• 제목/요약/키워드: acute abdomen

검색결과 105건 처리시간 0.036초

Discordant findings of dimercaptosuccinic acid scintigraphy in children with multi-detector row computed tomography-proven acute pyelonephritis

  • Lee, Jeong-Min;Kwon, Duck-Geun;Park, Se-Jin;Pai, Ki-Soo
    • Clinical and Experimental Pediatrics
    • /
    • 제54권5호
    • /
    • pp.212-218
    • /
    • 2011
  • Purpose: The diagnosis of acute pyelonephritis (APN) is often difficult, as its clinical and biological manifestations are non-specific in children. If not treated quickly and adequately, however, APN may cause irreversible renal damage, possibly leading to hypertension and chronic renal failure. We were suspecting the diagnostic value of $^{99m}Tc$-dimercaptosuccinic acid (DMSA) scan by experiences and so compared the results of DMSA scan to those of multi-detector row computed tomography (MDCT). Methods: We retrospectively selected and analyzed 81 patients who were diagnosed as APN by MDCT during evaluation of their acute abdomen in emergency room and then received DMSA scan also for the diagnostic work-up of APN after admission. We evaluated the results of imaging studies and compared the diagnostic value of each method by age groups, <2 years (n=45) and ${\geq}$2 years (n=36). Results: Among total 81 patients with MDCT-proven APN, DMSA scan was diagnostic only in 55 children (68%), while the remaining 26 children (32%) showed false negative normal findings. These 26 patients were predominantly male and most of them, 19 (73.1%) were <2 years of age. Conclusion: DMSA scan holds obvious limitation compared to MDCT in depicting acute inflammatory lesions of kidney in children with APN, especially in early childhood less than 2 years of age. MDCT showed hidden lesions of APN, those were undetectable through DMSA scan in children.

Case Series Study on the Use of BU Pharmacopuncture Treatment in Patients with Acute Lumbar Sprain

  • Yang, Muhack;Jang, Jongwon;Cha, Eunhye;Ahn, Byungsoo;Bang, Younghee;Song, Beomyong;Shin, Jiyong;Ahn, Chankeun;Kim, Deokho;Kim, Sungchul
    • 대한약침학회지
    • /
    • 제21권2호
    • /
    • pp.120-125
    • /
    • 2018
  • Objective: The purpose of this study was to investigate the clinical effects of BU pharmacopuncture therapy consisting of bear's gall(fel ursi) and ox bezoar(bovis calculus) on acute lumbar sprain. Methods: 12 patients diagnosed as acute lumbar sprain in 6 designated local Korean medicine clinics from October 2017 to February 2018 were treated by BU pharmacopuncture. Several acupoints in abdomen and lumbar region were selected by clinicians at their own discretion. The effectiveness of the therapy was evaluated using VAS and ODI. After that we reviewed the medical records of all these patients to evaluate the effectiveness and safety of the therapy. Results: The VAS and ODI scales were significantly decreased after BU pharmacopuncture therapy. And no major complications and adverse effects were reported. Conclusion: BU pharmacopuncture showed rapid pain relief in patients with acute lumbar sprain. It is possible to shorten the treatment period of acute lumbar sprain and prevent progressing to chronic back pain in advance. To establish the effects of BU pharmacopuncture therapy, more succeeding clinical and laboratory studies are needed.

소아 성장의 침구 및 수기요법에 대한 중의학 임상 연구 고찰 (Review of Clinical Researches in Chinese Medical Journal for Acupuncture, Moxibustion, and Manual Therapy of Pediatric Growth)

  • 박슬기;박소현;이선행;이진용
    • 대한한방소아과학회지
    • /
    • 제33권1호
    • /
    • pp.58-77
    • /
    • 2019
  • Objectives The purpose of this study is to investigate clinical studies on the effect of acupuncture, moxibustion, and manual therapy in pediatric growth by analyzing randomized controlled trials conducted in China. Methods We searched the clinical studies from the China Academic Journal (CAJ) in China National Knowledge Infrastructure (CNKI) by specific key words and criteria. Selected 31 clinical studies were collected and analyzed. Results Total of 31 randomized controlled trials were selected and analyzed. In most of the studies, the effectiveness of acupuncture, moxibustion, and manual therapy on growth was significantly high. The most commonly used therapies were massage. The most commonly used massage methods were pinching spine (捏脊), pressing and kneading $Z\acute{u}s\bar{a}nl\check{i}$ (按?足三里), supplementing $P\acute{i}j\bar{i}ng$ (補脾經), supplementing $Sh\grave{e}nj\bar{i}ng$ (補腎經), rubbing Abdomen (摩腹), pushing $Y\check{o}ngqu\acute{a}n$ (推涌泉), supplementing $F\grave{e}ij\bar{i}ng$ (補肺經), kneading $T\grave{a}iy\acute{a}ng$ (?太陽), and kneading $Sh\acute{e}nqu\grave{e}$ (?神闕) etc. Conclusions Based on the results of the clinical studies from China, acupuncture, moxibustion, and manual therapy can be a valuable option for pediatric growth.

오수유(吳茱萸) 물 추출물이 급성역류성 식도염에 미치는 효과 (Effect on Acute reflux Esophagitis by Evodiae Fructus Aquous Extract)

  • 김대준;노성수
    • 대한본초학회지
    • /
    • 제27권1호
    • /
    • pp.51-58
    • /
    • 2012
  • Objectives : This study was performed to investigate effect of evodiae fructus on acute reflux esophigitis rat induced by pylorus and forestomach ligation operation. Methods : Twenty-four laboratory rats were divided four groups and each group had six rats ; normal intact group, acute reflux esophagitis (RE) control group, two experiment RE group treated extract of evodiae fructus 600 mg/kg (EEF600) and 300 mg/kg (EEF300). All rats was fasted for 18 hr but free water, we induced RE by pylorus and forestomach ligation operation. Intact group and RE control group rats were orally administered a distilled water and two experiment groups were orally administed with EEF 600 mg/5ml/kg and 300 mg/5ml/kg. One hour after, rats were anesthetized, intact group was cut the abdomen open and sutured with 2.0 silk thread. RE control group and EEF group were cut the abdomen open, ligated pyloric canal and forestomach with 2.0 silk thread and sutured. Six hour after the operation, rats were sacrified, collected bloods in the abdominal vein, disectted a esophagus and stomach. The stomach was washed a 1 ml PBS and the esophagus was cut longitudinally and pictured a innter mucosa area to research damages in esophagus. Results : The esophagic tissue damage percentage of reflux esophagitis rat was increased compared to that of normal intact group. But esophagic damage percentage of EEF 600 were significantly decreased compared to that of RE control group. But there was no difference on gastric juice pH between control RE, alpha-tocopherol administration rat group and EEF administration rat group. In esophagus of RE control rat, gastric damage occurred severely and injury percentage of mucosa were increased, but EEF 600 mucous inflammatory damage percentage was significantly compared to that of RE control group. Proinflammatory cytokines such as TNF-alpha, IL-1beta and IL-6 in serum on RE control group were markedly grew than those of intact rat, those of vechicle group treated with EEF 600 and EEF 300 were remarkably decreased compared to production of proinflammatory cytokine of RE control group. In microscopic observation, intact group rat had no hyperemia, mucous injury and exclusion, ulcer and edema. But it could showed mucosa damages, submucosa edema and ulcer in RE control. However, administration of EEF 600 and EEF 300 made esophagus have less inflammation and injury by gastric acid. Conclusions : The results suggest that antiinflammatory Effect of EEF could attenuate the severity of reflux esophagitis and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.

고지혈성 급성 췌장염에 대한 대시호탕의 효과 : 체계적 문헌고찰과 메타분석 (The Effect of Dachaihu Decoction for Hyperlipidemic Acute Pancreatitis: A Systematic Review and Meta-Analysis)

  • 김윤정;정유진;박동일
    • 대한한방내과학회지
    • /
    • 제41권3호
    • /
    • pp.306-325
    • /
    • 2020
  • Objectives: The aim of this study is to investigate the effect of a Dachaihu decoction for hyperlipidemic acute pancreatitis (HLAP) by systematic review and meta-analysis of Chinese clinical studies. Methods: China National Knowledge Infrastructure (CNKI) was utilized as the major search engine. The date of the literature search was March 7, 2020. Randomized controlled trials (RCTs) about using a Dachaihu decoction for HLAP were included in this study. Meta-analysis was performed by synthesizing outcome data, including total effective rate, abdomen pain relief time, first bowel movement time, blood amylase recovery time, and triglyceride (TG) levels (mmol/L). The selected literature was assessed using Cochrane's risk of bias (RoB). Results: Twelve of 44 RCTs met the inclusion criteria. Most studies were evaluated with RoB as having unclear risk. The total effective rate of herbal medicine treatment based on the Dachaihu decoction was significantly higher than that of symptomatic supportive treatment in 10 articles (risk ratio=1.15, 95% CI: 1.08 to 1.21, p<0.00001, I2=0%). Herbal medicine treatment based on a Dachaihu decoction was significantly more effective than symptomatic supportive treatment in terms of reducing abdomen pain relief time (in all articles; mean difference=-1.70, 95% CI: -1.91 to -1.41, p<0.00001, I2=45%), first bowel movement time (in 7 articles; mean difference=-1.46, 95% CI: -1.86 to -1.05, p<0.00001, I2=73%), blood amylase recovery time (in 8 articles; mean difference=-1.48, 95% CI: -2.04 to -0.92, p<0.00001, I2=90%), and TG levels (in 8 articles; mean difference=-1.59, 95% CI: -2.28to -0.91, p<0.00001, I2=90%). Only one article reported side effects of treatment among the intervention group and control group, citing pancreatic ulcer and pancreatic pseudocyst formation. Conclusions: This study suggests that herbal medicine treatment based on a Dachaihu decoction could yield higher efficacy for HLAP than symptomatic supportive treatment alone. However, the results might be somewhat biased because of the poor quality and small sample size of the included RCTs. Well-qualified clinical studies are needed to prove the effectiveness of Dachaihu decoction therapy for HLAP.

소아에서 급성 복증으로 오진될 수 있는 복성 간질 (Abdominal Epilepsy Misdiagnosed as Acute Surgical Condition in Childhood)

  • 심우신;정풍만
    • Advances in pediatric surgery
    • /
    • 제1권2호
    • /
    • pp.170-176
    • /
    • 1995
  • 저자들은 발작적인 복통 혹은 주기적인 구토를 주소로 내원한 8~11세의 소아 4명에서 임상 및 뇌파 소견을 종합하여 '복성간질'로 진단하고 항경련제로 치료하여 증상이 호전되어 문헌고찰과 함께 보고한다. 소아에서 원인을 알 수 없는 발작적인 복통 혹은 구토가 계속될 때 복성 간질을 고려하여 뇌파 검사를 시행하고 항경련제의 투여를 고려해야 할 것으로 사료된다.

  • PDF

토르소 원형설계를 위한 피복인간공학적 분석방법 (Clothing-ergonomical Analysis Method for the Basic Torso's Pattern Drafting)

  • 김혜경;서추연;석은영;강죽형;김지선;김혜수;허지혜
    • 대한인간공학회지
    • /
    • 제19권1호
    • /
    • pp.109-125
    • /
    • 2000
  • The purpose of this study was to provide basic data for a more functional torso's pattern by analyzing multidimensional anthropometric measurements and the wearing condition. For the functional torso's pattern drafting, the fitness state of basic torso's patterns(4 types) was compared and evaluated from the cross-sectioned overlap maps by $moir{\acute{e}}$ topography. The results were as follows: 1. According to the measurements of four patterns by using the one-dimensional measurement, the amount of ease in girth item for pattern A was the smallest. The ease of clothes was affected by the position of dart, the amount of dart, and the drafting method. 2. As the results of wearing evaluation by $moir{\acute{e}}$ topography method, pattern B had the largest space length for hip part, pattern A, C and D had the largest space length for bust part. Also, in the all measurement items, pattern A had the smallest amount of ease. The space length for bust and waist part of pattern B was smaller than pattern D, but, for abdomen and hip part of pattern B was larger than pattern D. The space length of pattern C was revealed intermediate for all measurement part. 3. The significant difference of space length of each pattern was shown in all parts except bust part(p<.05). The amount of space was affected by the amount of dart, the characteristics of the somatotype, and the drafting method.

  • PDF

Terrunoua type A 유촉에 의한 인체감염 1예 (A Human Case Infected by the Larva of Terranova type A in Korea)

  • 서병설;채종일이순형홍성함
    • Parasites, Hosts and Diseases
    • /
    • 제22권2호
    • /
    • pp.248-252
    • /
    • 1984
  • 아니사키스붙 유충(Anisakis-llke larva)에 의한 인체감염은 일본과 네델란드 등지에서 많은 증례가 알려져 있다. 이들 인체기생례의 대부분은 유충에 의한 감염이며 일부만이 A형 유충에 의한 것이다. 우리나라에는 지금까지 8예의 아니사키스춘이 보고되어 있으나 인두에서 완전한 충체를 꺼내어 멸라담담힐 type I 유충으로 기록한 헛 예를 제외하고는 종을 동정한 경우는 없다. 저자들은 1984연 7월 급성충수돌기염의 진단하에 수술을 시행한 23세 남자의 복륙에서 움직이는 백색 충체를 적출하고 배erranowa type A유충으로 동정하였다. 환자는 우하응부에 심한 통증이 있었고 좌하복부에도 압통이 있어 금성충수돌기염의 증상을 보였고 대동맥판막 협착중의 소견을 나타내었다. 환자는 어린때부터 생선회를 즐겨 먹었고 발병 2일전에도 먹은 기억이 있다고 하였다. 충수돌기절제술 시행도중 유맹부근처의 적장벽을 기어다니는 충체를 발견하게 되어 이 충체가 급성복증(acute abdomen)의 원인이었음을 확인하였다. 충체는길이 25.76mm,폭0.66mm이었고 맹탕이 위양식도(ventriculus)쪽으로 을라와 있었으며 충체후단에 mucron이 뚜렷하여 Terranova type A 유충으로 동정되었다. 따라서 이 증례는 우리나라에서 배erraneva 유충인 체감염에 대한 최초 보고례이다.

  • PDF

Laboratory Markers Indicating Gastrointestinal Involvement of Henoch-Schönlein Purpura in Children

  • Hong, Jeana;Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제18권1호
    • /
    • pp.39-47
    • /
    • 2015
  • Purpose: To determine clinically useful biochemical markers reflecting disease activity and/or gastrointestinal (GI) tract involvement in Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods: A total of 185 children with HSP and 130 controls were included. Laboratory data indicating inflammation, standard coagulation, and activated coagulation were analyzed for the HSP patients, including measurements of the hemoglobin level, white blood cell (WBC) count, absolute neutrophil count (ANC), platelet count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, prothrombin time, activated partial thromboplastin time, and fibrinogen, D-dimer, and fibrin degradation product (FDP) levels. The clinical scores of the skin, joints, abdomen, and kidneys were assessed during the acute and convalescence phases of HSP. Results: The WBC count, ANC, ESR, and CRP, fibrinogen, D-dimer, and FDP levels were significantly higher in the acute phase compared with the convalescent phase of HSP (p<0.05). The total clinical scores were more strongly correlated with the D-dimer (r=0.371, p<0.001) and FDP (r=0.369, p<0.001) levels than with inflammatory markers, such as the WBC count (r=0.241, p=0.001), ANC (r=0.261, p<0.001), and CRP (r=0.260, p<0.001) levels. The patients with GI symptoms had significantly higher ANC (median [interquartile range], 7,138.0 [4,446.4-9,470.0] vs. 5,534.1 [3,263.0-8,153.5], p<0.05) and CRP (0.49 [0.15-1.38] vs. 0.23 [0.01-0.67], p<0.05), D-dimer (2.63 [1.20-4.09] vs. 1.75 [0.62-3.39]), and FDP (7.10 [0.01-13.65] vs. 0.10 [0.01-7.90], p<0.05) levels than those without GI symptoms. Conclusion: D-dimer and FDPs are more strongly associated with disease activity and more consistently reflect GI involvement than inflammatory markers during the acute phase of HSP.

급성 충수염처럼 보인 복부 방선균증 1예 (Abdominal Actinomycosis Mimicking Acute Appendicitis in Children: a Case Report)

  • 최식경;방윤규;오현식;이진
    • Pediatric Infection and Vaccine
    • /
    • 제25권3호
    • /
    • pp.170-175
    • /
    • 2018
  • 방선균은 피부, 구강, 위장관 및 하부 여성 생식기에 정상균무리로 존재하며 증식속도가 느린 사상체의 형태를 한 혐기 그람 양성균이다. 방선균증은 방선균 감염에 의한 질환으로 대부분 경부 안면 감염증, 복부, 골반 감염증, 그리고 흉부 감염증의 임상 형태로 나타난다. 저자들은 급성 충수염으로 충수절제술을 받은 건강한 6세 남아에서 수술 후 조직검사에서 복부 방선균증을 진단하고 장기간 항생제 치료한 1예를 경험하고 보고하는 바이다. 복부 방선균증은 소아에서는 드문 질환이고 증상이 비특이적이며 균동정을 위한 배양검사가 까다로운 점이 있어 초기 진단이 잘 되지 않고 주로 임상 검체에서 특징적인 조직소견으로 진단되는 경우가 많다. 이를 통해 방선균의 특징을 이해하고 복통을 주소로 내원한 환자에서 정상균무리가 체내로 침입할 수 있는 선행 요인 등을 가진 경우 감별진단에 복부 방선균증도 염두에 두는 것이 바람직하겠다.