• 제목/요약/키워드: Royal medicine

검색결과 197건 처리시간 0.033초

Use of Dual-Energy X-ray Absorptiometry in Children with Inflammatory Bowel Disease: A Large Single Centre Study

  • Jois, Asha;Perera, Sajini;Simm, Peter;Alex, George
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제25권6호
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    • pp.473-480
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    • 2022
  • Purpose: Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use. Methods: Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected. Results: Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], p=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], p=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], p=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred. Conclusion: Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.

Variation of Practice in Prophylactic Protocol to Reduce Prosthetic Joint Infection in Primary Hip and Knee Arthroplasty: A National Survey in the United Kingdom

  • James Morris;Lee Hoggett;Sophie Rogers;John Ranson;Andrew Sloan
    • Hip & pelvis
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    • 제35권4호
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    • pp.228-232
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    • 2023
  • Purpose: Prosthetic joint infection (PJI) has an enormous physiological and psychological burden on patients. Surgeons rightly wish to minimise this risk. It has been shown that a standardised, evidence-based approach to perioperative care leads to better patient outcomes. A review of current practice was conducted using a cross-sectional survey among surgeons at multiple centers nationwide. Materials and Methods: An 11-question electronic survey was circulated to hip and knee arthroplasty consultants nationally via the BOA (British Orthopaedic Association) e-newsletter. Results: The respondents included 56 consultants working across 19 different trusts. Thirty-four (60.7%) screen patients for asymptomatic bacteriuria (ASB) preoperatively, with 19 (55.9%) would treating with antibiotics. Fifty-six (100%) screen for methicillin-resistant Staphylococcus aureus and treat if positive. Only 15 (26.8%) screen for methicillin-sensitive S. aureus (MSSA) or empirically eradicate. Zero (0%) routinely catheterize patients perioperatively. Forty-one (73.2%) would give intramuscular or intravenous gentamicin for a perioperative catheterisation. All surgeons use laminar flow theatres. Twenty-six (46.4%) use only an impervious gown, 6 (10.7%) exhaust pipes, and 24 (42.3%) surgical helmet system. Five different antimicrobial prophylaxis regimens are used 9 (16.1%) cefuroxime, 2 (3.6%) flucloxacillin, 19 (33.9%) flucloxacillin and gentamicin, 10 (17.9%) teicoplanin, 16 (28.6%) teicoplanin and gentamicin. Twenty-two (39.3%) routinely give further doses. Conclusion: ASB screening, treatment and intramuscular gentamicin for perioperative catheterisation is routinely practiced despite no supporting evidence base. MSSA screening and treatment is underutilised. Multiple antibiotic regimens exist despite little variation in organisms in PJI. Practice varies between surgeons and centers, we should all be practicing evidence-based medicine.

Pemphigus-like Drug Reaction after Surgical Removal of a Splenic Hemangiosarcoma in a Dog

  • An, Sung-Ah;Wang, Hye-Bin;Han, Man-Gil;Jung, In-Sung;Song, Kun-Ho;Seo, Kyoung-Won
    • 한국임상수의학회지
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    • 제34권2호
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    • pp.103-107
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    • 2017
  • A 7-year-old spayed female Shih-tzu dog with 4-month history of anorexia and weight loss was diagnosed with splenic hemangiosarcoma. One week after splenectomy, the dog developed severe, multifocal, coalescing erosive and ulcerative dermatosis with epidermal collarettes and crusts on the dorsal trunk. The dog was prescribed systemic antibiotics comprising cephradine and enrofloxacin postoperatively. Histopathological examination of skin biopsies from haired skin lesions revealed changes consistent with pemphigus foliaceus (PF). Tentative diagnosis for this patient was pemphigus-like drug reaction resulting from cephradine treatment. However, given the dog's history of hemangiosarcoma, paraneoplastic pemphigus (PNP), a rarely reported cancer-related pemphigus in dogs, was also considered for tentative diagnosis. Significant clinical remission of dermal lesions was achieved with four weeks of prednisolone and mycophenolate mofetil (MMF) treatment. Drugs were gradually tapered and eventually discontinued with concurrent reduction of dermal lesions, and no further recurrence was noted.

조선 홍역발생과 관련의서 편찬관계 고찰 - 18C, 19C를 중심으로 - (A Research on Relation between Measles Occurrence and Related Medical Text during Joseon Dynasty - Based on 18th and 19th Century -)

  • 송지청;이훈상;박영채;엄동명
    • 한국의사학회지
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    • 제31권2호
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    • pp.41-52
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    • 2018
  • In this study, we research the tendency of medical text publication by examining the period of the great measles outbreak and the period of the publication of specialized smallpox texts. Using the National Institute of Korean History database for the Annals of Joseon Dynasty, the Daily Records of Royal Secretariat of Joseon Dynasty and Bibyeonsadeunglok, we will compare all records of measles occurrence. Measles and smallpox (Majin in Korean) have similar symptoms and treatment methods. In East Asia, when measles occurred it spread to Joseon and Japan, which are verified by records of the Annals of Joseon Dynasty, the Daily Records of Royal Secretariat of Joseon Dynasty and Bibyeonsadeunglok. The medical books related to measles are; Ryuhasinbang, Majinpyeon, Geupyubang, Yimsinyeokbang, Eulmisinjeon, Majingbang, Jinyeokbang, Magwahoetong, Majingibang, Susengsingam, Hongjinsinbang. Measles and Majin are the same disease. During the period of measles occurrence, measles-related medical books were published, and this relation of measles occurrence and measles-related medical text publication is verified by several national records.

숙종의 두창(痘瘡)에 관한 『승정원일기(承政院日記)』의 의안(醫案) 연구 (A study on the Clincal Records of 『The daily Records of Royal Secretariat of Chosun Danasty』)

  • 고대원;김동율;김태우;차웅석
    • 한국의사학회지
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    • 제25권1호
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    • pp.43-51
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    • 2012
  • Smallpox and measles might be the typical epidemics through Choson Danasty. Especially Sookjong was the first king who suffered from smallpox during the period of his reign. This study was examined critically focused on the Clinical Records about Smallpox which occurred in the 9th year of Sookjong's reign. The clinical records in Seungjeongwon Ilgi("承政院日記") was the main source and the Annals of the Joseon Dynasty was reffered. It tells us that Sookjong caught infectious disease, smallpox spread in town and the whole process of smallpox. Seungmagalgeuntang(升麻葛根湯) and hwadoktang(火毒湯) were given at the early term for treating Sookjong's smallpox, but later on, Bowontang(補元湯) was given for the treatment of smallpox. It showed us the medical view which placed emphasis on the vital force of human body. A dermatologist, Yoo Sang had joined since the beginning of the treatment and Siyakchung(侍藥廳) was established for Sookjong. Sasunghoichuntang(四聖回天湯) which was Chunyoohyung(全有亨)'s prescription showed us enough clinical experience and the ways of treatments. At the same time, the medical culture at that time was well known through the fact that smallpox was taboo among the royal family.

일차 사료와 지리 정보를 통한 동제학교에 대한 고찰 (Investigation of Dongje School Based on the Primary Historical Data and Geographical Information)

  • 하기태;최준용;김기봉
    • 동의생리병리학회지
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    • 제36권4호
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    • pp.105-112
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    • 2022
  • Dongje school (同濟學校), alternately Dongje medical school, is generally recognized as the first modern school for Korean medicine. However, there is very limited information concerning its establishment, duration period, governance, location, and contents for teaching. We found several points which are different from popular opinions through investigating news articles of those days and maps. Dongje school has established on June 1, 1906 and the time of its discontinuance is not clear. The school was founded with the cooperation of three former government officials of the Korean Empire, Eungse Lee (李應世), Piljoo Kang (姜弼周), and Dongho Cho (趙東浩) and many people donated fund for supporting Dongje school. However, there is no evidence of national or royal expenditures for operating the school. Dongje school has been established in 76-6, Seohak hill (西學峴), Yeogyeong-bang (餘慶坊), West county (西署), Seoul and moved to Naesum-si (內贍寺) located in Bongsangsi front village (奉常寺前門洞), Indal-bang (仁達坊), West county, at September 1906. The curriculum of the school comprehends several disciplines including literature in Korean and Chinese, mathematics, foreign language, physics, and Western medicine, as well as Korean medicine. Particularly at that time, they thought both of women and men. To elucidate the issue of the governance of Dongje school regarding the national or royal establishment, more information and extensive studies should be needed.

개의 하복부 림프관 육종 증례 (Lower Abdominal Lymphangiosarcoma in a Dog)

  • 류미현;김형진;오원석;김은옥;정인성;권린희;우계형;김대용
    • 한국임상수의학회지
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    • 제27권4호
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    • pp.488-490
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    • 2010
  • Lymphangiosarcoma was described in a 2-year-old male Miniature Poodle. A 5 cm by 3 cm slightly elevated tan ventral abdominal mass was surgically removed with a wide margin and submitted for diagnosis. The mass has being grown rapidly during the last six months. On histopathology, the mass was composed of anastomosing channels or empty spaces which were free of red blood cells and lined by flat to plump pleomorphic neoplastic cells. The neoplastic channels or spaces were invasive into the surrounding fat and muscle tissues. Mild perivascular lymphocytic infiltration was also noted. Immunohistochemically, the neoplastic cells were positive to vimentin and Factor VIII. Based on histopathology and immunohistochemistry, the tumor was diagnosed as lymphangiosarcoma. Recurrence or metastasis was not noted so far after surgery.

"침구택일편집(鍼灸擇日編集)"과 "의방유취(醫方類聚)"의 관계 연구 (Study on the Relationship between "Compilation of Chimgutaekil" and "Uibangryuchi")

  • 오준호
    • Korean Journal of Acupuncture
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    • 제28권1호
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    • pp.101-112
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    • 2011
  • Objectives : This research is aimed to consider the arranging process of the expertise on acupuncture & moxibustion in the corrective process of "Uibangyuchi" by studying the relationship between "Uibangyuchi" and "Compilation of Chimgutaekil". Methods : This researcher scrutinized the compilation & corrective process of "Uibangyuchi" through royal family records and considered the relationship between "Compilation of Chimgutaekil" and "Uibangyuchi" from the historial viewpoint. Results and Conclusions : 1. In the corrective process of "Uibangyuchi", the specialized knowledge of acupuncture & moxibustion were erased. 2. The contents related to "Chimgutaekil" among the erased contents are included in "Compilation of Chimgutaekil". 3. The method of arranging the knowledge in "Compilation of Chimgutaekil" coincides with that of "Uibangyuchi", which showes this book has a deep association with "Uibangyuchi" in the aspect of the period, organization of authors, and arrangement form. 4. The "Chimgutaekil"(Pick-a-date Method) is of no big consequence in the science of acupuncture & moxibustion but considers the example of medical procedures in the royal family of the Chosun Dynasty : the "Chimgutaekil" was the operation to be done at the very first beginning in time of the medical procedures using acupuncture & moxibustion. 5. Through such historical facts, the conclusion was made that the reason why specialized knowledge of acupuncture & moxibustion of specialty book was deleted in the compilatory process of "Uibangyuchi" is that its writing staff decided to compile these separately, thereby hurriedly publishing "Compilation of Chimgutaekil" as an example.

정조의 격기(膈氣)에 대한 연구 - 『승정원일기』를 중심으로 - (A Study on Gyeok-ki(膈氣) Symptoms of King Jeongjo - Foucsed on The Daily Records of Royal Secretariat of Joseon Dynasty -)

  • 김동율;정지훈
    • 대한한의학원전학회지
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    • 제32권3호
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    • pp.85-102
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    • 2019
  • Objectives : To examine the progression and presentation of King Jeongjo's Gyeok-ki(膈氣) symptoms during his reign. Methods : Based on recordings in the The Daily Records of Royal Secretariat of Joseon Dynasty related to Gyeok-ki(膈氣), characteristics of King Jeongjo's case was analyzed, then compared and examined against the political situation he was in. Results : During the 24 years of reign, King Jeongjo's Gyeok-ki(膈氣) developed in four stages; beginning stage with mild symptoms, intrinsic stage where it became the King's main disease, peak stage where symptoms intensified, and chronic stage where symptoms became rather manageable but the disease occurred regularly. Conclusions : From the year of accession to the year of death, King Jeongjo consistently complained of Gyeok-ki(膈氣), which seems to be strongly related to his family history and political situation.

Application of Minimally Invasive Plate Osteosynthesis to Tibial Shaft Fractures in Dogs

  • Rahman, Md. Mahbubur;Jeong, In-Seong;Kim, Nam Soo
    • 한국임상수의학회지
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    • 제34권3호
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    • pp.200-203
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    • 2017
  • The objective of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) method for treatment of tibial shaft fractures in dogs by comparing MIPO radiographic and fracture healing time results with those from the popular open reduction and internal fixation (ORIF) technique. In this clinical study at the Royal Animal Medical Center, five consecutive dogs with diagnoses of comminuted tibial shaft fractures were treated with the MIPO surgical approach. For comparison, an additional five breed-, age-, and weight-matched dogs with comminuted tibial shaft fractures were treated with the ORIF technique. Mean healing time was $75.6{\pm}12.5$ days in the MIPO group and $131.8{\pm}18.6$ days in the ORIF group (p < 0.01). The mean surgery time in the MIPO group ($36.4{\pm}3.5$ minutes) was significantly shorter (p < 0.01) than that for the ORIF group ($47.0{\pm}2.2$ minutes). Based on the short surgical and healing times, the MIPO approach is clinically superior to the ORIF approach and should be the preferred approach in tibial fracture cases.