• Title/Summary/Keyword: 급성기

Search Result 721, Processing Time 0.028 seconds

A Case of Gastric Cancer Presenting Acute Disseminated Intravascular Coagulation Palliated with Combination Chemotherapy of Irinotecan and Cisplatin (위암과 동반된 급성 파종성 혈관 내 응고증에 대하여 Irinotecan, Cisplatin 복합화학요법으로 완화요법을 시행한 1예)

  • Lee, Sang-Hoon;Woo, In-Sook;Kim, Seon-Young;Song, Myung-Jun;Rho, Sang-Young;Koh, Su-Jin;Lee, Myung-Ah;Kang, Jin-Hyoung;Hong, Young-Seon;Choi, Myung-Gyu;Lee, Kyng-Shik
    • Journal of Gastric Cancer
    • /
    • v.6 no.3
    • /
    • pp.189-192
    • /
    • 2006
  • Acute disseminated intravascular coagulation (DIC) associated with gastric cancer is not common and has short survival of 1 to 3 weeks. Systemic chemotherapy in spite of hematologic unstability for gastric cancer may prolong survival time. A 47-year-old woman who complained of dyspnea, vaginal bleeding and easy bruisibility was diagnosed to stage IV gastric cancer with acute disseminated intravascular coagulation based on the laboratory data. She also had multiple bone metastases and bone marrow involvement. This is the first case treated with combination chemotherapy of irinotecan and cisplatin for advanced gastric cancer complicated by disseminated intravascular coagulation at the time of diagnosis, With systemic chemotherapy, some of the bleeding symptoms and the DIC process improved, even not completely recovered. However the patient died of disease progression and survival time was 12 weeks.

  • PDF

The Significance of Renal Imaging Studies in the Diagnosis of Acute Pyelonephritis (급성 신우신염의 진단을 위한 영상 검사의 유용성)

  • Han, Hye-Jung;Kim, Ji-Hee;Lee, In-Sil;Lee, Hye-Sun
    • Childhood Kidney Diseases
    • /
    • v.11 no.2
    • /
    • pp.212-219
    • /
    • 2007
  • Purpose : It is difficult to diagnose acute pyelonephritis(APN) in young children, because of their nonspecific symptoms. The younger the age, the higher the risk of renal scars after APN, which can be prevented by early diagnosis and treatment. We compare the significance of renal imaging studies by age for diagnosis of APN in febrile urinary tract infection(UTI) in children. Methods : Fifty-three hospitalized children(34 patients under age 2 and 19 patients over age 2) with febrile UTI and who had undergone dimercaptosuccinic acid(DMSA) scan, renal ultra sonography(RUS) and voiding cystourethrography(VCUG) during the acute stage were re-viewed. We compared the renal imaging studies between the different age groups. Results : The DMSA scan showed cortical defects in 23.5% of patients under age 2, which was significantly lower than 63.2% of patents over age 2(P<0.05). The renal cortical defects on DMSA scan were associated only with a high peripheral leukocyte count, but not with fever duration, erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP). And there was no correlation between the DMSA scan, VCUG or RUS findings. Conclusions : The DMSA scan is not sensitive for diagnosis of APN in children less than 2 years of age and the findings cannot predict the presence of vesicoureteral reflux(VUR). VCUG may be necessary for proper management in this age group.

  • PDF

Circulating Levels of Interleukin-6 and Soluble Interleukin-6 Receptor in Acute Asthma (급성 천식환자에서 혈중 Interleukin-6 및 Soluble Interleukin-6 수용체의 변화)

  • Lee, Kyoung-Hoon;Lee, Yong-Chul;Cheon, Ki-Tae;Lee, Heung-Bum;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
    • /
    • v.48 no.4
    • /
    • pp.464-470
    • /
    • 2000
  • Background : The recognition of bronchial asthma as an inflammatory disease led to the search for soluble markers that would be useful in assessing airway inflammation. Interleukin-6 (IL-6) is a representative proinflammatory cytokine that has been shown to be connected with various inflammatory diseases. IL-6 acts via specific receptors that consist of the IL-6 binding glycoprotein gp80 and the signal transducer gp130. In the search for markers of airway inflammation, delete the role of soluble interleukin-6 receptor (sIL-6R) and IL-6 in acute asthma were investigated. Methods : Serum levels of sIL-6R and IL-6 were measured in 78 acute asthmatics, in 15 patients with asymptomatic asthma and in 10 healthy control subjects by a specific ELISA using a murine antihuman IL-6R, IL-6 mAb ($Quantikine^{(R)}sIL$-6R, IL-6). Results : Serum levels of IL-6 in acute asthmatics significantly exceeded those of control subjects. The levels of sIL-6R in acute asthmatics were also significantly increased compared to those of control subjects. The serum concentrations of IL-6 obtained in acute asthmatics were elevated compared with those in asymptomatic asthmatics. However, association between eosinophilic count/IgE and IL-6/sIL-6R in acute asthma could not be found. Conclusion : Our results suggest that IL-6 may be involved in the pathogenesis of acute asthma, and serum levels of IL-6 and sIL-6R may reflect the severity of airway inflammation.

  • PDF

A Case of Fat Embolism Syndrome of Fat Globules Found in BAL Fluid after Recovery from Acute Respiratory Failure (급성호흡부전 호전 후 기관지폐포세척에서 지방과립구가 확인된 지방색전증후군 1예)

  • Park, Song Ree;Kim, Hyun Soo;Lee, Jae Hyung;Kim, Sang Heon;Kim, Tae Hyung;Yoon, Ho Joo;Park, Sung Soo;Shin, Dong Ho;Park, Chan Kum
    • Tuberculosis and Respiratory Diseases
    • /
    • v.61 no.6
    • /
    • pp.562-566
    • /
    • 2006
  • Fat embolism syndrome is a rare clinical diagnosis of dyspnea with acute respiratory failure and neurological signs caused by a traumatic long bone fracture. We report a case of fat embolism in a 22 year-old man after a traffic accident. Dyspnea and stuporous mental changes developed on the $1^{st}$ day after the external fixation operation of a left metaphyseal femur fracture. On the following day, he was transferred from a hospital to this one because of acute respiratory failure. After recovery, macrophages with fat droplets were found in the bronchoalveolar lavage fluid 1. It is important to diagnose a fat embolism as the correct cause of acute respiratory failure through the BAL in the acute state of fat embolism syndrome It is believed that clinically apparent or sometimes hidden fat embolism syndrome can be diagnosed from the BAL during the recovery state.

Effects of Sweet Bee Venom Pharmacopuncture Combined with Korean Medicine Treatment for Acute Low Back Pain Syndrome Patient: A Case Report (급성 요통 증후군 환자에 대해 봉독약침요법을 병행한 한의학적 치료 효과: 증례보고)

  • Bong, Sung Min;Jang, Woo Seok;Kim, Kyung Ho
    • Korean Journal of Acupuncture
    • /
    • v.37 no.1
    • /
    • pp.54-62
    • /
    • 2020
  • Objectives : Acute low back pain syndrome causes pain and poor quality of life. There are various studies of SBV (Sweet bee venom) pharmacopuncture, but few have identified the therapeutic effects for patients unable to walk due to acute back pain. This case series report three cases of acute low back pain syndrome treated with SBV pharmacopuncture combined with Korean Medicine (KM) treatments. Methods : Three acute low back pain syndrome patients with no other acute abnormalities in the imaging were treated by KM treatments including SBV pharmacopuncture, acupuncture, cupping, herbal medicine and physical therapy. The improvement of symptoms was evaluated using Numerical rating scale (NRS), Oswestry disability Index (ODI), EuroQol-5 dimension index (EQ-5D) and EuroQol-visual analogue scale (EQ-VAS). Results : Patients who were unable to walk due to acute back pain were able to walk. There were significant improvements of NRS, ODI, EQ-5D and EQ-VAS after treatment. The patients experienced an average 90% decrease in low back pain after inpatient KM treatment for about 8 days. NRS decreased by an average of 78.9%, ODI decreased by an average of 49.4%, and EQ-VAS increased by an average of 92.6%. In the case 1, EQ-5D decreased in all categories, but in the case 2, it decreased in all categories except for pain/discomfort and anxiety/depression, but in the case 3, it decreased in all categories except anxiety/depression. There was no serious side effect after treatment of SBV pharmacopuncture. Conclusions : KM treatments including SBV pharmacopuncture may be effective for acute low back pain syndrome patients. However, randomized controlled trials are needed in the future to confirm the clinical effects of these interventions.

Rutin Ameliorates Neutrophilic Oxidative Stress-Induced Acute Lung Injury by Intratracheal IL-1 Insufflation in Rats (Interleukin-1으로 유도된 급성폐손상에서 rutin의 효과)

  • Kwon, Sung-Chul;Park, Yoon-Yub;Lee, Young-Man
    • Journal of Life Science
    • /
    • v.20 no.4
    • /
    • pp.474-480
    • /
    • 2010
  • Rutin, a group II phospholipase $A_2$ ($PLA_2$) inhibitor, was tested on interleukin-1 (IL-1) induced acute lung injury (ALI) in male Sprague-Dawley rats. Rutin did not alter the increased lung myeloperoxidase activity by IL-1. However, the number of neutrophils in bronchoalveolar lavage fluid (BALF) and IL-1 induced lung leak were decreased by rutin (p<0.001). Simultaneously, rutin decreased lung $PLA_2$ activity, which was increased by IL-1 (p<0.001). The reduction of neutrophilic respiratory burst by the inhibition of $PLA_2$ was confirmed by group II $PLA_2$ inhibitors such as rutin, manoalide and scalaradial. The increased level of cytokine-induced neutrophilic chemoattractant (CINC) in BALF by IL-1 was not affected by rutin. Ultrastructural changes of ALI and increased generation of free radicals in the lung by IL-1 were found, and rutin ameliorated these pathological findings. Taken together, rutin seems to be effective in decreasing IL-1 induced ALI through inhibition of group II $PLA_2$.

Hepatic Parenchrmal Changes After Percutaneous Injection of Holmium-166 in Rabbit (가토 간내에 Holmium-166 주입 후의 간 실질 변화)

  • 최병인;김명진;박영년;김주희;최병욱
    • Investigative Magnetic Resonance Imaging
    • /
    • v.5 no.1
    • /
    • pp.43-48
    • /
    • 2001
  • Purpose : To evaluate changes in rabbit liver parenchyma on MR images following percutaneous Holmium-166 injection, and to correlate those changes with histologic findings. Materials and methods. Holmium-166 (10-25 mCi) was percutaneously injected into the liver of rabbit (n=12) under sonographic guidance. MR images were obtained between one to two weeks (acute phasea) after the injection in four rabbits, and between two to four weeks (subacute phase) after the injection in four rabbits. Tissue specimens of these eight rabbits were obtained immediately after MR imaging. Tissue specimens were obtained without MR imaging in four rabbits (between one to two weeks in one rabbit and between three to four weeks in three rabbits). Results : Tissue specimens showed central liquefactive necrosis and peripheral coagulative necrosis containing deposition of small particles and hemorrhage. The peripheral margin of the lesions showed formation of the granulation tissue with fibrosis, which tended to be more prominent in subacute phase. The area of the necrosis tended to correlate with the dose of the radioactive Holmium-166. On MR images, the central portion of the necrosis showed hyperintensity on 72-weighted image, hypointensity on the precontrast T1-weighted images, and no enhancement on the dynamic MR images. The peripheral portion of the necrosis showed hypointensity on T2-weighted images, iso or mild hypointensity on the T1-weighted images, and mild peripheral enhancement on the delayed dynamic MR images. The peripheral margin of the lesion showed hypointensity on both T1- and T1-weighted images with increased enhancement on the delayed phase images of the dynamic MR images. Conclusion : After percutaneous Holmium-166 injection into rabbit liver parenchyma, the central portion showed liquefactive necrosis, the peripheral portion showed coagulative necrosis with granulation, fibrosis, hemorrhage and depostition of small granules. MR imaging may be helpful in evaluation of the histological change of the liver after percutaneous Holmium-166 treatment.

  • PDF

The Analysis of Risk Factors and Significance of Tumor Necrosis Factor(TNE)-$\alpha$ in Henoch-$Sch\ddot{o}nlein$ Nephritis (Henoch-$Sch\ddot{o}nlein$ 자반증 환아에서 신침범에 대한 위험인자 분석 및 tumor necrosis factor-$\alpha$의 의의)

  • Song Young-Jun;Ha Tae-Sun
    • Childhood Kidney Diseases
    • /
    • v.4 no.1
    • /
    • pp.40-47
    • /
    • 2000
  • Purpose: Renal involvement is the most important prognostic factor of HSP. Therefore, the pathogenesis and prognostic factors in renal involvement have been studied by many researchers. The aim of this study was to evaluate the clinical risk factors and the role of TNF-$\alpha$ in renal involvement of HS purpura. Methods: The subjects of this study were 12 patients of HS purpura, 7 patients of HS nephritis, and 5 age-matched controls. We have analysed the rist factors for renal involvement in clinical symptoms and collected the sera and urines of all subjects in acute and convalescent stage. The concentration of TNF-$\alpha$ in the collected sera and urines were measured by sandwich ELISA and compared with that of age-matched controls. Results: Statistical analysis showed that persistent purpura increased the risk of developing renal involvement (P=0.0018). and serum TNF-$\alpha$ levels in the acute stage of patients with renal involvement($11.45{\pm}7.01$ pg/ml) were significantly higher than those of without renal involvement($6.32{\pm}1.31$pg/m1) and of age-matched controls($5.99{\pm}1.34$pg/m1)(P=0.012, 0.027, respectively). However, urine TNF-$\alpha$ levels have no correlation with renal involvement. On investigation of serum TNF-$\alpha$ levels in acute stage of HS purpura, persistent purpura had a significantly higher increase(P=0.038). Conclusion: Serum concentration of TNF-$\alpha$ is a risk factor and has a predictable value along with clinical risk factors, such as, persistent purpura for renal involvement in HS purpura. Also, the effectiveness of the specific treatment fur antagonizing TNF-$\alpha$ in HS nephritis may need further study.

  • PDF

Comparison and analysis of the effectiveness to high dose of aspirin and ibuprofen in acute phase of Kawasaki disease (가와사끼병의 급성기 치료에서 고용량 아스피린과 고용량 이부프로펜 사용 효과 비교 분석)

  • Keum, Seung-woon;Oh, Yeon-kyun;Kim, Jong-duck;Yu, Seung-taek
    • Clinical and Experimental Pediatrics
    • /
    • v.52 no.8
    • /
    • pp.930-937
    • /
    • 2009
  • Purpose : We evaluated the effectiveness of treatment and cardiac complications of replacing a high dose of aspirin with a high dose of ibuprofen for children in acute phase of Kawasaki disease. We also analyzed the possibility of replacing a high dose of aspirin with a high dose of ibuprofen to prevent complications such as Reye󰡑s syndrome caused by aspirin. Methods : One hundred eight children with Kawasaki disease were admitted in the pediatrics department from January 1, 2004 to December 31, 2008. Echocardiography and laboratory tests were performed during diagnosis, and the children were followed-up at 6-8 weeks after the diagnosis. We retrospectively analyzed their characteristics and clinical results. Results : The children were assigned to receive either a high dose of aspirin with intravenous immunoglobulin (IVIG) (aspirin group) or a high dose of ibuprofen with IVIG (ibuprofen group). A total of 55 and 53 children were included in the aspirin and ibuprofen groups, respectively. The mean defervescence period was 6.5${\pm}$2.1 days in the aspirin group, and $6.9{\pm}1.9$ days in the ibuprofen group (P=0.309). The number of failed treatments, during and after treatment, was 8 in the aspirin group and 10 in the ibuprofen group (P=0.547). There were 11 initial cardiac complications in the aspirin group, and 14 in the ibuprofen group, but children who showed improvement at follow-up was 7 and 13 in the aspirin and ibuprofen groups, respectively (P=0.133). Laboratory findings were also improved in both groups. Conclusion : We can be considered whether we will replace high dose of aspirin by high dose of ibuprofen in acute phase of Kawasaki disease. Therefore, we can prevent the severe complications of aspirin use, such as Reye's syndrome.

Correlations between Neurologic and Psychiatric Symptoms in Acute Stroke Patients (급성기 뇌졸중 환자에서 신경 및 정신 증상간 상호관계)

  • Kang, Hee-Ju;Bae, Kyung-Yeol;Kim, Sung-Wan;Kim, Jae-Min;Shin, Il-Seon;Park, Man-Seok;Cho, Ki-Hyun;Yoon, Jin-Sang
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.20 no.2
    • /
    • pp.98-104
    • /
    • 2012
  • Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.

  • PDF