• 제목/요약/키워드: spontaneous methods

검색결과 554건 처리시간 0.031초

Staple Line Coverage with a Polyglycolic Acid Patch and Fibrin Glue without Pleural Abrasion after Thoracoscopic Bullectomy for Primary Spontaneous Pneumothorax

  • Hong, Ki Pyo;Kim, Do Kyun;Kang, Kyung Hoon
    • Journal of Chest Surgery
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    • 제49권2호
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    • pp.85-91
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    • 2016
  • Background: This study was conducted to determine the efficacy of staple line coverage using a polyglycolic acid patch and fibrin glue without pleural abrasion to prevent recurrent postoperative pneumothorax. Methods: A retrospective analysis was carried out of 116 operations performed between January 2011 and April 2013. During this period, staple lines were covered with a polyglycolic acid patch and fibrin glue in 58 cases (group A), while 58 cases underwent thoracoscopic bullectomy only (group B). Results: The median follow-up period was 33 months (range, 22 to 55 months). The duration of chest tube drainage was shorter in group A (group A $2.7{\pm}1.2day$ vs. group B $3.9{\pm}2.3day$, p=0.001). Prolonged postoperative air leakage occurred more frequently in group B than in group A (43% vs. 19%, p=0.005). The postoperative recurrence rate of pneumothorax was significantly lower in group A (8.6%) than in group B (24.1%) (p=0.043). The total cost of treatment during the follow-up period, including the cost for the treatment of postoperative recurrent pneumothorax, was not significantly different between the two groups (p=0.43). Conclusion: Without pleural abrasion, staple line coverage with a medium-sized polyglycolic acid patch and fibrin glue after thoracoscopic bullectomy for primary spontaneous pneumothorax is a useful technique that can reduce the duration of postoperative pleural drainage and the postoperative recurrence rate of pneumothorax.

Thoracic Scoliosis in Patients with Primary Spontaneous Pneumothorax

  • Lee, Yeiwon;Kim, Young Jin;Ryu, Han Young;Ku, Gwan Woo;Sung, Tae Yun;Yoon, Yoo Sang;Kim, Tae-Kyun
    • Journal of Chest Surgery
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    • 제51권4호
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    • pp.254-259
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    • 2018
  • Background: Primary spontaneous pneumothorax (PSP) affects patients without clinically apparent lung disorder found in tall and thin young male. Scoliosis refers to curves exceeding $10^{\circ}$ Cobb angle observed through chest X-ray and affects 2% to 4% of adolescents. Both conditions are commonly encountered in primary health care setting. The aim of this study is to access the correlation of thoracic scoliosis and PSP in adolescent. Methods: A retrospective analysis was conducted for patients diagnosed for PSP in Konyang University Hospital between January 2010 and March 2017. Chest X-rays of 222 patients and 155 normal control (NC) cases were reviewed to measure the Cobb angle. Greater than $10^{\circ}$ of Cobb angle is diagnosed as scoliosis. Results: Scoliosis in patient with PSP has higher incidence than that of NC group (p<0.001). Median value of Cobb angle is $12.9^{\circ}$ in PSP group and $14.7^{\circ}$ in NC group. Directional relationship between scoliosis and pneumothorax in PSP group is also observed; 40.5% cases are ipsilateral and 59.5% are contralateral. Conclusion: PSP patients tend to have thoracic scoliosis more commonly compared with normal healthy adolescent. Scoliosis may contribute to heterogeneity of alveolar pressure which exacerbates subpleural bleb formation that can cause pneumothorax. The causal relationship is unclear and further studies are needed in the future.

Internal derangement as a predictor of provoked pain on mouth opening: A magnetic resonance imaging study

  • Koh, Kwang-Joon;Park, Ha-Na;Kim, Kyoung-A
    • Imaging Science in Dentistry
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    • 제47권4호
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    • pp.219-226
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    • 2017
  • Purpose: This study investigated the relationship between pain and internal derangement in temporomandibular disorder(TMD) patients using magnetic resonance imaging (MRI). Materials and Methods: This study analyzed 356 TMD patients (712 temporomandibular joints [TMJs]). The inclusion criteria were the presence of spontaneous or provoked pain on one or both TMJs and having undergone MRI. The patients with provoked pain were divided into 3 groups: pain on palpation, pain on mouth opening, and pain on mastication. MRI was performed using a 1.5-T scanner. T1- and T2-weighted parasagittal and paracoronal images were obtained. According to the findings on the T1-weighted images, another 3 groups were created based on internal derangement: normal, disc displacement with reduction, and disc displacement without reduction. The MRI findings were independently interpreted by 2 experienced oral and maxillofacial radiologists at 2 different times. Statistical analysis was performed by the chi-square test using SPSS (version 12.0; SPSS Inc., Chicago, IL, USA). Results: Provoked pain on mouth opening was found to be correlated with internal derangement in TMD patients (P<.05). However, spontaneous pain and provoked pain on palpation or mastication were not associated with internal derangement(P>.05). Conclusion: These results suggest that internal derangement was a significant predictor of provoked pain on mouth opening.

출혈성 뇌졸중 환자의 회복: 자발성 뇌출혈(s-ICH) 환자와 자발성 지주막하 출혈(s-SAH) 환자의 회복 정도에 대한 탐색적 차원의 비교 연구 (Recovery State of Hemorrhagic Stroke Patients: Exploratory Comparison of Recovery State between Spontaneous Intracerebral Hemorrhage(s-ICH) and Spontaneous Subarachnoid Hemorrhage(s-SAH))

  • 오현수;서화숙;조화연;김미옥;김미란;모진아
    • 성인간호학회지
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    • 제20권4호
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    • pp.600-612
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    • 2008
  • Purpose: This study was conducted to compare the recovery state of 6 month between s-ICH and s-SAH patients. The patients' recovery state was measured with 2 dimensions: functional and cognitive. Methods: Non-experimental prospective design was adopted by including 108 hemorrhagic stroke patients(s-ICH: 52 vs s-SAH: 56) admitted to Intensive Care Unit of one university hospital. Results: The study results showed that overall functional recovery state of s-SAH patients was better than that of s-ICH patients, and s-SAH patients also showed better recovery states in all of the sub-dimensions of functional recovery, such as feeding, grooming, and toileting, than those of s-ICH in 6 month. On the contrary, the study results showed that overall cognitive recovery states of 6 month between two groups were not significantly different. However, according to the results comparing the sub-dimensions of cognitive recovery, s-SAH patients' recovery states on attention, communication and memory were significantly better than those of s-ICH patients, while recovery states on problem solving, safety behavior, and social behavior between 2 groups were not significantly different. Conclusion: From the study results, it was noted that s-SAH patients showed better recovery states in cognitive dimension as well as in functional dimension compared with s-ICH patients.

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Even in Patients with a Small Hemorrhagic Volume, Stereotactic-Guided Evacuation of Spontaneous Intracerebral Hemorrhage Improves Functional Outcome

  • Kim, Young-Zoon;Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
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    • 제46권2호
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    • pp.109-115
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    • 2009
  • Objective: The decision to adopt a conservative or surgical modality for a relatively small volume of spontaneous intracerebral hemorrhage (SICH) is difficult and often controversial, especially when consciousness is tolerable. The authors examined the results of stereotactic-guided evacuation of SICH for relatively small volumes with respect to functional outcome. Methods: This prospective study was performed on 387 patients with SICH who underwent stereotactic-guided evacuation (n = 204, group A) or conservative treatment (n = 183, group B) during the past 8 years. The primary end-point was recovery of functional status, which was estimated using the Modified Barthel Index (MBI) and the modified Rankin Scale (mRS). Results: All patients had a Glasgow coma scale (GCS) score of $\geq$ 13 and unilateral hemiparesis of less than motor power grade 3. Group demographic characteristics and initial neurological statuses were similar. In all cases, the volume of SICH involved was < 30 cm$^3$ and location was limited to basal ganglia and thalamus. At 6-month follow-ups, MBI was 90.9 in group A and 62.4 in group B (p < 005), and MRS was 1.2 in group A and 3.0 in group B (p < 0.05). Better motor function and stereotactic-guided evacuation had a significant effect on a functional recovery in regression analyses. Conclusion: Even in patients with a small volume of SICH, stereotactic-guided evacuation improved functional recovery in activities in daily life than conservative treatment did.

『傷寒論』 병증(病症)과 위기(衛氣)의 관계에 대한 연구(硏究) (A study on the relationship between the symptom of Shanghanlon(傷寒論) and the defensive Gi(衛氣))

  • 방정균
    • 대한한의학원전학회지
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    • 제29권2호
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    • pp.151-163
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    • 2016
  • Objectives : Shanghanlon is based on the Hwangjenaegyeong(黃帝內經)'s theory. Therefore, the contents of the Naegyeong can interpret Shanghanlon's provision, Chengwuji(成無己) followed the same way. Therefore, I studied the relationship between the symptom of Shanghanlon and the defensive Gi(衛氣), I try to prove that the Naegyeong is the theoretical basis of Shanghanlon. Methods : Naegyeong explains that defensive Gi protects the outer parts of the body, and runs the outer parts of the body. So I will explain the spontaneous sweating(自汗) aversion to cold(惡寒) pain(痛症) fever(發熱) difficulty of urination(小便不利) using the function of defensive Gi. Results & Conclusions : The defensive Gi and the nutrient Gi(營氣) run together, if the defensive Gi is weak, can not protect the nutrient Gi. If the defensive Gi does not perform the function of inducing astringency(固攝), the symptom of spontaneous sweating appears. If aversion to cold is caused by the weak of defensive Gi, we use the treatment of warming the Yang(溫陽). If aversion to cold is caused by the defensive Gi can not run, we use the treatment of activating the Yang(通陽). If the Gi and Blood(氣血) is not feeding properly, the pain occurs. In this case, we use the treatment of activating the Yang(通陽). The fever is caused by the stagnation of defensive Gi. If the defensive Gi is weak, the symptom of difficulty of urination appears.

흰쥐의 내측 전정신경핵 흥분성에 대한 전침자극의 효과 (Effects of Electroacupuncture on the excitability in Medial Vestibular Nuclei of Rats)

  • 김재효;이성호;손인철;김영선;김민선
    • Korean Journal of Acupuncture
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    • 제26권3호
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    • pp.27-42
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    • 2009
  • Objectives : The vestibular system detects head movement and serve to regulate and maintain the equilibrium and orientation of the body. It is known that the vestibular imbalance leads to vestibular symptoms such as nausea, vomiting, vertigo and postural disturbance. The objectives of the present study were to examine a modification of the dynamic activities of medial vestibular nucleus (MVN) neurons following electroacupuncture (EA) of GB43 (Hyepgye). Methods : In Sprague-Dawley rats weighing $250{\sim}300g$, dynamic responses induced by sinusoidal whole body rotation about vertical axis at 0.2 Hz were observed in MVN of rats during EA of GB43 (Hyepgye) with 0.2 ms, 40 Hz and $600{\pm}200{\mu}A$. Also, expression of cFos protein was observed 2 hours after EA for 30 mins. Results : In dynamic response of vestibular neuron, the excitatory or inhibitory responses of gain were predominant in the ipsilateral MVN neurons during EA but not predominant in the contralateral MVN. Most neurons showing decreased gain were classified to inhibitory responses of spontaneous firing discharge during EA and ones showing increased gain were classified to excitatory response of spontaneous firing discharge during EA. Also, EA of the left GB43 (Hyepgye) for 30 mins produced the expression of cFos protein in MVN, inferior olive (IO) and solitary tract nuclei (SOL). Spatial expressions of cFos protein were predominant in the contralateral MVN, ipsilateral IO and bilateral SOL. Conclusion : These results suggest that the excitability of MVN neurons was influenced by EA of GB43 (Hyepgye) and EA may be related to the convergence on MVN.

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EMR의 자발적 약물부작용보고 시스템을 이용한 한약약물유해반응 분석 (Analysis of Herbal-drug-associated Adverse Drug Reactions Using Data from Spontaneous Reporting System in Electronic Medical Records)

  • 김미경;한창호
    • 대한한의학회지
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    • 제36권1호
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    • pp.45-60
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    • 2015
  • Objectives: The purpose of this study was to understand the status of reporting and characteristics of adverse drug reactions (ADRs) induced by herbal drugs and to make a suggestion for the domestic pharmacovigilance system on herbal medicine. Methods: We carried out a hospital-based observational study at Dongguk University Ilsan Oriental Hospital from April 2012 to December 2014. We reviewed all the herbal-drug-associated ADRs reports registered to the spontaneous ADR reporting system in electronic medical records of the hospital in the period. Results: We found out 101 reports including 163 herbal-drug-associated ADRs from 97 patients. Females (69.3%) outnumbered males and the most frequent age group was the 50s (44, 27.0%). No serious adverse event was observed. The most commonly reported ADR was gastro-intestinal system disorders (68, 41.5%) followed by skin-related disorders (42, 25.8%). Diarrhea (29, 17.8%) was the most frequently referred clinical manifestation. Most ADRs were induced by internal medicines (160, 98.2%) including manufactured (36, 22.1%) and self-prepared decoction (160, 76.1%). The pairs of Igi-hwan-diarrhea, gamiboa-tang-vomiting, and Magnoliae Flos-gastro-intestinal-system-related ADRs were observed twice each and the others appeared only once. Conclusions: We propose Korean government to take an initiative in national pharmacovigilance system for herbal medicine. To perform the surveillance on herbal drugs, the Association of Korean Medicine (AKOM) should set up a nationwide network by designating centers connecting the Korean medical hospitals, local Korean medicine clinics, and the public health centers. The government and AKOM should also educate and encourage them to understand the pharmacovigilance system and report the ADRs actively.

Effects of human growth hormone on gonadotropin-releasing hormone neurons in mice

  • Bhattarai, Janardhan P.;Kim, Shin-Hye;Han, Seong-Kyu;Park, Mi-Jung
    • Clinical and Experimental Pediatrics
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    • 제53권9호
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    • pp.845-851
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    • 2010
  • Purpose: Recombinant human growth hormone (rhGH) has been widely used to treat short stature. However, there are some concerns that growth hormone treatment may induce skeletal maturation and early onset of puberty. In this study, we investigated whether rhGH can directly affect the neuronal activities of of gonadotropin-releasing hormone (GnRH). Methods: We performed brain slice gramicidin-perforated current clamp recording to examine the direct membrane effects of rhGH on GnRH neurons, and a whole-cell voltage-clamp recording to examine the effects of rhGH on spontaneous postsynaptic events and holding currents in immature (postnatal days 13-21) and adult (postnatal days 42-73) mice. Results: In immature mice, all 5 GnRH neurons recorded in gramicidin-perforated current clamp mode showed no membrane potential changes on application of rhGH (0.4, $1{\mu}g/mL$). In adult GnRH neurons, 7 (78%) of 9 neurons tested showed no response to rhGH ($0.2-1{\mu}g/mL$) and 2 neurons showed slight depolarization. In 9 (90%) of 10 immature neurons tested, rhGH did not induce any membrane holding current changes or spontaneous postsynaptic currents (sPSCs). There was no change in sPSCs and holding current in 4 of 5 adult GnRH neurons. Conclusion: These findings demonstrate that rhGH does not directly affect the GnRH neuronal activities in our experimental model.

척수손상 흰쥐에서 대장 운동에 대한 지실의 효과 (Effect of Poncirus Trifoliata on Colonic Motility in Spinal Cord Injured Rats)

  • 최철원;주민철;이문영
    • 한방재활의학과학회지
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    • 제18권4호
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    • pp.13-24
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    • 2008
  • Objectives : The purpose of this study was to investigate the effect of Poncirus Trifoliata(PT) on improvement of fecal impaction in spinal cord injured(SCI) rats. Methods : Fifteen adult Sprague-Dawley female rats were used weighing 200~250 g. A complete spinal cord transection was performed surgically at the T10 cord level. Experimental groups were assigned into 3 groups: Control(n=5), SCI+vehicle(n=5) and SCI+PT(n=5). PT was administered 100mg/kg in 0.5ml every 24 hours from 1st operation day to 7th day. We measured the body weight and food intake as well as the number and the weight of fecal pellet every morning. After 1 week of operation, whole colon was divided into proximal and distal segments under anesthesia. Each segment of colon was mounted with longitudinal direction in a organ bath. We measured spontaneous contraction and compared the area under the curve in each segments. Enhanced responses were observed by acetylcholine($10^{-6}M$), 40 mM KCl solution, L-NAME($10^{-4}M$). Results : The fecal number and weights were significantly higher in the group of SCI+PT than SCI+vehicle group(p<0.05). In organ bath study, area under the curves of the spontaneous contraction in SCI+vehicle and SCI+PT groups were significantly increased compared to control group. Contractility of distal colon in response to acetylcholine or KCl in SCI+vehicle group was significantly decreased compared to other groups(p<0.05). Conclusions : These results suggest that PT might be useful to promote bowel emptying in spinal cord injured rats.