• Title/Summary/Keyword: Bleeding detection

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A Clinical Manifestation of Meckel's Diverticulum (Meckel 게실의 임상양상)

  • Lee, Jin Beom;Lee, Yong Soon;Yoo, Eun Sun;Kim, Hae Soon;Son, Se Jeong;Park, Eun Ae;Lee, Seung Joo;Sung, Sun Hee;Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.466-472
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    • 2002
  • Purpose : The diagnosis of Meckel's diverticulum is difficult and delayed because it presents with various clinical symptoms. We evaluated clinical, imaging and pathologic findings of Meckel's diverticulum to facilitate detection of Meckel's diverticulum in children. Methods : Review of clinical, imaging, surgical and pathological findings in 10 children aged 7 days to 14 years with Meckel's diverticulum during an 8-year period, 1993-2001, at Ewha Womans University Hospital was undertaken. Results : The male to female ratio was 2.3 : 1. The chief complaint was painless lower gastrointestinal( GI) bleeding; others were abdominal pain, abdominal distention and vomiting, in order of frequency. The diagonsis before surgery were Meckel's diverticulum in 5 patients, non-reducible intussusception in 3 patients and intestinal obstruction in 2 patients. The diverticulum was located between 35 cm to 70 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 4 cm to 12 cm and 80% of it was within 5 cm. A Meckel scan($^{99m}Tc-pertechnetate$ scintigraphy) after cimetidine administration was done in 6 cases. All 5 cases that presented with lower GI bleeding had ectopic gastric mucosa confirmed on pathology. Out of 5 cases of ectopic gastric mucosa, only 4 cases were positive on the Meckel's scan. Conclusion : In cases of unexplained GI bleeding, obstruction, or inflammation diagnostic workup should be carried out to rule out Meckel's diverticulum. Laparoscopy, high resolution ultrasonography and computed tomography of the abdomen may be indicated in the assessment of pediatric patient with lower GI bleeding, especially in patients with suspected bleeding from Meckel's diverticulum showing negative Meckel's scan.

Hereditary Tyrosinemia Type I (Hereditary Tyrosinemia Type I 환아의 NTBC 치료 경험)

  • Kang, Hyun-Young;Kim, Sook Za;Song, Wung Joo;Chang, Mi-Young
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.4 no.1
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    • pp.13-17
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    • 2004
  • Hereditary tyrosinemia type I (fiunarylacetoacetate hydrolase deficiency) is an autosomal recessive inborn error of tyrosine metabolism that results in liver failure in infancy or chronic liver disease with cirrhosis, frequently complicated by hepatocellular carcinoma in childhood or early adolescence. Early detection of this condition is very important to early intervention for better prognosis of patients. Neonatal screening test using tandem mass spectrometry (MS-MS) is performed, and this method facilitates detection of the inborn error of tyrosine. For early treatment of tyrosinemia type I, phenylalanine and tyrosine restricted diet and NTBC (2-nitro-4-trifluoromethylbenzoyl-1,3-cyclohexanedione) for inhibition of succinylacetone production are recommended. We studied a 10-month-old Korean boy with tyrosinemia type I whose condition was not discovered earlier through conventional neonatal screening testing available in Korea. The patient presented hyperbilirubinemia, liver failure, bleeding tendency, colicky pain and skin melanin pigmentation in neonatal period. MS-MS made it possible to detect tyrosinemia type I and allowed immediate treatment of the patient. This was the first successful NTBC trial on tyrosinemia type I patient in Korea.

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Comparison of Oral Health Behavior and Oral Health Indexes between Patients Undergoing Scaling Regularly and Those Undergoing Scaling Irregularly (스케일링 환자들의 정기적인 스케일링과 비정기적인 스케일링의 구강건강행동지수와 구강건강지수 비교)

  • Kim, Yu-Rin
    • The Korean Journal of Health Service Management
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    • v.11 no.1
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    • pp.171-180
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    • 2017
  • Objectives : The objective of this study was to compare oral health behaviors and oral health indices between regular scaling group and irregular scaling group. Methods : This study was performed at M Dental Clinic in Busan on 352 dental patients treated between January 2014 and June 2015 using V6.0 software and medical interviews. The 352 patients were divided into 3 groups and oral health behavior (OHB) and oral health indices were compared. Results : The OHB scores significantly differed among Groups C and A. Group C had the lowest number of "Bad" scores for the Simplified Debris Index (S-DI), Simplified Calculus Index (S-CI), and Simplified Oral Hygiene Index (S-OHI). Groups B and A had the lowest number of "Excellent" scores. Group C had the lowest bleeding on probing (BOP), calculus rate (CR) and decayed teeth (DT). Furthermore, Group C had the highest number of missing teeth (MT) and filled teeth (FT). Conclusions : Patients who underwent regular scaling had the highest OHB and oral health index scores. This emphasizes the importance of regular scaling for prevention and early detection of oral disease.

A Clinical Evaluation of Mediastinoscopy (종격동경 검사의 임상적 의의)

  • Go, Yeong-Sang;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.26 no.9
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    • pp.705-709
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    • 1993
  • The mediastinoscopy was a well known useful diagnostic tool for detection of certain mediastinal tumors ,mediastinal lymph nodes invasion by bronchogenic carcinoma and metastatic cancer. A total of 33 cases of mediastinoscopies were reviewed, which were experienced at Chon Buk National University Hospital from August,1980 to October 1991. Mediastinoscopy was performed through anterior or parasternal approach in 18 cases, cervical approach in 14 cases and both in 1 case. In 12 cases which were used for preoperative stagig of lung cancer, 10 cases[83.3%] had the positive biopsy results at mediastinal nodes. In 11 cases for diagnosis of lymph nodes and masses with unknown lung lesion, small cell carcinoma revealed in 3 cases,squamous cell carcinoma in 2 , adenocarcinoma in 1 case and the others were had the negative biopsy results. In 10 cases for diagnosis of mediastinal tumors, lymphoma revealed in 2 cases, malignant thymoma in 2, sarcoidosis in 2, tuberculous granuloma in 1, mesothelioma in 1, metastatic cancer with unknown origin in 1 case. Thoracotomy was performed in 3 cases of lung cancers, 2 patients with negative biopsy results in preoperative staging and 1 patient with subcarinal lymph node involvement only. Bleeding complications during mediastinoscopy were developed in 2 cases, managed by anterior mini-thoracotomy.

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Uterine infarction in a patient with uterine adenomyosis following biochemical pregnancy

  • Lee, Jae-Yeon;Hwang, Kyu-Ri;Won, Kyu-Hee;Lee, Da-Yong;Jeon, Hye-Won;Moon, Min-Hwan
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.4
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    • pp.174-177
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    • 2014
  • Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

Hepatic Portojejunostomy for Biliary Atresia (담도폐쇄증에서 간문부-장 문합술의 성적)

  • Kim, In-Koo;Kim, Dae-Yeon;Kim, Seong-Chul
    • Advances in pediatric surgery
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    • v.5 no.2
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    • pp.111-115
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    • 1999
  • The results of hepatic portojejunostomy in 34 patients with biliary atresia operated upon by one surgeon between May 1989 and December 1997 were analyzed. Eleven (32.3 %) patients were 60 days or younger, 14 patient (41.2 %) were between 60 and 90 days, and 9 (26.5 %) were over 90 days of age. Jaundice cleared in 20 cases (58.8 %). Three patients died of liver insufficiency, 2 were anicteric but died from esophageal variceal bleeding. Three patients died as a result of sepsis, heart failure and left kidney agenesis. Five patients were lost to follow-up. The five-year survival rate was 73.8 %. Two patients over 90 days of age, survived more than 5 years. Survival rates were not significantly related to the age at operation. We conclude that hepatic portojejunostomy should be considered as a primary surgical modality for biliary atresia, even at age 90 days or more. Early detection of esophageal varices and sclerotherapy may be necessary. Liver transplantation is necessary if hepatic failure develops.

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Peutz-Jeghers Syndrome: A Case Report and Review of Literature (Peutz-Jeghers 증후군: 증례보고와 문헌고찰)

  • Kim, Hyun Soo;Kim, Soung Min;Choi, Jin Young;Myoung, Hoon;Lee, Suk Keun;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.363-366
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    • 2012
  • Peutz-Jeghers syndrome is a rare syndrome with characteristic features of multiple hamartomatous polyps and mucocutaneous pigmentation. This syndrome is an autosomal dominant disease, and has complications related with polyps of the gastrointestinal tract, such as small bowel obstruction, iron deficiency anemia associated with bleeding, and intussusceptions. Many studies have reported about higher cancer risk of patients with this syndrome than those with no syndrome in the gastrointestinal tract, including gastric, duodenal, jejunal and the extragastrointestinal organs, such as gallbladder, breast and reproductive system. There are guidelines for periodic test for early detection and treatment for higher risk organs. We report a case of Peutz-Jeghers syndrome patient in the emphasis of Oral and Maxillofacial surgeon's role with review of the literature.

A meta-analysis of microbiota implicated in peri-implantitis

  • Han-gyoul Cho;Ran-Yi Jin;Seung-Ho Ohk
    • International Journal of Oral Biology
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    • v.48 no.3
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    • pp.19-31
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    • 2023
  • Peri-implantitis is a disease affecting the tissue surrounding dental implants, destroying both soft and hard tissues. A total of 2,015 studies were collected by searching items in the National Library of Medicine, including keywords, such as "peri-implantitis," "microbiota," and "microbiome." Of them, 62 studies were screened and considered eligible for analysis. Only 16 studies qualified all criteria mentioned here: "Using PCR methods for microorganism detection," "Suggesting quantified results," "Stating obvious clinical diagnosis criteria ("Bleeding on probing," "Probing pocket depth," "Suppuration," and "Radiographic bone loss")." Only 8 studies were included in the meta-analysis because the others had special issues. Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, and Epstein-Barr virus were the microbiological subjects of analysis. The odds ratio (OR) between the healthy implants and peri-implantitis were calculated for each microorganism to compare two groups, and the forest plots were suggested as the visual materials. P. gingivalis (1.392 < OR < 2.841), T. forsythia (1.345 < OR < 3.221), T. denticola (2.180 < OR < 5.150), A. actinomycetemcomitans (1.975 < OR < 6.456), P. intermedia (1.245 < OR < 3.612), and Epstein-Barr virus (1.995 < OR < 9.383). The species showed that their 95% confidence interval of odds ratio was higher than 1, indicating that they were detected more frequently in periimplantitis than in healthy implants. Meanwhile, other species, such as Fusobacterium nucleatum and Staphylococcus aureus, were not included in the meta-analysis because the number of studies was insufficient.

Changes of estrus signs and genital organs by hormomal induction of estrus in the bitch (인공발정유도견의 발정기 변화와 생식기의 변화)

  • Yu, Il-jeoung;Kim, Yong-jun
    • Korean Journal of Veterinary Research
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    • v.36 no.3
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    • pp.719-729
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    • 1996
  • To investigate changes of estrus signs and genital organs in the bitch by hormonal induction of estrus, fourteen bitches of nulliparous and multiparous(2nd-5th) were grouped into diestrus and anestrus according to their estrus cycle. The hormonal treatments were divided into four groups: group A($PGF_2{\alpha}+PMSG+hCG$) and group B(PMSG+hCG) in diestrus bitches and group C(GnRH+FSH+hCG) and group D(PMSG+hCG) in anestrus bitches. The external signs of proestrus and estrus as well as the vaginal smear findings and natural breeding as estrus detection were investigated in all the experimental groups. Also, genital organs were examined at two months after the hormone treatment. The bitches in anestrus showed 100% of male attraction, vaginal bleeding and vulvar swelling as proestrus signs after the hormonal treatment for estrus induction and they showed higher numerical value of signs than the bitches in diestrus. The group A showed the lowest value in proestrous signs of all the groups. The bitches in anestrus treated with GnRH+FSH showed 100% of positive estrus by vaginal smear findings and 75% of natural breeding as estrus detection index and these values were the highest of all the groups. Pregnancy was recognized in only group C and the conception rate was 7.14% in al the experimental animals. Of the side effects after the hormone treatment, external findings of continous male attraction, continous external swelling and purulent exudate were recognized in all the experimental groups and the bitches in diestrus showed higher value of the findings than the bitches in anestrus. Of the changes of genital organs after the hormone treatment, hypertrophy of uterine horn, sanguineous exudate and purulent exudate as uterine findings were recognized in all the groups and these findings were shown more in the bitches in diestrus than in those in anestrus. These results indicated that group C showed the highest value of all the experimental groups in external signs of estrus and estrus detection and also pregnancy was recognized only in that group, consequently, that the hormonal treatment of group C would be the most effective for estrus induction, and also indicated that bitches in anestrus were more suitable than bitches in diestrus for the induction of estrus. In addition, side effects in external genital organs and uteri after hormone treatment were shown more in the bitches in diestrus than in those in anestrus, indicating that bitches in anestrus would be of choice for estrus induction.

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High Prevalence of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Infection in Thailand

  • Wanich, Nattawat;Vilaichone, Ratha-Korn;Chotivitayatarakorn, Peranart;Siramolpiwat, Sith
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2857-2860
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    • 2016
  • Background: Chronic hepatitis B (CHB) infection is one of the important causes of hepatocellular carcinoma (HCC) in Thailand, involved in the pathogenesis and leading to a development of HCC with or without cirrhotic changes of the liver. This study was aimed to investigate the predictive factors for HCC among CHB patients in a tertiary care center in Thailand. Materials and Methods: We conducted a retrospective study of CHB patients with or without HCC during the period of January 2009 and December 2014 at Thammasat University Hospital, Pathumthani, Thailand. Data on clinical characteristics, biochemical tests and radiologic findings were collected from review of medical records. Results: A total of 266 patients were diagnosed with CHB in Thammasat university hospital during the study period. However, clinical information of only 164/266 CHB patients (98 males, 66 females with mean age of 49.4 years) could be completely retrieved in this study. The prevalence of HCC in CHB infection in this study was 38/164 (23.2%). CHB patients with HCC had a mean age older than those without HCC (59.5 vs 47 years, P-value = 0.01). Furthermore, history of upper GI bleeding, tattooing, blood transfusion, and chronic alcoholism were significantly more common in CHB patients with HCC than patients without HCC (13.2% vs 3.2% P-value 0.03, OR = 4.6, 95%CI = 1.2-18.1, 20% vs 3.9%, P-value = 0.01, OR= 6.1, 95% CI= 1.6-23.6, 20% vs 6.3%, P-value = 0.03, OR = 3.8, 95%CI =1.1-12.7, 62.2% vs 30.3%, P-value <0.0001, OR = 3.7, 95%CI= 1.7-8.1 respectively). Interestingly, more CHB patients with HCC had evidence of cirrhosis than those without HCC (78.9% vs 20.4%, P-value <0.0001, OR = 14.6, 95%CI = 5.8-36.7). In CHB patients with HCC, surgical therapy provided longer survival than radiofrequency ablation (RFA) (72 vs 46.5 months, P-value= 0.04). The mean survival time after HCC diagnosis was 17.2 months. Conclusions: HCC remains a major problem among patients with CHB infection in Thailand. Possible risk factors are male gender, history of upper GI bleeding, chronic alcoholism, tattooing, blood transfusion and evidence of cirrhosis. For early stage HCC patients, surgical treatment provided longer survival time than RFA. Most HCC patients presented with advanced disease and had a grave prognosis. Appropriate screening of CHB patients at risk for HCC might be an appropriate approach for early detection and improvement of long-term outcomes.