• Title/Summary/Keyword: intractable

Search Result 684, Processing Time 0.023 seconds

Effect of Cnidium officinale Makino Aqua-acupuncture Solution on Carcinogen-induced Carcinogenesis in In vitro (In vitro에서 발암물질에 의한 발암진행에 미치는 천궁약침액의 영향)

  • Han Sang-Hoon;No Dong-Il;Lee Ki-Tek;Shon Yun-Hee;Baek Tae-Seon;Nam Kyung-Soo;Lim Jong-Kook
    • Korean Journal of Acupuncture
    • /
    • v.19 no.1
    • /
    • pp.7-13
    • /
    • 2002
  • The effects of Cnidium officinale Makino aqua-acupuncture solution (COMAS) and Cnidium officinale Makino water-extraced solution (COMWS) on the CYP1A1 activity and benzo[a]pyrene(B[a]P)-DNA adduct formation were examined. There were 6.8%, 12.1%, 15.1%, 18.3% and 22.6% inhibition in the activity of cytochrome 4501A1 enzyme with the treatment of $0.1{\times},\;0.5{\times},\;1{\times},\;3{\times},\;and\;5{\times}$ COMAS, respectively. At concentration of $0.1{\times}$ COMAS, the binding of $[^3H]B[a]P$ metabolites to DNA of NCTC-clone 1469 cell was significantly inhibited by 56.9%. These results suggest that COMAS has chemopreventive potential by inhibiting cytochrome P4501A1 activity and benzo[a]pyrene-DNA adduct formation.

  • PDF

Long-term Results of Stereotactic Psychosurgery (뇌정위적 정신수술의 장기 추적 결과)

  • Son, Byung-Chul;Kim, Moon-Chan;Lee, Chul;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
    • /
    • v.29 no.4
    • /
    • pp.514-520
    • /
    • 2000
  • Objective : Stereotactic psychosurgery is known as one of effective means of treating in some medically intractable psychiatric illness. However, it is unfamiliar and it's long-term clinical result has not reported in our country. The authors evaluated its long-term results of pscychosurgery and discussed its neuroanatomical basis. Methods : Since 1993, eight patients underwent stereotactic psychosurgery for medically intractable psychiatric illnesses. All were referred from psychiatrist of these disorders, one was aggressive behavior, five were obsessive-compulsive disorders(OCD), and two were depression with anxiety disorders. Bilateral amygdalotomy and subcaudate tractotomy were done for aggressive behavior, and limbic leukotomy was done for OCD and depression with anxiety. The results of OCD were evaluated with with YBOCS(Yale-Brown obsessive compulsive scale) and VAS (visual analogue scale), CGI(clinical global impairment) in OCD, and OAS(overt aggression scale), MMS, WAIS were checked for the evaluation of aggressive behavior. Hamilton depression scale(HAMD) was used for evaluation of depression. Ventriculography was used in the first five patients and MR-guided stereotaxy was used in recent three cases for localization of target. The lesions were made with radiofrequency lesion generator. Results : With long-term follow up(mean 45 months) in five OCDs, mean YBOCS declined from 34 to 3(n=5). All returned to previous social life. In OAS scores of aggressive behavior during six-year follow up, scores declined from 8 to 2 with clinical improvement. In two patients with depression with anxiety, HAMD declined from 28.5 to 16.5(n=2). There was no operative mortality and no significant morbidity except one case of mild transient urinary incontinence. Conclusion : With these long-term results, authors assumed that stereotactic psychosurgery could be one of safe and effective mtherapeutic methods in several medically intractable psychiatric illness.

  • PDF

A Case Report of Central Nervous System Disorder Induced Intractable Hiccups Treated with Korean Medicine (중추신경계 질환자에게 이환된 난치성 딸꾹질의 한방치험1례)

  • Moon, Jiseong;Min, Seonwoo;Kim, Yeseul;Park, Jiyoon;Hong, Junghwa;Choi, Dong-jun
    • The Journal of Internal Korean Medicine
    • /
    • v.43 no.2
    • /
    • pp.191-200
    • /
    • 2022
  • Intractable hiccups are those which persist for more than one month and can often occur in patients with disorders of the central nervous system, such as stroke, epilepsy, or brain tumor. An 80-year-old male patient undergoing conservative hemodialysis for diabetic nephropathy, recently developed paralysis and dysphagia due to central nervous system complications including stroke and epilepsy. He was admitted to the ◯◯ Oriental Medicine Hospital, and treated with herbal medicine (Gyulpijugyeo-tang, Jeonssiigong-san, and Ijin-tang) and electrical acupuncture for 30 days. No side effects were observed during hospitalization. The frequency and duration of hiccups were measured daily and found to reduce, and the effect persisted during his admission. The patient took no other nervous system drugs. In conclusion, Korean medicine like gyulpijugyeo-tang and acupuncture can be effective for patients with intractable hiccups who cannot use alternative drugs or treatment, because of other complications.

Delayed Sternal Closure Using a Vacuum-Assisted Closure System in Adult Cardiac Surgery

  • Hyun Ah Lim;Jinwon Shin;Min Seop Jo;Yong Jin Chang;Deog Gon Cho;Hyung Tae Sim
    • Journal of Chest Surgery
    • /
    • v.56 no.3
    • /
    • pp.206-212
    • /
    • 2023
  • Background: Delayed sternal closure (DSC) is a useful option for patients with intractable bleeding and hemodynamic instability due to prolonged cardiopulmonary bypass and a preoperative bleeding tendency. Vacuum-assisted closure (VAC) has been widely used for sternal wound problems, but only rarely for DSC, and its efficacy for mediastinal drainage immediately after cardiac surgery has not been well established. Therefore, we evaluated the usefulness of DSC using VAC in adult cardiac surgery. Methods: We analyzed 33 patients who underwent DSC using VAC from January 2017 to July 2022. After packing sterile gauze around the heart surface and great vessels, VAC was applied directly without sternal self-retaining retractors and mediastinal drain tubes. Results: Twenty-one patients (63.6%) underwent emergency surgery for conditions including type A acute aortic dissection (n=13), and 8 patients (24.2%) received postoperative extracorporeal membrane oxygenation support. Intractable bleeding (n=25) was the most common reason for an open sternum. The median duration of open sternum was 2 days (interquartile range [25th-75th pertentiles], 2-3.25 days) and 9 patients underwent VAC application more than once. The overall in-hospital mortality rate was 27.3%. Superficial wound problems occurred in 10 patients (30.3%), and there were no deep sternal wound infections. Conclusion: For patients with an open sternum, VAC alone, which is effective for mediastinal drainage and cardiac decompression, had an acceptable superficial wound infection rate and no deep sternal wound infections. In adult cardiac surgery, DSC using VAC may be useful in patients with intractable bleeding or unstable hemodynamics with myocardial edema.

Analysis of Treatment Failure for the Pulmonary and Neck Tuberculosis (폐 및 경부 결핵에서 항결핵제에 의한 치료실패 원인분석)

  • Jeon, Chang-Ho;Lee, Sang-Chae;Hyun, Dae-Sung;Choe, Jung-Yoon;Shin, Im-Hee;Sohn, Jin-Ho
    • Tuberculosis and Respiratory Diseases
    • /
    • v.50 no.4
    • /
    • pp.473-483
    • /
    • 2001
  • Background : There are only a few studies regarding the causes of treatment failure for tuberculosis. Therefore, this study aimed to determine the causes of intractable tuberculosis. Methods : M. tuberculosis, differentiated MOTT (Mycobacterium Other Than Tuberculosis) were isolated, and the RFLP (Restriction fragments length polymorphisms) pattern was analyzed from 204 patients with pulmonary tuberculosis and 53 suffering from neck tuberculosis. The IL-$1{\beta}$, IL-12, $^*1\;IFN{\gamma}$ and $^*2\;TNF{\alpha}$ blood levels were measured. All patients were regularly followed for 18 months after treatment. Results : There was no correlation between the RFLP patterns of M. tuberculosis treatment failure. From the 204 cases, 31.9% were intractable. The characteristics of patients with intractable tuberculosis were old age, being male and recurrent cases. The causes of treatment failure were identified as follows ; a decrease in the IL-12(59.4%) concentration, drug resistant strain(54.7%), irregular medication(15.4%), MOTT(6.2%) and a heavy infection(4.6%). The causes of all cases of intractable tuberculosis could be investigated. The IL-12 concentration in the blood was significantly lower in the intractable cases, where it disclosed a maximum sensitivity(64.7%) and specificity(75.4%) at 165.0 pg/mL. Most of the 53 cases of neck node tuberculosis were treated successfully. Therefore, we were unable to analyze the cause of treatment failure. Conclusion : A decrease in the blood IL-12 concentration and drug resistant strains were identified as the most significant causes of treatment failure for tuberculosis. In Korea, infection by clusters were prevalent, but no difference in the clinical course between clusters and non-clusters could be found.

  • PDF

Surgical Outcome of Intractable Seizure with Space-Occupying Lesion in Temporal Lobe (측두엽내 공간 점유 병소와 동반된 난치성 간질의 수술적 치료 성적)

  • Park, Jun Bum;Lee, Wan Su;Lee, Jung Kyo;Jeon, Sang Ryong;Kim, Jeong Hoon;Roh, Sung Woo;Ra, Young Shin;Kim, Chang Jin;Kwon, Yang;Rhim, Seung Chul;Kwun, Byung Duk;Kang, Joong Koo;Lee, Sang Ahm;Ko, Tae Sung
    • Journal of Korean Neurosurgical Society
    • /
    • v.30 no.1
    • /
    • pp.26-32
    • /
    • 2001
  • Objective : The increasing use of sensitive neuroimaging techniques has demonstrated that significant percentage of patients with intractable complex partial seizures have brain masses, especially in temporal lobe. The optimal surgical solution for these patients is still open to debate. The purpose of our investigation is to evaluate the surgical outcome of patient with lesion-related temporal lobe epilepsy with respect to the types of surgery and the location of lesion. Patients and Methods : From DEC. 1993 to Dec. 1997, 35 patients with intractable epilepsy and space occupying temporal lobe lesion identified in preoperative MRI were included in this study. The types of surgery were lesionectomy, anterior temporal lobectomy with or without hippocampectomy. The location of lesion was divided as anteromedial group and lateral cortical group. The postoperative seizure outcomes according to the type of surgery and location of the lesion were compared. Results : Twenty-six of 34 patients(76.5%) were seizure-free after surgery. The Engel's class was favorable after anterior temporal lobectomy with or without hippocampectomy(p=.044) Conclusion : It is favorable to perform anterior temporal lobectomy for the treatment of intractable epilepsy with space-occipying lesion in temporal lobe. The resection of the hippocampus can be individualized.

  • PDF

The Treatment for The Intractable Epidural Abscess Using Tensor Fascia Lata Graft and Anterolateral Thigh Free Flap (대퇴근막 이식과 전외측 대퇴 유리 피판을 이용한 난치성 경막 외 농양의 치료)

  • Park, Byung-Chan;Ryu, Min-Hee;Kim, Tae-Gon;Lee, Jun-Ho
    • Archives of Reconstructive Microsurgery
    • /
    • v.18 no.1
    • /
    • pp.23-26
    • /
    • 2009
  • Purpose: Artificial dura maters are commonly used in cranioplasty, but sometimes they can result in serious postoperative infection. Once complications such as epidural abscess or chronic draining ulcer arise, they are very difficult to treat. In this case, reclosure of dura defect using artificial dura mater may give rise to recurrence of infection. We experienced a case of intractable epidural abscess caused by use of artificial dura. To avoid repeated infection, we decided to use autologous tissue for the coverage of dura and soft tissue defect. Therefore, autologous tensor fascia lata graft and anterolateral thigh free flap were harvested at the same donor site incision to cover composite defect on the scalp and dura mater. Methods: A 13 year old male patient, who underwent the decompression cranioplasty and duroplasty, suffered from the intractable infection lesion. Twice, the epidural abscess was removed, both times the infection recurred. And eventually dura mater was exposed through the infected open wound. Nine months after dura exposed, infected aritificial dura mater was removed and extensive debridement was performed. Through a surgical incision on donor thigh, first, tensor fascia lata graft was harvested in process of the anterolateral thigh flap elevation. After the fascia lata graft was fixed over the dural defect, the anterolateral thigh flap was used to fill the dead space as well as the scalp defect. Results: Postoperatively, no recurrent infection and cerebrospinal fluid leakage are observed for a year. After the surgery, on the first and second day, venous congestion of the flap was observed, this problem was solved by thrombectomy and vein reanastomosis. And partial necrosis of flap occurred, but completely healed as conservative treatment for two weeks. Conclusion: Using the autologous tensor fascia lata graft and anterolateral thigh flap, we could obtain satisfactory results as treatment for the intractable infection lesion after duroplasty. Autologous tensor fascia lata in conjunction with anterolateral thigh flap is useful method for covering composite defect of scalp and dura mater.

  • PDF

Inhibition of Proinflammatory Cytokine-induced Invasiveness of HT-29 Cells by Chitosan Oligosaccharide

  • Nam, Kyung-Soo;Kim, Mee-Kyung;Shon, Yun-Hee
    • Journal of Microbiology and Biotechnology
    • /
    • v.17 no.12
    • /
    • pp.2042-2045
    • /
    • 2007
  • The effect of chitosan oligosaccharide (COS, 1 kDa${\gamma}$, 10 ng/ml IL-$1{\alpha}$, and 25 ng/ml TNF-${\alpha}$) in HT-29 cells. Inducible nitric oxide synthase (iNOS) expression induced by these cytokines was inhibited by COS. COS pretreatment inhibited the invasiveness of cytokines-treated HT-29 cells through Matrigel-coated membrane in a dose-dependent manner. COS also inhibited cytokines-induced matrix metalloproteinase (MMP)-2 activity. This study shows that proinflammatory cytokines induce NO production, iNOS expression, and invasiveness of human colorectal adenocarcinoma HT-29 cells. COS pretreatment inhibited cytokines-mediated NO production, iNOS expression, and invasiveness of HT-29 cells. These results provide sufficient information for the further development of COS as an antitumor metastatic agent for the treatment of colon cancer.