• Title/Summary/Keyword: chronic ulcer

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Vascularized Bipedicled Pericranial Flaps for Reconstruction of Chronic Scalp Ulcer Occurring after Cranioplasty

  • Yoon, Seok Ho;Burm, Jin Sik;Yang, Won Yong;Kang, Sang Yoon
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.341-347
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    • 2013
  • Background Intractable chronic scalp ulcers with cranial bone exposure can occur along the incision after cranioplasty, posing challenges for clinicians. They occur as a result of severe scarring, poor blood circulation of the scalp, and focal osteomyelitis. We successfully repaired these scalp ulcers using a vascularized bipedicled pericranial flap after complete debridement. Methods Six patients who underwent cranioplasty had chronic ulcers where the cranial bone, with or without the metal plate, was exposed along the incision line. After completely excising the ulcer and the adjacent scar tissue, subgaleal dissection was performed. We removed the osteomyelitic calvarial bone, the exposed metal plate, and granulation tissue. A bipedicled pericranial flap was elevated to cover the defect between the bone graft or prosthesis and the normal cranial bone. It was transposed to the defect site and fixed using an absorbable suture. Scalp flaps were bilaterally advanced after relaxation incisions on the galea, and were closed without tension. Results All the surgical wounds were completely healed with an improved aesthetic outcome, and there were no notable complications during a mean follow-up period of seven months. Conclusions A bipedicled pericranial flap is vascularized, prompting wound healing without donor site morbidity. This may be an effective modality for treating chronic scalp ulcer accompanied by the exposure of the cranial bone after cranioplasty.

Ginsenoside $Rb_1$: the Anti-Ulcer Constituent from the Head of Panax ginseng

  • Jeong, Choon-Sik;Hyun, Jin-Ee;Kim, Yeong-Shik
    • Archives of Pharmacal Research
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    • v.26 no.11
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    • pp.906-911
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    • 2003
  • We previously reported that the butanol (BuOH) fraction of the head of Panax ginseng exhibited gastroprotective activity in peptic and chronic ulcer models. In order to identify the active constituent, an activity-guided isolation of the BuOH faction was conducted with a HCI$.$ethanol-induced gastric lesion model. The BuOH fraction was passed through a silica-gel column using a chloroform-methanol gradient solvent system, and six fractions (frs. 1-6) were obtained. The active fr. 5 was further separated by silica-gel column, to yield 6 subfractions (subfrs. a-f). Subfr. d was composed of ginsenosides Re, Rc and $Rb_1$. The most active constituent was ginsenoside $Rb_1$ ($GRb_1$), a protopanaxadiol glycoside, which was investigated for its anti-ulcer effect. Gastric injury induced by HCI$.$ethanol, indomethacin and pyloric ligation (Shay ulcer) was apparently reduced with oral $GRb_1$ doses of 150 and 300 mg/kg. $GRb_1$ at these dosage significantly increased the amount of mucus secretion in an ethanol-induced model. The anti-ulcer effects were consistent with the result of histological examination. These results suggest that the major active constituent in the head of Panax ginseng is $GRb_1$ and that anti-ulcer effect is produced through an increase in mucus secretion.

Treatment of Venous Stasis Ulcer with $3M^{TM}$ $Coban^{TM}$ 2 Layer Compression System: A Case Report (두겹 압박방식 $3M^{TM}$ $Coban^{TM}$을 이용한 울혈성 정맥궤양의 치료: 증례보고)

  • Chu, Ho-Jun;Son, Dae-Gu;Kim, Jun-Hyung;Han, Ki-Hwan;Kim, Hyung-Tae
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.699-702
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    • 2011
  • Purpose: Venous stasis ulcer is the most severe form of chronic venous insufficiency and this commonly appears in the lower limb. Pharmacological therapy, reconstruction of the venous system, surgical management, cellular therapy and compression therapy are known as the treatments of venous stasis ulcer, but relapses are common, which make it a typical chronic wound. We report here on a case of recurrent venous stasis ulcer that healed with compression therapy without any other treatment. Methods: A 35-year-old man with a 13 years history of venous stasis had developed an ulcer on the distal third portion of the lower left limb which was developed 12-year before enrollment in this study. He had been treated with vacuum assist closure, 2 times of cell therapy and 3 times of skin graft for 8 years, but the lesion recurred. From November, 2008 compression therapy was done with the 3M $Coban^{TM}$ 2 Layer Compression System (3M, St. Paul, USA). The ulcer at that time was oval shaped and $3{\times}4$ cm in size. A comfort layer bandage was applied from the proximal phalanx of the great toe to the knee. A compression layer bandage was applied on the previous layer with it being overlapped one half the width of the comfort layer bandage. The dressing was changed every 4 days and the change was recorded with photography. Results: A total of 12 $Coban^{TM}$ 2 Layer Compression Systems were used. The size of the ulcer decreased to $2.5{\times}2.5$ cm in one month, to $2{\times}2$ cm in 2 months, it was $1{\times}1.8$ cm in size at 3 months and it completely healed in 4 months. Conclusion: The venous stasis ulcer was completely healed using the 3M $Coban^{TM}$ 2 Layer Compression System. This method was easy to apply, made the patient comfortable and it provided an excellent compression effect. As in the previous studies, this compression therapy has been proven to play an important role for the treatment and prevention of venous stasis ulcer.

A case of strongyloidiasis accompanied by duodenal ulcer (십이지장궤양을 동반한 분선충증 1례)

  • 김성용;김나영
    • Parasites, Hosts and Diseases
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    • v.30 no.3
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    • pp.231-234
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    • 1992
  • A 58-year-old chronic alcoholism patient, who complained of epigastric discomfort, nausea, and frequent loose stool was diagnosed as strongyloidiasis accompanied by duodenal ulcer. The symptoms first appeared two years ago and aggravated during the recent 3 months, and he lost 4 kg of his body weight. Stool examination revealed rhabditoid nematode larvae, which were confirmed as those of Strongyloides stercoralis after cultivation of them to alariform larvae. At duodenoscopy, duodenal ulcer was found. The patient was treated with albendagole (200 mg, bid, for 14 days) for stronglyloidiasis and with colloidal bismuth sulfate(240 mg, bid, for 6 weeks) for duodenal ulcer. After the medication, the symptoms of loose stool and epigastric discomfort were much improved and he was discharged with no clinical problems. This is an interesting case which suggests that S. stercoralis infection could be related with ulceration of the duodenal mucosa.

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Adult Patients with Peptic Ulcer in Korea-related Factors, Flexible Workers (한국 성인 변형근로자의 소화성궤양 환자 관련요인)

  • Park, Sun-Hee;Oh, Hyang-Suk;Kim, Chang-Hwan
    • The Korean Journal of Health Service Management
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    • v.6 no.2
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    • pp.211-217
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    • 2012
  • To identify health behavior of Peptic ulcer patients among all employees in Korea and examine relevant factors to present basic data for improving Korean adult employees' health conditions and quality of living, 3,515 employees aged 20 to 69 were sampled from the group that responded to the question concerning the presence of Peptic ulcer in the fourth Korea National Health and Nutrition Examination Survey for the third year (2009). After logistic regression analysis was carried out to see the effects of working conditions, harmful factors, shift work, stress perception, and experience of depression on the presence of Peptic ulcer, it was found that unsafe or unpleasant working conditions led to higher risk of getting Peptic ulcer, that flexible workers were more likely to get Peptic ulcer, and that depression or stress perception exerted almost no effect on Peptic ulcer. With the increase in the number of flexible workers, increasingly more interest is taken in the effects of shift work on health; occupational Peptic ulcer tends to become chronic as compared with the condition in the general population and reappear even after recovery in many cases; therefore, it is necessary to take special management measures by estimating the number of those at a risk of getting Peptic ulcer and by finding out its risk factors.

Effect of Recombinant Human Epidermal Growth Factor(DWP 401) on Gastric Secretion and Ulcers in Rats (재조합 인간 상피세포 성장인자(DWP 401)의 흰쥐 위액분비 및 궤양에의 작용)

  • Lee, Eun-Bang;Cheon, Seon-A;Lee, Eun-Sim;Kim, Ok-Gyeong
    • YAKHAK HOEJI
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    • v.40 no.4
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    • pp.456-461
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    • 1996
  • The effects of human epidermal growth factor(EGF) which was produced by recombinant DNA technique was investigated on gastric secretion, gastric lesion and ulcer models in rats. The EGF showed significant inhibition of secretion of gastric juice and total acid output, at 0.4mg/kg, id and also inhibited Shay ulceration at 0.4mg/kg, id in rats. The lesion induced by absolute ethanol was significantly reduced by oral administration of EGF at 0.4mg/kg. Likewise, EGF caused significant inhibition of indomethacin induced gastric ulcer at oral doses of 0.2 and 0.4mg/kg. The EGF produced dose-dependent inhibition of gastric ulcer induced by acidified aspirin, but showed no significant inhibition at oral doses of 0.1, 0.2 and 0.4mg/kg. The chronic gastric ulcer induced by injection of 20% acetic acid solution was significantly reduced by oral doses of 0.1 and 0.4mg/kg of EGF. Duodenal ulcer induced by mepirizole was dose-dependently inhibited by oral doses of 0.1, 0.2 and 0.4mg/kg of EGF. These data suggest that EGF possesses pronounced inhibitory action in gastric ulcer and duodenal ulcer of rats.

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Surgical Treatment for Chronic Peptic Ulcer with Gastric Outlet Obstruction (만성 소화성 궤양에 합병된 위출구 폐색의 수술적 치료)

  • Lee, Jei Hee;Yang, Shi Joon;Jeon, Young Woong;Park, Sei Hyeog;Kim, Jong Heung;Park, Jong Min
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.160-165
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    • 2008
  • Purpose: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. Results: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). Conclusion: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.

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The Physiological Activities of KYUNG OK-KO(III) -Effects on Inflammation, Gastric Ulcer, Analgesic and Homothermics- (경옥고의 생리활성(III) -염증, 위궤양, 진통 및 정상체온에 미치는 영향-)

  • Whang, Wan-Kyunn;Oh, In-Se;Kim, Yong-Bin;Shin, Sang-Duk;Kim, Il-Hyuk
    • Korean Journal of Pharmacognosy
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    • v.25 no.2
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    • pp.153-159
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    • 1994
  • The studies were conducted to investigate the inflammation, gastric ulcer, analgesic and homothrmic of experimental animals by KYUNG OK-KO water extract and drink, which is a traditional preparation in Korea. 1. It was exhibited significantly anti-inflammatory effects to acute inflammation on carragennan edema, and preventive and therapeutic effects to chronic inflammation on Freund's complete adjuvant in rats(100, 200, 400 mg/kg). Especially, preventive effect of KYUNG OK-KO water extracts at doses of 100, 200, 400 mg/kg in rats were showed dose-dependantly. 2. Aspirin-induced gastric ulcer were remarkably repaired by all experimental groups of KYUNG OK-KO water extracts. 3. The number of writing syndromes by acetic acid induced also were decreased which MPI's test was increased by tail flick apparatus in mice remarkably, all doses of water extracts(100, 200, 400 mg/kg) and dose-dependantly. 4. Aminopyrine-induced homothermic effects of KYUNG OK-KO water extract(100, 200, 400mg/kg) and drink (0.7, 1.4, 2.1 ml/kg) were significantly evaluated dose-dependantly in 400 mg/kg, 2.1 ml/kg groups.

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Chronic Pain Control of SCI Patients after Cervical Epidural Block -Case report on 2 cases- (경부 경막외 차단에 의한 척수손상 환자의 만성 통증 조절 -2예 보고-)

  • Lee, Ji-Young;Sung, Choon-Ho
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.273-278
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    • 1992
  • With the medical progress that has given spinal cord injured(SCI) individuals greater longevity and better overall health, chronic pain is emerged as major challenge in treating this population. According to past reports, estimates of prevalance of severe/disabling chronic pain in SCI patients have ranged from 18% to 63%. In etiologies of chronic pain in SCI patients, psychic or psychogenic pain categories should be included and more recent data have demonstrated that the persistant pain is directly related to higher levels of psychosocial distress and impairment. Recently, neurophysiological classification of the SCI pain syndrome into three etiologic groups(a; mechanical pain, b; radicular pain, c; deafferentation pain) is more frequently adopted for the classification of chronic SCI pain syndrome. The deafferentation pain is most common of the pain syndromes associated with SCI. After cervical epidural anesthesia for the surgical intervention of decubitus ulcer on the hip of two SCI patients, there were much reduction of existing chronic deafferentation character pain.

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Antigastritic and Antiulcerative Activities of Water Extracts Derived from Scutellaria baicalensis

  • Cho, So-Yean;Lim, Duk-Yun;Kang, Min-Hee;Yoon, Hye-Ran;Kim, Gun-Hee;Lee, Yong-Soo;Jeong, Choon-Sik
    • Biomolecules & Therapeutics
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    • v.14 no.3
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    • pp.171-177
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    • 2006
  • Gastritis and gastric ulcer were known to be induced by gastic acid, stress, ethanol, Helicobacter pylori and free radical, etc. This study was performed for the development of a new drug or nutraceutical from medicinal plants or natural products with anti-gastritis, anti-ulcerative and gastroprotective activities. The water extract of Scutellaria baicalensis was exhibited potent inhibition in HCl ethanol-induced gastric lesion, acetic acid-induced and Shay ulcers, indicating the effects on gastric lesion and ulcer in rats. The water extract of Scutellaria baicalensis significantly inhibited HCl ethanol-induced gastric lesions at the oral dose of 300, 500 mg/kg. In pylorus ligated rats, the treatments of the water extract from Scutellaria baicalensis showed decrease in the volume of gastric secretion and acid output and increase pH at oral dose of 300, 500 mg/kg. And significantly reduced acetic acid-induced ulcer at the oral dose of 500 mg/kg for 12 days. In this study, we have found that the water extract from Scutellaria baicalensis had significant improvement in acute gastritis and ulcer at the dose of 300, 500 mg/kg and in chronic gastritis and ulcer at the dose of 500 mg/kg. Also we evaluated the antibacterial activity against Helicobacter pylori treated with Scutellaria baicalensis. Scutellaria baicalensis had a equivalent antibacterial activity with ampicilin against H. pylori at the dose of $100\;{\mu}/ml$. In histological examination, the water extract of Scutellaria baicalensis drastically restored gastric damages induced by HCl ethanol solution, pylorus- ligature and acetic acid. Therefore, we may use the water extract from Scutellaria baicalensis as antigastritic and antiulcerative agent for the purpose of the improvement or treatment of gastritis and gastric ulcer.