• Title/Summary/Keyword: 위장의

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Sedative and Analgesic Effects of Intravenous Detomidine and Tramadol on Horses (말에서 detomidine과 tramadol의 정맥 투여에 의한 진정 및 진통효과)

  • Kim, Tae-Hoon;Jang, Min;Lee, Hang;Lee, In-Hyung
    • Journal of Veterinary Clinics
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    • v.29 no.3
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    • pp.226-232
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    • 2012
  • This study was performed to evaluate the sedative and analgesic effects of intravenous (IV) administration of detomidine (D) and tramadol (T) to horses. Six warmblood horses each received D (10 ${\mu}g/kg$), T (2 mg/kg), and a combination of DT (10 ${\mu}g/kg$ and 2 mg/kg). No significant differences in the heart rate, respiratory rate, rectal temperature, indirect arterial pressure, and gastrointestinal motility between D and DT were observed. The sedative effect was evident within 5 min after D and DT administration, but no significant difference between D and DT was observed. D and DT induced a similar analgesic effect up to 50 min after injection and DT maintained a longer analgesic effect than D. A significant increase in blood glucose was shown for D after the injection, but not for DT. A horse with T and DT showed an excited behavior within 5 min of the injection. This study suggests that the DT combination could be used for diagnostic procedures and simple surgeries in standing horses, with caution for excitement in the early phase after the administration.

Experience of Reoperation after Valve Replacement Using Mechanical Heart Valve -8 cases - (기계판막을 이용한 판막치환술 후 재수술에 대한 경험 -8예 보고-)

  • Kim Hyuck;Lee Hyung Chang;Wee Jang Seop;Kang Jung Ho;Chung Won Sang;Chon Sun Ho;Lee Chul Bum;Kim Young Hak
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.783-787
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    • 2005
  • Eight patients underwvnt reoperation after valve replacement surgery with a mechanical valve from January, 1992 to December, 2003. Among the various indications for reoperation, there were 4 patients with paravalvular leakage; 3 patients underwent resuturing of the area of leakage and one patient underwent redo valve replacement. Among the three patients with stenosis due to thrombosis of the valve, 2 patients underwent redo valve replacement and one patient underwent thrombectomy. In one patient, the valve functioned normally, but stenosis was caused by overgrowth of the patient and redo valve replacement was done 123 months later. There was no postoperative mortality or morbidity. After an average of 51 months ($2\~134$ months) of postoperative follow up, the patients were in good condition and were able to maintain a NYHA functional class of I or II. The operative method used, whether it be a redo valve replacement or valve sparing method, depends upon the type of lesion and the anatomic structure.

Early & Midterm Results after Redo Coronary Artery Bypass Grafting (관상동맥우회술 후 재수술의 단기 및 증기 성적)

  • 김준성;김홍관;장우익;김기봉
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.146-153
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    • 2004
  • As the experience of coronary artery bypass grafting (CABG) has been accumulated, the number of reoperation after CABG is increasing. We analyzed our clinical experience of redo-CABG. Material and Method: Fourteen patients who underwent redo-CABG between Jan. 1994 and Dec. 2002 were included in this study. The mean period from the first operation to reoperation was 66$\pm$56 (3∼157) months, and the average ages were 62.8$\pm$8.7 (51∼78) years. The survivors were followed up 39$\pm$29 (4∼101) months postoperatively. Indications of reoperation were stenosis or occlusion of previous grafts in 11 patients, progression of native coronary artery disease in one patient, and both etiologies in two patients. Result: There were two in-hospital mortalities (14.3%) resulting from low cardiac output syndrome, Postoperative morbidities were perioperative myocardiac infarction in 2 patients (14.3%), mediastinitis in one patient (7.2%), duodenal perforation in one patient, ischemic necrosis of the lower extremity in one patient, gastric perforation after mesenteric infarct in one patient, delayed brain infarct in one patient, and intraoperative splenic rupture in one patient. There was one late mortality at six months postoperatively during the follow up. There was no angina recurrence during the follow up. Conclusion: Although redo CABG demonstrated relatively high operative mortalities and morbidities, postoperative status and clinical outcome of the survivors were favorable.

A Case Report of Disseminated Extranodal Marginal Zone B-Cell Lymphoma of MALT Manifested by Solitary Pulmonary Nodule (고립성 폐결절로 발현한 파종성 림프절 외 변연부 B-세포 림프종 1예)

  • Cho, Joon Hyun;Jung, Jong Pil;Cha, Hee Jeong;Park, Chang Ryul;Kim, Sung Ryul;Kim, Hawk;Park, Jin Woo;Woo, Soon Joo;Eum, Eun A;Lee, Ki Young;Jegal, Yang Jin
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.171-177
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    • 2006
  • Extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is usually indolent. Although it was reported recently that about 20-30% cases of MALT lymphoma presented with a disseminated disease at diagnosis, it was described as a disease localized at diagnosis and remaining stable for a prolonged period. However, only a few cases of MALT lymphoma involved the lung and gastrointestinal tract all at once. We report a case of a 73-year-old man with disseminated MALT lymphoma. He presented with non-productive cough, initial chest radiograph showed a nodule in the right lower lobe. The diagnosis of stage IV MALT lymphoma was made by CT scan, video-assisted thoracoscopic excisional biopy, gastrofiberscopic biopsy and bone marrow biopsy. The lymphoma involved the lung, stomach and bone marrow at the time of diagnosis. Because he refused chemotherapy, he discharged after Helicobacter pylori eradication without chemotherapy. Regular follow-up examination did not show any evidence of disease progression over 22 months.

Evaluation of Proper Use of NSAIDs to Prevent Gastrointestinal and Cardiovascular Problems in Elderly Patients (노인환자에서 위장관계 및 심혈관계 부작용 발생 예방을 위한 NSAIDs 사용의 적절성 평가)

  • Joo, Sung-Lak;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.1
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    • pp.15-25
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    • 2014
  • Background: Elderly patients with gastrointestinal (GI) and cardiovascular (CV) risk factors may be more easily exposed to NSAID-related side effects (SEs). Based on the ACG guideline of year 2009, the aim of the study is to evaluate proper use of NSAIDs and gastroprotective drugs according to the degree of GI and CV risk strengths in the patients. Methods: Retrospectively surveyed 410 elderly patients with NSAIDs for more than 30 days at a general hospital in Korea. GI risk factor includes age, ulcer history, high-dose NSIADs, concurrent aspirin use, steroids or anticoagulants. CV risk factor includes angina, myocardial infarction, cerebral infarction, atrial fibrillation or coronary intervention requiring low-dose aspirin. These factors were classified as high/low cardiovascular groups and high/moderate/low GI groups. Results: There were 14 patients in high CV risk group and high GI risk group. The group was recommended not to use NSAIDs as it is not adequate. There were 101 patients in high CV risk group and moderate GI risk group. This group was recommended to use naproxen and PPI/misoprostol. But all patients except one were not adequate. There were 9 patients in low CV risk group and high GI risk group. This group was recommended to use selective COX-2 inhibitor and PPI/misoprostol. 5 cases were proper while 4 cases did not. There were 285 patients in low CV risk and moderate GI risk group who were recommended to use non selective NSAIDs and PPI/misoprostol or selective COX-2 inhibitor only. 103 patients were proper while 182 patients not adequate. Overall, the SEs were higher in those cases for inadequate use of drugs comparing to the adequate. CV SEs were statistically significant. However, SEs for each risk groups were different. For the case of low CV risk group and high/moderate GI risk group, the inadequate use of drugs makes the SE high and the other groups are not. Also, it was not statistically significant. Conclusions: In elderly patients, the inappropriate use of NSAIDs can increase the risk of the disease. Therefore, GI and CV risk must be considered simultaneously, and the proper use of NSAIDs and gastroprotective drugs for each risk groups should be reconsidered.

A Problem of Disqualified Fee Imposition Standard in Public Cremation Facilities on Internet Reservation of e-Haneul Funeral Total Information System and an Improvement Proposal (공설화장시설 사용료 부과기준 부적정이 e-하늘 장사종합정보시스템 인터넷 예약에 미치는 문제점 및 개선방안)

  • Choi, Jae-sil;Kim, Jeong-lae
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.16 no.3
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    • pp.163-172
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    • 2016
  • This study conducts an analysis of a problem on internet reservation of e-haneul funeral total information system by disqualified fee imposition standard in public cremation facilities through research and investigation focusing on the operational realities and an ordinance related to public cremation facilities made by each local government across the country, and then is to suggest a policy proposal to improve the drawn problem. As a result of the analysis, as a way to improve the drawn problems, this study suggests a policy proposal that prevents an illegal camouflaged move-in to reduce fee by restricting residence period in requirement of local residents inside the jurisdiction who can use public cremation facilities, raises fee of public cremation facilities of local residents inside the jurisdiction into the optimum level that is set cheaper than production cost, and unifies age norm of an object to apply adult fee in the central government about a difference of age norm of an object to apply fee of adult with the highest availability of public cremation facilities between local governments, resolving a fee difference through fee cutting of local residents outside the jurisdiction priced higher than production cost.

ORAL HEMORRHAGE CONTROL AS TREATMENT PRIORITY IN A MENTALLY RETARDED PATIENT WITH MULTIPLE TRAUMA (다발성 손상을 가진 정신지체 환자에서 치료 우선순위로 구강출혈의 조절)

  • Oh, Ji-Hyeon;Kim, Ji-Hun;Yoo, Jae-Ha
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.20-26
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    • 2016
  • Sympathetic reaction to grotesque facial injuries with oral bleeding can trigger confusion and generate inefficiency among emergency room personnel. Regardless of the extent of the injury, or of the sympathy elicated, the victim must be evaluated and treated as a whole patient with multiple trauma. There must be no confusion as to order of importance in the steps of evaluation : 1. airway 2. hemorrhage 3. shock 4. associated injuries 5. local injury 6. triage of facial injuries. The most dangerous aspect of oral hemorrhage is the possibility of its obstructing the upper airway. Swallowing large amounts of blood will usually cause gastric irritation and lead to vomiting, thus further complicating the management of the patient. Once a clear airway is assured and hemorrhage have been controlled, consideration is given to possible associated injuries before undertaking treatment of the facial injuries themselves. Status of the cardiopulmonary, gastrointestinal and neuromuscular systems all have a bearing on decisions concerning facial injury treatment. In this light, treatment priority becomes exceeding important. On the other hand, the importance of facial injuries should never be minimized, especially in a mentally retarded patient with oral hemorrhage. This is a case report about oral hemorrhage control as treatment priority in a mentally retarded patient.

EARLY DETECTION OF BEHCET'S DISEASE (베체트병의 조기 진단)

  • Kim, Seung-Hye;Song, Je-Seon;Choi, Hyung-Jun;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.575-579
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    • 2009
  • Behcet's disease(BD) is a multisystem vasculitis that almost any organ in the body may be involved. Its diagnosis bases on clinical criteria in the absence of any specific laboratory test to confirm it. The clinical criteria proposed for the diagnosis for BD include recurrent oral and genital ulceration, skin lesion, ocular changes, and positive response to pathergy test. Besides these essential features, BD may manifest itself on the gastrointestinal tract, central nervous system, and other systemic involvements. Among these clinical features, recurrent oral ulcers are present in most BD patients, often as the initial symptom, preceding other manifestations by many years. Therefore, dentists are in the important position for the early detection and diagnosis of BD. In this case report, we are presenting a case of 6 year-old girl, who came to the pediatric dentistry department for evaluation and treatment of pain and dysphagia caused by severe recurrent oral ulcers. Through taking detailed dental and medical history and clinical examination, we reported the possibility of BD to the medical team and prescribed topical lidocaine to relief pain during swallowing. The medical team, which involved pediatrics, ophthalmology, dermatology, and gastroenterology, finally confirmed BD through various examinations. Detection of the possibility of BD in the dental field helped early diagnosis and proper management by the medical team.

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Laparoscopy-assisted Total Gastrectomy with Pancreas-preserving Splenectomy for Early Gastric Cancer: A Case Report (조기위암에서 복강경보조 위전절제술 및 췌장보존식 비전절제술 1예)

  • Park, Jong-Min;Kim, Do-Yoon;Lee, Jae-Man;Leem, Chai-Sun;Jin, Sung-Ho;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.97-101
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    • 2007
  • We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.

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Undifferentiated Adenocarcinoma with Rhabdoid Features in the Stomach: A Case Report (횡문근양 미분화 위선암 1예 보고)

  • Im, Myoung-Goo;Jun, Kyong-Hwa;Won, Yong-Sung;Jung, Ji-Han;Chin, Hyung-Min;Park, Woo-Bae;Chun, Chung-Soo
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.107-112
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    • 2007
  • Rhabdoid tumor has been considered to be a rare subtype of Wilm's tumor with Rhabdomyoma features. Since rhabdoid tumor that developed in the kidney was described for the first time in 1989, it has been reported in the gastrointestinal tract, although this is rare. The appropriate treatment is radical resection, and the effect of adjuvant chemotherapy has not yet been reported on. The outcome of extra-renal rhabdoid tumor is different from renal rhabdoid tumor and the former shows a poor prognosis. Among extra-renal rhabdoid tumors, undifferentiated gastric adenocarcinoma with rhabdoid features is very rare and its prognosis is poor. A 63 years old male patient underwent total gastrectomy for a tumor that developed in the greater curvature of the gastric body and this was diagnosed as undifferentiated gastric adenocarcinoma with rhabdoid features, according to the histopathology. We experienced an undifferentiated gastric adenocarcinoma with rhabdoid features that was diagnosed by immunohistochemical staining and we report here on this case.

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