• 제목/요약/키워드: Ulcer index

검색결과 63건 처리시간 0.021초

The Influence of Comorbidities on Reoperations Following Primary Surgery of Lumbar Degenerative Diseases : A Nationwide Population-Based Retrospective Cohort Study from 2009-2016

  • Park, Hyung-Ki;Park, Su-Yeon;Lee, Poong-Hhoon;Park, Hye-Ran;Park, Sukh-Que;Cho, Sung-Jin;Chang, Jae-Chil
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.730-737
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    • 2020
  • Objective : Spinal degeneration is a progressive disease, worsening over time. Lumbar degenerative disease (LDD) is a major spinal disease in elderly patients. Surgical treatment is considered for medically intractable patients with LDD and reoperation after primary surgery is not uncommon. The surgical outcome is occasionally unpredictable because of comorbidities. In the present study, the relationship between comorbidities and the incidence of reoperation for LDD over time was determined. Methods : The claims data of the health insurance national database were used to identify a cohort of patients who underwent spinal surgery for LDD in 2009. The patients were followed up until 2016. Medical comorbidity was assessed according to the Charlson comorbidity index (CCI). Cox proportional hazard regression modeling was used to identify significant differences in sex, surgery, age, causative disease, and comorbidity. Results : The study cohort included 78241 patients; 10328 patients (13.2%) underwent reoperation during the observation period. The reoperation rate was statistically higher (p<0.01) in males, patients 55-74 years and 65-74 years of age, and patients with decompression or discectomy. Significant association was found between increasing reoperation rate and CCI score (p<0.01). Based on multivariate analysis of comorbidities, the significantly higher reoperation rates were observed in patients with peripheral vascular disease, pulmonary lung disease, peptic ulcer, diabetes, and diabetes complications (p<0.01). Conclusion : The study results indicate the reoperation rate for LDD is associated with patient comorbidities. The comorbidities identified in this study could be helpful in future LDD studies.

Hydrogel Dressing with a Nano-Formula against Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa Diabetic Foot Bacteria

  • El-Naggar, Moustafa Y.;Gohar, Yousry M.;Sorour, Magdy A.;Waheeb, Marian G.
    • Journal of Microbiology and Biotechnology
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    • 제26권2호
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    • pp.408-420
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    • 2016
  • This study proposes an alternative approach for the use of chitosan silver-based dressing for the control of foot infection with multidrug-resistant bacteria. Sixty-five bacterial isolates were isolated from 40 diabetic patients. Staphylococcus aureus (37%) and Pseudomonas aeruginosa (18.5%) were the predominant isolates in the ulcer samples. Ten antibiotics were in vitro tested against diabetic foot clinical bacterial isolates. The most resistant S. aureus and P. aeruginosa isolates were then selected for further study. Three chitosan sources were tested individually for chelating silver nanoparticles. Squilla chitosan silver nanoparticles (Sq. Cs-Ag0) showed the maximum activity against the resistant bacteria when mixed with amikacin that showed the maximum synergetic index. This, in turn, resulted in the reduction of the amikacin MIC value by 95%. For evaluation of the effectiveness of the prepared dressing using Artemia salina as the toxicity biomarker, the LC50 was found to be 549.5, 18,000, and 10,000 μg/ml for amikacin, Sq. Cs-Ag0, and dressing matrix, respectively. Loading the formula onto chitosan hydrogel dressing showed promising antibacterial activities, with responsive healing properties for the wounds in normal rats of those diabetic rats (polymicrobial infection). It is quite interesting to note that no emergence of any side effect on either kidney or liver biomedical functions was noticed.

The Effect of $Luteolin-7-O-{\beta}-D-Glucuronopyranoside$ on Gastritis and Esophagitis in Rats

  • Min, Young-Sil;Bai, Ki-Lyong;Yim, Sung-Hyuk;Lee, Young-Joo;Song, Hyun-Ju;Kim, Jin-Hak;Ham, In-Hye;Whang, Wan-Kyun;Sohn, Uy-Dong
    • Archives of Pharmacal Research
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    • 제29권6호
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    • pp.484-489
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    • 2006
  • This Study evaluated the inhibitory action of $luteolin-7-O-{\beta}-D-glucuronopyranoside$, luteolin which was isolated from Salix gilgiana leaves, and omeprazole on reflux esophagitis and gastritis in rats. Reflux esophagitis and gastritis were induced surgically and by the administration of indomethacin, respectively. The intraduodenal administration of $luteolin-7-O-{\beta}-D-glucuronopyranoside$ decreased the ulcer index, injury area, gastric volume and acid output, and increased the gastric pH compared with luteolin. $Luteolin-7-O-{\beta}-D-glucuronopyranoside$ significantly decreased the size of the gastric lesions that had been induced by exposing the gastric mucosa to indomethacin. The malondialdehyde content, which is the end product of lipid peroxidation, was increased significantly after inducing of reflux esophagitis. The malondialdehyde content was decreased by $Luteolin-7-O-{\beta}-D-glucuronopyranoside$ but not luteolin or omeprazole. $Luteolin-7-O-{\beta}-D-glucuronopyranoside$ has a more potent antioxidative effect than luteolin. $Luteolin-7-O-{\beta}-D-glucuronopyranoside$ is a promising drug for the treatment of reflux esophagitis and gastritis.

Helicobacter pylori의 병원성 비교를 위한 gerbil의 수침구속스트레스 모델 (Water-Immersion-Restraint Stress model in Mongolian gerbil forcomparison of pathoaenicity of Helicobacter pylori strains)

  • 이진욱;김옥진
    • 대한수의학회지
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    • 제44권4호
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    • pp.607-613
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    • 2004
  • Helicobacter pylori (H. pylori)-infection is an important pathogen of stomach cancer after chronic gastritis and ulceration in the stomach and duodenum. However, the virulences of H. pylori strains have not been well-defined between clinical isolates. This study was designed to establish water-immersion-restraint stress (WIRS) model in mongolian gerbil for comparison of pathogenicity of H. pylori strains. To determine an optimal duration time for WIRS model in gerbil, 5-week-old Mongolian gerbils were divided into different groups by WIRS duration time. After graded duration of WIRS, the macroscopic ulcer index (UI) was measured with the stomach and duodenum of sacrificed animal. There were no significant differences between male and female in same duration group. However, the UI increased significantly in a time-dependent fashion. The group of 6 hours-WIRS animals showed severe hemorrhage and ulceration in their stomach and duodenum. On the other hand, the very mild lesions induced in 2 hours-treated animals. Therefore, we determined an optimal duration time for WIRS model in gerbil as 4 hours. Thereafter, we evaluated whether this WIRS model in gerbil could be used as an useful tool for in vivo comparison of pathogenicity of H. pylori strains by enhancement of pathological severity in H. pylori-infected gerbils. Mongolian gerbils were divided into H. pyloriinfected and PBS-inoculated groups. Thereafter, they were divided again into 4 hours-WIRS and no WIRS subgroups. After treatment, the severity of pathological changes was evaluated in a same manner with previous duration-determining experiment. When the animals were exposed to WIRS, the UI was significantly higher in the infected group than in the uninfected group. These results suggested that the established gerbil-WIRS model in this study enhanced effectively the severity of pathogenic changes in the H. pylori-infected Mongolian gerbils and could be used as an useful tool for in vivo comparison of pathogenicity of H. pylori strains.

감염성 당뇨 족부 궤양 치료에서 Texas 기준 체계에 따른 음압치료 적용 (The Application of Vacuum-Assisted Closures According to the Texas Staging System in the Treatment of Infective Diabetic Foot Ulcers)

  • 임성안;최용수;장영재;백성년;배안나
    • 대한족부족관절학회지
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    • 제26권2호
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    • pp.66-70
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    • 2022
  • Purpose: A group of patients who were hospitalized for diabetic foot ulcers was classified according to the University of Texas Staging System for Diabetic Foot Ulcers, and we attempted to evaluate whether this staging system could be a criterion for treatment success using vacuum-assisted closure (VAC) technique. Materials and Methods: A total of 32 patients were diagnosed with diabetic foot ulcers according to the University of Texas Staging System for Diabetic Foot Ulcers. Of these, 24 patients who were evaluated as stage B according to the staging system were classified as Group 1, and 8 patients in stage D were classified as Group 2. After applying VAC, the treatment success rate was compared by evaluating the size and severity of ulcers between the two groups. Results: The grade of granulation after VAC was on average 3.75±0.53 in Group 1 and 2.25±0.71 in Group 2. There was better granulation after VAC application in Group 1 (p<0.01). The success rate of the treatment was 22 cases (91.67%) in Group 1 and one case (12.5%) in Group 2. Thus there were statistically significant differences in the success rate of treatment between groups 1 and 2 (Pearson's chisquare test, p=0.01; odd ratio 77.00, 95% confidence interval [CI] 1.26~14.66; relative risk 4.30, 95% CI 1.26~14.66). Conclusion: These results suggest that there was a higher success rate of treatment with VAC in stage B patients. The University of Texas Staging System for Diabetic Foot Ulcers can thus be an index for applying VAC to patients with infective diabetic foot ulcers.

산딸기, 유백피, 치자 추출물의 임상용 복합제제의 동물 실험모델에서의 위 질환 억제활성 (Preventive Effect of LS-RUG-com-a Mixture of Rubus crataegifolius, Ulmus macrocarpa, and Gardenia jasminoides-on Gastric Disorders in Animal Models)

  • 이영익;아텟삼 후세인;아지즈 압둘 라만;손호용;윤혜정;조진숙
    • 생명과학회지
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    • 제33권11호
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    • pp.923-935
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    • 2023
  • 산딸기(RC), 유백피(UM)와 치자(GJ)는 위장장애 개선 및 다양한 효능이 보고된 중요한 민간 의약품 소재이다. 본 연구에서는 안전한 천연물을 이용한 실제적 위장 질환 개선제의 상업화를 위해, 상기 3종 천연물 추출물의 분말을 각각 3:1:2(w/w/w) 비율로 혼합하여 제조한 임상용 복합제제(LS-RUG-com)의 위 질환 억제활성을 평가하였다. HCl/EtOH 유도 위염 모델에서 LS-RUG-com (150 mg/kg)은 76%의 우수한 위염 억제 효능을 보였다(lesion index; HCl/EtOH, 112.37±11.20 mm, RUG-com; 26.32±1.87 mm). 또한 indomethacin 처리에 의한 위궤양 rat model에서 LS-RUG-com (150 mg/kg) 처리 시 90.8%의 위궤양 억제 효능을 보여, 임상에서 사용중인 cimetidine (100 mg/kg) 처리구의 81.1% 억제활성보다 우수한 활성을 보였다(lesion index; indomethacin ; 121.72±3.19 mm, RUG-com ; 12.5±1.16 mm). 역류성 식도염 유발 모델에서는 LS-RUG-com (150 mg/kg) 처리군에서 조직학적으로 omeprazole (150 mg/kg)에 비교되는 우수한 위 및 위 점막 손상 회복 활성을 확인하였으며, 위 내용물의 pH 상승, 위점막 보호의 증가 및 위의 pepsin 생성억제를 확인하였다. 또한, 위 식도 조직에서 TNF-α 및 IL-1β 발현이 유의적으로 감소하여 염증 발생이 억제됨을 확인하였다. 또한 항 Helicobacter pylori 효능도 검증하였다. 본 연구는 LS-RUG-com이 인체의 위 관련 질환을 개선하고, 위 및 위 점막 손상을 예방, 개선할 수 있음을 제시하고 있다.

전기미각측정기를 이용한 구강점막질환 환자의 미각평가 (Evaluation of Taste in The Patients with Oral Mucosal Disease by Electrogustomter)

  • 이용한;태일호;고명연;안용우
    • Journal of Oral Medicine and Pain
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    • 제33권2호
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    • pp.133-145
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    • 2008
  • 본 연구의 목적은 전기 미각 측정기를 사용하여 구강점막질환(구강편평태선, 재발성 아프타성 궤양)을 지닌 환자의 미각 감수성을 조사하기 위함이다. 173명의 환자가 100명의 대조군과 73명의 실험군으로 구성되었으며 73명의 환자는 부산대학 병원 구강내과에 2005년 4월부터 2007년 1월까지 내원하였다. 대조군은 2006년 2월부터 8월까지 청주 및 인천 소재 치과의원에 내원한 치과환자를 대상으로 하였다. 전기미각측정기(electrogustometer)를 사용하여, 오른쪽 혀끝, 측방 중앙부위, 유곽유두 근처부위, 연구개부위에 미각측정을 시행하였으며 그 결과는 다음과 같다. 1. 실험군에서의 전기 미각 역치는 대조군에서 보다 유의하게 낮은 수치를 나타내었다(p<0.001). 2. 실험군에서 만성도와 병소의 개수에 따른 전기 미각 역치의 주목할 만한 변화는 관찰되지 않았다. 3. Dexan을 단독 사용했을 때와 Dexan과 Prednisolone을 함께 투여한 환자들에서, 전기 미각 역치의 주목할 만한 변화는 관찰되지 않았다. 4. 치료 경과(반응없음 vs 1/2 개선 vs 완전개선)에 따른 전기 미각 역치의 주목할만한 변화는 없었다. 그러나 NAS에 의해 측정된 증상의 개인적 지표는 미반응 군에서는 주목할 정도로 증가하였으며 완전 개선 군에서는 눈에 띄게 감소하였다(p<0.001)

중환자실 환자의 욕창 관련 경계압력 예측요인 (Factors Predicting the Interface Pressure Related to Pressure Injury in Intensive Care Unit Patients)

  • 신지선;김수진;이지현;유미
    • 대한간호학회지
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    • 제47권6호
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    • pp.794-805
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    • 2017
  • Purpose: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. Methods: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. Results: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (${\pm}14.90$), 41.15 (${\pm}16.04$), 53.44(${\pm}24.67$), and 54.33 (${\pm}22.80$) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ${\geq}70$ years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ${\geq}36.5^{\circ}C$ (OR 3.12, 95% CI: 1.17~8.17); age ${\geq}70$ years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ${\geq}36.5^{\circ}C$ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. Conclusion: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.

The Clinical Accuracy of Endoscopic Ultrasonography and White Light Imaging in Gastric Endoscopic Submucosal Dissection

  • Park, Soon-Hong;Sung, Sang-Hun;Lee, Seung-Jun;Jung, Min-Kyu;Kim, Sung-Kook;Jeon, Seong-Woo
    • Journal of Gastric Cancer
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    • 제12권2호
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    • pp.99-107
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    • 2012
  • Purpose: Gastric mucosal neoplastic lesions should have characteristic endoscopic features for successful endoscopic submucosal dissection. Materials and Methods: Out of the 1,010 endoscopic submucosal dissection, we enrolled 62 patients that had the procedure cancelled. Retrospectively, whether the reasons for cancelling the endoscopic submucosal dissection were consistent with the indications for an endoscopic submucosal dissection were assessed by analyzing the clinical outcomes of the patients that had the surgery. Results: The cases were divided into two groups; the under-diagnosed group (30 cases; unable to perform an endoscopic submucosal dissection) and the over-diagnosed group (32 cases; unnecessary to perform an endoscopic submucosal dissection), according to the second endoscopic findings, compared with the index conventional white light image. There were six cases in the under-diagnosed group with advanced gastric cancer on the second conventional white light image endoscopy, 17 cases with submucosal invasion on endoscopic ultrasonography findings, 5 cases with a size greater than 3 cm and ulcer, 1 case with diffuse infiltrative endoscopic features, and 1 case with lymph node involvement on computed tomography. A total of 25 patients underwent a gastrectomy to remove a gastric adenocarcinoma. The overall accuracy of the decision to cancel the endoscopic submucosal dissection was 40% (10/25) in the subgroup that had the surgery. Conclusions: The accuracy of the decision to cancel the endoscopic submucosal dissection, after conventional white light image and endoscopic ultrasonography, was low in this study. Other diagnostic options are needed to arrive at an accurate decision on whether to perform a gastric endoscopic submucosal dissection.

Anti-inflammatory Effects of Flavonoids on TNBS-induced Colitis of Rats

  • Joo, Minjae;Kim, Han Sang;Kwon, Tae Hoon;Palikhe, Alisha;Zaw, Tin Sandar;Jeong, Ji Hoon;Sohn, Uy Dong
    • The Korean Journal of Physiology and Pharmacology
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    • 제19권1호
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    • pp.43-50
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    • 2015
  • It has been shown that the extracts including eupatilin and quercetin-3-${\beta}$-D-glucuronopyranoside had mucoprotective effects on the esophagus and stomach through their antioxidant activities. This study was designed to investigate the anti-inflammatory effect of these flavonoid compounds in an animal model of inflammatory bowel disease induced by 2,4,6-trinitrobenzene sulfonic acid. Experimental colitis was induced by intracolonic administration of 2,4,6-trinitrobenzene sulfonic acid. Extracts including eupatilin or quercetin-3-${\beta}$-D-glucuronopyranoside were orally administered to animals 48, 24, and 1 h prior to the induction of colitis and then again 24 h later. The animals were sacrificed 48 h after by 2,4,6-trinitrobenzene sulfonic acid treatment and the macroscopic appearance of the colonic lesions was scored in a blinded manner on a scale of 1 to 10. The inflammatory response to colitis induction was assessed by measuring myeloperoxidase activity, nitric oxide production, tumor necrosis factor-${\alpha}$ expression, total glutathione levels, and malondialdehyde concentrations in the colon. The results indicated that extracts including eupatilin and extracts including quercetin-3-${\beta}$-D-glucuronopyranoside dose-dependently improved the morphology of the lesions induced by 2,4,6-trinitrobenzene sulfonic acid and reduced the ulcer index accordingly. In addition, rats receiving extracts including eupatilin and extracts including quercetin-3-${\beta}$-D-glucuronopyranoside showed significantly decreased levels of mucosal myeloperoxidase activity, nitric oxide production, tumor necrosis factor-${\alpha}$ expression, and malondialdehyde levels, and increased total glutathione levels. Extracts including eupatilin and extracts including quercetin-3-${\beta}$-D-glucuronopyranoside ameliorated the inflammatory response and colonic injury in acute colitis by decreasing oxidative stress and neutrophil activation. Extracts including eupatilin and extracts including quercetin-3-${\beta}$-D-glucuronopyranoside may inhibit acute colitis.