• 제목/요약/키워드: Leech

검색결과 74건 처리시간 0.024초

수지첨부 재건 후 거머리 사용시 발생하는 문제점에 대한 고찰 (The Problem of Leech Application in Digital Replantation)

  • 이내호;양경무
    • Archives of Reconstructive Microsurgery
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    • 제9권2호
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    • pp.158-163
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    • 2000
  • Over the past several years, countless patients have benefitted from the use of leeches in microsurgery. As we know, leeches are used to overcome the problem of venous congestion by creating prolonged localized bleeding uniquely characteristics of leech bite. Venous congestion, a common complication of digital replantation, often has been treated through surgical repair like arteriovenous anastomosis. The leech produces a number of important substances which contribute to the special property of the bite, including an anticoagulant, a local vasodilator and local anesthetics. The bite usually bleeds for 1 to 2 hours and under special circumstances may bleed for up to 24 hours. So venous congestion is relieved. However, leeches increase the possibility of infection through their gut content. Infection associated medical leech application is significant risk. Other risk include allergic reaction, adverse psychologic reaction and blood loss requiring transfusion. The 65 cases of medical leech application were performed between August, 1997 and May, 2000 according to an established protocol. The complication were 18 cases ; infection (13 cases), hemorrhage (2 cases), allergic reaction (1 case), psychologic problem (1 case) and hypochromic anemia (1 case). Then our study was performed on the base of indication. As a result, Aeromonas hydrophilia was cultured from gut of medical leech and Klebsiella, Staphylococcus and Pseudomonas were cultured from media. We present the clinical risk-benefit of the medical leech therapy through several cases following digital replantation.

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거머리 요법에 대한 연구동향 (The literature review of Leech therapy)

  • 장효길;허동석
    • 대한약침학회지
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    • 제13권1호
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    • pp.103-120
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    • 2010
  • Objective : To review the trend of the study related to Leech therapy and to establish the hereafter direction for the study on Leech therapy. Methods : I reviewed and analyzed all the theses published in Domestic and Foreign research institution from 1990 to 2009. Results : The following results were obtained in this study. 1. Analyzed number of theses published, there was no significance per year. 2. Classified by theme of journal, journals related to surgery were most(41 journals, 75.92%) among 54 kinds. 3. Classified by theses by research method and thesis types, case report accounted for nearly twothirds (52 pieces, 68.42%) of all theses and consideration of document was next(9 pieces, 11.84%). 4. With the most case of venous congestion after plastic and reconstructive surgery(33 pieces, 63.46%), leech therapy was effective on illnesses such as haematoma, macroglossia, purpura, varicous vein, avulsion injury, neurovascular compression, diabetic neuropathy, penoscrotal oedema, buerger's disease, rheumatoid arthritis. 5. Two most appeared adverse effects were anemia and infection. Immediate blood transfusion was done for recovering anemia and prophylactic 3rd generation antibiotics to infection were emphasized in more than half of case reports. 6. All of consideration of documents was retrospective study of cases related leech therapy and 3 pieces of them emphasized prophyratic antibiotic treatment for preventing infection. 7. The study of clinical trail type started first in 2002 and osteoarthritis of knee and carpometacarpal joint were main target. As see above result, Leech therapy was effective cure and could be used in disease induced by venous congestion. And I think that it is necessary to perform additional study related to solution of problems about leech therapy and protocol for using in clinical practice.

한약투여 및 의료용 거머리 요법을 병행 시술 후 관절 경직 및 부종이 호전된 국소 류마티즘 환자 증례 1례 (A Case of Live Leech(Hirudo Medicinalis) Therapy with Herbal Medication on Regional Rheumatoid Arthritis)

  • 유창길;이윤주
    • 한방재활의학과학회지
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    • 제19권3호
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    • pp.135-146
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    • 2009
  • Objectives : The purpose of this study is to report the effect of live leech(hirudo medicinalis) therapy with oriental medication on the patient with regional rheumatoid arthritis. The patient had resistant to DMARDs so she was in the debilitating condition and suffered from edema, pain, stiffness of joint and purpura before live leech(hirudo medicinalis) therapy. Methods : The regional rheumatoid arthritis patient had edema, pain, stiffness of joint and purpura on right foot. We treated the patient with live leech(hirudo medicinalis) therapy and oriental medicine. Results : The symptoms of regional rheumatoid arthritis was improved through live leech(hirudo medicinalis) therapy and oriental medicine. The patient maintains her condition with oriental medicine treatment after stopped all DMARDs such as MTX(methotrexate) and NSAIDs. After this treatment the patient's walking difficulty has been improved. Conclusions : This study shows that live leech(hirudo medicinalis) therapy and oriental medicine can elevate the regional rheumatoid arthritis patient's quality of life with continuous health care and treatment for major problem. For more accurate studies, further studies would be needed with more cases.

Fatty Acid Analysis from Leech Skin

  • Hong, Suk-Jin;Kim, Dong-Ryeong;Yoon, In-Joong;Kang, Ke-Won
    • BMB Reports
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    • 제28권3호
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    • pp.261-264
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    • 1995
  • The lipids of a Korean native blood-sucking leech (Hirudo nipponia) were isolated and analyzed. Cholesterol, fatty acids, triglycerides, glycerylether diester and cholesteryl esters were found from epidennal extracts. The major fatty acids in the leech skin were $C_{16:0}$, $C_{18:0}$, $C_{20:1}$. $C_{20:3}$ components. These components were derived from cholesteryl esters, glycerides, fatty acids and other polar lipids. After 60 days fasting, cholesterol, fatty acids and triglycerides in the skin were reduced in number and the total fatty acid composition was changed slightly. The data of total fatty acids in fasted and fed leech showed that medium-chain fatty acids were more affected than long-chain fatty acids. Other trace fatty acids appeared to be decreased by fasting.

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기침(蜞鍼)(거머리)療法(요법)을 이용한 버거씨병 증례보고 (Case of buerger's disease Improve by Gi-Chim Treatment (Leech Therapy))

  • 곽병민;홍권의
    • 대한약침학회지
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    • 제12권2호
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    • pp.91-98
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    • 2009
  • Objective : The purpose of this case is to show a case of buerger's disease improved by leech therapy. Methods : The patient received Leech Therapy and Oriental medical therapy(acupuncture and herb medicine). Result : We evaluate through visual analog scale(VAS), neuropathic total symptom score(TSS), fontaine grade and picture of patient's foot. Conclusion : Leech therapy and Oriental medical therapy had a good effect on buerger's disease.

피판 부전증의 구제를 위한 약용거머리 치료법 (Medicinal Leech Therapy for Salvage of the Failing Flap)

  • 백정환;신준호;박주현
    • 대한두경부종양학회지
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    • 제16권1호
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    • pp.20-25
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    • 2000
  • The medicinal leech, Hirudo medicinalis, has been used for salvage of the venous-congested flap following reconstructive surgery, with increasing frequency during the last two decades. Medicinal leech therapy is a safe, efficacious, economical, and well-tolerated intervention. The flap salvage with leeching occurs in approximately 70% of cases, and leeches need to be used as early as possible. At the time of the bite, evacuation of blood and injection of the leech saliva products, including anticoagulants and inhibitors of platelet aggregation, maintain capillary circulation of the flap, and then venous capillary return is established across the wound by angiogenesis. One of the salivary products, hirudin, represents the first parenteral anticoagulant introduced since the discovery of heparin. We analyzed two cases in which flap salvage with leeching was attempted, and reviewed medicinal leech therapy on the basis of our experiences and literature review. This has not been documented in the head and neck surgery literature in our country.

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최근 10년간의 수질(水蛭) 연구 동향: 비만 및 대사증후군에의 응용 가능성 제고 (Analytical Study on Medical Leech in the Last 10 Years: A Suggestion of Practical Use on Obesity and Metabolic Syndrome)

  • 이진원;박원형;차윤엽;송윤경
    • 한방비만학회지
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    • 제14권1호
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    • pp.1-12
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    • 2014
  • Objectives: The purpose of this study is to analyse research trends about medical leech in the last 10 years. Methods: We searched the papers with key words of 'medical leech', '水蛭' in China Knowledge Resource Integrated Database (CNKI), Korean traditional knowledge portal, DBPIA, KISS. We classified the papers by year and content. Results: 1. Result of the classification on the basis of the research methods, 50 studies are clinical case reports, 301 studies are experimental paper, 599 studies are clinical trial study, 219 studies are literature review. 2. Result of the classification on the basis of the research topics, 454 studies are the effect of anticoagulant research, 84 studies are diabetes and renal disease research, 194 studies are pharmacological properties research, and 43 studies are effect of allergic and anti-inflammatory research. 3. The proportion of the coagulation effect study tends to decrease every year since 2006. 4. Leech research tends to decrease in last 3 years. 5. Recently, there are many research in psychiatry, orthopedic diseases and beauty. 6. There are 10 studies related to leech in Korean. Conclusions: The researches of medical leech are actively done. The diversity of subjects is getting wider and richer.

소아에서 단순 복부 X-선 사진으로 변비를 진단하는데 있어 Barr, Blethyn과 Leech 점수체계의 정확도 (The Accuracy of Barr, Blethyn and Leech Scoring Systems on Plain Abdominal Radiographs in Childhood Constipation)

  • 문지영;문경래
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제10권1호
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    • pp.44-50
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    • 2007
  • 목 적: 소아에서 기능성 변비는 소화기 증상 중 가장 흔한 증상이나 각 개인이 호소하는 증상이 다양하여 쉽게 정의하기 어렵다. 단순 복부 X-선 사진을 이용한 점수체계(scoring system)는 간단하고 비용이 적게 들어 변비의 정도를 평가하는데 사용하고 있다. 그러나 소아변비의 정도를 평가하는데 어떤 점수체계가 임상적으로 더 유용한지에 대한 연구는 매우 드물다. 따라서 저자들은 소아 변비 환자에서 단순 복부 방사선사진을 이용하여 Barr, Blethyn과 Leech 점수를 측정하여 유용성을 비교 연구하였다. 방 법: 2006년 1월부터 8월까지 조선대학교 병원 소아과 외래를 방문하거나 입원한 4세에서 15세 사이의 환아 77명(변비군 38명, 대조군 39명)을 대상으로 하였다. 네 명의 전공의가 77매의 동일한 단순 복부 X-선 사진을 보고 Barr, Blethyn과 Leech 점수체계를 사용하여 1주 간격으로 각각 2회 점수를 매겼으며 점수 측정시에 환자의 대한 사전 정보를 배제하였다. 각 점수체계 방법에 대한 검사자들의 유의성은 ${\kappa}$ 상수을 계산하여 평가하였다. 결 과: 대상아 77명 중 남자는 41명(53.2%), 여자는 36명(46.8%)이었고 변비군은 38명(49.4%), 대조군은 39명(50.6 %)이었다. 네 명의 검사자가 측정한 Barr 점수로 계산한 ${\kappa}$ 상수는 각각 0.75, 0.66, 0.68, 0.71이었고, Blethyn 점수로 계산한 ${\kappa}$ 상수는 0.61, 0.58, 0.55, 0.63이며, Leech 점수로 계산한 ${\kappa}$ 상수는 0.88, 0.92, 0.86, 0.89이었다. Barr 점수로 계산한 ${\kappa}$ 상수는 첫 번째 측정 시에 각각 0.66, 0.67, 0.69, 0.66이었으며, 1주후에 두 번째 측정 시에는 각각 0.68, 0.65, 0.71, 0.68로 측정 시기에 따라 유의한 차이가 없었다(p>0.05)(Fig. 1). 네명의 검사자가 측정한 Blethyn 점수로 계산한 ${\kappa}$ 상수는 첫 번째 측정 시에 각각 0.44, 0.55, 0.48, 0.33이었으며, 1주 후에 두 번째 측정 시에는 0.65, 0.34, 0.39, 0.46으로 측정 시기에 따라 유의한 차이가 있었으며(p<0.05), Leech 점수로 계산한 ${\kappa}$ 상수는 첫 번째 측정시에 각각 0.88, 0.91, 0.92, 0.86이고 두 번째 측정 시에 각각 0.81, 0.88, 0.89, 0.84로 측정 시기에 따라 유의한 차이가 없었다(p>0.05). Barr 점수의 평균치는 변비군은 $9.68{\pm}3.55$, 대조군은 $5.32{\pm}3.45$로 두 군 사이에 유의한 차이가 없었다(p>0.05). Leech 점수의 평균치는 변비군은 $10.42{\pm}3.12$, 대조군은 $6.28{\pm}3.56$으로 두 군 사이에 유의한 차이가 있었다(p<0.05). 네 명의 검사자가 측정한 Barr 점수의 특이도는 각각 0.51, 0.55, 0.54, 0.71이었고 민감도는 각각 0.68, 0.61, 0.69, 0.61이었다. Leech 점수의 특이도는 각각 0.88, 0.91, 0.92, 0.86이었고 민감도는 각각 0.90, 0.89, 0.91, 0.84였다. 결 론: 단순 복부 X-선 사진을 이용한 점수체계는 소아 변비의 정도를 평가하는 데 있어서 검사자의 경력과는 무관하게 사용할 수 있으며 그 중 Leech 점수체계가 임상적으로 가장 유용하다.

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거머리 사용후 발생할수 있는 Aeromonas hydrophila 감염을 줄이기 위한 대책 (Measures to Reduce Aeromonas Hydrophila Infection that May Occur after Leech Apllication)

  • 윤효헌;정두성;최준
    • Archives of Reconstructive Microsurgery
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    • 제11권1호
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    • pp.73-77
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    • 2002
  • Medical application of leeches, by means of leech's blood suction, has advantages in not only directly removing blood congestion, but also preventing hindrance to venous drainage by inhibiting local thrombus formation and inducing continuous bleeding. Nevertheless, Aeromonas hydrophila infection secondary to such suction is most common and may develop into serious conditions from local inflammatory reaction to total necrosis of replanted parts and enterocolitis as well as sepsis. Once infected, it requires infection treatment, removal of necrotic tissues and reconstruction. Hence, duration and cost of treatment increase while functional recovery falls markedly. Accordingly, we present measures to reduce Aeromonas infections as follows: First, do not manipulate as much as possible while the leeches are sucking or moving. Second, the site which suction plates of the leeches are attached, should be selected away from the surgical wound site or open wound as much as possible. Third, contaminated or blood-wet gauze should be replaced often so that the skin of surgical areas would not swell. Furthermore, bleeding or oozing should be well-drained. Fourth, the areas other than the sites of leech attachment should be covered with sterilized gauzes in order to limit leech movement.

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Methicillin-Resistant Staphylococcus Aureus Following Leech Application at a Congested Flap after a Mastectomy

  • Hwang, Kun;Kim, Hyung Mook;Kim, Yeon Soo
    • Archives of Aesthetic Plastic Surgery
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    • 제23권3호
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    • pp.143-145
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    • 2017
  • Medical leech therapy is a treatment for the venous congestion of tissue flaps, grafts, and replants. We report a case of methicillin-resistant Staphylococcus aureus (MRSA) following leech application at a congested flap after mastectomy. A 45-year-old woman had an invasive ductal carcinoma. Modified radical mastectomy was performed. The chest wall defect was reconstructed with a local rotation flap. On postoperative day (POD) 1, congestion and color change were observed, and 10 medical leeches were applied to the congested area. On POD 4, another 10 medical leeches were applied. On POD 12, wound necrosis progressed and a pus-like discharge appeared. A wound swab culture revealed MRSA. Debridement was carried out on POD 15. From POD 16, vancomycin and piperacillin/tazobactam were injected for 18 days. The wound culture on POD 18 also revealed MRSA. A split-thickness skin graft was performed on POD 28. MRSA has not been clearly identified in the literature as a leech enteric bacterium. Although MRSA may have come from another source, the present case raises the possibility of MRSA infections following leech application at congested flaps. When medical leeches are applied at the congestion site of a flap, an aseptic cradle will be helpful. Vancomycin irrigation may be needed if infection occurs.