• Title/Summary/Keyword: 천자

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The Effects of Urokinase Instillation Therapy via Percutaneous Transthoracic Catheter Drainage in Loculated Tuberculous Pleural Effusion: A Randomized Prospective Study (소방이 형성된 결핵성 흉막염 환자에서 경피적 도관을 이용한 유로카나제 치료의 효과 ; 전향적 무작위연구)

  • Lee, Yong-Whan;Kwak, Seung-Min;Kwon, Mee-Young;Bae, In-Young;Park, Chan-Sup;Moon, Tae-Hun;Cho, Jae-Hwa;Ryu, Jeong-Seon;Lee, Hyong-Lyeol;Roh, Hyung-Keun;Cho, Chul-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.601-608
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    • 1999
  • Background: Tuberculous pleural effusion responds well to the anti-tuberculosis agents in general, so no further aggressive therapeutic managements to drain the tuberculous effusion is necessary except in case of diagnostic thoracentesis. But in clinical practice, we often see some patients who later decortication need due to dyspnea caused by pleural thickening despite the completion of anti-tuberculosis therapy in the patients with tuberculous effusion. Especially, the patients with loculated tuberculous effusion might have increased chance of pleural thickening after treatment. The purpose of this study was that intrapleural urokinase instillation could reduce the pleural thickening in the treatment of loculated tuberculous pleural effusion. Methods: Thirty-seven patients initially diagnosed as having loculated tuberculous pleural effusion were randomly assigned to receive either the combined treatment of urokinase instillation and anti-tuberculosis agents(UK group) and anti-tuberculosis agents(Non-UK group) alone. The 16 patients in UK group received a single radiographically guided pig-tail catheter ranging in size from 10 to 12 French. 100,000 units of urokinase was dissolved in 150 ml of normal saline and instilled into the pleural cavity via pig-tail catheter every day, also this group was treated with anti-tuberculosis agents. While the 21 patients in Non-UK group were treated with anti-tuberculosis agents only except diagnostic thoracentesis. Then we evaluated the residual pleural thickening after treatment for their loculated tuberculous pleural effusion between the two groups. Also the duration of symptoms and the pleural fluid biochemistry like WBC counts, pH, lactic dehydrogenase(LDH), glucose, proteins, and adenosine deaminase(ADA) were compared. Results: 1) The residual pleural thickening(RPT)($5.08{\pm}6.77$ mm) of UK group was significantly lower than that($20.3222{\pm}26.37$ mm) of Non-UK group(P<0.05). 2) The duration of symptoms before anti-tuberculosis drug therapy of patients with RPT$\geq$10 mm($5.23{\pm}3.89$ wks) was significantly longer than the patients with RPT<10 mm($2.63{\pm}1.99$ wks)(P<0.05). 3) There were no significant differences in the pleural fluid findings like WBC count, glucose, LDH, proteins, pH, ADA between the patients with RPT$\geq$10 mm and the patients with RPT<10 mm. Conclusion : The treatment of loculated tuberculous pleural effusion with the urokinase instillation via percutaneous transthoraic catheter was effective to reduce the pleural thickening.

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Two Cases of Giant Cell Tumor of the Bone Diagnosed by Fine Needle Aspiration Cytology (골 거대세포종의 2예 세침 천자 세포학적 소견)

  • Myong, Na-Hye;Ha, Chang-Won;Cho, Kyung-Ja;Jang, Ja-June;Baek, Goo-Hyun;Lee, Soo-Yong
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.93-97
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    • 1990
  • Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are described. Case 1 was a 28-year-old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multiseptation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 revealed moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus. Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms. Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells. All two cases revealed neither nuclear atypism nor increased abnormal mitoses In both giant and stromal cells, suggesting no evidence of malignancy. Thereafter the lesions were treated with excision and curettage, and histologically confirmed as giant cell tumors of the bone.

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Effect of Post Operative Daily Activity on Post-dural Puncture Headache after Spinal Anesthesia (척추마취수술 환자의 수술 후 일상활동이 경막천자 후 두통 발생에 미치는 효과)

  • Park, Jee Eun;Jung, Hyun Joo;Kim, Jung Hwa;Han, Bok Hee;Sin, Joo Hee;Yu, Ga Kyung;Choi, Hyun Jin;Kang, Hwa Ja
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.3
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    • pp.336-344
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    • 2016
  • Purpose: The purpose of this study was to compare and analyze differences in effects of postoperative daily activity on headaches in patients who underwent surgery under spinal anesthesia. Methods: The study was conducted with 219 adults, 20 years or older. Official approval (Approval number: KMC IRB 1434-01) was received from K university hospital clinical trials review board. The research design was a nonequivalent control group non-synchronized design with a daily activities group and the bed rest group. Data was collected after receiving written consent from the participants. Results: There were no participants in either group who experienced headaches. Changes in a physiological index were also not significantly different between the daily activities group and the bed rest group. Conclusion: The results indicate that allowing daily activities in the ward, rather than maintaining bed rest for 6 hours, the existing method of nursing care for the prevention of postoperative headaches, in spinal anesthesia patients, is not detrimental to these patients post operatively.

A Case of Buccal Cellulitis Caused by Haemophilus influenzae Type b in an Immunocompetent Child (면역 기능이 정상인 소아에서 발생한 b형 Haemophilus influenzae에 의한 협부 봉와직염(Buccal Cellulitis) 1례)

  • Lee, Jin A;Kim, Dong Ho;Koo, Ja Wook;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.234-240
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    • 2001
  • Buccal cellulitis which presents with high fever and a swelling of the cheek with violaceous hue in young children is most often caused by H. influenzae. Bacteremia is common in buccal cellulitis caused by H. influenzae, and a culture of cerebrospinal fluid should be obtained because meningitis may be present despite the lack of meningeal irritation signs. Although buccal cellulitis is considered to be one of the important manifestations of H. influenzae infection, only two cases have been reported in Korea yet. We experienced a case of buccal cellulitis with H. influenzae bacteremia in an immunocompetent girl of 18-month-old. She was presented with high fever followed by rapidly progressive swelling and tenderness of both cheeks with violaceous hue in four hours. The blood culture revealed H. influenzae type b. There was no concurrent otitis media, sinusitis, or meningitis and no portal of entry was identified. Fever subsided two days after starting intravenous cefotaxime. Intravenous cefotaxime was subsequently changed to oral cefixime, and antibiotics were administered for a total of two weeks. We report this case with a review of related literature.

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Re-Examination of Blood Vessels of Rat Tail Using Angiographic and Histological Methods (혈관조형술과 조직학적 방법을 이용한 랫드 꼬리의 혈관구조 규명)

  • Lee, Kyoung-Sun;Jeong, Eui-Suk;Heo, Seung-Ho;Seo, Jin-Hee;Lee, Min-Su;Eom, Ki-Dong;Choi, Yang-Kyu
    • Journal of Veterinary Clinics
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    • v.27 no.2
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    • pp.159-162
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    • 2010
  • Although the tail vessels are frequently used for serial blood sampling in rat, the definition of its vasculature remains in dispute. Herein, we investigated the number of blood vessels in Sprague-Dawley rat tail using angiographic and histological methods. Our results showed rat tail has one dorsal vein, two lateral veins, one ventral artery and one ventral vein. In the conclusion, when deciding which site is best for collecting blood, it is critical to consider the structure and features of the blood vessels to be used. This study will also be helpful for investigators to understand the structure of blood vessels in rat tail.

Carbon Monoxide Dehydrogenase in Cell Extracts of an Acinetobacter Isolate (Acinetobacter sp.1의 일산화탄소 산화효소의 특성)

  • 조진원;김영민
    • Korean Journal of Microbiology
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    • v.24 no.2
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    • pp.133-140
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    • 1986
  • Extracts of CO-autotrophically grown cells of Acinetobacter sp. 1 were shown to use thionin, methylene blue, or 2,6-dichlorophenol-indophenol, but not NAD, NADP, FAD, or FMN, as electron acceptors for the oxidation of CO under strictly anaerobic conditions. The CO dehydrogenase (CO-DH) in the thes bacterium was found to be an inducible enzyme. The enzyme activity was determined by an assay based on the CO-dependent reduction of thionin. Maximal reaction rates were found at pH 7.5 and $60^{\circ}C$, and the Arrhenius plot revealed an activation energy of 6.1 kcal/mol(25.5kJ/mol). THe $K_m$ m/ for CO was $154{\mu}M$. Known metalchelating agents tested had no effects on the CO-DH activity. No divalent cations tested affect the enzyme activity significantly escept $Cu^{2+}$ which suppressed the activity completely. The enzyme was inhibited by glucose and succinate. The same extracts catalyzed oxidation of hydrogen gas and formate with thionin as electron acceptor. The CO-DH of Acinetobacter sp. 1 was to have no immunological relationship with that of Pseudomonas carboxydohydrogena.

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Epidural Steroid Injection in the Treatment of Cervical Radiculopathy (Cervical Radiculopathy에 대한 경막외 Steroid 주입에 관하여)

  • Choe, Huhn;Han, Young-Jin;Baek, Hae-Jung;Kim, Dong-Chan
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.152-156
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    • 1991
  • Cervical radiculopathy has been recognized as a common cause of neck, shoulder, and arm pain. It was conventionally treated with rest, traction, cervical collars, manipulation, transcutaneous electrical nerve stimulation, and nonsteroidal anti-inflammatory drugs with varying results. Surgery has not always been successful so the idea of epidural steroid injection was developed as in the case of lumbar epidural injections, for the treatment of low back pain and sciatica. Thirty one patients with evidence of cervical radiculopathy were treated with injections of triamcinolone acetate into the cervical epidural space. The effect of the steroid injection could be evaluated in twenty one patients who received epidural injections more than twice. No improvement was seen in 6 patients and 15 patients showed good to excellent pain relief for a week to over 6 months. Epidural steroid injection seems to have a positive role in the treatment of cervical radiculopathy.

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Predicting Factors for the Distance from Skin to the Epidural Space with the Paramedian Epidural Approach (방정중접근법에 의한 경막외 천자시 피부로부터 경막외강까지의 거리의 예측인자)

  • Shim, Jae-Chol;Lee, Myoung-Eui;Kim, Dong-Won
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.349-353
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    • 1996
  • Background: Although the paramedian approach for epidural blockade is useful in some clinical situation, the parameters which are correlated with the distance from skin to the epidural space has not been established. Methods: We studied in 143 patients having elective continuous epidural blocks for relief of postoperative pain. All blocks were performed using paramedian approach with Tuohy needle in the lumbar (group 1, n=100) and thoracic (group 2, n=45) area. We measured the distance from skin to the epidural space, body weight, height, and the angle between the shaft of the needle and the skin. Data were analyzed by linear regression. The relationships between parameters identified by the F-test with a P value of less than 0.05 were considered statistically significant. Results: The mean distance from skin to the lumbar epidural space was $4.4{\pm}0.7$ cm. significant correlation between the body weight and the depth of lumbar epidural space ($\gamma$ value : 0.492) was noted with regression equation of depth(cm)=2.293+0.034${\times}$body weight (kg). Also the significant correlation between the ponderal index (PI) and the depth of lumbar epidural space ($\gamma$ value : 0.539) was noted with regression equation of depth(cm)=1.703+0.07${\times}$PI, The mean distance from skin to the thoracic epidural space was $5.2{\pm}0.7cm$ which did not correlated with other anatomic measurements. Conclusion: We found that PI and body weight are the suitable predictors of the depth of the lumbar epidural space, but not the thoracic epidural space.

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A Case of Acute Idiopathic Thrombocytopenic Purpura Following Influenza B Virus Infection (B형 인플루엔자 감염에서 나타난 특발성 혈소판 감소성 자색반증)

  • Jung, Seungwon;Kang, Sunghee;Kang, Jin Han;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.22 no.2
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    • pp.117-120
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    • 2015
  • Virus-associated immune thrombocytopenic purpura (ITP) can occur following common viruses, but cases of ITP associated with influenza infection has seldom been reported. In this report we describe a previously healthy 5-year-old boy who admitted with fever, flu-like symptoms and a few bruises on both legs. Severe thrombocytopenia were found. Bone marrow aspirates and biopsy showed no abnormalities and results of coagulation tests were all in normal limit. Real-time polymerase chain reaction was positive for influenza B infection. The patient fully recovered with intravenous immunoglobulins and steroid therapy.

Pulmonary Aspergillosis in Cardiac Transplant Patients -The Report of Two Cases (심장이식후 발생한 아스페르길루스증-2례 보고-)

  • 박국양;김희정
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.330-335
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    • 1997
  • Aspergillus Infection is a major.cause of mortality in individuals with depressed cell-mediated immunity. Despite therapy with intravenous amphotericin B and oral antifungal agents, high mortality has been reported among heart transplant recipients. We experienced two cases of pulmonary aspergillosis among 15 heart transplantation cases. Both cases were similiar in terms of age, time of diagnosis, and medication. Percutaneous needle aspiration biopsy revealed Aspergillus fumigatus in both cases. The thirst case showed multiple aspergilloma on both lung fields and were treated by IV Amphotericin B and oral itraconazole. After completion of treatment, the lesion completely disappeared and he has been followed up for more than one year in his good condition. The second case showed a single nodule on his right lower lung field and were treated by both medication and surgery. The patient recovered well and had been doing well until 4th postoperative month when he developed humoral rejection and expired.

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