• Title/Summary/Keyword: morbid

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Difficult Airway Management with Fiberoptic Bronchoscopy Combined with Video Laryngoscope in a Patient with Ludwig Angina (Ludwig's Angina 환자의 어려운 기도 관리에서 기관지내시경과 비디오 후두경의 병용 경험)

  • Song, Jaegyok;Kim, Seokkon;Bae, Jeong-Ho
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.189-193
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    • 2013
  • We experienced dfficult airway management in a patient who had Ludwig angina with morbid obesity, dfficulty with mouth opening and neck extension. We planned to perform awake-nasotracheal intubation with fiberoptic bronchoscopy but the patient's condition was not suitable to do this procedure. Thus, we tried fiberoptic nasotracheal intubation under general anesthesia but we experienced difficult airway management due to epistaxis. We tried to use video laryngoscope instead of fiberpotic bronchoscopy but also failed to guide the tube into trachea due to limited mouth opening. We used video laryngoscope to make a view of vocal cord and used fiberoptic bronchoscope as an intubation guide of endotrachedal tube and successfully intubated the patient.

Robotically Assisted Mitral Valve Repair as the Treatment of Choice for Patients with Difficult Anatomies

  • Russo, Marco;Ouda, Hamed;Andreas, Martin;Taramasso, Maurizio;Benussi, Stefano;Maisano, Francesco;Weber, Alberto
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.55-57
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    • 2019
  • Robotically assisted mitral valve repair has proven its efficacy during the last decade. The most suitable approach for patients with difficult anatomies, such as morbid obesity, sternal deformities, cardiac rotation, or vascular anomalies, represents a current challenge in cardiac surgery. Herein, we present the case of a 71-year-old patient affected by severe degenerative mitral valve regurgitation with pectus excavatum and a right aortic arch with an anomalous course of the left subclavian artery who was successfully treated using a Da Vinci-assisted approach.

Growth Hormone Therapy in Children with Prader-Willi Syndrome

  • Im, Minji
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.5 no.1
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    • pp.34-38
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    • 2021
  • Prader-Willi syndrome is a complicated genetic disorder caused by a mutation on chromosome 15q11-13. The disease results in morbid obesity due to hyperphagia, growth disturbance, multiple endocrine problems from hypopituitarism, developmental delay, and cognitive or behavioral problems. Recombinant human growth hormone has been used to improve body composition and muscle mass, which plays a main role in treating patients with Prader-Willi syndrome. We describe previous studies showing the efficacy and safety of growth hormone treatment in children with Prader-Willi syndrome and provide treatment guidelines. Growth hormone therapy could be beneficial for children with Prader-Willi syndrome and improve their quality of life.

Low-Dose Off-Label Use of Phentermine/Topiramate in the Individual with Morbid Obesity and Postoperative Hypothyroidism (수술 후 갑상선기능저하가 동반된 고도비만환자의 펜터민염산염/토피라메이트의 저용량 오프라벨 사용)

  • Park, Jung Ha
    • Archives of Obesity and Metabolism
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    • v.1 no.1
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    • pp.43-45
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    • 2022
  • Intensive lifestyle modifications and anti-obesity medications are essential for obesity treatment. Antiobesity medications should be selected according to the patient's comorbidities, symptoms, and preferences. This case report describes the treatment of a morbidly obese patient with a history of depression, who complained of tingling and numbness after total thyroidectomy for papillary thyroid cancer. Very low-dose controlled-release phentermine/topiramate was prescribed and intensive lifestyle modifications were encouraged. As a result, the patient effectively lost weight and reached a near-normal weight without adverse drug effects. This implies that even an off-label anti-obesity medication low dose may be better for some patients, and the most important factor in obesity treatment is patient-tailored treatment.

Management of Gastrointestinal Foreign Bodies with Brief Review of the Guidelines

  • Kaan Demiroren
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.1
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    • pp.1-14
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    • 2023
  • Foreign body (FB) ingestion is a common health problem that affects children more than adults. According to gastroenterologists' guidelines, the management of FB ingestion differs slightly between adult and children. This review aimed to compile adult and children guidelines and establish an understandable association to reveal the requirements and timing of the endoscopic procedure, which is the most effective and least complicated technique for gastrointestinal FBs. Coins, pins, and chicken and fish bones have been the most commonly ingested FBs. However, with their increasing use in recent years, large batteries with lithiumion conversion, stronger magnets composed of rare earth metals, such as neodymium, and superabsorbent objects have become the most morbid and mortal, necessitating new management strategies. Although the approach to gastrointestinal FBs is controversial, with different treatment options available in different disciplines, many studies have demonstrated the efficacy and safety of endoscopic procedures. Many factors influence the timing of endoscopy, including the nature, size, and location of the ingested object and the patient's clinical condition.

A Case of Morbid Obese Patient with Comorbidities: Why a Lifestyle Modification is Important (동반 질환을 가진 고도 비만 환자의 증례: 생활습관 교정이 왜 중요한가?)

  • Eunjin Shin;Seon Yeong Lee
    • Archives of Obesity and Metabolism
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    • v.2 no.2
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    • pp.64-70
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    • 2023
  • Obesity is a complex multifactorial disease that is associated with various complications, including cardiovascular diseases. The prevalence of obesity among young adult males has increased, and this has increased the prevalence of several comorbidities. This trend was closely linked to lifestyle factors, including heavy drinking, smoking cigarettes, and an imbalanced diet. This emphasized the necessity of lifestyle improvements for effective obesity management. In this case, the comprehensive lifestyle changes and adjuvant medication resulted in weight loss and improvement in several comorbid conditions in a young adult male. The case highlighted the importance of a comprehensive approach to managing obesity. Furthermore, it emphasized the importance of a healthy lifestyle in addressing obesity and its complications.

A Study ‘On the Morbid Pulse of Abdominal Fullness, Cold Mounting, and Abiding Food' in the Chapter 10 of Synopsis of Golden Chamber (금궤요약(金匱要略).복만한산숙식병맥증병치제십(腹滿寒疝宿食病服證幷治第十)에 대(對)한 연구(硏究))

  • Seo, Dae-Seon;Ahn, Jun-Mo;Cho, Gyeong-Jong;Jeong, Heon-Young
    • Journal of Korean Medical classics
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    • v.19 no.2 s.33
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    • pp.138-162
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    • 2006
  • 'On the Morbid Pulse of Abdominal Fullness, Cold Mounting, and Abiding Food' in the Chapter 10 of Synopsis of Golden Chamber that enunciates Abdominal Fullness, Cold Mounting, and Abiding Food is related to the stomach and intestines respectively, and is similar to the region and symptom of disease in the light of both abdominal fullness and symptoms of pain. This chapter was united into one because the formula mentioned in this chapter can be applied to three disease patterns. Abdominal fullness shows the symptoms of distention and unease, but judging from the text as well as a specific formula and symptoms, it follows pain. Accordingly Abdominal fullness dealt with in this chapter is the first consideration and it is a kind of a disease pattern attendant on abdominal pain. Cold Mounting does not mean mounting gi disease but means the abdominal pain. The cause of cold mounting is mainly due to insufficiency of yang gi and oversufficiency of cold evil. And the main symptoms of cold mounting follow the severe pain around the naval and sweating, cold of the extremities, pulse deep and tight. Abiding food is of the same meaning such as damage of food today. Abiding food is now referred to as damage of food. Principles which have set forth in this chapter are put to use of the method of ejection in case that abiding food places in the upper part, precipitation in the lower part. The symptoms of abiding food show that the pulse is slight and slippery and the wrist pulse is both superficial and large and rough in applying the pressure, and the cubit pulse is also slight and superficial as well, and that have diarrhea and have little appetite.

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Safety Evaluation of IGEs Separated and Refined from Colostrum (초유로부터 분리.정제된 IGFs의 안전성 평가에 관한 연구)

  • 조양희;이수원;정명섭;백승화;제갈승주;박강용
    • Food Science of Animal Resources
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    • v.23 no.2
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    • pp.137-144
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    • 2003
  • This study was carried out to investigate safety evaluation of IGEs separated and refined from bovine milk and commercial recombinant human IGFs. In order to evaluate toxicity of these samples, acute toxicity test and short term toxicity test were investigated with IGF-I separated and refined from colostrum and commercial recombinant human IGF-I from R&D systems company. for acute toxicity test, we selected recombinant human IGF-I from R&D systems company and establish one control group and three dose-level groups(0, 10, 20 and 50 $\mu\textrm{g}$ per rat). We have intravenously injected tail of rats with selected sample once. After 20 days, pathological cellular tissue analyses were investigated with liver, kidney and spleen of 12 rats in all test groups. However, Morbid tissue and abnormal statistical results were not discovered in all cellular tissues. For short term toxicity test, we selected IGF-I separated and refined from colostrum and establish one control group and three dose-level groups(0, 5, 10 and 15 $\mu\textrm{g}$/day per rat). Rats were orally injected with selected sample once a day during two weeks. After short term toxicity test period, Pathological cellular tissue analyses were investigate with liver, kidney and spleen of 12 rats in all test groups. However, Morbid tissue and abnormal statistical results were not discovered in all cellular tissues. These results suggest that IGF-I treated groups show no significant toxicological findings with changes of body weight, food consumption, water consumption, and pathological findings compared with control groups.

A Study on the Standards of Medical-Nutritional-Education by the Type of Bariatric Surgery in Morbid-obesity Patients (고도비만 환자의 수술적 치료방법에 따른 영양교육 기준 설정에 관한 연구)

  • Kim, Hye-Jin;NamGung, Sin-A;Hong, Jeong-Im;Mok, Hee-Jung
    • Journal of the Korean Dietetic Association
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    • v.16 no.2
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    • pp.178-187
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    • 2010
  • This study examined the effects of postoperative medical nutrition therapy on patients who had undergone bariatric surgery. Eighty seven patients who underwent bariatic-surgery at Yeouido St. Mary's Hospital from January 2007 to April 2009 were evaluated. The bariatric surgery patients included 42 Laparoscopic Roux-en Y gastric bypass (LRYGB) and 45 Laparoscopic adjustable gastric banding (LAGB) patients. Weight loss was more significant after LRYGB than after LAGB after 9 months (p<0.05). The LRYGB group was more satisfied with the weight loss (LRYGB 4.4/5.0, LAGB 3.0/5.0 p<0.001). The mean albumin, hemoglobin and hematocrit levels were significantly lower in the LRYGB group than in the LAGB group at the time of discharge (p<0.05~0.001). The GOT/GPT was significantly higher in the LRYGB group at the time of the operation than the LAGB group (p<0.01). The LRYGB group showed significantly lower intakes of total energy, carbohydrates, protein and fat from 1 week after surgery than the LAGB group. Multiple regression showed that the weight change after LRYGB was significantly more associated with the intakes of total energy at 1 week after surgery (p<0.01), SWS (sweets and high-calorie beverages) at 1 and 6 months after surgery (p<0.001), and fat at 3 months after surgery (p<0.01). In addition, LAGB was significantly more associated with the intakes of protein and NLS (non-liquid sweets) at 1 week after surgery (p<0.001, p<0.01), carbohydrate at 1 months after surgery (p<0.01), total energy at 3 months after surgery (p<0.001), HCL (high-calorie liquids) at 6 months after surgery (p<0.05), and fat at 9 months after surgery (p<0.01). These results suggest that continuous-follow-up medical nutrition therapy is needed according to the types of bariatric surgery, particularly during the weight loss phase (the first 1 week to 12 months).

The Interaction of High Sensitivity C-Reactive Protein and Uric Acid on Obesity in Koreans: Based on the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII, 2016~2018) (대한민국에서 비만에 대한 고감도 C-반응성 단백과 요산의 상호작용: 제7기 국민건강영양조사를 이용해서(KNHANES VII, 2016~2018))

  • Pyo, Sang Shin
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.4
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    • pp.342-352
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    • 2021
  • We used data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES) (2016~2018) to investigate an association between high sensitivity C-reactive protein (hsCRP) and uric acid in the obese. Obesity was defined as a body mass index (BMI) of 25 kg/m2 or more, severe obesity as a BMI of 30 kg/m2 or more, and morbid obesity as a BMI of 35 kg/m2 or more. In the complex samples multiple logistic regression, despite adjustment by adding major risk factors, the odds ratio (OR) for obesity was higher in the group with high levels of both, hsCRP and uric acid than the reference group at all stages (obesity, OR 1.89, P<0.001 vs. severe obesity, OR 5.04, P<0.001 vs. morbid obesity, OR 8.20, P<0.001). The association between hsCRP and uric acid in obese patients increased from 1.89 to 8.20 as the obesity level increased, suggesting that participants with increased BMI were significantly affected by hsCRP and uric acid. Moreover, the interaction between hsCRP and uric acid was statistically significant even in the model corrected for major confounding factors (P for interaction=0.009).