

  • 용수민 ;김태훈;정현주
    • Pediatric Infection and Vaccine
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    • 제29권3호
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    • pp.173-178
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    • 2022
  • Streptococcus intermedius는 입안, 상부 호흡기, 위장관 등에 정상 상재균 중 하나로 존재하는 그람 양성 산소내성 혐기성 알균이다. 면역저하나 심장질환자에서 외상 또는 침습적 치료 후에 발생하는 기회 감염의 원인이 될 수 있다. 저자들은 최근 침습적 치료나 외상 등 특이 과거력이 없이 건강했던 7세 소아에서 S. intermedius에 의해 발생한 엉덩관절 화농 관절염을 경험하였기에 보고하고자 한다. 환자는 내원 3주전부터 왼쪽 엉덩관절 통증이 있었으며, 본원 내원 당일부터 발열이 발생하였다. 엉덩관절 자기공명영상에서 왼쪽 엉덩관절의 급성 화농 관절염으로 진단한 후 수술적 배농을 시행하였고, 혈액과 흡인 관절액에서 S. intermedius가 배양되었다. 수술 후 2주간의 ceftriaxone 정맥주사 후 3주간의 amoxicillin 경구 항생제로 치료한 후 재발없이 안정된 상태를 보이고 있다.

명치 통증으로 내원한 COVID-19에 감염된 8세 소아의 단독 급성 췌장염 1례 (A Case of Isolated Acute Pancreatitis Presenting With Epigastric Pain in an 8-Year-Old Child Infected With COVID-19)

  • 진주옥;정세리;곽병옥;황숙민;조기영
    • Pediatric Infection and Vaccine
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    • 제30권2호
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    • pp.104-110
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    • 2023
  • Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)는 호흡기계 뿐만 아니라 소화기계에도 감염을 일으킨다. 이중 SARS-CoV-2가 급성 췌장염을 일으키는 경우는 성인과 소아를 포함하여coronavirus disease 2019 (COVID-19) 확진 환자의 약 0.16% 정도이다. COVID-19에 확진된 소아 환자에서의 급성 췌장염은 그 동안 소아다기관염증증후군이나 중증의 코로나 감염 환자에서 동반 질환으로 보고되는 게 대부분이며 단독으로 급성 췌장염만 일으키는 사례는 거의 없었다. 저자들은 SARS-CoV-2에 감염된 소아 환자에게서 단독으로 급성 췌장염이 발생한 예를 경험하였고 성공적으로 치료하였기에 보고하는 바이다.

Ruminal impaction with an indigestible foreign body in long-tailed goral (Naemorhedus caudatus)

  • Sangjin Ahn;Woojin Shin;Yujin Han;Sohwon Bae;Chea-Un Cho;Sooyoung Choi;Yeonsu Oh;Jong-Taek Kim
    • 한국동물위생학회지
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    • 제46권2호
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    • pp.161-165
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    • 2023
  • A 6-year-old female long-tailed goral (Naemorhedus caudatus, goral) was admitted to the Gangwon wildlife medical rescue center due to severe starvation and hypothermia. The goral displayed clinical signs of severe weight loss, dehydration, lethargy, regurgitation, hypothermia, and bloating, with blood tests showing a decrease in albumin, calcium, glucose, and sodium. Supportive care was given through heating, oxygen supply, and fluid therapy, but the goral's condition worsened, and the goral died three days after admission. Radiographic and computed tomography scans revealed the presence of an indigestible foreign body (IFB) in the rumen, which was confirmed during the necropsy. The cause of goral's death was identified as chronic rumen impaction caused by the IFB (a ball of string), with other pathological findings including bloating, the presence of serous ascites, and congestion of digestive organs. Blood biochemical changes, clinical signs, and veterinary medical imaging diagnosis can be helpful in diagnosing ruminal impaction. This case report can provide valuable information for the diagnosis and treatment of ruminal impaction caused by IFB in endangered gorals, which may include rumenotomy or other surgical procedures.

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

  • 양재혁;박용수
    • 현장농수산연구지
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    • 제20권2호
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    • pp.117-123
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    • 2018
  • 본 연구의 목적은 성숙한 당나귀의 큰잘록 창자 폐색 증례를 진단하여 보고하고자 한다. 당나귀(Equus africanus asinus; 암, 6세) 1마리가 제주경마공원 동물병원에 전날부터 시작된 식욕부진 증상으로 내원하였다. 장음소실, 탈수, 심한 복강 확장 등의 증상을 확인하였으나 호흡수 및 심박수는 정상이었고, 복통 증상은 없었다. 직장검사에서 폐색된 부분이 잘록 창자임을 확인하였다. 위세척, 수액요법 및 비스테로이드 계열의 진통제를 투여하였으나 다음날 새벽 갑자기 몸을 떨며 기립곤란과 같이 신체상태가 악화되기 시작한지 2시간 만에 폐사하였다. 부검에서 특히 왼배쪽 잘록 창자와 같은 큰잘록 창자에서 다량의 식괴를 발견하였고, 막창자와 곧창자는 정상이었다. 당나귀는 내원하기 11일 전에 새로 입사해서 사양 관리체계가 바뀌었다. 사료변경, 수분섭취 감소, 운동부족 등이 질병을 유발하였을 것으로 생각된다. 그러나 당나귀의 정확한 급사원인은 더 연구해야 할 과제로 남는다.