• Title/Summary/Keyword: acute abdomen

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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
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    • v.54 no.5
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    • pp.212-218
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    • 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
    • Journal of Pharmacopuncture
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    • v.21 no.2
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    • pp.120-125
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    • 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.

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

  • Park, Sul Gi;Park, So Hyun;Lee, Sun Haeng;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.33 no.1
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    • pp.58-77
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    • 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.

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

  • Kim, Dae-Jun;Roh, Seong-Soo
    • The Korea Journal of Herbology
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    • v.27 no.1
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    • pp.51-58
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    • 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.

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

  • Kim, Yoon-jung;Jung, Yu-jin;Park, Dong-il
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.306-325
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    • 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.

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

  • Shim, Ooh-Shin;Jung, Poong-Man
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.170-176
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    • 1995
  • Abdominal epilepsy is accepted as unusual cause of abdominal pain in children and young adolescents. Although its abdominal symptoms may be similar to those of the irritable bowel syndrome, it may be distinguished from the latter condition by the presence of the altered consciousness during some of attacks, EEG abnormalities, and a good response to anticonvulsant medication. The diagnosis of abdominal epilepsy came into vogue in the 1950s and 1960s as an explanation for childhood abdominal complaints. More recently, it has been recognized that isolated vomiting without loss of consciousness or other more common paroxysmal symtoms is rarely attributable to abdominal epilepsy. We report 4 cases of abdominal epilepsy, whose ages ranged from 8 to 11 years, with paroxysmal abdominal pain or vomiting consistent with a diagnosis of abdominal epilepsy.

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

  • Kim, Hye-Gyeong;Seo, Chu-Yeon;Seok, Eun-Yeong;Gang, Juk-Hyeong;Kim, Ji-Seon;Kim, Hye-Su;Heo, Ji-Hye
    • Journal of the Ergonomics Society of Korea
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    • v.19 no.1
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    • pp.109-125
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    • 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.

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

  • 서병설;채종일이순형홍성함
    • Parasites, Hosts and Diseases
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    • v.22 no.2
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    • pp.248-252
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    • 1984
  • A human case infected with Terranova type A larva was found in Korea. The patient was a 23-year old soldier of the Korean Army and the chief complaint was acute abdominal pain. The pain was chiefly at right lower quadrant. Appendectomy was performed under the clinical impression of acute appendicitis. However, during the surgery, a nematode larva was found moving on the serosal surface of terminal ileum. The worm was 25.76mm long and O. 66mm -wide, and had the intestinal cecum reaching to anterior one-third level of ventriculus and a mucron at posterior end. Therefore, it was diagnosed as Terranova type A larva. This is the first human case of Terranova type A larva infection in Korea.

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

  • Hong, Jeana;Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.39-47
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    • 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.

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

  • Choi, Sik Kyung;Bang, Yun Gyu;Oh, Hyeonsik;Lee, Jin
    • Pediatric Infection and Vaccine
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    • v.25 no.3
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    • pp.170-175
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    • 2018
  • Actinomyces are anaerobic, Gram-positive bacteria that are part of the endogenous flora of mucous membranes in humans. Infection caused by these bacteria is termed actinomycosis. The 3 most common types of actinomycosis are cervicofacial, abdominopelvic, and pulmonary. A previously healthy 6-year-old boy presented with the emergency room with fever, vomiting, and abdominal pain and initially diagnosed with acute appendicitis. Exploratory laparoscopy was done. Histologic finding demonstrated acute gangrenous appendicitis complicated by perforation and sulfur granules compatible with actinomycosis. Subsequently, he was diagnosed with abdominal actinomycosis and received long-term antibiotic therapy. Abdominal actinomycosis is uncommon in children and difficult to diagnose because of its nonspecific symptoms and of difficulties in growing Actinomyces in the clinical setting. It is necessary to include abdominal actinomycosis as a differential diagnosis of children presenting with abdominal pain.