• 제목/요약/키워드: digestive disease

검색결과 415건 처리시간 0.025초

Postoperative Clinical Outcomes of Colonic Stent Placement as Bridge-to-surgery vs. Emergency Surgery in Left-sided Malignant Colonic Obstruction

  • Choe, Eun Ju;Lee, Yong Kang;Jeon, Han Ho;Choi, Jong Won;Park, Byung Kyu;Won, Sun Young;Seo, Jeong Hun;Lee, Chun Kyon;Cho, Yong Suk
    • Journal of Digestive Cancer Reports
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    • 제9권2호
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    • pp.43-49
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    • 2021
  • Background/Aims: Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes. Methods: The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence. Results: Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-to-surgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridge-to-surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-to-surgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024). Conclusions: SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

Qualitative Content Analysis of Forest Healing Experience in Forest Life

  • Kang, Hee Won;Lee, Geo Lyong
    • 인간식물환경학회지
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    • 제24권3호
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    • pp.301-309
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    • 2021
  • Background and objective: The purpose of this study is to analyze the case of healing experience for lifestyle and environmental diseases through life and activities in the forest from the perspecitive of critical realism, and how the causal power and mechanism of the healing experience relate to forest healing factors and programs. Methods: 93 video data of people who started living in the forest for disease treatment were analyzed using a qualitative content analysis method from the perspective of critical realism. Categories for analysis include general categories (age, duration, occupation, disease name), forest therapy categories (climate therapy, plant therapy, water therapy, diet therapy, kinesiotherapy, psychotherapy), and other categories (ecology, learning and management, life tools), etc., and the unit of analysis is the context unit. Results: 1) The diseases that motivated life in the forest were digestive system diseases, lung diseases, cardiovascular diseases, endocrine system diseases, and various lifestyle-related diseases and environmental diseases in similar proportions. This indicates that forest life does not have specificity to respond to specific diseases, but provides treatment and recovery for all lifestyle and environmental diseases. 2) Among the forest therapies, climate therapy and plant therapy are related to the climatic and residential environment in the forest where 'natural persons' live. And others such as water therapy, diet therapy, kinesiotherapy, psychotherapy indicate the change from the lifestyle that caused the disease to the lifestyle for treatment and recovery. Conclusion: Life and activities in the forest provide an environment for treatment and recovery in which the healing principles such as aromatherapy, nutritional and dietary therapy, kinesiotherapy, and emotional psychotherapy are integrated in the 'real world'.

Prevalence of giardiasis of stray cats in the Daejeon city

  • Dong-Kwan, Lee;Han-Joon, Lee;Joong-Hyun, Song;Kun-Ho, Song
    • 한국동물위생학회지
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    • 제45권4호
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    • pp.249-252
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    • 2022
  • Giardiasis is widespread all over the world, and it is a disease that causes both acute and chronic digestive symptoms. It is zoonotic disease that affects animals and humans. There are few studies on giardiasis in stray cats due to difficulties in catching and sampling. Therefore, this study evaluated the prevalence of giardiasis in stray cats in the Daejeon city because of increasing interest as zoonotic disease. The specimens were the feces of stray cats captured for the neutering project (TNR) in Daejeon; 30 fecal samples were collected from 2021 to 2022 in each of 5 districts in Daejeon. A total of 150 samples were collected. All samples were tested for giardiasis using the Giardia SNAP kit (SNAP test, IDEXX Laboratories. Inc., Westbrook, ME). The overall prevalence rate was 46 out of 150 cats (30.7%). By age, 25 out of 71 juvenile cats (35.2%) were positive, and 21 out of 79 adult cats (26.6%) were positive. A total of 19 out of 69 cats (27.5%) with diarrhea were positive, and 27 out of 81 asymptomatic cats (33.3%) were positive. For gender, 38 out of 99 females (38.4%) were positive, and 8 out of 51 males (15.7%) were positive. The positive rate of giardiasis in stray cats was over 30%, which is high compared to other research results. It is necessary to increase the public's awareness of the value of deworming stray cats and the sanitation of people who have come into contact with them.

A Case of 1-Month Fever Caused by CMV Infection in a Patient With MIS-C Treated With IVIG, Infliximab, and High-Dose Methylprednisolone

  • Gihun Jeong;Jihye You
    • Pediatric Infection and Vaccine
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    • 제31권1호
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    • pp.140-146
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    • 2024
  • 소아 다기관 염증 증후군(multisystem inflammatory syndrome in children, MIS-C)은 코로나바이러스감염증-19 (코로나 19; coronavirus disease 2019, COVID-19)의 드문 합병증으로 심장, 폐, 신장, 소화관 및 신경계를 포함한 다기관 손상을 일으킨다. 코로나19 팬데믹 이후 MIS-C 사례가 증가함에 따라 MIS-C에 대한 적절한 치료의 중요성이 강조되고 있다. anakinra, infliximab, 스테로이드와 같은 면역 조절제는 MIS-C에 대한 intravenous immunoglobulin (IVIG)의 1차 치료에 대한 추가 요법으로 고려되지만 cytomegalovirus (CMV), Epstein-Barr 바이러스 및 결핵과 같은 2차 감염을 유발할 소지가 있다. 저자들 MIS-C로 IVIG, steroid 및 infliximab을 투여한 환자에서 동반된 CMV 감염으로 인하여 약 한달간 지속되는 발열이 발생한 3세 남아의 증례 1례를 처음으로 보고하였다.

종합 건강검진 과정에서 나타난 일부 중년기 여성의 건강문제 (Health Problem of the Middle-Aged Women)

  • 성미혜
    • 대한간호학회지
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    • 제29권2호
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    • pp.258-270
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    • 1999
  • This study was carried out to offer the basic data for more qualitative lives of the middle-aged women through their health maintenance and control. So, the researcher reviewed and analyzed the health problems of the middle-aged women, the differences of main symptoms in each subject, positive ratcs in screening tests, the difference of screening tests with age and the correlation of obesity and blood pressure with screening tests. All subjects were 218 women(40-59years) who had a check-up at a comprehensive health check-up center in K University Hospital in Seoul from July 1, 1998 to August 31. 1998. Questionaires were developed to get subjects, general characteristics. main symptoms, medical examination and diagnosed disease by the researcher referring through the questionaires of comprehensive health check-up center and the medical recorders were used as a tool of study. The researcher analyzed the data with SPSS PC+ ; the distribution of the subjects, general characteristics and main symptoms with percentage : the difference between main symptoms and screening tests with X$^2$-test, ANOVA. The results are as follows. 1) Among the age distribution, most were 40-45 years old and unemployed. 2) The most common complaints were indigestion in digestive system, cough in respiratory system, heart beat in cardiovascular system, general sweat in endocrine system. edema in urinary system, easy bruise in hematologic system, backache in musculoskeletal system, headache in psychoneurologic system, lochia in gynecology, itch in dermatology system, eye ball pain in visual system and tinnitus in auditory system. 3) In main symptoms according to age, the 40-45 age group had a higher rate of complaints in digestive system and gynecology than other age group ; the 46-49 age group in endocrine system. 4) The main symptoms according to diagnosis had no difference statistically. 5) The screening tests which showed high rates of abnormality were mammography(the highest), abdominal ultrasonography, upper gastrointestinal series/gastrofiberscopy, PFT. In all age group the highest rate of abnormality was seen in mammography. 6) In screening tests according to age. the 46-49 age group showed higher positive rates of pap smear, blood sugar test, urine test than any other age group ; the 50-55 age group showerd higher positive rates of obesity, BP, chest X-ray, abdominal ultrasonography, ESR, SGOT, CRP and urine micro. 7) In correlation of obesity with screening test, the obesity group showed higher positive rates of blood pressure, chest X-ray, abdominal ultrasonography, HCT and CRP than the normal weight group. 8) In correlation of blood pressure with screening test, the hypertension group showed higher positive rate of obesity, chest X-ray, abdominal ultrasonography, pap smear and blood sugar than the normal blood pressure group. In conculusion, the middle-aged women have various physical symptoms and affected by age. The obesity and BP have an important effect on the health of the middle aged women. Therefore, this study is considered significant as data for qualitative lives of the middle-aged women playing an important part of family health care by catching of their health problem complaints for prevention of disease and promotion of health.

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응급실 체류 중에 의식이 저하된 환자의 특성: 의식명료 환자와의 비교연구 (Characteristics of patients with decreased mental status while staying in an emergency department: Comparative study with alert patients)

  • 문선희
    • 한국산학기술학회논문지
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    • 제19권10호
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    • pp.222-230
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    • 2018
  • 본 연구는 내원 당시에는 의식이 명료했으나 응급실 체류 중에 의식이 저하된 환자의 특성을 의식이 명료한 환자와 비교하여 파악하기 위한 후향적 조사연구이다. 연구대상은 일개 응급실에 방문한 응급환자 중 내원 당시에는 의식이 명료했으나 내원 후 의식저하를 보인 환자 90명과 내원당시 의식이 명료했으며 응급실 체류 중에도 의식저하가 없는 환자 중 무작위 추출한 100명이었다. 연구결과 의식저하 군은 의식명료 군에 비해 뇌혈관 질환, 간질환, 당뇨, 고혈압의 기저질환이 많았다(p=.001, p=.003, p<.001, and p=.002, respectively). 중증도 분류 결과 의식저하 군은 의식명료 군에 비해 중증도가 높았다(p<.001). 의식저하 군의 최종 진단명은 신경계 질환 64.9%, 소화기계 질환 63.3%로 의식명료 군과 차이가 있었다(p<.001). 의식저하 군 중 56명(62.2%)은 응급실 간호사에 의해 의식저하 상태가 발견되었다. 의식저하 군 중 9명은 심정지가 발생하여 심폐소생술을 받았다. 본 연구결과 응급실 간호사는 응급실 내원 당시 의식이 명료하더라도 중증도가 높고, 신경계 질환이나 소화기계 질환이 의심되는 환자는 의식수준을 자주 사정해야 함을 시사한다.

수지침 경험자들의 수지침에 대한 효율성과 효과성 인식정도 (Recognition of Efficiency and Effectiveness of the Experiences with Hand Acupuncture)

  • 이연주;박경민
    • 지역사회간호학회지
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    • 제12권1호
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    • pp.278-287
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    • 2001
  • The purpose of this study is to provide with basic information on application of hand acupuncture as a complementary and alternative therapy by giving some recognition of efficiency and effectiveness of hand acupuncture. And so, answers for questionnaires of 290 respondents were used for this research and collected from June 5 through 13, 1999 from adults twenty and over who were participating in the hand acupuncture training program in Seoul and had some direct experiences with hand acupuncture therapy, whatever they had been treated and/or had treated. To secure reliability of measurement tool. Cronbach'a has been calculated and Factor Analysis was done as Validity Analysis of question classification. Demograprucal characteristics of hand acupuncture experienced people and factors related to hand acupuncture experiences are calculated based on the real number and percentage. The degree of recognition of efficiency and effectiveness of hand acupuncture is made as average and standard deviation, while the degree of recognition of efficiency and effectiveness based on general characteristics come from one-way ANOVA. 1. According to socio-demographical analysis. the questioned could be classified firstly as age (40-49 : 32.5%. 30-39 : 24.9%. 50-59 : 21.9%. 60-69 : 14.7%. 20-29 : 6.0%). secondly gender (male 36.6%. female 63.4%). thirdly occupation (housewife: 43.8%. self-employed: 15.5%. company-employee: 14.8%). fourthly education (high school graduate: 41.9%, college graduate: 37.9%), and lastly monthly-income (1 to 2 million: 51.4%. 2 to 3 million: 20,3%) 2, As for the general aspects related to hand acupuncture. 80,0% of the respondents answered almost zero for the monthly average number of visit to hospital and 15.5% responded 1 to 2 visits, 6,2% of the respondents is complaining of a disorder of digestive system. 19,0% circulatory disease, 10.7% bad nervous system. By utilizing hand acupuncture, 84% of the questioned have following experiences in curing diseases: digestive system 47.3%, circulatory system 9.3%, nervous system 8.3%, 54,1% are curing 1 to 2 and 10.3% 3 to 4 patients on a daily basis with hand acupuncture. Research on the demerits of giving medical treatment with hand acupuncture shows 23,8% are feeling economic burden. 16.6% difficulty of learning and 16.2% weak theoretical backgrounds. 3. Among the efficiency recognition, possibility of general application is average 4,29 and simple treatment is 4,19. economic merits 4.36. possibility of establishment with supplementary and alternative medicine 4.17, medical effectiveness 4.09. 4, As a result of demographical analysis on the efficiency and effectiveness of hand acupuncture therapy, it appears that the recognition of efficiency based on occupation and the recognition of effectiveness based on monthly income are most significant to be noticed. In an orderly fashion. government-employee, self-employed, company-employee. and then housewife have perceived hand acupuncture very efficiently, And those who recognize hand acupuncture to be most effective are people earn 1 million to 2 million won a month, 5. The efficiency(p = .003) and effectiveness (p= .049) of hand acupuncture therapy by number of visit to hospital were statiscally significant, and effectiveness of hand acupuncture therapy by disease exist was statiscally significant (p= .033).

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Aeromonas veronii의 실험적 감염에 의한 양식 메기, Silurus asotus의 병리학적 변화 (Pathological Changes in Cultured Korean Catfish (Silurus asotus) Artficially Infected with Aeromonas veronii)

  • 김진도;도정완;최혜승;서정수;정승희;조혜인;박명애;이남실;박성우
    • 환경생물
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    • 제31권4호
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    • pp.486-492
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    • 2013
  • 최근 국내의 양식 메기에 표피 박리와 근육 괴사를 특징으로 하는 새로운 질병이 발생하였다. 그 폐사율은 낮으나 질병으로 인한 상품가치의 저하로 경제적 손실이 크다. 병어로부터 원인균을 분리하고 자연감염어와 인위감염어의 병리학적 변화를 관찰하였다. 원인균은 Aeromonas veronii로 동정되었으며, 원인균을 건강어에 인위감염시켜 폐사 및 증상의 발현을 매일 관찰하였다. 인위감염된 어류의 증상은 자연감염어와 유사하였으며 원인균을 감염시킨 후 7일 이내에 모두 폐사하였다. 병어의 조직표본을 제작하여 관찰한 결과, 자연감염어의 간, 비장, 신장의 울혈 및 간세포 변성과 비장 협조직의 초자적변성이 관찰되었으며, 특히 심장에서 염증성 변성과 세균응집체가 관찰되었다. 소화관에서의 울혈과 점막고 유층의 섬유화 현상도 특징적이었다. 자연감염어에 비해 약한 경향이지만 인위감염어의 조직학적 변화도 관찰되었으며, 소화관에서의 조직학적 변성은 관찰되지 않았다.

간흡충 충체의 부위별 항원성에 대한 면역조직화학적 연구 (Immunohistochemical study on the antigenicity of each organ structure of Clonorchis sinensis)

  • Jin Kim;Jong-Yil Chai;Weon-Gyu Kho;Kyu-Hyuk Cho;Soon-Hyung Lee
    • Parasites, Hosts and Diseases
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    • 제29권1호
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    • pp.21-30
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    • 1991
  • 간흡충의 충체 부위별 항원성을 알아보고자 면역조직화차적 방법을 이용하여 간흡충의 소화기관, 생식기관, 배설기관, 흡반, 표피 등의 염색강도를 비교 관찰하였다. 간흡충 실험 감염 후 2~8주 된 토끼에서 담관 내 충체를 포함하는 간 조직을 얻어 중성 포르말린 용액에 고정하고 파라핀으로 포매한 다음 4 $\mu\textrm{m}$두께로 잘라 항원으로 이용하였다. 항-간흡충 항체(1차 항체)는 실험 감염 10주 된 고양이 혈청을 희석하여 사용하였고 peroBidaseconjugated goat anti-cat IgG를 2차 항체로 하여 간접 면역효소 염색을 시행하였다. 가장 적합한 1차 항체의 희석 농도는 1 : 1,000~1 : 2,000, 2차 항체의 희석 농도는 1 : 1,000이었다. 충체의 장 상피세포, 장 내용물 및 배설낭은 1차 항체 희석 농도 1 : 1,000~1 : 2,000에서 강한 양성 반응을 보인 반면, 자궁 및 일부 자궁 내 충란, 난관선, 웅성 생식기관 등은 1차 항체 회석 농도 1 : 1,000에서 미약한 양성 반응을 나타내었다. 한편, 흡반, 표피, 표피하 세포, 충체 실질 등은 1차 항체 회석 농도 1 : 1,000에서도 음성 반응을 나타내었다. 이상의 결과를 종합하면, 간흡충 감염시 숙주의 항체 반응은 충체의 소화-분비 기관에서 유래된 이른바 분비-배설 항원에 의해 가자 강력하게 유발되는 것으로 추측된다.

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Prospective Multicenter Study of the Challenges Inherent in Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction

  • Yang, Min Jae;Kim, Jin Hong;Hwang, Jae Chul;Yoo, Byung Moo;Lee, Sang Hyub;Ryu, Ji Kon;Kim, Yong-Tae;Woo, Sang Myung;Lee, Woo Jin;Jeong, Seok;Lee, Don Haeng
    • Gut and Liver
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    • 제12권6호
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    • pp.722-727
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    • 2018
  • Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.