• Title/Summary/Keyword: respiratory management

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Etiological Study of Porcine Viral Abortions and Stillbirths in Gyeongbuk Province (경북지역 돼지의 바이러스성 유사산 원인조사)

  • Chae, Tae-Chul;Kim, Seong-Guk;Cho, Kwang-Hyun;Eo, Kyung-Yeon;Kwon, Oh-Deog
    • Journal of Veterinary Clinics
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    • v.30 no.4
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    • pp.236-240
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    • 2013
  • A total of 170 litters (575 samples) of aborted and stillbirth fetuses submitted to the Gyeongsangbuk-Do Veterinary Service Laboratory (GVSL) between January 2006 and December 2010 from pig farms in Gyeongbuk province were studied to identify porcine abortion- and stillbirth-associated viruses such as Porcine parvovirus (PPV), Encephalomyocarditis Virus (EMCV), Japanese Encephalitis Virus (JEV), Porcine Reproductive and Respiratory Syndrome Virus (PRRSV), and Aujeszky's Disease Virus (ADV). Virus was not detected by PCR in 36 litters, but viral antibody was detected by HI and ELISA in 93 litters. The majority of etiological viruses were PPV (67 litters, 39.4%), EMCV (50 litters, 29.4%), PRRSV (15 litters, 8.8%), and JEV (11 litters, 6.5%); ADV was not detected by either PCR or ELISA. Single infection occurred in 52 litters (30.6%), co-infection occurred in 41 litters (24.1%), and unknown cases with no detection of any of the five viruses occurred in 77 litters (45.3%).

뮤코다당증의 장기 치료 효과와 한계점 극복을 위한 노력

  • Son, Yeong-Bae
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.29-36
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    • 2014
  • Mucopolysaccharidoses (MPSs) are a group of rare inherited metabolic diseases caused by deficiency of lysosomal enzymes. MPSs are clinically heterogeneous and characterized by progressive deterioration in visceral, skeletal and neurological functions. The aim of this article is to review the treatment of MPSs, the unmet needs of current treatments and vision for the future including recent clinical trials. Until recently, supportive care was the only option available for the management of MPSs. Hematopoietic stem cell transplantation (HSCT), another potentially curative treatment, is not routinely advocated in clinical practice due to its high risk profile and lack of evidence for efficacy. From the early 2000s, enzyme replacement therapy (ERT) was approved and available for the treatment of MPS I, II and VI. ERT is effective for the treatment of many somatic symptoms, particularly walking ability and respiratory function, and remains the mainstay of MPS treatment. However, no benefit was found in the neurological symptoms because the enzymes do not readily cross the blood-brain barrier (BBB). In recent years, intrathecal (IT) ERT, substrate reduction therapy (SRT) and gene therapy have been rapidly gaining greater recognition as potential therapeutic avenues. Although still under investigation, IT ERT, SRT and gene therapy are promising MPS treatments that may prevent the neurodegeneration not improved by ERT.

Surgical Management of Chylothorax Complicating Transhiatal Esophagectomy in Benign Esophageal Stricture (식도 열공을 통한 식도 제거술 시행후 발생한 유미흉의 외과적 치료)

  • 홍종면;노윤우
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.672-674
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    • 1996
  • Chylothorax is a rare, but well-recognized complication of cardiothoracic surgery and operations in the region of the esophageal or aortic diaphragmatic hiatus. Especially, in nutritionally depleted patients requiring esophagectomy for benign or malignant diseases, it is a potentially life-threatening disorder that has profound respiratory, nutritional and immunologic co sequences . We have experienced a case of chylothorax after transhiatal esophagectomy in benign esophageal stricture. The diagnosis of chylothorax was confirmed after feeding through the jejunostomy tube by the change of the character of pleural effusion and high triglyceride level on the 5th postoperative day. On the thirteenth postoperative day, supradiaphragmatic thoracic duct ligation was performed through right thoracotomy. We could remove the chest tube on the 22th postoperative day, and the patient is being followed-up at out patient clinic without complications.

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Effects of Spinal-Z in Patients with Gastroesophageal Cancer

  • Panahi, Yunes;Saadat, Alireza;Seifi, Maghsoud;Rajaee, Mahdi;Butler, Alexandra E.;Sahebkar, Amirhossein
    • Journal of Pharmacopuncture
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    • v.21 no.1
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    • pp.26-34
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    • 2018
  • Objective: The purpose of this study was to investigate the efficacy and safety of spinal-Z, derived from Peganum harmala seeds and Dracocephalum Kotschyi Boiss leaves, in patients with esophageal and stomach adenocarcinoma, and squamous cell carcinoma of the esophagus. Methods: Sixty-one patients with malignancies of the upper gastrointestinal tract were randomly assigned to one of two groups (treatment or control) in a double-blind fashion. Six capsules of Spinal-Z were prescribed to the patients with the regimen of 600 mg/m2/day, and placebo to the control group, for six months. Results: There were no significant differences between the two groups with regard to age, sex, duration of cancer, type of cancer and family history of cancer. There were significant differences in abdominal pain, heartburn, constipation and vomiting between the two groups, following spinal-Z therapy. Evaluation of drug side effects showed no difference in cough or other respiratory symptoms, itching, headache or dizziness between the two groups, both before and after treatment. Conclusion: This study indicates that Spinal-Z is safe and efficacious in the management of patients with upper gastrointestinal tract cancers.

Surgical Management of Gastroesophageal Reflux Disease (소아 위식도 역류 질환의 외과적 치료)

  • Kim, Seong-Chul;Kim, Dae-Yeon;Kim, Kyung-Mo;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.6 no.2
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    • pp.100-105
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    • 2000
  • Eleven children with gastroesophageal reflux disease underwent fundoplication. Eight had neurological impairment, two had hiatal hernias and one had a history of esophageal repair for esophageal atresia. The most common and significant symptom was vomiting(81.8 %), followed by recurrent respiratory infections(72.7 %) and failure to thrive(72.7 %). The most common diagnostic tool was 24 hour esophageal pH study, which showed pH less than 4 for more than 10 % of the total recorded time in 6 of 9 patients. Nissen fundoplication was performed in 10 patients. Thal fundoplication was carried out in one patient with esophageal atresia. Stamm gastrostomy was added for nutritional and/or swallowing problem in all 8 patients with neurological impairment. The median follow up period was 13 months. There was one late death of unrelated cause and one recurrence. The quality of life after antireflux surgery was greatly improved. Antireflux surgery should be done if indicated, and a simultaneous gastrostomy considered in a patient with neurological impairment.

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Clinical Analysis of Cervical Necrotizing Fasciitis (경부 괴사성 근막염의 임상적 고찰)

  • Park, Byung Kuhn;Lee, Do-Joon;Lee, Sang Joon
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.46-49
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    • 2011
  • Background and Objectives Cervical necrotizing fasciitis is a fulminant disease associated with necrosis of connective tissue, spread along the fascial plane, and high mortality. We analyzed the clinical characteristics and treatment outcome of this rare fatal disease. Materials and Methods We retrospectively reviewed the medical records of 19 patients treated for cervical necrotizing fasciitis from January 1999 to January 2009. Mean age was 53.7 years. Results The most common predisposing illness was tonsillitis (36.8%), followed by odontogenic infection (15.7%). Diabetes mellitus was most common underlying disease. Liver cirrhosis and chronic renal failure were found in 2 patients each. All patients were treated with combination of parenteral antibiotics and wide surgical debridement by transcervical and/or thoracotomy approach. Multiple surgical debridements were performed in 7 patients. Tracheotomy was performed in most of the patients (88.8%). Period of total hospitalization and Intensive care unit was 23 days and 10.1 days. Two patients died of disease and overall survival rate was 89.4%. Conclusion Early surgical management and care in intensive care unit are essential for cervical necrotizing fasciitis. Possible complications such as respiratory failure, mediastinitis or sepsis should be carefully evaluated.

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Factors Influencing Functional Status in People with Chronic Lung Disease (만성폐질환 환자의 기능상태에 영향을 미치는 요인)

  • 오의금;김조자;이원희;김소선;권보은;장연수;이지연;김영진
    • Journal of Korean Academy of Nursing
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    • v.32 no.5
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    • pp.643-653
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    • 2002
  • The purpose of this study was to identify factors that influence the functional status of chronic lung disease patients. Method: A descriptive, correlational study design was used. The study was conducted at the outpatient respiratory clinic of the large university hospital in Korea. A convenience sample of 128 chronic lung patients (age = 64.2 yrs; 106 COPD, 17 bronchiectasis, 5 DILD) with mean FEV1 64.4 % predicted. Functional status was measured with SIP. Physical variables (FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress), psychological variables (mood, stress), and situational variable (sleep quality) were examined. Dyspnea was measured by the BDI, fatigue was measured with the MFI. Mood was measured with the modified Korean version of POMS. Sleep quality was measured with the Pittsburgh Sleep Quality Index. Potential independent variables for the regression were age, gender, years since diagnosis, FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress, stress, and sleep quality. Result: In general, functional status was relatively good. In regression analysis, functional status were significantly influenced by dyspnea, mood, age and fatigue. These variables explained 70 % of the variances in functional status. Conclusion: The results suggest that psychophysiologic symptom management should be a focus to enhance the functional status in this group.

Surgical Management for Incidental Finding of an Intrapulmonary Foreign Body - A case report (우연히 발견된 폐내 이물의 수술적 치료 -1예 보고-)

  • Ko, Moo-Sung;Lee, Sub;Park, Ki-Sung
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.248-250
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    • 2006
  • A 48-years-old woman was visited to our hospital because of incidental finding of intrapulmonary foreign body. Chest X-ray showed a 4cm sized foreign body in left upper lung field without adjacent fibrosis. Chest CT showed a sewing needle shaped foreign body of metallic density, located in the 113ft upper lobe. The foreign bodies including the needle were removed surgically using a wedge resection. The extracted needle was divided into three 4 cm pieces. Patient was discharged without other respiratory symptoms after surgery. We report a case of wedge resection in a patient with intrapulmonary needle in the left upper lobe, with review of literatures.

Tracheoinnominate Artery Fistula -A Case Report- (기관 무명 동맥루 -1례 보고-)

  • 김맹호;김일현;김광택;김학제
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.536-539
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    • 1998
  • Tracheoinnominate artery fistula is a rare complication that can happen after tracheostomy, the mortality rate is high and it reqiures urgent surgical management. The patient had received a left pneumonectomy 30 years ago and post-operative course was in uneventful. And tracheostomy was performed for acute respiratory failure due to trachea stenosis for 2 months in recent. She was improved in general condition and changed to a 11 mm silicone Montgomery T-tube. On the 3rd day after the tube changed, she had cardiac arrest due to the excessive hemorrhaging due to tracheoinnominate artery fistula. We report an successusful experience for control of bleeding by an innominate artery fistula division and the Utley maneuver for the tracheoinnominate artery fistula. We report the operation method of bleeding control.

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Aesthetic soft tissue management in facial trauma (안면 외상에서 연부조직 치료에 있어 미용적 재건)

  • Chung, Kyu Jin;Kim, Tae Gon;Lee, Jin Ho
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.715-723
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    • 2018
  • Facial soft tissue injury due to trauma is common. Severe damage of soft tissue causes functional and cosmetic problems. In the initial evaluation of patients with facial trauma, airway maintenance and respiratory maintenance are the most important. The principles of treatment include adequate irrigation and debridement, primary closure, or secondary wound healing. Postoperative care such as taping, silicone gel sheeting, and sun screening is important to prevent scarring. The scalp and forehead are abundant in blood and can cause severe bleeding. The eyelid is very thin and has a multi-layered structure, requiring accurate suturing and reconstruction of the layers. It is advisable to determine the presence of hematoma in the ear and treat it. When the cheek area is damaged, it is necessary to identify and treat the damage of the parotid gland and the facial nerve branch. The lips should be sewn with the white roll of lip and vermillion.