• Title/Summary/Keyword: Upper abdomen

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Clinical Evaluation of Abdominal Stab Wound Patients in the ED (복부 자상환자의 처치에 대한 응급의학에서의 고찰)

  • Park, Jong-Hak;Kim, Jung-Youn;Shin, Jun-Hyun;Yoon, Young-Hoon;Cho, Han-Jin;Moon, Sung-Woo;Choi, Sung-Hyuk;Lee, Sung-Woo;Hong, Yun-Sik
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.21-28
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    • 2010
  • Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

Literature Review on Parkinson's Disease in Oriental Medicine (파킨슨병의 한의학적 고찰 -병인병리(病因病理)와 침구요법(鍼灸療法)을 중심으로-)

  • Park, Sang-min;Lee, Sang-hoon;Yin, Chang-shik;Kang, Mi-kyeong;Chang, Dae-il;Kang, Sung-keel;Lee, Yun-ho
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.202-210
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    • 2004
  • Objective: In order to find oriental medical therapies on Parkinson's disease and to make a fundamental basis for clinical application, this study was performed. Methods: We reviewed 35 kinds of the ancient and modern text, and related articles. Results: Parkinson's disease is an extrapyramidal disease characterized by akinesia, tremor at rest, rigidity, and slowness of movement. In old oriental medical text, Parkinson's disease is described as Jinjeon(振顫), Chi, Gyeong (痙), Gyejong, Ryeon(攣) and Pyeongo(偏枯), Tantan, Jungbu(中腑症) of Jungpung(中風). According to the text, major pathological causes were Wind(風), Fire(火), Phlegm(痰), and Blood stasis(瘀血). And Parkinson's disease can be classified into four clinical types as liver & kidney yin-deficiency, qi & blood deficiency, retention of phlegm-heat, and qi-stagnation & blood stasis. Standardized acupuncture points are GV20, GB20, GV14 on head, CV12, ST25 on abdomen, GV26, ST7, GB1, S14, LI20 on face, LI4, LI11, TE5, SI3, HT3, LI15, SI6 on upper extremity, and ST36, GB34, SP6, LR3, KI1, GB30, BL40 on lower extremity. Other methods, such as scalp acupuncture, electro-acupuncture, and herb-acupuncture, can be applied to treat Parkinson's disease. Conclusions: We find out that there are oriental medical concepts related with Parkinson's disease such as Jinjeon(振顫), Chi, Gyeong (痙), Gyejong, Ryeon(攣) and Pyeongo(偏枯), Tantan, Jungbu(中腑症) of Jungpung(中風), of which major causes are Wind(風), Fire(火), Phlegm(痰), and Blood stasis(瘀血). We can also apply many effective acupuncture points and acupuncture therapies according to differential diagnosis, for example, liver & kidney yin-deficiency. qi & blood deficiency, retention of phlegm-heat, and qi-stagnation & blood stasis.

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Combination of FDG PET/CT and Contrast-Enhanced MSCT in Detecting Lymph Node Metastasis of Esophageal Cancer

  • Tan, Ru;Yao, Shu-Zhan;Huang, Zhao-Qin;Li, Jun;Li, Xin;Tan, Hai-Hua;Liu, Qing-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7719-7724
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    • 2014
  • Background: Lymph node metastasis is believed to be a dependent negative prognostic factor of esophageal cancer. To explore detection methods with high sensitivity and accuracy for metastases to regional and distant lymph nodes in the clinic is of great significance. This study focused on clinical application of FDG PET/CT and contrast-enhanced multiple-slice helical computed tomography (MSCT) in lymph node staging of esophageal cancer. Materials and Methods: One hundred and fifteen cases were examined with enhanced 64-slice-MSCT scan, and FDG PET/CT imaging was conducted for neck, chest and upper abdomen within one week. The primary lesion, location and numbers of metastatic lymph nodes were observed. Surgery was performed within one week after FDG PET/CT detection. All resected lesions were confirmed histopathologically as the gold standard. Comparative analysis of the sensitivity, specificity, and accuracy based on FDG PET/CT and MSCT was conducted. Results: There were 946 lymph node groups resected during surgery from 115 patients, and 221 were confirmed to have metastasis pathologically. The sensitivity, specificity, accuracy of FDG PET/CT in detecting lymph node metastasis were 74.7%, 97.2% and 92.0%, while with MSCT they were 64.7%, 96.4%, and 89.0%, respectively. A significance difference was observed in sensitivity (p=0.030), but not the others (p>0.05). The accuracy of FDG PET/CT in detecting regional lymph node with or without metastasis were 91.9%, as compared to 89.4% for MSCT, while FDG PET/CT and MSCT values for detecting distant lymph node with or without metastasis were 94.4% and 94.7%. No significant difference was observed for either regional or distant lymph node metastasis. Additionally, for detecting para-esophageal lymph nodes metastasis, the sensitivity of FDG PET/CT was 72%, compared with 54.7% for MSCT (p=0.029). Conclusions: FDG PET/CT is more sensitive than MSCT in detecting lymph node metastasis, especially for para-esophageal lymph nodes in esophageal cancer cases, although no significant difference was observed between FDG PET/CT and MSCT in detecting both regional and distant lymph node metastasis. However, enhanced MSCT was found to be of great value in distinguishing false negative metastatic lymph nodes from FDG PET/CT. The combination of FDG PET/CT with MSCT should improve the accuracy in lymph node metastasis staging of esophageal cancer.

The Study on The ischemic heart disease Explained In Nei-jing(內經) (내경(${\ll}$內經(${\gg}$)에 나타난 허혈성 심질환에 대한 연구)

  • Hong, Tian-Biao;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.144-156
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    • 1998
  • This study has been carried out to investigate the cause, pathological mechanism and treatment of symptoms regarded as the ischemic heart disease in Nei-jing(內經). I've got the following conclusions. 1. From the side of xing-bi(胸痺), the ischemic heart disease(IHD) was caused by that the energy in one's heart wasn't extended in the way of Yin-xie(飮邪), namely waste matter of human body and symptoms and treatment wern't written. 2. From the side of xin-bi (心痺), HID was catched by the mechanisms that the blood vessel is blocked. or the heart's blood was deficient owing to the mutation of mo-bi(脈痺), the lack of yang-ming(陽明) and excessive thoughts and worry and others. The symptoms were feeling oppressed in one's brest, palpitating, sudden dyspnea, the dryness of thorat, frequent belching and the fear by the inverse flow of the energy(氣). The treatment was that the yin(陰) was cured immediately, but the yang(陽) mustn't be attacked. 3. From the side of xing-tong(心痛), IHD was suffered from by mechanisms that following the han-sa(寒邪), namely the cold makes a invasion on humanbody, the vessel was blocked, spasm, filled and the amount of blood flow was poor, or caused by injury of vessel, the inverse flow and the disease of shi-dong(是動病) of shou-shao-xin-jing(手少陰心經) and so on. The pain was cramped into the upper and lower back or lower abdomen or throat and accompanied with nausea, abdominal dropsy, constipation, the impending of breathing and so on. The cure was mainly that acupuncture was applied at the jin-su(筋縮) region or meridian in relation to symptoms, but if the pain were severe, acupuncture mustn't be applied. The prog nosis was worse. 4. From the side of xing-tonge(心痛), IHD was divided into zhen-xing-tong(眞心痛) and jue-xing-tong(厥心痛), but pi-xiog-tong(脾心痛) and wei-xing-tong(胃心痛) out of jue-xing-tong(厥心痛) also included the symptoms of the digestive disease.

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Case of Treatment Using Adaptive Servo-Ventilation in a Patient with Central Sleep Apnea after a Lateral Medullary Infarction (외측 연수 경색에 의해 발생한 중추성 수면 무호흡 환자의 자동-적응형 양압기를 사용하여 치료한 경험)

  • Kim, Dae Jin;Cho, Jae Wook;Kim, Hyun Woo;Choi, Jeong Su;Mun, Sue Jean
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.278-283
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    • 2020
  • Central sleep apnea (CSA) is characterized by respiratory failure of at least 10 seconds without any effort of the chest and abdomen in the absence of upper airway resistance during sleep. In this case, the patient experiences respiratory failure that does not meet the CSA diagnostic criteria and CSA symptoms. Magnetic resonance imaging diffusion-weighted imaging (MRI DWI) scans revealed a lateral medullary infarction. Continuous positive airway pressure (CPAP) was applied as a primary treatment for CSA and respiratory failure. During the titration of CPAP, the apnea-hypopnea index (AHI) and arousal index (AI) were worse than the results before its use (AHI: 42.5/hr→82.8/hr, AI: 21.7/hr→40.8h). As a result, adaptive servo-ventilation (ASV) was chosen as the secondary treatment. Compared to the night-polysomnography results before the ASV treatment, the AHI improved (42.5/hr→8.6/hr). Therefore, ASV is a potential treatment for CSA and respiratory failure in these patients.

Infiltrating Intramuscular Lipoma (침윤성 근육내 지방종)

  • Suh, Jeung-Tak;Kim, Jeung-Il;Cheon, Sang-Jin;Lee, Choon-Key;Ku, Ja-Gyung;Kim, Young-Goun
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.40-45
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    • 2005
  • Purpose: To suggest an accurate diagnosis and treatment of infiltrating intramuscular lipoma by analysis of the clinical, biological, radiological and pathological features. Materials & Methods: 20 patients who treated at our hospital for infiltrating intramuscular lipoma from 1998. to 2001 were selected for this study. Mean age was 45.8 years old. Four were male and eight female. All cases were checked preoperative radiographs, MRI and diagnosed by biopsy. The methods of surgical treatment included excision of tumor and peripheral tissue. We assessed the recurrence by follow up. Results: Tumors located in upper limbs 5 cases, lower limbs 3 cases, abdomen 3 cases, gluteal region 1 case. In preoperative radiographs, infiltrating intramuscular type were 7 cases. In 11 cases, tumors were completely excied with peripheral tissue. 1 cases was incompletely excised because it was very huge mass and infiltrated lung. Encapsulated tumors were 3cases and uncapsulated tumors 9 cases. There were no recurrence excepts 1 case that was infiltrated lung. Conclusion: Infiltrating intramuscular lipoma was wrongly diagnosed as well differentiated liposarcoma. To increase the rate of correct diagnosis, preoperative radiographs, MRI and pathologic diagnosis were performed. Careful wide excision is necessary to prevent the recurrence.

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The Wearing Effect of Sport Underwear -Focusing on the Loss of Weight and Amount of Sweat according to the Materials- (운동용 속옷의 착용효과 -소재별 발한량과 체중감량을 중심으로-)

  • Na, Mi-Hyang;Kim, Mi-Sun;Jung, Bock-Hee
    • Korean Journal of Human Ecology
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    • v.11 no.3
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    • pp.273-285
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    • 2002
  • Three materials for sport underwear were manufactured by order for study, and among them, suitable material in order to perform an experiment on the effect of wearing was adopted. The results are as follows: The result of wearing an experimental clothes for sports manufactured as a foundation-type underwear for sports showed that if the same compositional materials were applied, laminating material had higher rate than that of others in the amount of sweat. Concerning relative humidity in clothes and the amount of sweat absorbed in clothes among the two kinds of materials which were produced by laminate, material 2(nylon+modal) was statistically exerts higher influence on the amount of sweat. The humidity in clothes keeps the optimal condition of 59.8%, and breast part showed the highest relative humidity. The material 2(nylon+modal) showed the highest comfortableness, the sense of warmth, humidity and voluminousness, and the sense of pressure. Follow-up survey revealed that in case of material 2, higher amount of sweat than that of the group objects in its early phase, and the amount of sweat varies from individuals. The temperature in clothes of folded parts of experimental clothes and maximum surface temperature was equivalent to that of average skin. With the lapse of time, the weight decreased of 11.03% in maximum, and 3.12% in minimum. The amount of change in the girth was greater in part of body frame than that of limbs, and especially, navel and waist part showed high decrease, and upper breast, breast and the largest part of abdomen showed relatively low decrease. The above experiment revealed that materials for suitable to the underwear for sports for loss of weight by an exercise should be made of doubled-nylon and modal, along with the laminate processing, which heightens the amount of sweat. Thus, wearing an experimental wear gave satisfaction in the view of the beauty of appearance as it did not discharge flowing secretion to the outside at the time of exercise.

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Comparison of the Measured Radiation Dose-rate by the Ionization Chamber and GM(Geiger-Müller) Counter After Radioactive Iodine Therapy in Differentiated Thyroid Cancer Patients (분화성 갑상선암환자의 방사성 요오드 치료시 전리함과 Geiger-Muller계수관에서 방사선량률 측정값 비교)

  • Park, Kwang-hun;Kim, Kgu-hwan
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.565-570
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    • 2016
  • Radioactive iodine($^{131}I$) treatment reduces recurrence and increases survival in patients with differentiated thyroid cancer. However, it is important in terms of radiation safety management to measure the radiation dose rate generated from the patient because the radiation emitted from the patient may cause the exposure. Research methods, it measured radiation dose-rate according to the elapsed time from 1 m from the upper abdomen of the patient by intake of radioactive iodine. Directly comparing the changes over time, high dose rate sensitivity and efficiency is statistically significant, and higher chamber than GM counter(p<0.05). Low dose rate sensitivity and efficiency in the chamber had lower levels than gm counter, but not statistically significant(p>0.05). In this study confirmed the characteristics of calibrated ionization chamber and GM counter according to the radiation intensity during high-dose radioactive iodine therapy by measuring the accurate and rapid radiation dose rate to the patient explains, discharged patients will be reduced to worry about radiation hazard of family and others person.

The Distribution and Patient Care in Radiography for Emergency Outpatients (응급환자의 방사선영상검사 분포 및 Patient Care)

  • Lee, Hwan-Hyung;Kang, Won-Han
    • Journal of radiological science and technology
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    • v.19 no.1
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    • pp.55-74
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    • 1996
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distribution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 761 emergency outpatients who visit during JAN, 1994 at ER of the general hospital in Pusan city. The results is as follows: Emergency radiography rate of simple radiography was 61.1 %, special radiography 2.5 %, CT 12.6 %, and ultrasonography 6.7 %. In simple radiography rate, a high rate was distributed on male(63.6 %), thoracicsurgery part(90.0%), admission patient(74.9 %), and long stayed patient at ER. In special raiography rate, a high rate was observed in urologic part(28.6%), and in CT rate, observed neurosurgery part(49.2 %) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8 %) and internal medicine part(15.9 %). There are distributed regional radiography rate in radiographic type that chest(55.3 %) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0 %) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neurosurgery, chest(90.0%) in thoracic-surgery, abdomen(58.0%) in general-surgery, spine (40.0% ) in neuro-surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic-surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiographic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transfered patient(2.7) in patient type, and on neurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional part was highly distributed on chest(499 case number). Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, radiographer should know well about dealing with contrastmedia administration and related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography, Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always silted with CT room and monitoring-patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiography should be established in ER area, and the radiographer of this room should be stationed radiologic technician who is career and can implement emergency patient care.

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An in-depth interview for use of moxibustion therapy in Korea (국내 뜸 요법 임상 실태 파악을 위한 면접조사)

  • Han, Chang-Hyun;Shin, Mi-Suk;Kang, Kyung-Won;Kang, Byoung-Kab;Park, Sun-Hee;Choi, Sun-Mi
    • Korean Journal of Acupuncture
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    • v.25 no.1
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    • pp.85-97
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    • 2008
  • Objectives : Moxibustion therapy is one of the most popular oriental treatments in Korea. In this study, we operate the in-depth interview for use of moxibustion therapy in Korea. Methods : Survey questions were developed based on consensus of acupuncture professors. The list of the Korean medical doctors with experiences more than 10 years is provided by the Association of the Korean Oriental Medicine. The in-depth interview was conducted in 30 Korean medical doctors who answered in the previous telephone survey that they use moxibustion therapy for more than 30 % of patients everyday. Interview survey with them were conducted by the well-trained interviewers of Korea Institute of Oriental Medicine in medical researcher from 22th May to 28th June 2007. Results : Korean medical doctors prefer to use the moxibustion with moxa stick (83.9%). The most common treatment disease was musculo-skeletal disorder (28.9%), gynecology (14.1%), digestive disorder (28.6%). The most common treatment area was the abdomen (35.3%), back (22.5%), lower extremity (15.8%) and upper extremity (16.9%). Indirect moxibustion’s was as frequent as 73.5% of moxibustion method. The most common instrument for treating was mini-moxa of manufactured goods (39.3%). Most Korean medical doctors (48.8%) took up the position that bring symptom relief following good treatment area. 'High preferences of patients' (32.7%) was one of moxibustion strong points but 'Lots of smell and smoke' (54.7%)' was a weak points. The most common side effects was the 'slight burn' (34.9%), 'skin rash' (22.5%), 'skin pruritus' (23.8%) Conclusions : This survey provides unique insight into the perception of the Korea medical doctor at moxibustion therapy. Future research needs to provide more in-depth insight into doctor views of the experience.

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