• Title/Summary/Keyword: 급성장기

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A Clinical Study of the Acute Respiratory Distress Syndrome in Children (소아에서의 급성 호흡 곤란 증후군에 대한 임상적 고찰)

  • Lee, Taek Jin;Kim, Dong Soo;Shin, Dong Hwan
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.42-50
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    • 2003
  • Purpose : The acute respiratory distress syndrome(ARDS), an acute form of severe alveolar-capillary injury evolving after a direct or indirect lung insult is thought to be a common cause of respiratory failure though not many clinical studies on the subject have been made yet. Methods : Between January 1992 and December 2001, we conducted a retrospective study on 33 children who fulfilled the definition of the ARDS recommended by the American-European Consensus Conference in 1994. Results : A total of 33 patients(20 boys and 13 girls) were selected. Their age ranged from 4 months to 12 years with seven children younger than 1 year. The overall mortality rate was 78.8% and no significant difference was noted based on age or sex. Concerning seasonal variation, incidence of the ARDS increased in spring, especially in May(21.2%). Pneumonia(66.7%) was found to be the most common risk factor of the ARDS followed by sepsis(24.2%) and aspiration(3.0%). In immune compromised children(six cases), including a recipient of bone marrow transplantation, the mortality rate was 100%. Compared with children with multiple organ failure recording a 83.3% mortality rate, those with isolated respiratory failure, showed a lower mortality rate of 33.3%, although stastistically insignificant. Between survivor and non-survivor groups, significant differences were shown in hematocrit, $PaO_2$, $PaCO_2$, PEEP, and $PaO_2/FiO_2$ on the seventh day after the onset of the ARDS. Conclusion : According to our study, respiratory failure proved to have a great effect on mortality rate in the ARDS. More aggressive intervention and further studies on this subject should be done to improve the survival rate.

Coracoclavicular Ligament Augmentation Using TightRope® for Acute Acromioclavicular Joint Dislocation : Surgical Technique and Preliminary Results (TightRope®를 이용한 급성 견봉 쇄골 관절 탈구의 치료 : 수술 술기 및 예비 보고)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Kang, Chul-Hyung;Oh, Geon-Myeoung
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.165-171
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    • 2008
  • Purpose: The purpose of this study was to introduce a new surgical technique and to evaluate the preliminary results after operative treatment with using TightRope$^{(R)}$ for treating acute acromioclavicular joint dislocation. Material and Methods: We studies 10 patients who were followed up for more than 6 months after operative treatment with using an TightRope$^{(R)}$. A longitudinal incision approximately 4cm in length was made from 1cm medial to the acromioclavicular joint to the coracoid process, and then coracocalvicular ligament augmentation using TightRope$^{(R)}$ was done after splitting the deltoid. For postoperative stability, two 1.6 mm Kirschner wires were inserted temporarily across the acromioclavicular joint in all cases. The radiologic results on the serial plain radiographs and the clinical results according to the UCLA score were analyzed. Results: Radiologically, 7 cases showed anatomical reduction, 2 cases showed a slightly loss of reduction and 1 case showed partial loss of reduction. Clinically, 6 cases were excellent, 3 cases were good and 1 case was fair. Conclusion: Coracoclavicular ligament augmentation using TightRope$^{(R)}$ for treating acute acromioclavicular joint dislocation is a minimally invasive, safe procedure that provides satisfactory radiologic and clinical preliminary results. Yet the long-term results have to be analyzed to determine the final results of this procedure.

A Case of Subacute Necrotizing Lymphadenitis Presenting as Fever of Unknown Origin (불명열로 오인된 아급성 괴사성 림프선염 1례)

  • Yang, In Suk;Park, Kyung Ho;Kang, Jin Han;Kim, So Young;Lee, Won Bae;Kim, Hyun Hee
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.253-259
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    • 2001
  • Kikuchi's disease(histiocytic necrotizing lymphadenitis) is characterized by lymphadenopathy in young patients below 30 years old, and persistent fever, lymphopenia and splenomegaly are concomitantly developed in many cases. So, it has been confused with lymphoma, SLE, and tuberculosis, and has easily led to inappropriate diagnostic procedures and administration of drugs. Many reports have indicated that Kikuchi's disease should be added to the list of causes of FUO in the setting of lymphadenopathy, and recommended early lymph node biopsy to distinguish from lymphoma, SLE, and tuberculosis to avoid unnecessary treatments. We experienced a case of subacute necrotizing lymphadenitis in a 14-year-old boy who presented with persistent high fever, productive coughing and cervical lymphadenopathy for about 1 month. Initially, diagnostic workup was done to look for the causes of FUO in vain. Finally, we confirmed diagnosis by histopathological findings of lymph node biopsy and detected latent gene of EBV in the biopsied specimen using in situ hybridization.

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Benefit Payment Trends of the Health Insurance, Covering Critical Illiness (3대 특정질병 진단보험금 지불현황)

  • Kim, Yong-Eun
    • The Journal of the Korean life insurance medical association
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    • v.19
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    • pp.109-117
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    • 2000
  • 연구배경 : 3대 특정질병 진단보험금지급의 양상과 경향을 평가하고자 하였다. 방법 : 1997년 7월${\sim}$1999년 3월까지 당사의 한 건강보험가입자 중 1998년 1월${\sim}$1999년 9월 기간동안 당사 약관상의 정의에 의한 악성종양, 급성심근경색증, 뇌졸중으로 진단보험금이 지불된 총 411건에 대해 조사하였다. 결과 : 3대 특정질병 진단보험금 지급건 총 411건의 구성을 보면 악성종양이 290건(70.6%), 급성심근경색이 25건(6.1%) 그리고 뇌졸중이 96건(23.3%)이었다. 남녀비율은 남자 280건(68.1%), 여자 131건(31.9%)이었다. 3대 특정질병 진단급여금 지급건의 평균연령은 $3.88{\pm}5.9$이었다. 3대 특정질병 진단보험금 지불건은 $30{\sim}39$세 연령대에서 187건(45.4%)으로 가장 많았고, 그 다음으로 $40{\sim}49$세 연령대 178건(43.2%)의 순이었다. 계약시점에서 3대 특정질병 진단보험금 지급 시까지 평균진단확정 기간은 325.2일${\pm}$184.9일 이었다. 계약 후 12개월 내에 진단지급보험금 발생건은 총 193건(55.3%)이었고, 12개월 이후에 지급된 건은 156건(44.7%)이었다. 계약 후 12개월 내에 진단지금보험금 발생건 193건을 분석하여 보면 3개월 이상${\sim}$4개월 미만이 40건(20.7%)로 가장 많았다. 악성종양의 신체계통별로 보면 소화기관>유방>여자생식기>호흡기계 순이었다. 악성종양을 장기별로 보면 위암>유방암>간암 및 담도계암>결장암과 직장암, 자궁경부암의 순이었다. 남자의 경우 위암>간암 및 담도계암>결장암과 직장암의 순이었고 여자의 경우 유방암>자궁경부암(상피내암 제외)>결장암, 직장암의 순이었다. 뇌졸중의 종류별 빈도를 보면 뇌경색증(47.9%)>뇌내출혈(34.4%)>거미막하출혈(9.4%)의 순이었다. 결론 : 3대 특정질병 중 악성종양이 다수를 차지하고 있었고, 남자가 여자보다 훨씬 많았고 주로 $30{\sim}39$세 연령대, $40{\sim}49$세 연령대였다. 계약 후 12개월 내에 진단지급보험금 발생건을 분석하여 보면 3개월 이상${\sim}$4개월 미만이 40건(20.7%)으로 가장 많았다는 것은 역선택의 가능성 그리고 제척기간 중 발생한 3대 특정질환이 3개월 이후 특히 3개월 이상${\sim}$4개월 미만 사이에 지급청구되었을 가능성을 시사하는 것으로 사료된다.

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A Case of Eosinophilic Gastritis Mimicking Borrmann Type-4 Advanced Gastric Cancer (Borrmann 4형 진행위암과 같은 형태를 보인 호산구성 위염(Eosinophilic Gastritis) 1예)

  • Shin Hyun-Wook;Suh Byoung-Jo;Yu Hang-Jong;Lee Hye-Kyung;Kim Jin-Pok
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.47-51
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    • 2005
  • Eosinophilic gastroenteritis is a rare clinicopathologic entity of unknown etiology with a variety of digestive symptoms. The pathogenesis is poorly understood. Diagnostic criteria include demonstration of eosinophilic infiltration of the affected bowel wall, lack of evidence of extraintestinal disease, and exclusion of various disorders that could mimic similar conditions. The disease might involve any area of the gastrointestinal tract from the esophagus to the rectum, but the stomach and the proximal small bowel are most commonly affected. The clinical features depend on which layer and site are involved. We report the case of a 59-year-old male patient with a 3-week history of post-prandial vomiting with malnutrition and weight loss. An abdominopelvic CT showed a gastric outlet obstruction with diffuse wall thickening, as with linitis plastica. Three gastrofiberscopic biopsies showed chronic gastritis. We carried out a radical total gastrectomy with D2 lymph node dissection. The pathologic report revealed a mural type eosinophilic gastritis with a marked hypertrophic scar formation at the proper muscle layer. We report this case with a brief review of the literature. (J Korean Gastric Cancer Assoc 2005;5:47-51)

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POST-EXTUBATION ACUTE RESPIRATORY DISTRESS SYNDROME OCCURRED IN THE ORTHOGNATHIC SURGERY PATIENT : A CASE REPORT (악교정 수술 환자에서 발관 후 발생된 급성 호흡곤란 증후군 : 증례보고)

  • Park, Ji-Young;Lee, Jung-A;Yun, Sung-Hun;Park, Min-Kyou;Kim, Chang-Hyun;Park, Je-Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.1
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    • pp.79-84
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    • 2007
  • Acute respiratory distress syndrome(ARDS) is severe acute hypoxic respiratory failure state with dynamic impairment in oxygen and carbon dioxide transfer with the need for high levels of supplementary oxygen and a high minute ventilation. This syndrome is caused by pulmonary edema due to increased permeability of the alveolar capillary barrier by various factors. ARDS is an uncommon, but a potentially life-threatening complication. Therefore, immediate diagnosis and appropriate therapy must be performed. The present case is post-extubation ARDS immediately occurred in an orthognathic surgery patient who are healthy 19-year-old man. He rapidly recovered from ARDS without complication by early diagnosis and proper treatment. This case report was aimed to describe the process of the development, possible causes and the management of ARDS occurred in an orthognathic surgery patient

Mouse Single Oral Dose Toxicity Test of Chongmyung-tang Aqueous Extracts (총명탕(聰明湯) 열수(熱水) 추출물의 마우스 단회 경구투여 독성 실험)

  • Hwang, Ha-Yeon;Jang, Woo-Seok;Baek, Kyung-Min
    • The Journal of Internal Korean Medicine
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    • v.35 no.1
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    • pp.37-49
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    • 2014
  • Objectives & Methods : The objective of this study was to evaluate the single oral dose toxicity of Chongmyung-tang (CMT) in ICR mice. Korean traditional herbal prescription CMT has traditionally been used as a neuroprotective for treatment of learning disability and memory improvement. CMT, lyophilized aqueous extracts (yield=9.7%) were administered to female and male mice with oral dose of 2,000, 1,000 and 500 mg/kg (body weight) according to the recommendation of Korea Food and Drug Administration (KFDA) Guidelines. Animals were monitored for mortality, changes in body weight, clinical signs and gross observation during 14 days after administration upon necropsy; organ weight and histopathology of 14 principle organs were examined. Results : We could not find any CMT extracts treatment related mortalities, clinical signs, changes in body and organ weight, or gross and histopathological observations against 14 principle organs up to 2,000 mg/kg in both female and male mice, except for some accidental sporadic findings which did not show any obvious dose-relations and most of which also demonstrated in both the female and male vehicle control mice in this experiments. Conclusions : Based on the results of this experiment, the 50% lethal dose ($LD_{50}$) and approximate lethal dose (ALD) of CMT extracts after single oral treatment in female and male mice can be considered to be over 2,000 mg/kg, and is likely to be safe in humans.

A Case of Primary Signet Ring Cell Carcinoma of the Lung (원발성 기관지 반지세포암 1예)

  • Choi, Won-Il;Sohn, Jeong-Ho;Kwon, Oh-Young;Hur, Jeong-Suk;Hwang, Jae-Seok;Han, Seong-Beom;Song, Hong-Suck;Jeon, Young-June;Kwon, Kun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.562-567
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    • 1994
  • Signet ring cell carcinoma has been previously described in many organs, most frequently in the stomach, and rarely in the colon, rectum, gallbladder, pancreas, breast, nadsal cavity, prostate, urinary bladder and ureter. Signet ring cell carcinomas in the lung, especially, when examined by small biopsies, are generally believed to be metastatic. This case was diagnosed by bronchoscopic biopsy. We also examined various organs by noninvasive method, including UGI series, barium enema and abdomen CT scan, but all studies were nomal. Patient received cisplatin and etoposide combination chemotherapy followed by local radiotherapy as a primary non-small cell lung cancer. Patient died of his disease 6 months after diagnosis. Now we report a case of primary signet ring cell carcinoma of the lung.

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Apoptotic Signaling Pathway by Cadmium in Hepalclc7 cells (Hepa1c1c7 세포에서 카드뮴에 의한 세포사멸 신호전달체계에 관한 연구)

  • 오경재;염정호
    • Toxicological Research
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    • v.17 no.3
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    • pp.215-223
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    • 2001
  • Cadmium is an ubiquitous toxic metal and chronic exposure to cadmium results in the accumulation of cadmium in the liver and kidneys. In contrast, acute exposure leads to damage mainly in the liver. Apoptosis induced by cadmium has been shown in many tissues in vivo and in cultured cells in vitro. However, the molecular mechanism of cadmium-induced apoptosis is not clear in hepatocyte. To investigate the induction of apoptosis in the hepatocyte, we used mouse hepatoma cell line, Hepalclc7 cells, and analysed the molecules that involved in cadmium-induced apoptosis. Cadmium induced the genomic DNA fragmentation, PARP cleavage, and activation of caspase-3 like protease. Caspase-9 cysteine protease was activated in a time-dependent manner but caspase-8 cysteine protease was not significantly activated in cadmium-treated Hepalclc7 cells. Cadmium also induced mitochondrial dysfunction including cytochrome c release from mitochondria, change oj mitochondrial membrane potential tranition, and tranlocation of Bax Protein into mitochondria. These results strong1y indicated that the signal Pathway of apoptotic death in cadmium-treated Hepalclc7 cells is modulated by caspase cascade via mitochondria.

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A histopathological study on porcine cysticercosis (돼지 유구낭미충증의 병리조직학적 관찰)

  • Shin, Tae-kyun;Kim, Seung-ho
    • Korean Journal of Veterinary Research
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    • v.33 no.3
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    • pp.465-469
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    • 1993
  • This paper dealt with the histopathological findings on the natural cysticercosis in pigs. Three cases of porcine cysticercosis, which had been kept in the Department of Veterinary Medicine, Cheju. University more than ten years, were histopathologically examined in order to see the host reaction to the parasite. Capsules containing scolex were mainly found in the fascia of skeletal muscle, heart, and brains. Microscopically, cysticerci in the epicardium and the fascia of skeletal muscles were encapsulated with fibroblasts and collagen fibers. Around capsules, there was infiltration of eosinophils, lymphocytes and macrophages, although the degree and severity of inflammatory reaction varied case by case. Cerebral cortex also had the inflammatory exudate of lymphoid cells in the vicinity of the scolex. whereas perivascular lymphocytic cuffings were commonly seen around capsules. GFAP immunoreactive fibers formed a limiting membrane along the outer side of capsules. There was also proliferation of GFAP-positive astrocytes encirling infiltrating lymphocytes around vessels. In the central nervous system, astrocytes and lympoid cells play an important role in the demarcation of cysts and local immunity, respectively. In conclusion, host tissue reaction in porcine cysticercosis seemed to vary significantly according to the affected organs of pigs. It is assumed that capsules containing worms seemed to be formed at early stage of cysticercosis.

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