• 제목/요약/키워드: surgical diseases

검색결과 918건 처리시간 0.03초

High Spontaneous Resolution Rates of Severe Primary Vesicoureteral Reflux and Minimal Development of New Renal Scars

  • Cha, Jihei;Lee, Seung Joo
    • Childhood Kidney Diseases
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    • 제20권1호
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    • pp.18-22
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    • 2016
  • Purpose: The previous reports regarding VUR resolution were not precise due to early frequent surgical intervention. We evaluated the spontaneous resolution (SR) rate and the incidence of new renal scars in primary VUR, focusing on severe reflux. Methods: Medical records of 334 patients with primary VUR who were on medical prophylaxis without surgery for 1 to 9 years, were retrospectively reviewed. Medical prophylaxis was initiated with low-dose antibiotic prophylaxis or probiotics. Radioisotope cystourethrography was performed every 1 to 3 years until SR of reflux. New renal scar was evaluated with follow-up $^{99m}Tc$ DMSA renal scan. Results: The SR rates decreased as VUR grades were getting higher (P=0.00). The overall and annual SR were 58.4% and 14.9%/yr in grade IV reflux and 37.5% and 9.3%/yr in grade V reflux. The median times of SR were 38 months in grade IV reflux and 66 months in grade V reflux. The probable SR rates in grade IV and V reflux were 7.8% and 8.9% in the 1st year, 46.0% and 30.8% in the 3rd year and 74.4% and 64.4% in the 5th year. The incidences of new renal scars between low to moderate reflux and severe reflux showed no significant difference (P=0.32). Conclusion: The SR rates of severe primary VUR were higher than previously reported and most new renal scars were focal and mild.

Actinomycosis and Sialolithiasis in Submandibular Gland

  • Kang, Jin Seok;Choi, Hwan Jun;Tak, Min Sung
    • 대한두개안면성형외과학회지
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    • 제16권1호
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    • pp.39-42
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    • 2015
  • Actinomycosis is a subacute or chronic suppurative infection caused by Actinomyces species, which are anaerobic Gram-positive bacteria that normally colonize the human mouth and digestive and urogenital tracts. Cervicofacial actinomycosis is the most frequent clinical form of actinomycosis, and is associated with odontogenic infection. Characterized by an abscess and mandibular involvement with or without fistula, but the cervicofacial form of actinomycosis is often misdiagnosed because the presentation is not specific and because it can mimic numerous infectious and non-infectious diseases, including malignant tumors. We report a rare case of actinomycosis infection with coexisting submandibular sialolithiasis. The patient presented with a $1{\times}1cm$ abscess-like lesion below the lower lip. Punch biopsy of the lesion revealed atypical squamous cell proliferation with infiltrative growth, suggestive of squamous cell carcinoma. The patient underwent wide excision of this lesion, where the lesion was found to be an abscess formation with multiple submandibular sialolithiases. The surgical specimen was found to contain Actinomyces without any evidence of a malignant process. We assumed that associated predisposing factors such as poor oral hygiene may have caused a dehydrated condition of the oral cavity, leading to coexistence of actinomycosis and sialolithiasis.

소화기계 무증상환자에 대한 소화기계 약제 투약현황 (Use of Gastrointestinal Drugs in Patients without Digestive Symptoms)

  • 고희경;이숙향
    • 한국임상약학회지
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    • 제10권2호
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    • pp.57-61
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    • 2000
  • Gastrointestinal (GI) medications have been administered to many patients without any gastrointestinal diseases. The objectives of this study were to evaluate use of GI drugs and assess related factors. Medical records of 600 outpatients were reviewed from January 1997 to December 1997 at A Hospital, Kyunggi-do, Korea. Fifty patients every month among all outpatients were randomly selected up to total 600 patients. Surgical patients, visitors for regular health examination and inpatients were excluded. GI symptoms included nausea, vomiting, diarrhea, dyspepsia, constipation, heartburn, dysphagia and abdominal pain. The prescribed gastrointestinal drugs were antacids. $H_2$-antagonist, sucralfate, cisapride, omeprazole, laxatives, digestive enzymes and antidiarrheal agents. Patients without GI symptoms were 348 out of 600 outpatients who were screened. Two hundred and eighty two of 348 patients $(81\%)$ were given GI drugs though they did not have any GI symptoms. There were no differences in regard to sex and age of patients. Most of medical departments prescribed gastrointestinal drugs for these patients. The most frequently prescribed drugs were in order of digestive enzyme, antacids and $H_2$-antagonists. In view of economic aspects, patients paid 12.28 percents of total cost per prescription for unnecessary medicines. The medical practice of prescribing GI drugs should be assessed to define appropriate subgroups to have benefits with prophylactic administration and to reduce adverse effects caused by drug interactions. Pharmacists would have a significant role to promote rational drug therapy.

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Bilateral Ureteral Obstruction Related to Pelvic Rhabdomyosarcoma Presenting with Acute Kidney Injury: A Case Report

  • Han, Sanghoon;Han, Kyoung Hee
    • Childhood Kidney Diseases
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    • 제23권2호
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    • pp.116-120
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    • 2019
  • Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

Intracranial abscess from facial cellulitis

  • Park, Jonghyun;Kim, Woo Seob;Kim, Han Koo;Bae, Tae Hui
    • 대한두개안면성형외과학회지
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    • 제20권5호
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    • pp.332-335
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    • 2019
  • Cellulitis, one of most common diseases of everyday life, is often overlooked for its significance. Although cellulitis does not cause or lead to serious problems usually, its possibility to cause lifethreatening problem should be known. In present case, a patient who had received acupuncture treatment a week earlier presented to the clinic with symptoms of facial cellulitis. The disease resolved within few weeks under empirical antibiotic treatment but recurred after 3 months. Under close history review of the patient, we found out that the patient had received craniectomy 20 years ago. The patient had blunt headache with no other neurological symptoms that could suspect cranial infection, but considering the risk originating from the patient's surgical history, brain computed tomography (CT) was taken. CT images revealed abscess formation in the subgaleal and epidural spaces. Craniotomy with abscess evacuation was done promptly. With additional antibiotic treatment postoperatively, the disease resolved, and the 1-month postoperative followup brain CT showed no signs of abscess formation.

편측 성대마비 82례에 대한 임상 분석 (A Clinical Analysis on 82 Cases of Unilateral Vocal Cord Paralysis)

  • 이재진;김상윤;이광선;남순열
    • 대한기관식도과학회지
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    • 제4권1호
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    • pp.59-63
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    • 1998
  • Background: Unilateral vocal cord paralysis(UVCP) by recurrent laryngeal nerve injury is one of the common laryngological diseases. Objectives : We attempted to study the clinical feature and the causes of UVCP and also tried to investigate what is to be the initial approach for determining the causes of unknown-origin UVCP Materials and methods The charts of 82 patients with the diagnosis of UVCP were reviewed. The records were analyzed for patient's gender and age, the status of paralysed vocal cord, the crucial tests for the diagnosis, and the etiologies. Results : forty-nine(59.8%) male and 33(40.2%) female patients were included in this study. The age group of sixth decade was most commonly involved. Most of the cases showed paramedian position of palsy, and the left side(59.8%) was more frequently attacked. The most common cause of UVCP in this series was the unknown origin, followed by the surgical trauma and neoplasms. The etiologies of the six(12.5%) unknown-cause cases were found with the further evaluation, with the most useful test being a CT scan. Conclusion: Chest X-ray, esophagography, and CT scan should be included in the mandatory initial investigation of patients with unknown-origin UVCP

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Permanent Tracheostomy in a Thoroughbred Mare with Arytenoid Chondritis

  • Park, Soomin;Park, Kyung-won;Lee, Eun-bee;Sohn, Yongwoo;Jeong, Hyohoon;Kang, Tae-Young;Seo, Jong-pil
    • 한국임상수의학회지
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    • 제38권5호
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    • pp.244-248
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    • 2021
  • A 10-year-old Thoroughbred mare was referred to the Jeju National University Equine Hospital with roaring, dyspnea, and weight loss. On endoscopic examination, the horse was diagnosed with right arytenoid chondritis. Surgical treatment was selected due to the failure of a previous medical treatment. Permanent tracheostomy was performed in a standing position. The horse was restrained and tied in a proper position in the stock. The cranial parts of the 2nd to 5th tracheal cartilages were resected, as were the associated skin, mucosa, muscle, and cartilages. After the stoma was formed, external mucosa and skin were sutured using a simple interrupted method. The horse was hospitalized for 22 days receiving postoperative care including antibiotics, non-steroidal anti-inflammatory drugs, dressing as required, and was pregnant six months after the surgery. A permanent tracheostomy is thought to be effective in horses with diseases causing upper respiratory tract obstruction.

Differential Diagnosis and Treatment of Septic Arthritis in the Temporomandibular Joint: A Case Report and Literature Review

  • Kim, Bola;Choi, Hyo-Won;Kim, Jae-Young;Park, Kwang-Ho;Huh, Jong-Ki
    • Journal of Oral Medicine and Pain
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    • 제44권3호
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    • pp.127-132
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    • 2019
  • Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.

국소 마취 하 굴곡 내시경 후두 레이저 수술로 치료한 성문 제자리 암종 1례 (Treatment of Carcinoma in Situ of Glottis by KTP Fiberoptic Laryngeal Laser Surgery Under Local Anesthesia)

  • 이윤지;이은상;박기남;이승원
    • 대한후두음성언어의학회지
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    • 제30권1호
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    • pp.53-56
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    • 2019
  • The optimal treatments of carcinoma in situ of glottis include radiotherapy, laser surgery and vertical partial laryngectomy. Conventional surgical treatments need general anesthesia and radiotherapy has several complications. Recently, the effectiveness of 532 nm potassium titanyl phosphate (KTP) laser has been proven and widely used in vocal fold diseases even some cases of vocal fold dysplasia. A patient with difficult laryngeal exposure underwent fiberoptic laryngeal laser surgery using KTP laser under local anesthesia, showed improved voice outcome and the glottic lesion was removed successfully without local recurrence and regional metastasis 18 months after surgery.