• Journal of Chest Surgery
• /
• 제52권4호
• /
• pp.227-231
• /
• 2019

Background: There is no established surgical procedure for the treatment of epiphrenic esophageal diverticulum. The aim of this study was to compare the clinical outcomes of esophageal diverticulectomy using abdominal and thoracic approaches. Methods: We retrospectively reviewed 30 patients who underwent esophageal diverticulectomy through the thoracic or abdominal approach for an epiphrenic diverticulum at a single center between 1996 and 2018. We compared clinical outcomes, including the postoperative length of stay, time from the operation to oral feeding, leakage rate, and reoperation rate between the 2 groups. Results: The median age was 56 years. Of the 30 patients, 18 (60%) underwent diverticulectomy via the thoracic approach and 12 (40%) underwent the abdominal approach. The median hospital stay was 10 days (range, 5-211 days) in the thoracic approach group and 9.5 days (range, 5-18 days) in the abdominal approach group. The median time from the operation until oral feeding was 6.5 days (range, 3-299 days) when the thoracic approach was used and 5 days (range, 1-11 days) when the abdominal approach was used. In the thoracic approach group, the leakage rate was 16.67% and the reoperation rate was 27.78%. However, there were no cases of leakage or reoperation in the abdominal approach group. Conclusion: The abdominal approach for esophageal diverticulectomy is a feasible and appropriate alternative to the thoracic approach.

• 대한한방내과학회지
• /
• 제43권2호
• /
• pp.219-228
• /
• 2022

Objective: The aim of this study is to describe the effects of traditional Korean medicine on a patient with dysphagia and anorexia following an acute lumbar compression fracture. Methods: The patient was treated with acupuncture and herbal medicine (Bojungikgi-tang and Insamyangyoung-tang), and the effects of the treatment were evaluated by monitoring oral feeding and using the Modified Barium Swallow (MBS) test. Results: After treatment, the amount of oral feeding more than doubled and the MBS was also improved. Conclusion: The results suggest that traditional Korean medicine may be effective for treating dysphagia and anorexia after an acute lumbar compression fracture.

• 대한영양사협회학술지
• /
• 제7권3호
• /
• pp.217-226
• /
• 2001

It is important to supply adequate nutrition to critically ill patients, whose gastrointestinal system is properly functioning, through the enteral tube feeding if oral intake is impossible. In this study we investigated the changes in nutritional status with enteral tube feeding according to the volume required. We investigated the volume ordered according to the patient's requirements, volume infused according to the volume ordered in 41 enteral tube feeding patients in intensive care unit from Jannuary to July, 2000. Body weight, serum albumin level, and total lymphocyte count were evaluated to assess nutritional status. The mean fasting period was 5 days before the enteral feeding and patients whose fasting period over 3 days were 51%. The mean enteral tube feeding period was 29 days and method of feeding was nasogastric, bolus feeding 6 times per day. The volume ordered was 69.7% of the patients' recommended calorie and volume infused was 86.6% of their volume prescribed. Accordingly, the volume infused was estimated 61.7% of their volume required. Only 44.6% of their reqiured volume was infused within 3 days after enteral tube feeding was started. It took 16 days in average to meet the patients' recommended calorie; 56% of subjects still did not fully met their requirements by the end point. Among the impeding factors in supplying enteral tube feeding, factors related to the number of feeding were high residual volume in stomach, vomiting, gastrointestinal bleeding, abdominal distension and surgery. Factors related to the acctual infused volume were diarrhea, gastrointestinal bleeding, abdominal distension, airway management and tube reinsertion. Significant correlations were shown between the volume infused and changes in both the patients' weight and serum albumin level. Deviding the subjects into two groups by their infused volume, less than 70% and more than that, we compared the two to come up with a significant difference in their serum albumin level, -0.23 vs 0.21, and their body weight, -4.52 vs 0.12. In enteral tube feeding, the volume delivered in sufficient to the pateints' energy requirement can affect their nutriitional status in critically ill patient; adequate nutritional management plan is essential. It is necessary to make every effort to educate clinical staff and to set up a unified management program to prescribe adequate ammount of energy for the patient's nutritional requirement.

• KSBB Journal
• /
• 제21권6호
• /
• pp.433-438
• /
• 2006

Bacillus subtilis BB-1 (KFCC l1344P)으로부터 분리된 혈전용해효소 유전자 (BCF-1)를 대량발현 벡터인 pEB 벡터에 크로닝하여 순수분리 된 혈전용해효소를 rat 경구 투여하여 출혈시간, 혈액의 응고, serum의 혈전용해능 등에 대한 in vivo 실험을 실시하였으며, 혈전용해효소의 단회경구투여에 따른 독성을 검사하였다. 효소의 경구투여에 따른 rat의 출혈시간에서는 대조군에 비하여 모든 경구 투여군에서 출혈시간이 유의적으로 약 1.75배 이상 길게 나타남을 확인하였고(P<0.05), 혈액의 출혈시간 또한 활발히 진행됨을 관찰하였다. 혈액으로부터 분리된 serum의 혈전용해작용 있어서는 경구투여 후 1시간부터 채혈한 혈액 내에서 혈전용해효소의 활성이 검출되기 시작하여 3시간째까지 높은 활성을 보였으며 4시간째부터 서서히 활성이 감소하는 것을 확인하였고 혈액의 응고 역시 대조군에 비하여 경구 투여군에서 상당히 지연되는 것을 알 수 있었다. Western blot에 의한 효소 검출에서는 경구 투여군에서 30,000 Da 크기의 단일밴드를 확인하였으며, 혈전용해효소의 rat에 대한 단회경구투여 독성실험에서 중량의 변화, 장기의 이상여부, 사망률 등에서 어떠한 이상이나 병변이 발견되지 않았다. 이상의 결과로 동물실험을 통한 혈전용해 효소의 경구투여에 의한 작용을 혈액 내에서 확인 할 수 있었으며, 본 효소의 단회 경구투여 시의 독성은 전혀 없음을 확인할 수 있었다.

• 대한수의학회지
• /
• 제58권2호
• /
• pp.87-94
• /
• 2018

This study assessed the effects of Weissella cibaria (W. cibaria) CMU on oral health in male and female beagles (n = 18) by measuring oral malodor and periodontal disease-related parameters (calculus, plaque, and gingivitis indices). Oral malodor and indicators of periodontal disease were assessed in five treatment groups: negative control (scaling and 0.24 mg of maltodextrin, n = 3), positive control (0.24 mg of maltodextrin, n = 3), and W. cibaria CMU groups (each n = 4) at low (CMU-L, $2{\times}10^7$ colony forming unit [CFU]), medium (CMU-M, $2{\times}10^8CFU$), and high (CMU-H, $2{\times}10^9CFU$) concentrations. After feeding with W. cibaria CMU for 6 weeks, total volatile sulfur compound concentrations in the CMU-L ($2.0{\pm}1.04ng/10mL$), CMU-M ($2.4{\pm}1.05ng/10mL$), and CMU-H ($2.6{\pm}1.33ng/10mL$) groups were significantly lower than in the positive control group ($3.2{\pm}1.65ng/10mL$). Also, CMU-L ($1.4{\pm}0.83ng/10mL$) and CMU-H ($1.9{\pm}1.14ng/10mL$) groups had methyl mercaptan levels lower than that in the positive control group ($2.4{\pm}1.21ng/10mL$) at week 2. The plaque index was significantly lower in the CMU-H group ($4.5{\pm}0.28$) than in the positive control group ($5.9{\pm}1.08$) at week 6. W. cibaria CMU could be useful as a novel oral hygiene probiotics for reducing volatile sulfur compounds production and inhibiting plaque growth in companion animals.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제41권6호
• /
• pp.346-351
• /
• 2015

Angiography is the gold standard for the diagnosis and complete resection of arteriovenous malformations (AVMs). The absence of residual AVM after surgery is commonly believed to reduce the risk of future hemorrhage. However, AVMs can recur after proven complete angiographic resection can occur, albeit rarely, especially in the pediatric population. We report a rare case of a recurrent AVM two years after complete resection in an adult patient. This case report shows that AVMs in adults can recur despite their rarity and despite postoperative angiography confirming complete removal. Moreover, in this case, the recurrent AVM involved a new feeding vessel that was not involved with the initial lesion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제48권4호
• /
• pp.232-236
• /
• 2022

A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

• Asian-Australasian Journal of Animal Sciences
• /
• 제25권10호
• /
• pp.1411-1418
• /
• 2012

The objective of the present study was to investigate the relationships between terpenes… intake and their presence in animal tissues (blood and milk) as well as in the final product (cheese). Eight dairy goats were divided in two balanced groups, representing control (C) and treatment (T) group. In T group oral administration of a mixture of terpenes (${\alpha}$-pinene, limonene and ${\beta}$-caryophyllene) was applied over a period of 18 d. Cheese was produced, from C and T groups separately, on three time points, twice during the period of terpenes… oral administration and once after the end of experiment. Terpenes were identified in blood by extraction using petroleum ether and in milk and cheese by the use of solid phase micro-extraction (SPME) method, followed by GC-MS analysis. Chemical properties of the milk and the produced cheeses were analyzed and found not differing between the two groups. Limonene and ${\alpha}$-pinene were found in all blood and milk samples of the T group after a lag-phase of 3 d, while ${\beta}$-caryophyllene was determined only in few milk samples. Moreover, none of the terpenes were traced in blood and milk of C animals. In cheese, terpenes' concentrations presented a more complicated pattern implying that terpenes may not be reliable feed tracers. We concluded that monoterpenes can be regarded as potential feed tracers for authentification of goat milk, but further research is required on factors affecting their transfer.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제8권1호
• /
• pp.96-101
• /
• 2005

덤핑 증후군은 소아의 위공장 경관식이의 합병증으로 발생할 수 있는 질환으로, 19개월된 여아에서 식후 나타나는 특징적인 임상증상과 당부하 검사상 조기 고혈당 후 나타나는 후기 저혈당으로 진단할 수 있었으며, 생옥수수 전분을 포함한 식이요법만으로도 증상의 호전과 영양상태의 호전을 보일 수 있었다.

• 대한기관식도과학회지
• /
• 제8권1호
• /
• pp.42-49
• /
• 2002

Backgroud and Objectives : Supracricoid partial laryngectomy(SCPL) has showed good functional and oncological results since it was introduced by Laccourreye in 1990. But loss of laryngeal functions, especially glottic sphincteric one, due to a wide resection of laryngeal structures is a major problem and needs a active and effective rehabilitation postperatively. Modified barium swallow(MBS) is a videofluoroscopy designed to define the etiology of the aspiration or dysphagia and simultaneously provide the therapeutic and rehabilitative method eliminating etiology of the aspiration. And we examined the effectiveness of the MBS in swallowing rehabilitation of the SCPL Patients. Materials and Methods : We reviewed the medical records of the 52 Patients who received SCPL for laryngeal squamous cell carcinoma according to the description of Laccourreye in our clinic from 1993 to 2001. Among them 21 patients were performed MBS(MBS(+) group) postoperatively and remaining 31 were not(MBS(-) group). During MBS, we selected 12 patients who showed aspiration and trained them with a swallowing rehabilitation maneuver which was identified as the most effective one eliminating the aspiration and remaining nine without aspiration were able to feed orally immediately after MBS without rehabilitation. In MBS(-) Uoup, they were received the traditional rehabilitation training with a supraglottic swallow. Results : The mean postoperative day(POD) of decannulation was earlier in MBS(+) group ($12.6{\pm}4.7$ POD) than in MBS(-) group ($19.5{\pm}11.0$ POD) (p =0.012), especially in patients showing aspiration (MBS(+) ; $12.9{\pm}5.2$ POD, MBS(-) : $22.3{\pm}9.9$ POD (p =0.008)). No significant difference was found in the mean POD of oral feeding between MBS(+) and (-) group, but in patients showing aspiration the time of oral feeding was earlier in MBS(+) group than in MBS(-) by average 10 days though it was not statistically significant. The incidence of aspiration pneumonia was lower in MBS(+) group (1/12cases) than in MBS(-) (7/12cases). Conclusions : In SCPL Patients, the Swallowing rehabilitation introduced to eliminate the aspiration during MBS after SCPL is very helpful for some patients to resume the safe oral intake more rapidly.