• Title/Summary/Keyword: Oral ulcer

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Giant Right Atrial Thrombi Formation Associated with Hemodialysis Catheter Placement in a Dog

  • Shin, Du-Ree;Yang, Hyuck-Joo;Kim, Hye-Young;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.478-480
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    • 2017
  • A Cocker spaniel (7-year-old, female) was presented with one week of anorexia, halitosis, oral ulcer, intermittent vomiting, acute weight loss and 3-day history of oliguria. The patient was diagnosed with acute on chronic kidney disease and pancreatitis. Hemodialysis was continued three times a week (total 7 sessions) with improved clinical signs and kidney panel, but presented with another episode of abdominal distention, respiratory distress, and large bowel diarrhea. Echocardiography revealed nearly totally occlusive thrombus in the cranial vena cava, as well as a right atrial mass of approximately $2cm{\times}1cm$. The patient was treated with catheter removal, thrombolysis and anticoagulation therapy with recombinant tissue plasminogen activator. During anticoagulation therapy, size of atrial thrombus was not changed and heart function was not improved after treatment. Since clinical signs were deteriorated, the patient was euthanized by owner's request. Catheter-related giant thrombus in right atrium is a rare complication and treatment guideline for atrial thrombus does not exist. This case is first report of hemodialysis catheter-induced thrombus in Korea.

Superior Vena Cava Syndrome Without Thrombosis Found in Behcet's Disease

  • Kim, Hyun-Soo;Kim, Hyung-Jun;Hur, Ki-Hwan;Kim, Kyung-Rok;Choi, Jae-Won;Kang, Dong-Woo
    • Journal of Yeungnam Medical Science
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    • v.29 no.1
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    • pp.38-41
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    • 2012
  • Behcet's disease is a rare multisystemic disorder whose main pathological defectis vasculitis, and superior vena cava (SVC) syndrome without thrombosis is a very rare manifestation of the disease. These authors encountered a case of SVC syndrome without thrombosis caused by Behcet's disease. A 33-year-old man visited the hospital for aggravated dyspnea without any related medical and familial history. He had a threeday history of abrupt swelling of the face, neck, and right arm. He suffered from recurrent oral ulcer, and there were acneiform nodules on his face as well as redness and swelling at the site of the intravenous injection. On the multi-detected computed tomography (CT) chest angiograms (chest angio MDCT), the SVC narrowed without thrombosis. Venogram was carried out, and percutaneous transluminal balloon angioplasty of the SVC stenotic site was performed. The following day, the swelling was found to have subsided. The details of the case are reported herein.

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Preventive Strategies of Ventilator Associated Pneumonia

  • Kim, Jin-A;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.42-55
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    • 2009
  • Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

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The Effects of Implementation of Ventilator-Associated Pneumonia Prevention Bundles (인공호흡기 관련 폐렴 예방 번들 적용의 효과)

  • Kim, Sea Joung;Lee, Yun Mi;Cho, Jeonghyun
    • Journal of Korean Critical Care Nursing
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    • v.10 no.2
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    • pp.14-23
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    • 2017
  • Purpose: The purpose of this study was to evaluate the effectiveness of a ventilator-associated pneumonia (VAP) bundle. Methods: This was a retrospective study that was carried out between June 2010 and October 2015. In this study, 3,224 intubated patients were included. The VAP bundle which was applied to Group 1 patients (n=470) included head-of-bed elevation to 30 degrees, cuff pressure monitorization, prophylaxis of peptic ulcer, and prophylaxis of deep vein thrombosis. The VAP bundle for Group 2 patients (n=1,914) included all the elements of the VAP bundle for Group 1 patients and one additional element which was oral care with 0.12% chlorhexidine. The VAP bundle for Group 3 patients (n=870) added sedative interruption and assessment of readiness to extubate to the VAP bundle for Group 2. Results: The numbers and incidences of VAP were significantly different among the three groups. Moreover, there were significant differences among groups in ICU length of stay and mortality. Conclusion: Three different VAP prevention bundles made different effects in patient outcomes.

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A case of Diagnosing Paraquat Intoxication on Transferred Patient with Acute Renal Failure (원인 불명의 급성 신부전으로 발현된 급성 파라콰트중독 1례)

  • Gil Hyo Wook;Yang Jong Oh;Lee Eun Young;Hong Sae Yong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.1
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    • pp.45-48
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    • 2004
  • Paraquat, a widely used herbicide, is extremely toxic, causing multiple organ failure in human. Many treatment modality has been used, but now paraquat is very fatal drug. Elimination rate of plasma paraquat seems to be a factor for the survival rate. So early diagnosis and early treatment are very important. Plasma paraquat concentration could be measured by radioimmunoassay. But it is impossible that the test was done at Emergency room and the result was checked immediately. There was relation between plasma paraquat concentrations and urine paraquat concentration. Because of its simplicity and low cost, urine paraquat concentration test is complementary to the plasma concentration measurement. If the patient has psychotic problem or unconscious mental state, and is observed unexplained dyspnea and oral ulcer, urine paraquat test is very important to rule out acute paraquat intoxication. We experienced a patient who was presented as unexplained acute renal failure initially and was diagnosed as paraquat intoxication later.

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Mass paraquat poisoning in a small island community (case report) (한 작은 섬에서의 파라콰트 집단중독)

  • Lee, Sung-Woo;Chung, Tae-Wha;Choe, Kang-Won;Lim, Jung-Ki;Lee, Duk-Hyoung
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.454-465
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    • 1989
  • In a small island community with a population of less than 100 residents, nine persons died and five experienced severe illnesses during the period from November 1986 to May 1988. Their initial symptoms were sore throat and fever. Renal failure and hepatitis developed within one week after the onset. Oral mucosal ulcer developed in some cases. After one week, progressive respiratory failure and dyspnea developed evidently and severe respiratory distress and hypoxia preceded those fatal cases. Chest X-ray findings revealed bilateral diffuse multiple cystic lesion with occasional multiple large emphysematous bullae. Based on these features paraquat poisoning was diagnosed and route of poisoning was investigated. In three sources of drinking water, trace amount of paraquat was detected in November 1988, six months after the incidence of recent fatal case. In November 1988, soybean sauces and soybean pastes from 12 households were found contaminated with high concentration of paraquat, the cause could not be identified. The possibility of the contamination of drinking water as the cause of this mass poisoning has been suggested.

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Anti-oxidant Effects of Portulaca oleracea L. on HCl-ethanol Induced Gastritis in Rats (염산-에탄올에 의해 유발된 흰쥐 위염에 대한 마치현의 항산화 작용)

  • Kim, Chae-Hyun
    • The Korea Journal of Herbology
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    • v.24 no.1
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    • pp.35-40
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    • 2009
  • Objectives : The purpose of this study is to evaluate whether or not a pretreatment with Portulaca oleracea has an antioxidant effect in HCl-ethanol induced gastric mucosal damage. Methods : We elucidated the level of reactive oxygen species (ROS), lipid peroxidation, and two important constituents of antioxidant defense such as superoxide dismutase (SOD), glutathione (GSH) in these effects. Results : The oral administration of crude extract from P. oleracea attenuated the gastritic lesion area, submucosal edema and hemorrhage, and mucosal necrosis induced by HCl-ethanol. The MDA levels of control group were higher than those in the rats given the P. oleracea pretreatment. While the GSH levels of control were decreased, the GSH activity on the gastric mucosal layer maintain normal level in rats given the Portulaca oleracea pretreatment before HCl-ethanol induced gastritis significantly increased. However, the SOD activites were not altered by P. oleracea. Conclusions : The administration of Portulaca oleracea have a protective antioxidant effect against the gastric lesion induced by HCl-ethanol and may therefore be a promising drug for gastritis and gastric ulcer.

Evaluation after Applicated a Mold to a Paraneoplastic Autoimmune Multiorgan Syndrome Patient with Hypervascular Ulcer in the Oral Cavity during Treatment with Mold Brachytherapy (Paraneoplastic Autoimmune Multiorgan Syndrome으로 인하여 구강 내 국소적으로 발생한 과다혈관성 궤양의 방사선 근접치료 시 자체 제작한 Mold의 유용성 평가)

  • Park, Ju-Kyeong;Lee, Sun-Young;Lim, Seok-Geon;Kwak, Geun-Tak;Lee, Seung-Hun;Kim, Yang-Su;Hwang, Ho-In;Cha, Seok-Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.1
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    • pp.25-31
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    • 2009
  • Purpose: Evaluate the mold we have made to improve the reproducibility of the patient position and make homogeneous dose distribution to the treatment volume effectively when treating the patient who has hypervascular ulcer on her tongue caused by paraneoplastic autoimmune multiorgan syndrome by mold brachytherapy. Materials and Methods: The mold is consisted of upper and lower parts. We inserted 2 mm of lead sheet on the gums toward the oral cavity to protect them from unnecessary irradiation during the treatment. We had planned on orthogonal images obtained the patient. 200 cGy was delivered in every fraction with a total dose of 3000 cGy. To evaluate the effect of the lead sheet, we made a measurement with a phantom that has gums and tongue made of tissue with an equivalent material (bolus). Five of TLDs were placed on the interesting points of gums to measure the dose during irradiation with lead sheet and without lead sheet for three times respectively. Results: The result of the measurement without lead sheet are A: 33.9 cGy, B: 30.1 cGy, C: 31.8 cGy, D: 23.3 cGy, E: 24.1 cGy. The results of measurement with lead sheet are A: 20.6 cGy, B: 18.8 cGy, C: 19.6 cGy, D: 14.7 cGy, E: 15.1 cGy. Conclusion: Since we are using the mold made in our department during the treatment of the patient with hypervascular ulcer on tongue, we could deliver a proper dose to the treatment volume. In addition, the mold provided highly accurate and reproducible treatment and reduced the dose to the gums and teeth. Therefore, the possibility of side effects could be decreased significantly.

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Clinical and Therapeutic Aspects of Squamous Cell Carcinoma of Oral Tongue (구강 설 편평 상피 세포암의 임상적, 치료적 고찰)

  • Ryu Samuel;Lee Chang Gul;Park In Kyu;Suh Chang Ok;Kim Gwi Eon;Loh John J.K.
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.105-110
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    • 1987
  • Fourty nine patients with squamous cell carcinoma of oral tongue were reviewed retrospectively for the evaluation of clinical manifestation and for the comparison between therapeutic modalites. The gross shape of the tumor was infiltrative in 22, ulcerative in 12, ad ulcer-oinfiltrative type in 10 patients. Direct extension of the tumor was most commonly to the floor of the mouth. The incidence of nodal metastasis generally increased with tumor stage. $55\%$ of the patients showed neck nodal metastasis at the time of diagnosis. Ipsilateral subdigastric node were most commonly involved, followed by submandibular nodes. The 5-year survival rate of patients treated with surgery and radiotherapy was $58.7\%$ in contrast to $21.6\%$ in radiation alone group. Overall 5-year survival rate was $31\%$ In radiation alone group, half of the patients in stage I, II were locally controlled. But the local control In stage III, IV was much inferior to early lesions. Especially, of 4 patients combined with implantation technique, 3 were completely controlled. 5-year survival rate of these implanted patients was $50\%,\;49.4\%$ of patients treated over 7,000cGy survived 5 years. This was significant in contrast to $6.4\%$ of the group treated below 7,000cGy. The most common sites of failures were primary sites. In early lesions primary radiotherapy with implantation would be an appropriate treatment in cancer of oral tongue, operation reserved for radiation failure. Operation and adjuvant radiotherapy is recommended in cases of advanced disease.

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Induction of Heme Oxygenase-1 by Traditional Herb Mix Extract Improves MKN-74 Cell Survival and Reduces Stomach Bleeding in Rats by Ethanol and Aspirin in vivo

  • Kang, Young-Jin;Moon, Hyung-Suk;Kim, Hye-Jung;Seo, Han-Geuk;Lee, Jae-Heun;Chang, Ki-Churl
    • The Korean Journal of Physiology and Pharmacology
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    • v.11 no.2
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    • pp.65-70
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    • 2007
  • Chinese herb medicines have traditionally been used to treat or alleviate the symptom of various diseases. The rationale for use of certain herbs to certain disorder is now getting unveiled by modern technology. In the present study, we investigated whether herb mix extract(HMX), which is alleged to be useful for gastric ulcer, protects stomach from oxidative stress. Rats were allowed to normal diet with and without HMX (1, 5, 10 mg/kg) for 30 days. To induce gastric ulcer, ethanol (75%, 1.5 ml) or acidified aspirin (100 mg/kg in 0.2 N HCl) was administered by oral route in 24 h-fasted rats and examined the gastric ulceration(bleeding) by measuring the size 1 h after the treatment. Results indicated the area of gastric bleeding was significantly less in HMX fed rats than in normal diet fed ones, and it was dependent on the duration and amount of HMX. To investigate the underlying mechanism by which HMX protects stomach from oxidative stress, expression of enzymes like heme oxygenase (HO), cyclooxygenase (COX), and inducible nitric oxide (iNOS) were investigated in MKN-74 cells, where aspirin or H. pylori was introduced. The results were compared with RAW 264.7 cells to check if there's cell specificities exist. The expression of HO-1 but not COX-2, iNOS was significantly increased by HMX. Furthermore, HO-1 inhibitor, SnPP IX reduced the HO-1 activity and reversed the survival rate in HMX-treated MKN-74 cells. There's no difference between RAW 264.7 cells and MKN-74 cells. We, thus, concluded that HMX is beneficial for protection from oxidative injury, and induction of HO-1 by HMX in gastric cells is, at least, responsible for protection from oxidative stress such as ethanol, aspirin and possibly H. pylori infection.