• Title/Summary/Keyword: Urinary dysfunction

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Treatment of severe sepsis and septic shock associated with urogenital tract infection (요로감염과 관련된 중증 패혈증 및 패혈성 쇼크의 치료)

  • Hwang, Kyu Bin;Huh, Jung-Sik;Kim, Young-Joo;Park, Kyung Kgi;Kim, Sung Dae;You, Hyun Wook
    • Journal of Medicine and Life Science
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    • v.17 no.3
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    • pp.80-85
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    • 2020
  • Urinary tract infections are among the most common infectious diseases and are the major causes of mortality and morbidity. These diseases result in many severe hospitalizations each year. Severe sepsis and septic shock are common and life-threatening medical conditions, and large cases are associated with urinary tract infection. The medical term "severe sepsis" is defined as sepsis complicated by hypotension, organ dysfunction, and tissue hypoperfusion, whereas "septic shock" is defined as sepsis complicated either by hypotension that is refractory to fluid resuscitation or by hyperlacteremia. A recent multicenter-study in Korea reported that the rate of in-hospital mortality associated with severe sepsis and septic shock was > 34%. Among the causative diseases, urogenital tract infection showed a high correlation. Moreover, it is very important that clinicians detect severe sepsis and septic shock early and treat them properly. The principles of initial treatment include provision of sufficient hemodynamic resuscitation and early administration of appropriate antibiotic therapy to mitigate uncontrolled infection. Initial resuscitation includes the use of vasopressors and intravenous fluids, and it is a key to achieve the target of initial resuscitation. Supportive care in the intensive care unit, such as glucose control, stress ulcer prophylaxis, blood transfusion, deep vein thrombosis prophylaxis, and renal replacement therapy, is also significant. We have summarized the key components in the treatment of severe sepsis and septic shock in patients with urinary tract infection. Urologists should be aware that appropriate early treatment is necessary to prevent fatal outcomes in these patients.

Report on the Guillain-Barre Syndrome with Autonomic Dysfunction(1 Case) (자율신경 기능 이상을 동반한 Guillain-Barre 증후군 1례)

  • Kim, Dong-Ung;Shin, Sun-Ho;Cho, Gwon-Il;Shin, Hak-Su;Han, Myung-A;Choi, Jin-Young;Choi, Woo-Jung;Yang, Jae-Hun;Chung, Yong-Jun;Kim, Kwan-Sick
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.453-458
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    • 2001
  • Guillain-Barre syndrome, or acute inflammatory demyelinating Polyradiculoneuropathy, is frequently accompanied by cardiac and autonomic dysfunction. We report a patient who had tachycardia, orthostatic hypotension, hypertension, pronounced blood pressure fluctuations, abnormal sweating, constipation and urinary frequency as well as qudriparesis. We thought that the GBS was incurred by Damp-Heat, used Heat-Clearing and Dampness-Transforming decoction(Chongjoo-tang) in the early stage. In the later stage, fortifying the Spleen and Boosting Qi plus Supplementing the Kidney decoction(Palmultang+chongawon) was used to remove low back pain and boost recovery. The patient reached the nadir 14 days after onset. He became bed-bound and autonomic dysfunction was very severe. From 3rd week, abnormalities of autonomic function and paresis impoved gradually and he could walk above 5m without walker or equivalent support at the 5th week after onset.

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Long-term Outcomes of Augmentation Cystoplasty in a Pediatric Population With Refractory Bladder Dysfunction: A 12-Year Follow-up Experience at Single Center

  • Mehmood, Shahbaz;Alhazmi, Hamdan;Al-Shayie, Mohammed;Althobity, Ahmed;Alshammari, Ahmed;Altaweel, Waleed Mohamed;Almathami, Ahmed;Vallasciani, Santiago
    • International Neurourology Journal
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    • v.22 no.4
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    • pp.287-294
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    • 2018
  • Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

A Case Report of a Patient with Voiding Dysfunction Caused by Cerebral Infarction Treated with Dangguishaoyao-san-hap-Jeoryeong-tang (뇌경색 이후 발생한 배뇨곤란 환자에 대한 당귀작약산 합 저령탕 치험 1례)

  • Sun-woo Kwon;Choong-hyun Park;Ji-yoon Lee;Hye-soo Youn;Eun-chang Lee;Jung-min Son;Yi-jae Kwon;Hyo-jeong Lee;Jung-eun Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.1041-1049
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    • 2023
  • Objectives: The aim of this study is to describe the effects of treatment with traditional Korean medicine on a patient with voiding dysfunction caused by cerebral infarction. Methods: The patient was treated with herbal medicine, moxibustion, acupuncture, and electroacupuncture. The effects of these treatments were evaluated using the Korean version of the Modified Barthel Index and a post-void residual volume. Results: In this study, the Korean medicine Dangguishaoyao-san-hap-Jeoryeong-tang resulted in improvements in this patient with post-stroke urinary retention and successful removal of the indwelling catheter. Conclusion: The results suggest that traditional Korean medicine may be effective in ameliorating dysfunction caused by cerebral infarction.

A Case of Cantharidin Poisoning after the Ingestion of Herbal Medicine (한약복용 후 발생한 칸타리딘 중독 1례)

  • Ji Ho Jin;Kim Hyun;Kim Sun Hyu;Oh Sung Bum;Moon Joong Bum;Lee Kang Hyun;Hwang Sung Oh
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.56-59
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    • 2005
  • Blister beetles produce cantharidin, which is toxic to people and animals. Cantharidin has been believed to be an aphrodisiac and an abortifacient based on its tendency to cause marked irritation to the genitourinary system leading to priapism in men and pelvic congestion in women for many years. Cantharidin was used by oriental traditional medicine for more than 2000 years. Typical signs related to cantharidin ingestion are gastrointestinal tract and urinary tract irritation, endotoxemia, shock and myocardial dysfunction. Cantharidin is a severe irritant to epithelial linings (gastrointestinal tract, urinary tract, and skin) and develop systemic inflammatory response syndrome. We report a case of corrosive esophagogastritis and acute renal failure by ingestion of cantharidin.

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Preparation and Evaluation of $PGE_1$ Urethral Suppositories ($PGE_1$ 요도좌제의 제조 및 평가)

  • Park Somin;Choi Myeongsin;Han Kyuwon;Kim Kil-Soo
    • YAKHAK HOEJI
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    • v.49 no.4
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    • pp.260-267
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    • 2005
  • [ $PGE_1$ ] is an endogenous substance of potent vasodialator as well as inhibitor of platelet aggregation. It has been used therapeutically in peripheral arterial occlusive disease and impotence. Intracavernous injection of $PGE_1$ for erectile dysfunction has been established for several years as a treatment option for erectile dysfunction of diverse etiologies, but this mode of administration is limited by penile discomfort, pain at the injection site, inconvenience and noncompliance. As the matter of worse, the $\beta-hydroxy$ moiety of $PGE_1$ is extremely susceptible to dehydration in solution to give inactive $PGA_1$ and $PGB_1$. For the improvement of stability, rapid absorption at action site and the convenience of application, $PGE_1$ was formulated as urethral suppositories of three types of formulations, such as PEG, witepsol, and the mixture of PEG and witepsol. The stability test of $PGE_1$ and the release test in urinary suppositories were performed. Futhermore, the effect of enhancers and vehicle composition on the penetration of $PGE_1$ through excised rat skin was evaluated by permeability coefficient and enhancement ratio.

Aggravated Concealed Penis Resulting from Circumcision (포경수술에 의해 악화된 매복음경)

  • Nam, Seung Min;Choi, Hwan Jun;Kim, Mi Sun;Kim, Young Bae
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.514-517
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    • 2006
  • Purpose: To report a rare case of concealed penis that was aggravated by circumcision and simple way of treatment using skin flap. The concealed penis is a primarily pediatric disease and is usually treated by urologists. The plastic surgeons tend to see these patients when it become secondary deformation or in conjoinment with other specialties. In such situation, the plastic surgeons do not have many experiences. Methods: A 3-year-old boy was admitted with aggravated concealed penis after circumcision in congenital webbed penis. Patient had been operated with scar revision and skin flap and peri operative antibiotics. Results: The patient recovered well without any complication such as infection, hematoma and necrosis of flap. Patient was discharged POD#7 with remaining sutures. Patient was followed up for 7 months and he has no sign of erectile dysfunction, voiding dysfunction and evidence of inflammation of the urinary system. Conclusion: We experienced a case of concealed penis that was aggravated from aggressive circumcision in congenital webbed penis.

Improvement Effect of Sibjotang on Blood Glucose and Renal Dysfunction in Type II Diabetic Mice (제2형 당뇨 마우스에서 십조탕(十棗湯)에 의한 혈당 및 신기능 부전 개선효과)

  • Yoon, Jung Joo;Lee, Yun Jung;Kim, Hye Yoom;Ahn, You Mee;Jin, Xian Jun;Hong, Mi Hyeon;Hwang, Jin Seok;Lee, Ho Sub;Kang, Dae Gill
    • The Korea Journal of Herbology
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    • v.32 no.1
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    • pp.15-23
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    • 2017
  • Objectives : It is well known that Sibjotang (Shizaotang), traditional herbal medicine formula, regulates the body fluid blood pressure homeostasis. This study is to investigate whether Sibjotang improves diabetic renal dysfunction in type II diabetes mellitus animal model, db/db mice. Methods : The animals model were divided into three groups at the age of 8 weeks; control group (C57BLKS/J-db/m mice), diabetic group [(C57BLKS/J+Lepr)-db/db mice], and Sibjotang group [(C57BLKS/J+Lepr)-db/db mice + Sibjotang 100 mg/kg/day]. During 8 weeks of treatment, blood glucose and urinary albumin excretion were checked in metabolic chamber at 8, 12, and 16 weeks of age, respectively. Results : Body weight and food intake of diabetic group were significantly higher than control group after 8 weeks administration. However, there were not significant different between the diabetic group and Sibjotang group. Urinary albumin excretion was significantly decreased in the Sibjotang group than the diabetic group. In addition, supplementation with Sibjotang significantly lowered levels of blood glucose, insulin, and homeostatic model assessment-insulin resistance (HOMA-IR), suggesting reduced insulin resistance. The ratio of mesangial matrix/glomerular area was markedly larger in diabetic group than control group, whereas Sibjotang significantly reduced this expansion. Moreover, immunohistological study revealed that Sibjotang attenuated the increase of transforming growth $factor(TGF)-{\beta}$ expression in kidney. Conclusion : Sibjotang ameliorates diabetes-associated renal injury through the improvement of the blood glucose and insulin sensitivity, and inhibiting the $TGF-{\beta}1$ expression. Therefore, Sibjotang may be a new therapeutic formula for the treatment of diabetic-associated renal dysfunction.

Removal of Urinary Calculi by Laparoscopic-Assisted Cystoscopy in Five Dogs (다섯 마리의 개에서 복강경 보조 방광경을 이용한 요로결석 제거)

  • Lee, Seung-Yong;Park, Se-Jin;Jin, So-Young;Kim, Min-Hyang;Seok, Seong-Hoon;Kim, Young-Ki;Lee, Hee-Chun;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.371-375
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    • 2014
  • This article describes the use of laparoscopic-assisted cystoscopy for removal of urinary calculi in five dogs. All dogs had micturition disorder due to urinary calculi. The surgical technique used was same in all cases. A urethral catheter passed into the urinary bladder through the urethra preoperatively. A 5-mm diameter cannula was placed in the ventral midline, 1 to 2 cm cranial to the umbilicus, and the 5-mm laparoscope was introduced via the cannula. A 10-mm diameter cannula was placed adjacent to the apex of the bladder under the visual guidance of laparoscopy. The bladder was then partially exteriorized through the 10-mm portal site, and a stab incision was performed on the bladder wall. The incisional margin of the bladder was sutured to the skin of the second portal site in $360^{\circ}$ simple continuous suture. A 2.7-mm diameter cystoscope with a sheath was introduced into the bladder lumen. The cystic and urethral calculi were removed under the visual guidance of cystoscopy with continuous fluid flushing. No major postoperative complications were identified. During the follow up period (range 7 to 21 months), no episodes of urinary dysfunction or recurrence of clinical signs were observed.

Chronic Cadmium Intoxication and Renal Injury Among Workers of a Small-scale Silver Soldering Company

  • Choi, Won-Jun;Kang, Seong-Kyu;Ham, Seunghon;Chung, Wookyung;Kim, Ae Jin;Kang, Myunghee
    • Safety and Health at Work
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    • v.11 no.2
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    • pp.235-240
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    • 2020
  • Background: Cadmium exposure may induce chronic intoxication with renal damage. Silver soldering may be a source of cadmium exposure. Methods: We analyzed working environment measurement data and periodic health screening data from a small-scale silver soldering company with ten workers. Concentrations of cadmium in air from working environment measurement data were obtained. Concentrations of blood and urinary cadmium, urine protein, and urine β2-microglobulin (β2M) were obtained. The generalized linear model was used to identify the association between blood and urine cadmium and urine β2M concentrations. Clinical features of chronic cadmium intoxication focused with toxicological renal effects were described. Results: The mean duration of work was 8.5 years (standard deviation [SD] = 6.9, range = 3-20 years). Cadmium concentrations in air were ranged from 0.006 to 0.015 mg/㎥. Blood cadmium concentration was elevated in all ten workers, with a highest level of 34.6 ㎍/L (mean = 21.288 ㎍/L, SD = 11.304, range = 9.641-34.630 ㎍/L). Urinary cadmium concentration was elevated in nine workers, with a highest level of 62.9 ㎍/g Cr (mean = 22.151 ㎍/g creatinine, SD = 19.889, range = 3.228-62.971 ㎍/g creatinine). Urine β2M concentration was elevated in three workers. Urinary cadmium concentration was positively associated with urine protein concentration (beta coefficient = 10.27, 95% confidence interval = [4.36, 16.18]). Other clinical parameters were compatible with renal tubular damage. Conclusion: Cadmium intoxication may occur at quite low air concentrations. Exposure limit may be needed to be lowered.