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홍연정,장세웅,이기종,정인성 로얄에이알씨 주식회사 2005 로얄동물임상의학 Vol.3 No.3
6년령의 1.3㎏ 요크셔 테리어가 내원 5일전 닭뼈를 먹고 간헐적인 구토 및 식욕부진으로 내원하였다. 흉부 일반 방사선상에 심장 근위에서부터 전측 흉부식도에 6cm정도의 뼈이물이 있었다. 전혈검사상에 이상 없었고 저혈당(Glu 58)과 간효소 수치의 상승(ALP 271)이 있었다. 식도 조영검사상 조영제가 흉강안에 차는 식도 천공 양상을 보였고 따라서 C-arm 촬영을 실시하였고 좌측 흉부 식도의 천공을 확인할 수 있었다. 확인 직후 적절한 탈수와 혈당 교정을 한후 수술을 실시하였다. C-arm상 확인된 천공 식도부인 좌측 4-5늑간 사이로 개흉하였다. 닭뼈이물은 좌측 흉부식도를 천공하여 좌전엽폐를 천공한후 폐의 협착을 일으킨 상태였다. 이에 좌폐엽 부분 절제술을 시행하고 흉부 식도를 성형 봉합하였다. 이후 음식물이 가득 차있던 좌 흉강안에 흉관을 장착하였고 좌 복벽을 절개하여 위관을 장착하였다. 환자는 이후 수액요법, 항생제, 소염제주사 및 흉관 관리를 하였고 1일 6회 유동식을 위관으로 급여하였다. 환자는 이후에도 지속적인 흉강 삼출액이 있었으며 술후 4일째 그 양이 줄어들기 시작하여 수술 7일째 흉관을 제거하였으며 수술후 7일째부터 구강을 통한 유동식 급여가 이루어졌고 수술후 9일째 위관을 제거하였다. 이후 환자는 건강을 회복하여 정상적인 생활이 가능하여졌다. 경부식도 천공에 비해 흉부식도 천공은 수술기법과 유지, 관리가 어렵지만 개흉술을 통한 흉부 식도 봉합은 적극적이고 효과적인 방법으로 사료된다.
홍연정,장세웅,이기종,정인성 로얄에이알씨 주식회사 2005 로얄동물임상의학 Vol.3 No.2
Two dogs with unilateral restrictive dorsolateral strabismus was referred to Royal Animal Medical Center. One dog had traumatic rupture of the medial rectus muscle and inferior oblique muscle after ocular proptosis. The other dog suffer congenital strabismus. Rupture of an medial rectus muscle is a common problem after ocular proptosis. clinically, abnormalities were restricted to the extraocular muscle with sparring of the masticatory muscles and limb muscles. According to aucultation, physical examination, radiography, these patients were normal condition. Although clients have requested reattachment of the medial rectus muscle, finding and reattaching fragment of torn muscle is not likely to be sucessful following proptosis injury. however, two cases was operated. Definitive repair requires firm reattachment of tendon to sclera with non absorbable suture support. One patient had a persistent small undercorrection in the primary gaze position. Surgical correction may restore eye position and vision. It also appears to be suitable for use in situation when other rectus muscles are absent or unavailable for surgical manipulation.
홍연정 로얄에이알씨 주식회사 2004 로얄동물임상의학 Vol.2 No.4
Large contaminated wounds are difficult to manage and treatment also expensive. Sugar has a bactericidal effect through its osmotic action, which draws macrophages to the wound. A 2-years old female Maltese was referred to Royal Animal Medical Center with a complaint of severe septic wound on left lateral flank and thigh by automobile accident. An estimated area of 15% of total body surface was lost. After stabilization, initial wound management started with debridement of necrotic tissue and removal of foreign materials and lavage with warm saline. Then the patient was treated with general antibiotics. On the third day after hospitalization, an obvious odoriferous discharge and septicemia was found. Sugar therapy was also initiated with antibiotics at this time. Within 24 hours, the wound was much clear and malodor was diminished. At 48-72 hours after wound lavage, a fine, pale layer of granulation tissue and a shiny film were observed over the wound and no odor was detected. The wound was first closed by skin grafting at 9 days but the gaping between the lips was found even after 5 days (14 days of hospitalization). At 14 days, again the injury was closed by cosmetic surgery. Complete healing was achieved in one month after admission and the dog returned to normal life. Thus the use of sugar can be an effective and economical approach to managing large wounds.