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- 저자 : Paynter (검색결과 4 건)
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Paynter Jessica A.,Qin Kirby R.,Situ Dongrong,Lee Chun Hin Angus 대한대장항문학회 2023 Annals of Coloproctolgy Vol.39 No.5
Purpose: A patient presented to a regional surgical center with Fournier gangrene (FG) and concurrent multifocal necrotizing fasciitis (NF). Given the rarity, it was decided to undertake a systematic review to investigate the incidence and prevalence of FG with multifocal NF and consequently determine the treatment and approach to management of such presentation. Methods: Firstly, the report of the 56-year-old male patient is discussed regarding his surgical management. Secondly, a systematic review was undertaken according to PRISMA guidelines using MEDLINE, Scopus, and Embase databases. Searches used the following MeSH terms: (“fournier’s gangrene”) AND ((necrotising fasciitis) OR (necrotising soft tissue infection)). Once the search results were obtained, duplicate articles were removed. Titles, abstracts, and articles were reviewed by 2 authors. Results: The search strategy using the 3 databases revealed a total of 402 studies. Fifty-seven studies were removed due to duplication. A total of 345 records were screened via title and abstract, of which 115 were excluded. Two hundred and thirty studies were reviewed for eligibility. A total of all 230 studies were excluded; 169 were excluded as they included the incorrect patient population (patients suffered from FG or NF, but not both collectively), 60 studies were excluded due to incorrect study designs, and 1 report occurred in the wrong setting. Conclusion: This highlights that while being a relatively known, uncommon infection both FG and NF are well documented separately within the literature. However, FG with concurrent multifocal NF has not been documented within the literature.
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Jessica A. Paynter,Kirby R.Qin,Georgia Seamer,Ruchira Fernando,Janelle Brennan,Chun Hin Angus Lee 대한대장항문학회 2023 Annals of Coloproctolgy Vol.39 No.3
Colitis caused by vasculitis is a rare and poorly understood pathology. Little evidence exists on its clinical presentation, path to diagnosis, and surgical management. In this report, we present a case report and literature review. A healthy 20-year-old male patient presented with hemorrhagic colitis requiring total colectomy with end ileostomy. Pathological examination showed pancolitis with multiple ulcers, transmural inflammation, hemorrhage, and microvascular thrombosis. Extensive serological testing revealed elevated cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) and eosinophilia, leading to a diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA) and vasculitis-induced colitis. A literature review was subsequently conducted. Nineteen studies were found documenting vasculitis-induced colitis in the absence of inflammatory bowel disease (IBD). Systemic signs of vasculitis, hemorrhagic colitis, and progression to fulminant colitis were present. Of all patients, 40.0% required colorectal surgery and 62.5% of those patients received a stoma; 25% underwent emergency surgery following failed immunosuppression. All cases relied on clinical correlation with serology and/or histopathology to reach a final diagnosis. We report a case of vasculitis-induced colitis caused by c-ANCA−positive EGPA. The review shows that vasculitis-induced colitis without IBD is an important differential that clinicians should be aware of in patients presenting with colitis.
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Asymptotic analysis of an adhered complete contact between elastically dissimilar materials
Kim, Hyung-Kyu,Hills, David A,Paynter, Robert JH SAGE Publications 2014 The Journal of strain analysis for engineering des Vol.49 No.8
<P>A complete contact problem between elastically dissimilar materials is studied using an asymptotic analysis. A quarter plane wedge on a half-plane represents the contact edge geometry. Two eigenvalues are obtained for pairs of contacting materials, and their characteristics are classified on the Dundurs parallelogram. Generalized stress intensity factors, <I>K<SUB>I</SUB> </I> and <I>K<SUB>II</SUB> </I>, are derived to use a two-term stress equation of dimensionless form with developing a mode separation angle. It is found that the order of stress singularity increases as the wedge becomes more rigid than the half-plane. Slipping characteristics on the contact interface are investigated in detail, especially for the case of <I>K<SUB>I</SUB> </I> < 0 < <I>K<SUB>II</SUB> </I> that represents a typical adhesive complete contact condition. An example case is given using a finite element model to provide calibration of the stress intensities for a specific material, geometry and load combination.</P>
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