• Title/Summary/Keyword: Ulceration

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Instrumental perforation of the esophagus the results of delayed surgical drainage more than 24 hours (식도질환의 기계적 처치후 발생한 식도파열 치험 -외과적 처치가 지연되었던 6예-)

  • 이두연
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.744-749
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    • 1986
  • Even in the hands of the expert endoscopists, an occasional instrumental perforation of the esophagus occurs. But instrumental perforation of the esophagus should not be difficult to diagnose if the possibility is borne in mind. Occasionally patient with esophageal perforations show little reaction at first, but usually they develop systemic manifestation if surgical management is delayed. Early surgical drainage of esophageal perforation is very important & effective therapeutic method. The delayed surgical treatment of esophageal perforation would have increased the morbidity & mortality by allowing mediastinitis & empyema thoracis. We have experienced 6 cases of delayed surgical management of instrumental perforation of esophagus from May 1974 to April 1986 in the department of thoracic and cardiovascular surgery, Yonsei University, college of the medicine. The ages ranged from 4 years to 57 years. The underlying esophageal diseases consisted of esophageal stricture in 3 cases, foreign bodies in the esophagus in 2 cases and esophageal ca. in one case. Most clinical manifestations on admission were high fever, chest discomfort, chest pain, dysphagia and subcutaneous emphysema. Most complications due to esophageal rupture were acute mediastinitis with or without empyema thoracis. Failure to diagnose promptly and failure to promptly institute adequate treatment undoubtedly were largely responsible for this patients death. All 6 patients had been taken delayed surgical drainage more than 24 hours following esophageal perforation. One patient had been in the open drainage state for long time and the another patient has been in the tracheostomy with postintubation vocal cord ulceration. The third patient died due to respiratory failure and sepsis due to fulminant mediastinitis & empyema thoracis. Even if the patients with esophageal perforation have been taken delayed surgical management, the patients should be survived with aggressive & effective surgical drainage with intensive post-operative care.

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Lateral Arm Free Flap for Small Sized Diabetic Foot Ulcer around Toes (족지 주위의 작은 크기의 당뇨 족부 궤양에 대한 외측 상완 유리 피판술)

  • Jung, Heun-Guyn;So, Gwang-Young;Kuk, Woo-Jong;Kim, Hee-Dong
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.28-35
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    • 2008
  • The purpose of this study was to present the clinical analysis of the results of lateral arm free flap for small sized and infected diabetic foot ulcer around toes. From May 2006 to December 2007, Seven patients were included in our study. Average age was 52.8 years, six were males and one was female. All had infected diabetic foot ulcer and had exposures of bone or tendon structures. Ulcers were located around great toe in four patients, 4th toe in one and 5th toe in two. Three patients had osteomyelitis of metatarsal or phalanx. After appropriate control of infection by serial wound debridement and intravenous antibiotics, lateral arm flap was applied to cover remained soft tissue defects. Posterior radial collateral artery of lateral arm flap was reanastomosed to dorsalis pedis artery of recipient foot by end to side technique in all cases in order to preserve already compromised artery of diabetic foot. All flaps were designed over lateral epicondyle to get longer pedicle and averaged pedicle length was 8 cm. Two cases were used as a sensate flap to achieve protective sensation of foot. All flaps survived and provided satisfactory coverage of soft tissue defects on diabetc foot ulcers. All patients could achieve full weight-bearing ambulation. No patients has had recurrence of infection, ulceration and further toe amputations. There were three complications, a delayed wound healing of flap with surrounding tissue, a partial peripheral loss of flap and a numbness of forearm below donor site. All patients were satisfied with their clinical results, especially preserving their toes and could return to the previous activity levels. Lateral arm free flap could be recommend for infected diabetic foot ulcers around toes, to preserve toes, coverage of soft tissue defect and control of infection with low donor site morbidity.

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Quercetin, A Bioflavonoid, Protects Against Oxidative Stress-related Gastric Mucosal Damage in Rats

  • Rao, Ch.V.;Ojha, S.K.;Govindarajan, R.;Rawat, A.K.S.;Mehrotra, S.;Pushpangadan, P.
    • Natural Product Sciences
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    • v.9 no.2
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    • pp.68-72
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    • 2003
  • Quercetin and its sugar conjugates are the most abundantly distributed bioflavonoids and represent the largest proportion of flavonols in the plant kingdom. The present study was undertaken to demonstrate the effect of quercetin on the role of reactive oxygen species (ROS) in the development of gastric ulcers in rats. Administration of quercetin in doses of 50, 100 and $200\;mg\;kg^{-1}$ twice daily for 5 days, showed dose dependent significant protection against ethanol (EtOH), aspirin (ASP), cold-restraint stress (CRS) and pylorus ligation (PL) -induced gastric ulcer models and the results were comparable with those elicited by sucralfate. The thiobarbituric acid reactive substances in the stomach mucosa, an index of lipid peroxidation and regulation of plasma corticosterone were significantly increased in CRS-induced gastric ulceration. The queroetin $(100\;mg\;kg^{-1})$ and reduced glutathione effectively inhibited gastric lesions induced by CRS with a significant decrease in the lipid peroxidation and plasma corticosterone. These results indicate that quercetin a bioflavonoid exerts its antiulcer effect in light of free radical scavenging and plasma corticosterone in cold restraint stress ulcers.

Superficial Necrolytic Dermatitis (Hepatocutaneous Syndrome) in a Dog with History of Long-Term Phenobarbital Administration (개에서 페노바비탈 장기 투여로 유발된 표재성 괴사성 피부염 1례)

  • Chung, Tae-Ho;Kim, Ji-Hyun;Nam, Eui-Hwa;Kim, Dae-Yong;Kim, Hyung-Jin;Choi, Min-Cheol;Youn, Jung-Hee;Youn, Hwa-Young;Hwang, Cheol-Yong
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.445-449
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    • 2010
  • A dog with a history of long-term phenobarbital administration presented to Seoul National University Hospital for Animals with clinical signs of footpad ulceration and facial ulcerative dermatitis. Skin lesions (facial/footpad dermatitis), histopathologic signs (parakeratotic hyperkeratosis, edema and hyperplasia of the epidermis), and liver involvement (increased plasma liver enzymes and nodular lesions) suggested a diagnosis of superficial necrolytic dermatitis (SND). The patient died suddenly at home of unknown cause after 8 months medical treatment, but intravenous amino acid supplementation and supportive hepatic medication proved as effective for the skin conditions.

Documentational Study and Observation from the View of Hyungsang Medicine on Bangpungtongseong-san (방풍통성산(防風通聖散)의 문헌(文獻) 및 형상의학적(形象醫學的) 고찰(考察))

  • Suck, Min-Hee;Kim, Jun-Hong;Lee, Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.1
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    • pp.51-59
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    • 2008
  • The following conclusions were obtained from the studies on Bangpuntongseongsan both from the documents and Hyungsang medicine. Bangpungtongseong-san was created by Yu Wan-so to relieve both interior and exterior of disease from the pathogenic fire, and it cures wind syndrome and dry syndrome. Bangpungtongseong-san is of light herbal combination and it works in the upper part of the body and is mainly applied to skin disease. Perspiration without harming the exterior and purgation without hurting the interior shows that it is not a severe prescription belonging to meditation therapy. It is mostly used for curing the disease of internal heat caused by over drinking and consuming heavy food, and it has special relationship with Yangmyung meridian. It is mentioned in the chapters of spirit, head, face, eye, ear, nose, throat, skin, hair, prescription, wind, dryness, fire, internal damage, epidemic infectious disease, carbuncle and cellulitis, ulceration, and pediatrics of ${\ulcorner}$Donguibogam${\lrcorner}$. It is usually applied to those who belong to Yangmyung type of the six meridian types or wind type, who has excessive heat, people with red complexion, reddened nose, pimples over the face and nose, coarse heel, loss of hair due to wind-heat, and to those who tend to have dandruff. Through examination over the cases treated with Hyungsan medicine, Bangpungtongseong-san was found efficacious in bloodshot eyes, brandy nose, loss of hair, various skin problems, tetanus, acute alcoholism, paralysis of hand and foot, deafness, and tinnitus.

A Case Report of Gastroesophageal Reflux Disease(GERD) with Hiatal Hernia (식도열공탈장을 동반한 위식도 역류성 질환 환자 치험 1례)

  • Park, Jung-Han;Cho, Hyun-Seok;Kim, Jung-Chul;Oh, Sung-Won;Lee, Sang-Hoon;Kim, Byoung-Woo;Lee, Jae-Eun
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.244-251
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    • 2005
  • Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm. It causes various symptoms(heart bum, chest pain, dysphagia, vomiting etc.) when it is associated with a condition called gastroesophageal reflux disease(GERD). In this occasion, complications included bleeding because of the erosion, ulceration and inflammation of the mucosa. For treatment, there are $H_2$ blockers and proton pump inhibitors, but they have many side effects. In Oriental Medicine effectively treated cases are rare. Therefore, it is essential to seek radical agents and effective treatments for these disorders. In this case report, these disorders are approached by focusing on the deficit of 'yin(陰)'especially 'pi-yin(脾陰)'. Desired results were seen with herbal medications which enhance the 'yin(陰)', especially through 'wuyin-jian(五陰煎)' which enhances the 'pi-yin(脾陰)'. This is reported to contribute to development of future treatments.

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Phenol Lumbar Sympathetic Block for Buerger's Disease (Phenol에 의(依)한 요부교감신경절(腰部交感神經節) 차단(遮斷) -증예(症例) 보고(報告)-)

  • Moon, Hwa-Young;Jeong, Chang-Toung;Park, Chan-Jin
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.120-124
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    • 1988
  • Phenol sympathetic block is valuable for the treatment of ischemic pain, gangrene, intermittent claudication, Paget's disease of the bone and pain associated with pancreatitis, pancreatic carcinoma, etc. The author has experienced a case of successful lumber sympathetic block using 7% phenol under fluoroscopy and given to a patient with Buerger's disease who had severe pain and ulceration of the right great toe for several years. After the sympathetic block, 2 epidural blocks with 2.5% bupivacaine were done in order to augment the effects of this sympathetic block. Subsidence of rest pain, increase in walking distance from under 100 M to over 500 M and circulatory improvement of the affected limb were observed, Improvement of circulation was confirmed by strain gauge plethysmography.

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The change of ankle of plantar pressure and range of motion joint according to treadmill gradients (트레드밀보행 시 경사도에 따른 족저압과 발목관절의 관절가동범위의 변화)

  • Kim, Tae-Ho;Kim, Byoung-Gon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.14 no.1
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    • pp.39-47
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    • 2008
  • Purpose : The purpose of this study was to investigate the change of the peak plantar pressure distribution under the foot areas and the range of motion (ROM) of ankle joint according to gradients in treadmill gait. Method : Thirty normal subjects (15 male and 15 female) walked on treadmill at three gradient conditions ($0^{\circ}$, $10^{\circ}$, and $15^{\circ}$) in normal speed. The ankle ROM was measured using the CMS70P that is three dimensional analyzer for excursion of ankle ROM, plantar flexion, and dorsi flexion. The peak plantar pressure distribution under the hallux, 1st metatarsal head (MTH) and heel was measured using the F -Scan system with an in-shoe sensor. Data was collected from 9 steps of left sife foot in at each gradient condition while all subjects walked. Result : As the treadmill gradient increased, the excursion of ankle joint was significantly increased (p<.05). Also, plantar flexion and dorsi flexion was significantly increased according to treadmill gradients (p<.05). The peak plantar pressure under the 1st MTH was significantly increased (p<.05) and the peak plantar pressure under the heel was significantly decreased (p<.05) as the treadmill gradient increased. No significant different in the peak plantar pressure under the hallux was observed. Conclusion : This study suggests that physical therapy for patients who have limited ankle ROM should be considered sufficient range of motion for functional ambulation. And individuals that have painful forefoot syndromes, including metatarsalgia, hallux valgus, and plantar ulceration should be careful in walking to uphill, as there is high plantar pressure under the forefoot.

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Perforation of Meckel's Diverticulum in Children (소아에서 발생한 천공성 메켈게실)

  • Ghil, Tae-Hwan;Yun, Jung-Hoon;Kim, Sang-Woo;Huh, Young-Soo
    • Advances in pediatric surgery
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    • v.8 no.1
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    • pp.28-32
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    • 2002
  • Meckel's diverticulum (MD) occurs in approximately 2 % of the population. The major complications of MD are bleeding, intestinal obstruction, infection and perforation. Perforation is the least common but most serious complication, the incidence od which is about 5-10 %. The causes of perforation are inflammatory diverticulitis and peptie ulceration. the purpose of study is to review the characteristics of perforated MD in children. Six patients with perforated MD who had been operated upon at the Department of Pediatric Surgery, Yeungnam University Hospital from April 1984 to July 2001 were included. Male predominated in a ratio of 5:1 and there were 2 neonates. The chief complaints were abdominal pain and distension. Half of the children showed a past history of bloody stools. The average age was 4 year and 9 months. The mean distance from the ileocecal valve to the diverticulum was 60 cm. Average length of the diverticulum was approximately 3 cm and width was 1.7 cm. The perforation site was the tip of the diverticulum in 3 cases, the base in 2 cases and along the lateral border in one. In two patients, ectopic gastric mucosa was found in the specimen. All of the patients were operated upon with a diagnosis of peritonitis of unknown etiology. In conclusion, when a child shows symptoms of acute abdomen or peritonitis, especially in boys, with the history of bloody stools and episodic abdominal pain, perforated MD should be suspected.

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Model-based and wavelet-based fault detection and diagnosis for biomedical and manufacturing applications: Leading Towards Better Quality of Life

  • Kao, Imin;Li, Xiaolin;Tsai, Chia-Hung Dylan
    • Smart Structures and Systems
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    • v.5 no.2
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    • pp.153-171
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    • 2009
  • In this paper, the analytical fault detection and diagnosis (FDD) is presented using model-based and signal-based methodology with wavelet analysis on signals obtained from sensors and sensor networks. In the model-based FDD, we present the modeling of contact interface found in soft materials, including the biomedical contacts. Fingerprint analysis and signal-based FDD are also presented with an experimental framework consisting of a mechanical pneumatic system typically found in manufacturing automation. This diagnosis system focuses on the signal-based approach which employs multi-resolution wavelet decomposition of various sensor signals such as pressure, flow rate, etc., to determine leak configuration. Pattern recognition technique and analytical vectorized maps are developed to diagnose an unknown leakage based on the established FDD information using the affine mapping. Experimental studies and analysis are presented to illustrate the FDD methodology. Both model-based and wavelet-based FDD applied in contact interface and manufacturing automation have implication towards better quality of life by applying theory and practice to understand how effective diagnosis can be made using intelligent FDD. As an illustration, a model-based contact surface technology an benefit the diabetes with the detection of abnormal contact patterns that may result in ulceration if not detected and treated in time, thus, improving the quality of life of the patients. Ultimately, effective diagnosis using FDD with wavelet analysis, whether it is employed in biomedical applications or manufacturing automation, can have impacts on improving our quality of life.