• Title/Summary/Keyword: 신경계 합병증

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Cervical Spinal Cord Injury Caused by Acupuncture (침 시술 이후 발생한 경추 척수 손상)

  • Woo, Young-Ha;Lee, Ji-Min;Shim, Dae-Moo;Bae, Hyuk
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.550-553
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    • 2020
  • Acupuncture, which is a procedure of inserting needles in a specific portion of the body to control pain, is conducted widely. The procedure is considered relatively safe because of its minimal side effects and low occurrence (1 in 200,000). On the other hand, its side effects include neurological damage, infection, hematoma, emphysema, etc. The authors report a case of cervical neurological damage that occurred after an acupuncture procedure.

The effects of shortened dexamethasone administration on remission rate and potential complications during remission induction treatment for pediatric acute lymphoblastic leukemia (급성림프구성백혈병 환아의 관해유도 치료 중 덱사메타손 투여기간의 단축이 관해유도율 및 합병증 발생에 미치는 영향)

  • Lee, Jae Wook;Lee, Kwang Hee;Kwon, Young Joo;Lee, Dae Hyoung;Chung, Nak Gyun;Jeong, Dae Chul;Cho, Bin;Kim, Hack Ki
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1217-1224
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    • 2007
  • Purpose : Due to its high potency against leukemic blasts, our institution has opted for the use of dexamethasone during acute lymphoblastic leukemia (ALL) remission induction, but in our most recent treatment protocol, CMCPL-2005, we shortened the length of steroid treatment from 4 to 3 weeks. We compared both the rates of remission induction and significant complications observed during induction with CMCPL-2005, with those noted for our previous protocol, CMCPL-2001. Methods : We retrospectively reviewed the records of patients diagnosed with ALL from January, 2001 to December, 2006 at the Department of Pediatrics, St. Mary's Hospital, the Catholic University of Korea. Data concerning age, sex, WBC count at diagnosis, immunophenotype, cytogenetic traits, and risk group were collected for each patient. Results of remission induction treatment were compared between the two patient groups. Infection and other major complications resulting from treatment were investigated according to NCI toxicity criteria. Results : A total of 141 and 88 patients received remission induction under CMCPL-2001 and CMCPL-2005 respectively. In the CMCPL-2001 group, 136 (96%) achieved complete remission while 82 (93%) achieved CR in the CMCPL-2005 group. Patients in the CMCPL-2005 group were more likely to undergo remission induction without experiencing major complications. However, with regards to steroid related toxicities such as infection, no significant differences were noted. Conclusion : We shortened the length of steroid administration from four to three weeks, yet found the remission induction rate to be comparable to that of our previous regimen. However, rates of steroid related toxicities such as infectious complications remain unchanged despite shortened exposure to dexamethasone.

Herpes zoster complicated by deep vein thrombosis: a case report (대상포진에 합병된 심부정맥혈전증 1예)

  • Choi, Woo-Yeon;Cho, Young-Kuk;Ma, Jae-Sook
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.607-610
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    • 2009
  • Varicella zoster virus (VZV) causes two diseases: Varicella, a generalized, primary infection, and herpes zoster (zoster), a secondary infection caused by latent VZV reactivation. Zoster can also be caused by latent VZV reactivation after a varicella vaccination. The complications associated with varicella include cutaneous infections, which are the most common, as well as pulmonary and neurological involvement. However, a deep venous thrombosis (DVT) has been rarely described as a varicella-associated complication. Here, we describe the case of a child with varicella zoster who developed a DVT that completely resolved after intravenous acyclovir and subcutaneous low-molecular-weight heparin treatment.

Effect of Sternal Closure Method on Sternal Dehiscence With or Without Infection (흉골 봉합 방법이 흉골 열개 및 감염에 미치는 영향)

  • 이삼윤;박권재;고광표;최종범
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.485-489
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    • 2001
  • Background: The most important factor in preventing sternal complications is stable sternal approximation. We have tried to find the most effective sternal closure method by examining the incidence of sternal dehiscence with or without infection in patients with cardiac surgery through median sternotomy. Material and Method: This study was performed in 489 patients over 45 years of age with median sternotomy for open cardiac surgery. Simple closure with interrupted 6 wires was performed in 159 patients, figure-of-8 closure technique in 119, overlapping interrupted closure using 10 wires in 150, and combined closure technique of interrupted simple closure and figure-of-8 suture closure in 61. Two hundred thirty-four patients underwent valve and aortic operations and 213 patients coronary artery bypass surgery. Result: Sternal dehiscence with or without infection occurred in 12 (2.5 %) patients. The complication developed in 5 of 159 patients (3.1%) with six interrupted simple closure, in 4 of 119 patients (3.4%) with figure-of-8 closure, and in 3 of 150 patients (2.0%) with overlapping interrupted closure using 10 wires, but there was no complication in 61 patients with combined closure technique (relative risk for other closure techniques, p<0.05). There was no significant difference in the incidence of the sternal complication between valve and aortic operation group and coronary artery bypass group (3.0% vs 2.3%, not significant), but diabetes mellitus was a significant independent risk factor (odds ratio and multivariate analysis, p<0.05). Conclusion: The sternal closure technique that combines simple interrupted suture closure and figure-of-8 suture closure may be a more useful technique to enhance sternal stabilization compared to other closure techniques, such as simple interrupted closure, 8-figure closure, and overlapping interrupted closure.

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The Effect of Systemic Hypertension on the Pediatric Brain (중추신경계에 미치는 소아 고혈압의 영향)

  • Hur, Yun-Jung
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.22-28
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    • 2011
  • Hypertension is one of the most common chronic diseases in childhood and adolescence. Untreated hypertension adversely affects many organs including heart, brain, kidney and peripheral arteries. We reviewed the complication of central nervous system caused by pediatric hypertension. Cerebral blood flows are maintained constantly in response to changes in blood pressure by cerebral autoregulation. Severe hypertension which destructs cerebral autoregulation results in acute hypertensive encephalopathy syndrome, ischemic or hemorrhagic stroke. Chronic pediatric hypertension induces learning disability and cognitive defect which are subclinical symptom prior to brain damage caused by severe hypertension. We should consider the effect of hypertension on pediatric brain because appropriate antihypertensive drugs could prevent these complications.

The dental management of infantile osteopetrosis: case report (유아형 골화석증 환아의 구강관리: 증례보고)

  • Lee, Hyo-Seol;Song, Je-Seon;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.4 no.2
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    • pp.77-81
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    • 2008
  • 골화석증(Osteopetrosis)은 전신의 뼈가 대리석 모양으로 골 경화를 일으키며 골수강의 폐쇄 및 골의 취약성을 보이는 드문 질환이다. 성인형(Adult form)은 우성 유전되며 경미한 증상을 나타낸다. 반면에 유아형(Infantile form)은 열성 유전되면서 심각한 증상을 나타내고, 조기에 사망에 이를 수도 있다. 골화석증은 골격계, 조혈계, 신경계에서 다양한 증상을 유발한다. 본 증례의 목적은 드물게 발생하는 유아형 골화석증을 가진 2 명의 환아를 치료한 후, 그 질환과 치과적 관리에 대해 고찰하고자 함이다. 첫 번째 증례는 골화석증으로 진단된 5세 8개월 남환이었다. 임상 및 방사선 검진 결과 악골 및 치아의 변형을 나타내었으나, 특별한 병적 소견이 없어 예방 치료 및 주기적인 검진 시행하였다. 두 번째 증례는 중증도의 치아우식증을 가진 환아로 의료진과의 협조 하에 수혈한 후 발치하였다. 유아형 골화석증은 다양한 구강 합병증을 유발하며, 질환의 심각성에 의해 치료 자체도 어렵다. 치과의사로서 골화석증 환아를 관리할 때에는 건전한 구강 상태를 유지하기 위한 지속적인 관심과 예방 치료가 필요하며, 아무리 간단한 발치나 치과 술식이더라도 의료진과 협조를 해야 한다.

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The Role of Axillary Artery Cannulation in Surgery for Type A Acute Aortic Dissection (급성 상행대동맥 박리증 수술에서 액와동맥 삽관술의 역할)

  • 유지훈;박계현;박표원;이영탁;김관민;성기익;양희철
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.343-347
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    • 2003
  • Background: The femoral artery is the most common site of canuulation for cardiopulmonary bypass in surgery for type A aortic dissection. Recently, many surgeons prefer the axillary artery to the femoral artery as the arterial cannulation site for several benefits. We evaluated the safety and usefulness of axillary artery cannulation in surgery for acute type A aortic dissection. Material and Method: Between Oct. 1995 and Sep. 2001, 71 patients underwent operations for acute type A aortic dissection. The arterial cannula was inserted into the axillary artery in 31 patients (AXILLARY group, mean age=56), and into the femoral artery in 40 patients (FEMORAL group, mean age=57). We retrospectively compared the incidence of mortality, morbidities, and hospital course. Result: The mean duration of cardiopulmonary bypass and circulatory arrest were significantly shorier in the AXILLARY group (207 min and 39min, respectively) than in the FEMORAL group (263min and 49 min, respectively; P<0.05). Postoperative hospital stay was significantly shorter in the AXILLARY group than in the FEMORAL group (mean 15 days vs. 35 days, p<0.05). Although there was no difference in the incidence of new-onset permanent neurological dysfunction (3.2%, in the AXILLARY group, 2.5% in the FEMORAL group), the incidence of transient neurological dysfunction was significantly lower in the AXILLARY group (12.9% vs. 25%, p<0.05). In the FEMORAL group, two patients needed urgent conversion to cannulation site due to arch vessel malperfusion. In the AXILLARY group, there was only one patient who had a complication related to the cannulation, i.e., median nerve injury. Conclusion: Axillary artery cannulation was safe and helpful in decreasing the cerebral ischemic time and incidence of transient neuroligcal dysfunction in surgery for acute type A aortic dissection, It enabled us to approach the patients with aortic arch pathology more aggressively.

Aortic Root Replacement with Homograft in Behcet's Disease -A Case Report- (베체씨 병에서의 동종 이식편을 이용한 대동맥 근위부 치환술 - 1례 보고 -)

  • Moon, Hyeon-Jong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.92-96
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    • 1997
  • The prognosis of Behfet's disease characterized by recurrent orogenltal ulcers and ocular and skin lesions depends upon the complications in the central nervous system, the gastrointestinal tract And the vascular system. Cardiac involvement, especially aortic regurgitation, is quite uncommon and hemodynamic instability is usually treated with ope heart surgery. But serious postoperative complications had been reported in many cases, which are prosthetic valve detachment, paravalvular leakage, conduction disturbance, and false aneurysm. Many efforts to prevent the complications have been made such as application of cryopreseved homograft. We have described an experience of root replacement with homograft in d 39 year-old male patient for prosthetic valve detachment because of Behfet's aorlitis with a review of the literatures regarding treatment, complication, and prognosis.

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운동 중 이럴 때 주의하라

  • Song, Sang-Uk
    • The Monthly Diabetes
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    • s.208
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    • pp.25-28
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    • 2007
  • 운동요법은 인슐린이 발견되기 수세기 이전부터 당뇨병의 치료로 이용되어 왔으며, 운동이 당뇨병환자의 신체 대사에 미치는 단기 및 장기 효과에 대해서도 이미 많은 연구결과들이 보고되어 그 유용성이 증명되었다. 그러나 많은 당뇨병환자들이 막상 운동을 시작하려해도 어떻게 시작하는 것이 효과적이고 어떤 점을 유의해야하는 지에 대해서는 잘 알지 못하고 있는 것이 사실이다. 그래서 여기서는 당뇨병환자에게 있어서 실제적인 운동 시 주의해야 할 점에 대해서 알아보고자 한다. 사실 운동프로그램을 시작하기 전에 당뇨병환자는 적절한 진단 검사와 자세한 의학적 평가가 이루어져야만 한다. 여기에는 운동에 의해서 악화될 수 있는 혈관성 합병증의 유무도 자세히 살펴보아야만 한다. 심장, 혈관, 눈, 신장, 신경계에 영향을 미치는 질병의 증상과 증후에 초점을 맞추어 세심한 병력과 신체진찰을 받고 환자 개개인에 대한 위험을 최소화 할 수 있는 개별화된 운동처방에 따라 운동을 시작하는 것이 바람직하다.

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Neurologic Complications following Epidural Analgesia -Two case reports- (경막외 차단 후 발생한 신경계 합병증 -증례보고-)

  • Moon, Dong-Eon;Shim, Jae-Yong;Lim, Yong-Gul;Kim, Yee-Suk;Kim, Byung-Chan;Kim, Sung-Nyeon
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.291-295
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    • 1997
  • Technique of epidural analgesia is generally regarded a safe procedures which is widely applied in postoperative and chronic pain control. Incidence of neurologic complications following epidural analgesia are rare; however, increasing number of published reports describing transient or permanent neurologic complications following such procedures have been appearing more frequently. We report two cases of neurologic complications following epidural analgesia as we believe it is important to draw the attention of other anesthesiologist to the possibility of existence of other complications of significant medicolegal consequences.

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