• Title/Summary/Keyword: emergency surgery

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Intestinal Neuronal Dysplasia in Twins (쌍생아에서 발생한 Intestinal Neuronal Dysplasia)

  • Lim, In-Suk;Chung, Ju-Young;Choi, Myung-Jai;Kim, Sang-Woo;Kim, Hong-Ju;Kim, Jeong-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.202-207
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    • 2003
  • Intestinal neuronal dysplasia (IND) is a disorder of abnormal intestinal innervation resulting in dysfunctional colonic motility. IND shares clinical features with Hirschsprung's disease but differentiated by histological findings such as hyperplasia of submucosal and myenteric plexuses, giant ganglia, ectopic ganglion cell and increased acetylcholinesterase activity in lamina propria. Although IND may exist as an isolated condition, more commonly, it occurs in association with Hirschsprung's disease. We report a case of twins affected with IND. Both children manifested with delayed passage of meconium and severe abdominal distention after birth. Barium enema in both patients showed microcolon. They underwent emergency ileostomy under the impression of total aganglionosis. But surgical biopsy specimens showed hyperganglionosis in submucosa with formation of giant ganglia. Both neonates suffers from several episodes of peudo-obstruction after the repair operation of colostomy.

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Surgical treatment of recurrent pseudochylothorax occurring after therapy of tuberculous pleurisy (결핵성 흉막염 치료 후 반복되는 가성유미흉의 수술적 치료)

  • Yi, Jae Ryung;Kim, Woo Sik;Jeong, Eun Jung;Jung, Yu Na;Lee, Hee Sook;Jo, Gi Ho;Lee, Ji Yeon
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.65-68
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    • 2014
  • Pseudochylothorax is an uncommon pleural effusion disease characterized by the presence of cholesterol crystals or high lipid content not resulting from a disrupted thoracic duct. Most of the cases reported so far had been found in patients with long-standing pleural effusion due to a chronic inflammatory disease such as old tuberculous pleurisy or chronic rheumatoid pleurisy. Authors encountered a case of pseudochylothorax in a 45-year-old man who had been treated for tuberculous pleurisy 6 years before his visit to authors' hospital. After that, he had visited the emergency department many times for removal of pleural effusion. The patient's chest X-ray revealed dyspnea and large left-sided pleural effusion. Although a large amount of pleural fluid was removed with a drainage catheter, massive pleural effusion was likely to recur, and the underlying lung was able to fully re-expand. Accordingly, decortication was done, and the patient's symptom was improved without postoperative complications.

Coronavirus Disease (COVID-19) Outbreak and Its Impact on Spinal Daily Practice : Preliminary Report from a Single (Regional) University Hospital in Republic of Korea

  • Ham, Chang Hwa;Moon, Hong Joo;Kim, Joo Han;Park, Youn-Kwan;Lee, Tae Hoon;Kwon, Woo-Keun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.407-414
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    • 2020
  • Objective : Since the first discovery of the 2019 novel coronavirus (COVID-19), rapid and wide spread of the disease has been reported and the World Health Organization announced that a 'pandemic' has started. Up to date there is little known regarding the impact of this outbreak on spinal specialists' daily clinical practice. We intended to evaluate how COVID-19 has affected the number of spinal disease patients we meet and operate in daily practice. Methods : The de-identified data regarding number of patients visiting the spine clinic at a tertiary referral hospital and a secondary level hospital from January, February and March of 2017 to 2020 were retrospectively reviewed. The number of out-patient department (OPD) visits, number of emergency room (ER) visits as well as number of surgeries performed during the reviewed period were collected and analyzed, comparing 2020 to the previous 3 years. Results : The number of daily OPD visits showed a steady decrease starting from January, and presented a statistically significant decrease by early March 2020, compared to the previous 3 years. During the same period, decrease in number of daily ER visits was statistically significant as well. The number of elective surgeries or number of surgeries for patients admitted via ER during COVID-19 outbreak remained similar to that of 2017-2019 suggesting, despite the decrease of patients visiting the hospital for spinal diseases, those whom required surgery still visited the hospital. The results were consistant among other hospital level. Conclusion : The outbreak of COVID-19 affected our daily practice as OPD and ER visits reduced but did not affect the number of surgeries. We believe that this report will be informative to spinal specialists worldwide fighting the COVID-19 pandemic.

Seroprevalence of Toxoplasma gondii Infection and Characteristics of Seropositive Patients in General Hospitals in Daejeon, Korea

  • Shin, Dae-Whan;Cha, Dong-Yeub;Hua, Quan Juan;Cha, Guang-Ho;Lee, Young-Ha
    • Parasites, Hosts and Diseases
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    • v.47 no.2
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    • pp.125-130
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    • 2009
  • To figure out the epidemiological status and relevance with other diseases in toxoplasmosis, we checked serum IgG antibody titers of 1,265 patients and medical records of seropositive patients. Seropositive rates were 6.6% by latex agglutination test (LAT) and 6.7% by ELISA. No significant differences were detected between sexes and age groups. The peak seroprevalence was detected in the 40-49-year-old age group. According to clinical department, Toxoplasma-positive rates were high in patients in psychiatry, ophthalmology, health management, emergency medicine, and thoracic surgery. Major coincidental diseases in seropositive cases were malignant neoplasms, diabetes mellitus, arthritis, chronic hepatitis B, chronic renal diseases, schizophrenia, and acute lymphadenitis, in the order of frequency. In particular, some patients with chronic hepatitis B and malignant neoplasms had high antibody titers. These results revealed that the seroprevalence of toxoplasmosis in a general hospital-based study was similar to that in a community-based study, and T. gondii seropositivity may be associated with neoplasms, diabetes, and other chronic infections.

Chest Pain due to Rapidly Developed Metastatic Spinal Tumor - A case report - (급속도로 진행된 전이성 척추종양에 의한 흉통)

  • Lee, Jun-Hak;Kim, Hyung-Tae;Mun, Cheol-Sin;Heo, Hyeon-Eon;Kwon, Young-Eun
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.88-94
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    • 2009
  • Chest pain is a symptom observed commonly in outpatients and emergency room patients, and its causes are variable. Because treatment and prognosis of chest pain are different depending on its cause, it is more important than anything else to accurately diagnose the cause of chest pain. Most of patients complaining of chest pain undergo basic tests at a private local clinic or at the Internal medicine or chest surgery department of a general hospital and, they are referred to the pain clinic, with a note stating no particular finding. However, if they have sustained severe neuropathic pain in spite of nerve block, accurate diagnosis for chest pain is essential. We experienced rapidly developing spine breakdown and cord compression caused by metastatic spinal tumor in an inpatient who was being treated for chest pain, and thus, we report here in the case with literature review.

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A Case of Severe Acute Respiratory Distress Syndrome Treated with Extracorporeal Life Support (체외생명보조를 이용한 중증 급성호흡곤란증후군 치료 1예)

  • Kim, Young Mook;Lee, Jue Yong;Lee, Myung-Goo;Lee, Chang Youl;Kim, Go Woon;Sohn, Kyoung Min;Yang, Ha Na;Kim, Dae Yong;Choi, Hyun Hee;Kim, Hyoung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.6
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    • pp.526-530
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    • 2007
  • The incidence of acute respiratory distress syndrome (ARDS) has been estimated worldwide to range from 1.7 to 75 cases per 100,000. There are many treatments for ARDS, but only the low tidal volume strategy is based on strong clinical evidence from randomized clinical trials. The efficacy of extracorporeal life support (ECLS) in adults remains controversial. Ongoing clinical trials and research have shown a benefit for its use to salvage severe ARDS patients that are in failure with conventional treatment. We encountered a 41-year-old woman who developed ARDS induced by pneumococcal pneumonia. Despite conventional mechanical ventilation in the emergency room, severe hypoxia remained. We treated the patient immediately with ECLS. The patient has almost fully recovered, and was discharged from a 177-day stay at our hospital.

A Case of Norepinephrine Secreting Pheochromocytoma in a Dog (개에서 Norepinephrine 분비 갈색세포종 증례1)

  • Choi, Ul-Soo;Kim, Dong-Hoon;Kim, Hyun-Wook;Choi, Ji-Hye;Jang, Jae-Young
    • Journal of Veterinary Clinics
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    • v.26 no.3
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    • pp.268-272
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    • 2009
  • An-11-year-old male Shih-tzu was admitted to emergency care unit of Haemaru Referral Animal Hospital with signs of dyspnea, anuria and depression. There were abnormalities on complete blood count and serum chemistry included leukocytosis with mild left shift, mild azotemia, and increased ALT activity. Fluid therapy(0.9% saline, 40 ml/hr) and antibiotics were immediately initiated. The patient began to vomit after 5 hours' rest and pale mucous membrane, bradycardia, and hypertension were noted. Abdominal ultrasonography revealed enlarged left adrenal gland and thrombus in caudal vena cava(CVC). Result of ACTH stimulation test was normal. Cytology of ultrasound-guided FNA smears showed numerous naked nuclei, which was suggestive of adrenal medullar tumor. Concentrations of 24 hour urine metanephrine and normetanephrine was moderately increased compared to those of a control dog. Adrenal mass was surgically removed, and biopsy of the CVC mass was obtained. After surgery the patient began to recover but the dog acutely developed cardiopulmonary arrest and died. On histopathology the adrenal mass and biopsy of the CVC mass were consistent with pheochromocytoma. On electron microscopic view norepinephrine specific granules were found in the cytoplasm of tumor cells.

Risk factors of delayed diagnosis of acute appendicitis in children: for early detection of acute appendicitis

  • Choi, Jea Yeon;Ryoo, Eell;Jo, Jeong Hyun;Hann, Tchah;Kim, Seong Min
    • Clinical and Experimental Pediatrics
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    • v.59 no.9
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    • pp.368-373
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    • 2016
  • Purpose: This study examined the risk factors of a delayed diagnosis of acute appendicitis in children undergoing an appendectomy. Methods: This retrospective study involved children aged below 18 years, who underwent an appendectomy. After dividing them into a delayed diagnosis group and nondelayed diagnosis group according to the time interval between the initial hospital visit and final diagnosis, the risk factors of delayed diagnosis were identified using logistic regression analysis. Results: Among 712 patients, 105 patients (14.7%) were classified in the delayed diagnosis group; 92 patients (12.9%) were diagnosed using ultrasonography (US), and both US and computed tomography were performed in 38 patients (5.3%). More patients in the delayed diagnosis group underwent US (P=0.03). Spring season and prior local clinic visit were significantly associated with a delayed diagnosis. Fever and diarrhea were more common in the delayed diagnosis group (fever: odds ratio [OR], 1.37; 95% confidence interval [CI], 1.05-1.81; diarrhea: OR, 1.94; 95% CI, 1.08-3.46; P<0.05). These patients showed symptoms for a longer duration (OR, 2.59; 95% CI, 1.78-3.78; P<0.05), and the admission course (OR, 1.26; 95% CI, 1.11-1.44; P<0.05) and C-reactive protein (CRP) levels (OR, 1.47; 95% CI, 1.19-1.82; P<0.05) were associated with the delayed diagnosis. Conclusion: To decrease the rate of delayed diagnoses of acute appendicitis, symptoms such as fever and diarrhea, seasonal variations, admission course, and CRP levels should be considered and children with a longer duration of symptoms should be closely monitored.

Anthocyanins from the Fruit of Vitis Coignetiae Pulliat Inhibit TNF-Augmented Cancer Proliferation, Migration, and Invasion in A549 Cells

  • Lu, Jing Nan;Panchanathan, Radha;Lee, Won Sup;Kim, Hye Jung;Kim, Dong Hoon;Choi, Yung Hyun;Kim, GonSup;Shin, Sung Chul;Hong, Soon Chan
    • Asian Pacific Journal of Cancer Prevention
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    • v.18 no.11
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    • pp.2919-2923
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    • 2017
  • Objective: Anthocyanins belong to a class of flavonoids, exhibiting antioxidant and anti-inflammatory actions have been reported to have anti-cancer effects. Here, we investigated whether anthocyanins can inhibit cancer cell proliferation, invasion, and angiogenesis in human lung cancer A549 cells, which are critically involved in cancer metastasis. Methods: We used anthocyanins from fruits of Vitis coignetiae Pulliat (AIMs) which has been used in Korean folk medicine for the treatment of inflammatory diseases and cancers. We have performed cell proliferation assays, cell invasion assay, gelatin zymography, wound healing assay and western blotting to examine whether anthocyanins can inhibit cancer cell proliferation, invasion, and angiogenesis in A549 cells. Result: AIMs did not inhibit cancer cell proliferation on A549 cells. Also, AIMs suppressed cancer migration, and invasion by supressing MMP-2 and MMP-9 expression. The Immuno-blotting results also revealed that AIMs suppressed the proteins involved in cancer proliferation (COX-2, C-myc, cyclin D1), migration and invasion (MMP-2, MMP-9), anti-apoptosis (XIAP, and c-IAP2), adhesion and angiogenesis (ICAM-1, VEGF). Conclusion: This study demonstrates that the anthocyanins isolated from fruits of Vitis coignetiae Pulliat inhibit cancer proliferation, cancer migration, and invasion that is involve in cancer-metastasis. This study provides evidence that AIMs might have anti-cancer effects on human lung cancer.

The Knowledge and Confidence in Performance on Patient Safety among Health-Related Majors : Convergent Approach (보건계열 학생의 환자안전 지식 및 수행 자신감 : 융복합적 접근)

  • Lee, Mi Hyang;Park, Jung Hee;Bae, Seok Hwan
    • Journal of Digital Convergence
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    • v.17 no.1
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    • pp.219-227
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    • 2019
  • The purpose of this study was to investigate the knowledge on patient safety and performance confidence for the subject of health-related major students. Participants were 349 Health-related majors. Data were analyzed using SPSS 21.0. According to the study results, correct answer rate for patients' knowledge on safety was 65.7% in average. Average point of performance confidence was $7.11{\pm}1.74$. Considering in terms of question, patient identification was high, while effective communication was shown to be low. Patient identification, communication, surgery procedure, fall, patient's safety accident report as the lower domain for patients' knowledge on safety and performance confidence had a positive correlation, while knowledge and infection management, facility environment had a negative correlation for health-related major students, development of patients' safety education program is needed to enhance importance of patients' safety before clinical practice and to allow implementation of safe clinical practice.