• Title/Summary/Keyword: Surgery, method

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Usefulness of Gastric Emptying Time Test for Dog byUsing Radiopaque Marker KOLOMARK (비투과 표지자 KOLOMARK를 이용한 개의 위배출시간검사에 대한 유용성)

  • Cho, Young-Kwon;Kim, Seon-Chil
    • Journal of the Korean Society of Radiology
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    • v.6 no.4
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    • pp.267-273
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    • 2012
  • Abnormal gastric emptying time of dog by alien substance, neoplasm, pyloric antrum hyperplasia, stomach surgery, electrolyte imbalance, stomach-dilated torsion is clinically important as a digestive disease. Therefore study aims to provide basic data on the clinical usefulness of gastric emptying time test which uses radiopaque Kolomark developed in Korea rather than using the existing BIPS for the dog. 9 beagles were used for this experiment and their average weight was about 10.3kg with 2.5 year-old average age. For the test, fast for 12 hours was made without chemical sedation, and just before the test, 1 capsule of Kolomark was fed with 25% of daily feed amount, and we took photographs at ventrodorsal and right lateral position after 2, 4, 8 and 12 hours. As for interested reading area, we observed entire stomach from cardia to stomach pyloric part, and as for analysis method, we counted Kolomarks remained in the stomach per time and judged only P value below 0.05 to be meaningful by using Friedman Test. After feeding Kolomark through oral cavity, it took average 7.55 hours for the Kolomark to have escaped from the stomach to small intestine. In this study of gastrointestinal tract passing time after feeding matured dog, we used Kolomark and expect that it could be a basic data for normal gastrokinetic time.

A Study in Bridging Sciatic Nerve Defects with Combined Skeletal Muscle and Vein Conduit in Rats (백서의 좌골신경에서 정맥 및 골격근을 이용한 결손신경 봉합술에 대한 연구)

  • Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.29-38
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    • 1997
  • A peripheral nerve when approximation of the ends imparts tension at the anastomosis and with a relatively long segment defect after excision of neuroma and neurofibroma cannnot be repaired by early primary suture. The one of the optimistic reconstruction method of severed peripheral nerves is to restore tension-free continuity at the repair site putting an autogenous nerve graft into the neural gap despite of ancipating motor or sensory deficit of the donor nerve area. To overcome the deficit of the autogenous nerve graft, several other conduits supplying a metabolically active environment which is able to support axon regeneration and progression, providing protection against scar invasion, and guiding the regrowing axons to the distal stump of the nerve have been studied. An author have used ipsilateral femoral vein, ipsilateral femoral vein filled with fresh thigh muscle, and autogenous sciatic nerve for the sciatic nerve defect of around 10 mm in length to observe the regeneration pattern in rat by light and electron microscopy. The results were as follows. 1. Light microscopically regeneration pattern of nerve fibers in the autogenous graft group was more abundant than vein graft and vein filled with muscle group. 2. On ultrastructural findings, the proxial end of the graft in various groups showed similar regenerating features of the axons, myelin sheaths, and Schwann cells. The fascicular arrangement of the myelinated and unmyelinated fibers was same regardless of the type of conduits. There were more or less increasing tendency in the number and the diameter of myelinated fibers correlated with the regeneration time. 3. In the middle of the graft, myelinated nerve fibers of vein filled with muscle group were more in number and myelin sheath was thinner than in the venous graft, but the number of regenerating axons in autogenous nerve graft was superior to that in both groups of the graft. The amount of collagen fibrils and amorphous materials in the endoneurial space was increased to elapsed time. 4. There was no difference in regenerating patterns of the nerve fibers of distal end of the graft. The size and shape of the myelinated nerve fbers were more different than that of proximal and middle portion of the graft. From the above results, the degree of myelination and regenerating activity in autogenous nerve is more effective and active in other types of the graft and there were no morphological differences in either ends of the graft regardless of regeneration time.

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HGFK1 is Associated with a Better Prognostis and Reverses Inhibition by Gefitinib in NSCLC Cases

  • Zhou, Xiao-Hui;Tang, Li-Na;Yue, Lu;Min, Da-Liu;Yang, Yi;Huang, Jian-An;Shen, Zan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1457-1461
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    • 2012
  • Purpose: Non small cell lung cancer (NSCLC) is the leading worldwide source of cancer-related deaths. Although some drugs targeting EGFR mutations have been developed, most advanced cases are still incurable. New targets for anticancer drugs are demanded. The kringle 1 domain of hepatocellular growth factor alpha chain (HGFK1) is a potent anti-angiogenesis factor. It has also emerged as a potential anticancer factor in hepatocellular carcinoma (HCC). The expression of HGFK1 protein in patients with NSCLC has not been reported to date. Method: Here, we assessed HGFK1 expression by Western blotting in 103 cases with advanced NSCLC to investigate the impact of HGFK1 on survival. Results: Results revealed 33 (30.1%) patients were classified as high expressors, this being significantly associated with less remote metastasis (P = 0.002) but not with lymph node metastasis (P = 0.062). There was also a significant association between HGFK1 expression and tumor size (P = 0.025) as well as clinical stage (P = 0.012). Kaplan-Meier survival analysis showed that both overall survival (OS) and progression free survival (PFS) of patients with HGFK1 expression were longer than those of patients without HGFK1 expression (P = 0.004 and P = 0.001 respectively). HGFK1 reversed gefitinib inhibition in the resistent NSCLC cell line A431/GR but did not inhibit the proliferation of NSCLC cells A431 and A431/GR directly. Reversion of gefitinib inhibition in A431/GR cells by HGFK1 was related to decreased phosphorylation of ERK and STAT5. Conclusions: HGFK1 may be a useful prognostic factor of advanced NSCLC patients and a potential drug for gefitinib resistant patients.

Degree of Enteral Tube Feeding in the Intensive Care Unit and Change in Nutritional Status (병원 중환자의 경관유동식 공급 현황 및 영양상태 변화)

  • Im, Hyeon-Suk;Park, Eun-Gyeong;Lee, Jong-Ho
    • Journal of the Korean Dietetic Association
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    • v.7 no.3
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    • pp.217-226
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    • 2001
  • It is important to supply adequate nutrition to critically ill patients, whose gastrointestinal system is properly functioning, through the enteral tube feeding if oral intake is impossible. In this study we investigated the changes in nutritional status with enteral tube feeding according to the volume required. We investigated the volume ordered according to the patient's requirements, volume infused according to the volume ordered in 41 enteral tube feeding patients in intensive care unit from Jannuary to July, 2000. Body weight, serum albumin level, and total lymphocyte count were evaluated to assess nutritional status. The mean fasting period was 5 days before the enteral feeding and patients whose fasting period over 3 days were 51%. The mean enteral tube feeding period was 29 days and method of feeding was nasogastric, bolus feeding 6 times per day. The volume ordered was 69.7% of the patients' recommended calorie and volume infused was 86.6% of their volume prescribed. Accordingly, the volume infused was estimated 61.7% of their volume required. Only 44.6% of their reqiured volume was infused within 3 days after enteral tube feeding was started. It took 16 days in average to meet the patients' recommended calorie; 56% of subjects still did not fully met their requirements by the end point. Among the impeding factors in supplying enteral tube feeding, factors related to the number of feeding were high residual volume in stomach, vomiting, gastrointestinal bleeding, abdominal distension and surgery. Factors related to the acctual infused volume were diarrhea, gastrointestinal bleeding, abdominal distension, airway management and tube reinsertion. Significant correlations were shown between the volume infused and changes in both the patients' weight and serum albumin level. Deviding the subjects into two groups by their infused volume, less than 70% and more than that, we compared the two to come up with a significant difference in their serum albumin level, -0.23 vs 0.21, and their body weight, -4.52 vs 0.12. In enteral tube feeding, the volume delivered in sufficient to the pateints' energy requirement can affect their nutriitional status in critically ill patient; adequate nutritional management plan is essential. It is necessary to make every effort to educate clinical staff and to set up a unified management program to prescribe adequate ammount of energy for the patient's nutritional requirement.

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Clinical Prognostic Factors of Terminal Cancer Patients with Palliative Procedures for Malignant Gastrointestinal Obstruction (완화적 시술을 받은 악성 위장관 폐색 말기 암환자의 임상적 예후인자)

  • Moon, Do-Ho;Choe, Wha-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.200-208
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    • 2005
  • Purpose: Palliative procedures or surgical interventions not only manage various symptoms of malignant gastrointestinal obstruction, but also improve the quality of life. We investigated the clinical characteristics and prognostic factors of terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction. Methods: We retrospectively reviewed the medical records of 48 terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction at Sam Anyang hospital from May in 2002 to May in 2005. We excluded patients with palliative tumor resection. We analyzed prognostic factors in symtom-free survival and overall survival using Kaplan-Meier method, univariate and multivariate analysis. Results: There were 25 males (52%) and 23 females (48%), and median age of 48 patients was 65 years. The most common cause of malignant gastrointestinal obstruction was colorectal (26 patients, 55%), followed by stomach (10, 21%). Twenty patients (42%) received previous treatment (chemotherapy, surgery, and radiotherapy) and 28 (58%) never received any. Eighteen of 20 had received chemotherapy. The most common symptom was pain (15 patients, 31%). Twenty three patients (48%) had Eastern Cooperative Oncology Group(ECOG) performance status of 1 or 2 score and 25 patients (52%) 3 or 4 score. The most common palliative procedure was colostomy and there was no mortality concerning the palliative procedures. By univariate and multivariate analysis, performance status was the only independent prognostic factor in overall survival and symptom-free survival. Overall survival was 150 days and symptom-free survival was 90 days. Conclusion:. We confirmed that perftatdormance status is significant independent prognostic factor in terminal cancer patients with palliative procedures for malignant gastrointestinal obstruction.

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Nasal Carriage of Staphylococcus aureus from Healthy Children Attending Day Care Center (어린이집 소아에서의 황색포도알균의 비강 보균율에 관한 연구)

  • Kim, Young Min;Oh, Chi Eun;Kim, So Hee;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.9-15
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    • 2010
  • Purpose : This study was performed to investigate the prevalence of Staphylococcus aureus (S. aureus) nasal carriage in Korean children attending day care centers. Methods : During September and October 2009, a survey for nasal carriage of S. aureus and methicillin-resistant S. aureus (MRSA) was conducted among children attending day care centers located in Seoul with questionnaire survey for evaluation of risk factors of acquisition of MRSA was obtained from their guardians. A culture of the anterior nares swabs using enrichment broth was executed for isolating S. aureus and oxacillin susceptibility was assessed by the disk diffusion method. Results : Out of the 428 children enrolled whose mean age was 55 months old, 163 (38.1%) were colonized with S. aureus. Of the 163 isolates, 40 (24.5%) were MRSA. The nasal carriage rate of S. aureus showed an increasing trend with increase of age. Based on the answer to the questionnaire, 9.2% and 3.6% of children had a recent history of hospitalization and surgery, respectively, and approximately 40% of children had a history of prescription of antibiotics within 1 year prior to enrollment. Of the 428 subjects, 40 (9.3%) were MRSA nasal carriers. Conclusion : S. aureus and MRSA carriage rate of children attending day care center in Korea was 38.1% and 9.3%, respectively. Continued surveillance for nasal carriage rate of S. aureus and MRSA (especially community-associated MRSA) is mandatory.

Change of Clinical Effect upon Use of Glutamine to Critically Ill Patients over Age 60 Receiving TPN (정맥영양 투여 받는 60세 이상 중환자에서 glutamine 사용에 따른 임상 효과의 변화)

  • Lee, Hye Seung;Kim, Sungtae;Min, Young Sil;Sohn, Uy Dong
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.1
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    • pp.9-14
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    • 2014
  • Background: It is known to reduce the mortality when glutamine is supplied to patients during the surgery or in intensive care unit through intravenous nutrition supply. The purpose of this study is to establish the appropriate basis for use of glutamine and guidelines of nutrition supply for critically ill patients in the hospital by examining the clinical effects of administration of glutamine with subjects of elderly critically ill patients receiving intravenous nutrition in one hospital in Korea. Method: Among elderly patients with age of 60 or more hospitalized in Yeuido St. Mary's Hospital from August 2012 to July 2013, those who stayed in the intensive care unit for more than a week and received TPN (Total Parenteral Nutrition) for more than 3 days during staying in the intensive care unit were classified to a test group using glutamine and a control group without glutamine. Duration of use of mechanical ventilator, duration of hospitalization, occurrence of infectious disease and death were compared between two groups. We would like to identify the clinical test figures affected by the use of glutamine by examining changes in SCr, Total Protein, Albumin, AST, ALT, TB, DB and GFR at the time of admission and discharge. Results: At the time of admission to intensive care unit, gender, physical measurement information and clinical test figures did not show any significant difference between 72 subjects in a test group and 24 subjects in a control group. Thus, two groups began in the same condition. There were no significant difference in duration of hospitalization, duration of intensive care unit, use of mechanical ventilator, occurrence of infectious disease and death. As the results of statistical analysis of the average changes of clinical test figures at the time of admission and discharge of intensive care unit, SCr and GFR were significantly changed in the test group. GFR was significantly changed in a control group. As the result of analysis of the clinical test figures at the time of discharge with reflection of average changes after clinical test figures were corrected at the time of admission of intensive care unit, TB and GFR were significantly increased in a test group compared with those in a control group. Other clinical test figures were not significantly changed. Conclusion: If glutamine is administered to critically ill patients over age 60 receiving TPN and careful monitoring for total bilirubin is made in the future, it is expected to give the positive effect on renal function andminimize the side effect of arise in total bilirubin.

The Effects of Music Therapy on recovery of consciousness and vital signs in post operative patient in the recovery room (음악요법이 수술직후 환자의 의식회복과 활력징후에 미치는 영향)

  • Kim Sook-Jung;Jun Eun-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.222-238
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    • 2000
  • The purpose of this study was to demonstrate the effect of music therapy as a nursing intervention on changes in recovery of consciousness and vital signs for postoperative patients in the recovery room. The subject for this study were fifty three of postoperative patients who were transferred from the OR to the RR at Kwangju Christian Hospital in Kwangju City. Thirty of them were assigned to the experimental group, and twenty three, to the control group. The age of the subject was between twenty and sixty years of age. The subject had a general anesthesia without any special complications, and they were not completely awake. The data were collected for six months from July 1999 to February 2000. The method used was to compare the condition of the subjects in each group at the beginning and at certain times repeatedly. The features observed were the level of consciousness, the frequency of complaints of pain, and vital signs of the subject before and 15 minutes, 30 minutes, and 60 minutes after hearing their favorite music for 30 minutes. The results are as follows 1. The recovery of consciousness was revealed through significant changes in facial expression, facial color, and grip strength in the experimental group more strongly than in the control group. No significant changes were shown in verbal order. The differences in recovery of consciousness in the pre-post music therapy between the two groups was not significant in verbal order, facial expression, or grip strength. However, significant changes were seen in facial color. 2. There were no significant differences between the two groups in changes in the frequency of pain complaints after music therapy. However, a significant difference was shown in the pre-post music therapy scres. 3. Vital signs did not show a significant difference between the two groups. However, the $SPO_2$ of the experimental group was significantly elevated after 60 minutes. The difference pre-post to the music therapy in the vital signs between two groups was significant only in body temperature. This study showed that the effect of music therapy given to postoperative patients is that it promotes changes in facial expression, facial color, and grip strength helping recovery of consciousness, stabilizing vital signs, elevating levels of $SPO_2$. and reducing complaints of pain. It is recommended that if the patient wants it music therapy be given right after surgery in the recovery room as a nursing intervention.

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LINGUAL FRENECTOMY UNDER ORAL SEDATION (경구 진정요법하에 시행한 설소대 절제술)

  • Jang, Yong-Gul;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.568-574
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    • 2009
  • Tongue-tie is a congenital anomaly characterized by an abnormally short lingual frenum, which may restrict tongue tip mobility, In the neonate and infant, tongue-tie was said to cause difficult breast-feeding, In the older infant, toddler and young child, poor speech has been frequently listed because movement of tongue tip is limit ed. Also as a abnormal tongue position, various orthodontic problems, later mechanical and social manifestations could be developed. Treatment options such as observation, speech therapy, frenotomy and frenectomy have been suggested. The optimal timing for the surgery has not been determined, but early intervention may be appropriate for the children with significant tongue-tie who has the significant potential to speech difficulties and later social and mechanical problems. Sedation is an effective method for incapable of cooperative and the handicapped children, necessary to early intervention. We report three cases, using oral sedation for the frenectomy in young children with severe tongue-tie. After treatments, we could find out sufficient tongue movement and improved speech ability.

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APPLICATION OF THE MODIFIED-MOUTHGUARD TO PREVENT SELF-INJURIOUS BEHAVIORS IN A CHILD WITH CEREBRAL PALSY : A CASE REPORT (뇌성마비 환아의 자해 방지를 위한 변형된 마우스가드의 적용)

  • Pak, Eun-Kyung;Kim, Kwang-Chul;Choi, Sung-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.351-356
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    • 2008
  • Cerebral palsy, a range of non-progressive syndromes of posture and motor impairment, is a common cause of disability in childhood. Self-injurious behavior(SIB) is deliberate harm to the body without suicidal intend, often involving repetitive actions that cause tissue damage. One of the most common orofacial self-injurious behavior is chewing tongue, lip or oral mucosa. This kind of SIB in children is not common in normal children. High occurrence rates are observered in cases of syndromatic, mentally retarded children, and children with congenital disease. Various methods such as behavior modification, behavior control by drugs, body restraints, application of dental appliance, surgery and extraction of teeth have been suggested to control those self-injurious behavior. Using mouthguard as one of dental applainaces is the most conservative and appropriate method in terms of reducing oral self-injurious habits and protection of tissue. This case report describes a child with cerebral palsy who presented with self-injurious ulceration of lip and buccal mucosa. A modified mouthguard was effective in preventing self-injurious oral trauma in a child with cerebral palsy.

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