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검색결과 339건 처리시간 0.022초

천골욕창에 발생한 우췌양 암종 1례 (Case Report of Verrucous Carcinoma Arising in Sacral Pressure Sore)

  • 정재훈;허찬영;권순성;백롱민;민경원
    • Archives of Plastic Surgery
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    • 제34권4호
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    • pp.520-523
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    • 2007
  • Purpose: Verrucous carcinoma is a rare, low-grade and well-differentiated squamous cell carcinoma, representing as a warty tumor. Estimation of the incidence for cutaneous lesions is not available because they are rare. We describe a case of verrucous carcinoma, a rare type, complication of a chronic pressure ulcer of duration more than 15 years. Methods: A 17-year-old boy presented with a large lesion involving the sacral area, which had been neglected for about 15 years. He had a history of surgical extirpation 2 years ago, but not cured. Examination revealed a cauliflower-like mass arising from an irregularly oval-shaped tumor which was $6.0{\times}4.5cm$ in size with signs of infection and ulcer. The lesion involved the sacrococcygeal area, spreading to both medial gluteal regions. The perianal skin did not appear to be directly affected. Results: A preoperative punch biopsy revealed a extremely well differentiated verrucous carcinoma. There were positive results in immunohistochemistry in the items of p53, p63, Ki-67. An 'en-bloc' excision of the tumor with the clinically normal surrounding tissue was carried out. Reconstruction was achieved by local regional flap. Histopathological findings of the excised area fully confirmed the preoperative biopsy report. It remained free of recurrence for a period of about 8 months. Conclusion: We believe that in patients with buttock involvement, regardless of the extent of such tumors, surgical therapy should be considered as the first-choice of treatment as reconstruction can be performed without excessive impairment for the patient.

Comparison of Clinical Characteristics Between Patients With Different Causes of Vocal Cord Immobility

  • Kim, Min-Hyun;Noh, Junsoo;Pyun, Sung-Bom
    • Annals of Rehabilitation Medicine
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    • 제41권6호
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    • pp.1019-1027
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    • 2017
  • Objective To analyze the clinical characteristics between neurogenic and non-neurogenic cause of vocal cord immobility (VCI). Methods The researchers retrospectively reviewed clinical data of patients who underwent laryngeal electromyography (LEMG). LEMG was performed in the bilateral cricothyroid and thyroarytenoid muscles. A total of 137 patients were enrolled from 2011 to 2016, and they were assigned to either the neurogenic or non-neurogenic VCI group, according to the LEMG results. The clinical characteristics were compared between the two groups and a subgroup analysis was done in the neurogenic group. Results Among the 137 subjects, 94 patients had nerve injury. There were no differences between the neurogenic and non-neurogenic group in terms of demographic data, underlying disease except cancer, and premorbid events. In general characteristics, cancer was significantly higher in the neurogenic group than non-neurogenic group (p=0.001). In the clinical findings, the impaired high pitched 'e' sound and aspiration symptoms were significantly higher in neurogenic group (p=0.039 for impaired high pitched 'e' sound; p=0.021 for aspiration symptoms), and sore throat was more common in the non-neurogenic group (p=0.014). In the subgroup analysis of neurogenic group, hoarseness was more common in recurrent laryngeal neuropathy group than superior laryngeal neuropathy group (p=0.018). Conclusion In patients with suspected vocal cord palsy, impaired high pitched 'e' sound and aspiration symptoms were more common in group with neurogenic cause of VCI. Hoarseness was more frequent in subjects with recurrent laryngeal neuropathy. Thorough clinical evaluation and LEMG are important to differentiate underlying cause of VCI.

시멘트 경화제 중독으로 인한 급성 신손상 1례 (A Case of Cement Hardening Agent Intoxication with Acute Kidney Injury)

  • 서영우;장태창;김균무;고승현
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.157-160
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    • 2018
  • Chronic silica nephropathy has been associated with tubulointerstitial disease, immune-mediated multisystem disease, chronic kidney disease, and end-stage renal disease. On the other hand, acute intentional exposure is extremely rare. The authors' experienced a 44-year-old man who took rapid cement hardener (sodium silicate) in a suicide attempt whilst in a drunken state. He visited the emergency department approximately 1 hour after ingestion. Information on the material was obtained after 3 L gastric lavage. The patient complained of a sore throat, epigastric pain, and swollen to blood tinged vomitus. Proton pump inhibitors, hemostats, steroid, and fluids were administered. Nine hours after ingestion, he was administered 200 mL hematochezia. Immediately after, a gas-troenterologist performed an endoscopic procedure that revealed diffuse hyperemic mucosa with a color change and variable sized ulceration in the esophagus, whole stomach, and duodenal $2^{nd}$ portion. Approximately 35 hours later, persistent oligouria and progressive worsening of the renal function parameters (BUN/Cr from 12.2/1.2 to 67.5/6.6 mg/dL) occurred requiring hemodialysis. The patient underwent 8 sessions of hemodialysis for 1 month and the BUN/Cr level increased to 143.2/11.2 mg/dL and decreased to 7.6/1.5 mg/dL. He was discharged safely from the hospital. Follow up endoscopy revealed a severe esophageal stricture and he underwent endoscopic bougie dilatation. Acute cement hardener (sodium silicate) intoxication can cause renal failure and strong caustic mucosal injury. Therefore, it is important to consider early hemodialysis and treatment to prevent gastrointestinal injury and remote esophageal stricture.

체압센서를 장착한 의료용 침대 시스템의 개발 (Development of medical bed system equipped with body pressure sensors)

  • 선민주;이영대
    • 문화기술의 융합
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    • 제7권1호
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    • pp.646-653
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    • 2021
  • 본 연구에서 개발된 의료용 침대는 N개의 건반으로 이루어져 각각이 엑츄에이터에 의해 수직으로 구동된다. 각 건반에는 M개의 센서가 실장되어 체압을 측정하므로 체압지도의 해상도는 MN에 의해 결정된다. 각 건반에는 센서 제어기가 실장되어 M개의 센서로부터 측정한 체압값을 CAN(Car Area Network)와 같은 직렬 통신 네트워크를 통해 메인제어기로 전달한다. 각 건반에는 모터를 구동하는 서보 드라이버가 하나씩 장착되며 메인 제어기와 CAN으로 연결되어 메인 제어기에서 지시된 변위값대로 건반의 높낮이를 제어하며 향후 개발될 인공지능 제어 알고리즘을 위해 신체 각부의 편안도를 조사하여 건반의 높낮이를 맞추었다. 또한, 건반 각부에 걸리는 최대 체압값과 체압비를 계산하여 인공지능에 의한 침대 편안도 제어를 위해 기초 데이터로 활용한다. 결과적으로 제시된 시스템은 향후 개발될 인공지능에 의한 신체의 안락함과 욕창 방지 제어를 위해 활용될 수 있는 토대가 될 수 있다.

청폐배독탕 및 청폐배독탕거마황을 사용해 COVID-19 증상의 개선을 보인 증례 보고 : 후향적 사례군연구 (Treating COVID-19 with Qingfei Paidu Decoction with and without Ephedra Herba: A Retrospective Case Series)

  • 김광호;강건희;이영웅;강선이;지상호;송주환;김철현;이상관
    • 대한한방내과학회지
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    • 제43권2호
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    • pp.264-273
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    • 2022
  • The purpose of this report is to describe the effects of Qingfei Paidu decoction (QPD) and QPD without Ephedra Herba on COVID-19 patients. One COVID-19 patient was treated with QPD and two others who had been sensitive to ephedra were treated with QPD without it. The fever, cough, and sore throat of all three were monitored three times a day through non-face-to-face assessment for a total of five to seven days, and cough and throat pain changes were evaluated with a numeric rating scale (NRS). After treatment, the fever and NRS scores were improved for all three patients. These results indicate that both QPD and QPD without Ephedra Herba is an effective treatment for COVID-19 symptoms.

고관절 골절 수술 후 한의 입원치료 효과 및 다빈도 처방 약재 네트워크 분석 (The Effect of Traditional Korean Medicine Treatment and Herbal Network Analysis in Postoperative Hip Fracture Inpatients)

  • 오지홍;이명종;김호준
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.119-129
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    • 2022
  • Objectives This study aimed to evaluate the effects of Integrative treatment of traditional Korean medicine (TKM) on 7 hospitalized patients after hip fracture surgery, and to identify significant herbs and co-prescribed herbs by using network analysis and association rule mining. Methods A retrospective chart review of the 7 hospitalized patients treated for postoperative hip fractures between January and December 2021 was performed. All TKM treatments for the patients were identified and Wilcoxon signed-rank test was performed to compare hip pain and mobility on admission and discharge. We visualized the network of herbal medicines and complications. By using network analysis, we also identified the significant herbs (high centrality of degree, eigenvector, and sub-graph). Co-prescription patterns for the hip fracture patients were further analyzed by association rule mining. Results We found that TKM treatment significantly relieved hip pain and improved mobility. Accompanying symptoms reported by the patients were general weakness, anorexia, dizziness, delirium, edema, sputum, sore throat, cough, rhinorrhea, and chills. Herbs composed of Sagunja-tang and Samul-tang showed high centralities and high associations with other herbs. In addition, Gupan, Nokyong, Yukjongyong, Useul, and Hyunhosaek were identified as important herbs for postoperative hip fracture patients. Conclusions This study provides evidence for clinical TKM use as an effective postoperative treatment for pain relief and improvement of mobility in patients with hip fractures. In addition, herbs that can be considered in the treatment of patients after hip fracture surgery were identified through network analysis and association rule mining.

척추체의 광범위한 파괴와 뇌척수액 축적이 동반된 샤르코 척추 관절병증: 감염성 척추염과 유사한 소견을 보이는 증례보고 (Charcot Spinal Arthropathy with Extensive Vertebral Body Destruction and Cerebrospinal Fluid Collection: A Case Report Mimicking Infective Spondylitis)

  • 조규정;김여주;김영태;윤영훈
    • 대한정형외과학회지
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    • 제55권4호
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    • pp.348-353
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    • 2020
  • 68세 남자 환자가 허리의 피부에서 고름을 동반한 욕창으로 내원하였다. 초진시 일반 방사선상 제4요추체의 광범위한 파괴 소견과 자기공명영상 촬영에서 제4요추 척추체의 결손 부위에 고인 조영 증강된 많은 양의 액체가 양측 요근 및 후관절까지 확장된 소견을 보였다. 신경병성 척추병증으로 일차 진단하였으나 농양을 동반한 감염성 척추염을 배제할 수 없어 정맥 항생제를 2주 투여하였다. 자기공명영상을 재촬영한 결과 농양의 크기는 줄어 들지 않아 수술적 치료로 진행하였다. 샤르코 척추 관절병증은 광범위한 척추체 파괴를 일으켜 감염성 척추염과 유사한 소견을 보일 수 있으며 특히 척추체 불안정으로 인한 경막 파열로 뇌척수액이 축적되면 감별이 어려울 수 있어 이 증례를 보고하는 바이다.

사회복지사가 지각하는 윤리풍토가 경력몰입에 미치는 영향 (Influence of Ethical Climate on Career Commitment of Social Worker)

  • 최상훈;김정아;권경자
    • 사회복지연구
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    • 제42권1호
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    • pp.55-82
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    • 2011
  • 본 연구는 사회복지사들이 지각하는 사회복지조직의 윤리풍토를 확인하고, 윤리풍토가 경력몰입에 미치는 영향을 확인하고자 시도하였다. 이를 통해 사회복지조직의 윤리풍토를 긍정적으로 개선함과 동시에 사회복지사의 경력몰입을 증진시킬 수 있는 전략에 기초자료를 제공하고자 한다. 본 연구는 사회복지기관에 근무하는 사회복지사 155명을 대상으로 수행하였다. 사회복지사가 지각하는 윤리풍토는 법과 전문코드형 윤리풍토, 사회적 책임형, 효율성형을 높게 인지하고 있는 것으로 나타났다. 또한, 사회복지사가 지각하는 윤리풍토가 경력몰입에 미치는 영향을 분석한 결과 개인이익형 윤리풍토를 지각할수록 경력몰입에 부정적인 영향을 미쳤으며 법과 전문코드형 윤리풍토를 지각할수록 사회복지사의 경력몰입에 긍정적인 영향을 미치는 것으로 나타났다. 이에 사회복지조직의 경력몰입을 증진시키기 위해 법과 코드형 및 효율성형 윤리풍토를 정착시키고 발전시킬 수 있는 효율적인 조직 윤리 풍토 관리 전략이 적극적으로 모색되어야 할 것이다. 또한 사회복지조직의 개별적 특성에 맞는 윤리 교육 프로그램 및 경력몰입을 증진시킬 수 있는 경력개발 프로그램의 개발이 필요하다.

Protective Effects of Nypa fruticans Wurmb against Oxidative DNA Damage and UVB-induced DNA Damage

  • So-Yeon Han;Tae-Won Jang;Da-Yoon Lee;Seo-Yoon Park;Woo-Jin Oh;Se Chul Hong;Jae-Ho Park
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2023년도 임시총회 및 춘계학술대회
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    • pp.54-54
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    • 2023
  • Nypa fruticans Wurmb (N. fruticans) is a plant that belongs to Araceae and N. fruticans is mainly found in tropical mangrove systems. The parts (leaves, stems, and roots) of N. fruticans are traditionally used for asthma, sore throat, and liver disease. N. fruticans contains flavonoids and polyphenols, which are substances that have inhibitory effects on cancer and oxidant. In previous studies, some pharmaceutical effects of N. fruticans on melanogenesis and inflammation have been reported. The present study is conducted to investigate the effect of the ethyl acetate fraction of N. fruticans (ENF) on oxidative DNA damage and UVB-induced DNA damage. DNA damage response (DDR) pathway is important in research on cancer, apoptosis, and so on. DDR pathways are considered a crucial factor affecting the alleviation of cellular damage. ENF could reduce oxidative DNA damage derived from reactive oxygen species by the Fenton reaction. Also, ENF reduced the intensity of intracellular ROS in the live cell image by DCFDA assay. UVB is known to cause skin and cellular damage, then finally contribute to causing the formation of tumors. As for the strategies of reducing DNA damage by UVB, inhibition of p53, H2AX, and Chk2 can be important indexes to protect the human body from DNA damage. As a result of confirming the protective effect of ENF for UVB damage, MMPs significantly decreased, and the expression of apoptosis-related factors tended to decrease. In conclusion, ENF can provide protective effects against double-stranded DNA break (DSB) caused by oxidative DNA damage and UVB-induced DNA damage. These results are considered to be closely related to the protective effect against radicals based on catechin, epicatechin, and isoquercitrin contained in ENF. Based on these results, it is thought that additional mechanism studies for inhibiting cell damage are needed.

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Nypa fruticans wurmb Inhibits Melanogenesis via cAMP/PKA/CREB Signaling Pathway in B16 F10 Cells

  • So-Yeon Han;Hye-Jeong Park;Jeong-Yong Park;Seo-Hyun Yun;Mi-Ji Noh;Soo-Yeon Kim;Tae-Won Jang;Jae-Ho Park
    • 한국자원식물학회:학술대회논문집
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    • 한국자원식물학회 2021년도 춘계학술대회
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    • pp.54-54
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    • 2021
  • The Melanoma Research Coalition reported melanoma affects humans of various races. This study was conducted to confirm the inhibitory effect of melanogenesis in B16 F10 cells of Nypa fruticans Wurmb of ethyl acetate fraction (NEF). Nypa fruticans Wurmb is an important component of the East Asian mangrove vegetation. It belongs to Araceae family. Traditionally, N. fruticans was used to treat various diseases such as asthma, sore throat, liver disease, a pain reliever, and can also be used as sedative and carminative. The present study, the inhibitory effect on melanogenesis was determined by Western blotting and RT-qPCR. The level of expression of tyrosinase, TRP-1, and TRP-2 is regulated by microphthalmia-associated transcription factor (MITF) and cAMP, and cAMP affects the activity of protein kinase A (PKA). Activated PKA stimulates the phosphorylation of cAMP-reactive element-binding protein (CREB) in the nucleus, thereby increasing the amount of MITF expression and enhancing melanogenesis. Western blotting and RT-qPCR analysis showed that NEF treatment decreased the expression of tyrosinase. Similarly, TRP-1 and TRP-2 levels were decreased, which were decreased significantly at compared with the untreated control. Also, NEF attenuated the IBMX mediated increase in the intracellular cAMP level and the phosphorylation of PKA. In conclusion, NEF significantly inhibited the expressions of melanogenesis through cAMP/PKA/CREB signaling pathways.

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