• Title/Summary/Keyword: 신증후군

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A Case of Chronic Renal Failure Associated with Systemic Capillary Leak Syndrome (전신성 모세혈관 누출 증후군으로 인한 만성 신질환 1예)

  • Baek, Seon Ha;Shin, Nara;Kim, Hyo Jin;Han, Mi Yeun;Choi, Dong-Ju;Bang, Soo-Mee;Kim, Sejoong;Paik, Jin Ho
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.145-149
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    • 2012
  • Systemic capillary leak syndrome (SCLS) is an unusual entity characterized by hypovolemic shock, hemoconcentration, and hypo-albuminemia associated with paraproteinemia as a result of marked capillary hyper-permeability. Complications of this syndrome can include compartment syndromes, pulmonary edema, thrombosis, and acute kidney injury. This paper reports a case of severe SCLS accompanied by acute tubular necrosis caused by hypoperfusion and myoglobinuria secondary to rhabdomyolysis, which resulted in chronic kidney disease that necessitated hemodialysis. However, there have been rare data of residual end-organ damage after acute attacks in Korea. Therefore, this paper reports a case of complicated SCLS enough to hemodialysis and that developed into chronic kidney disease.

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Two Cases of Contact Urticaria Syndrome from Cefotiam in Nurses (Cefotiam에 의한 접촉 담마진 증후군 2례)

  • Jang Pyeong-Moon;Lee Jung-Won;Kim Yong-Seung;Cho Young-Shin;Yu Ki-Won;Lim Hoon;Kim Ho-Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.1
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    • pp.65-68
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    • 2006
  • Contact urticaria describes a wheal and falre response elicitied within 30-60 minutes after cutaneous exposure to certain agents. Contact urticaria encompasses a number of different clinical manifestations and the symptoms which can vary from the mildest forms of burning, stinging and itching sensation to life-threatening anaphylaxis referred to as contact urticaria syndrome. Cefotiam is one of the most popular second generation cephem antibiotic used in korea. Since 1975, contact urticaria due to cephalosporins has been reported, and also, in japan, this reported from about last 15 years. Recently we experienced three nurses working at the general wards with showing contact urticaria and anaphylaxis after occupational exposure to cefotiam antibiotics.

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A Case of Bartter Syndrome with Muscle Weakness and Short Stature (근무력증과 왜소증을 동반한 Bartter syndrome 1례)

  • Kim In-Sung;Kang Ju-Hyung;Shin Yun-Hei;Lee Dong-Kuk;Kim Soon-Nam;Pai Ki-Soo
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.259-265
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    • 2002
  • Bartter syndrome is a rare disorder characterized by the association of hypokalemic hypochloremic metabolic alkalosis, hyperreninemia, hyperaldosteronemia, short stature and nephrocalcinosis. This disorder presents with hyperplasia of juxtaglomerular apparatus on renal biopsy. We experienced a case of late-onset Bartter syndrome with nephrocalcinosis in a 9-year-old boy, whose chief pictures were muscle weakness, short stature, persistent sterile pyuria and microscopic hematuria. We report this case with a brief review of related literatures.

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A Study of Irritable Bowel Syndrome and Stress on Female College Students in Korea (국내 여자 대학생에서 과민성 장증후군과 스트레스에 관한 연구)

  • Shin, Jieun;Kim, Kwang Joon;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.3
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    • pp.156-165
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    • 2019
  • Objective: The purpose of this study was to provide a database for making better decisions of the treatment of the irritable bowel syndrome (IBS) patient, and for improving the recognition of IBS in the Korean society. Methods: The survey was conducted on 174 female college students in Korea from January 2017 to January 2018. Out of the total students surveyed, 160 questionnaires were analyzed after excluding 14 uncompleted questionnaires. Results: Based on the survey, the prevalence of IBS among female college students in Korea was found to be 13.8%. Statistically, the results proved that there were significant differences in the stress levels between the students with IBS and non-IBS diagnosed by ROME IV criteria. Students with IBS had higher stress levels than students without the ailment. Conclusions: Based on this study, stress management related treatment should be actively considered. Furthermore, it is necessary to develop more efficient and updated guidelines for the treatment of IBS and new patient care programs.

Difference in Sleep Characteristics between Restless Leg Syndrome With and Without Periodic Limb Movement during Wakefulness (각성 중 주기성사지운동 여부에 따른 하지불안증후군 환자의 수면 특성 차이에 대한 비교연구)

  • Shin, Yu Yong;Byun, Jung-Ick;Shin, Won Chul
    • Journal of Sleep Medicine
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    • v.15 no.2
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    • pp.62-67
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    • 2018
  • Objectives: Restless leg syndrome (RLS) is a common sensorimotor disorder and is frequently associated with periodic limb movement in sleep (PLMS). Also about one third of patient with RLS have periodic limb movement during wakefulness (PLMW). However there is little research on the correlation between PLMW and RLS. We aimed to evaluate difference in sleep characteristics between patients with RLS with PLMW and those without PLMW. Methods: Our study included twenty eight RLS patients. Subjects underwent suggested immobilization test (SIT) prior to one full-night polysomnography study. Patients were classified into two groups according to the presence of PLMW based on SIT-PLMW index. Polysomnographic findings, subjective sleep quality, and hematologic results were analyzed and compared between the two groups. Results: Mean age of patient with frequent PLMW (SIT-PLMW ${\geq}40/hr$) was significantly higher. RLS patients with frequent PLMW were also significantly related to insomnia severity. The PLMS index was higher in patients with PLMW and showed a significant correlation with the PLMW index. Conclusions: PLMW influence sleep quality such as insomnia and is correlated with movement during sleep.

Bilateral Facial Palsy in a Patient with Guillain-Barre Syndrome after COVID-19 Vaccination (Covid-19 백신 접종 후 발생한 길랑-바레 증후군에 동반된 양측성 안면마비 1례)

  • Kim, Jee-Hee;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.1
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    • pp.81-90
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    • 2022
  • Objectives : The purpose of this study is to report a case of bilateral facial palsy in a patient with Guillain-Barre Syndrome after coronavirus disease 2019(COVID-19) vaccination. Methods : The patient diagnosed as Guillain-Barre Syndrome and Bilateral facial palsy after COVID-19 vaccination. We applied Korean medical treatment including acupuncture and herbal medicine for bilateral facial palsy. We used HBGS(House-Brackmann Grading System), VAS(Visual Analog Scale) to estimate the symptoms. Results : After the treatment, both facial palsy showed big improvement. Compared to the onset, HBGS improved by Grade 1/2 and VAS by 2. Conclusions : This case report shows effect of Korean medicine on Bilateral facial palsy and suggests a possibility of Korean medicine to treat adverse events following COVID-19 vaccination.

Maternal and Neonatal Outcome of Twin Pregnancies after in vitro Fertilization and Embryo Transfer (체외수정시술로 출생한 쌍생아의 임상적 경과에 대한 비교 분석)

  • Kim, Kyung-Ah;Min, Uoo-Gyung;Lim, Jae-Woo;Jun, Nu-Lee;Won, Hye-Sung;Kim, Chung-Hoon;Kim, Ellen Ai-Rhan;Lee, Pil-Ryang;Lee, In-Sik;Kim, Ki-Soo;Kim, Ahm;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.224-229
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    • 2003
  • Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

Arthroscopic treatment of septic arthritis of the knee in adults (성인의 화농성 슬관절염의 관절경적 치료)

  • Kyung Hee-Soo;Ihn Joo-Chul;Oh Chang-Wug;Kim Sung-Jung;Kim Joon-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.21-24
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    • 2002
  • Purpose : The purpose was to assess the result of arthroscopic management of the septic arthritis on the knee in compromised patients. Materials and Methods : Fourteen patients with septic knee were analyzed. The mean age was 55 years and the mean follow-up period was 14.6 months. Underlying diseases included 4 cases of diabetes, and history of direct acupuncture in 4 cases. Clinical stage of septic arthritis was judged by $G\ddot{a}chter's$ classification, which was determined by arthroscopic findings. After arthroscopic irrigation and debridement, we observed the results of laboratory data and improvement of clinical findings. Results : Causative organism was identified in 7 cases and no organism was detected in the remaining 7 cases. Stage I was 1, stage II 8, stage III 4, and stage IV 1, respectively. Eleven of 14 cases were improved by one stage operation. Two cases of stage III were recurred and additional arthroscopic management was done. In 1 case of stage IV, symptom was not improved and needed arthrotomy. The result was unsatisfactory in patients with stage III and IV. Serum erythrocyte sedimentation rate and C-reactive protein were normalized after 29.3 and 20.8 days following the operation, respectively. Clinical symptoms disappeared average 2 days following the operation. Conclusion : Arthroscopic management of acute septic arthritis of the knee would be an effective and satisfactory treatment modality in that its postoperative pain and complications are minimal, and it can be done with ease repeatedly.

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An Experience of Therapeutic Plasma Exchange in 9 Pediatric Patients (소아에서 시행한 치료적 혈장교환술 9례의 임상적 고찰)

  • Lee Jee-Hyun;Jeon Ga-Won;Park Sung-Eun;Jin Dong-Kyu;Paik Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.38-45
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    • 2005
  • Purpose : The purpose of this study was to analyze the therapeutic effect of plasmapheresis in various pediatric diseases. Methods : Therapeutic plasmapheresis was performed by COBE Spectra centrifugation. Nine cases were included in this study. The number an[;. method of plasmapheresis, together with the progress and prognosis of each case were retrospectively reviewed. Results : The patients' ages ranged from 26 mont]Is to 16 years of age, and the mean age was 9.9 years. There were S males and 4 females. The underlying diseases requiring plasmapheresis included 2 cases of hemolytic uremic svndrome(HUS), 1 case of lupus nephritis, 2 cases of rapidly Progressive glomerulonephritis(RPGN), 1 case of focal segmental glomorulosclerosis(FSGS), 1 case of systemic vasculitis after pulmonary hemorrhage, 1 case of acute renal failure associated with pulmonary hemoIThage, and 1 case of acute rejection after renal transplantation. The average number of plasmapheresis performed was 6.2 times with a range of 3 to 13 times. The patients with HUS, lupus nephritis, ANCA positive systemic vasculitis induced by pulmonary hemorrhage and ARF-associated pulmonary hemorrhage showed a good response to therapeutic plasmapheresis, but the patients with RPGN, refractory FSGS, and acute rejection after renal transplantation were not responsive to treatment. The most common side effect was hypocalcemia which was rarely symptomatic. Vital signs were not compromised. Conclusion : Although it is presumptuous to generalize the therapeutic effects of plasma pheresis in different diseases due to the small number of study subjects, this study shows that plasmapheresis may be an effective therapeutic modality in various pediatrics diseases and should be considered as a therapeutic option.

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Combined Primary IgA nephropathy and Membranous Glomerulonephritis in a Child (소아에서 IgA 신병증과 막성 사구체신염이 병발한 사구체신염 1례)

  • Kim Mi-Kyung;Choi Jeong-Hoon;Won Nam-Hee;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.232-236
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    • 1999
  • IgA 신병증은 사구체 중맥에 IgA가 침착하는 것이 특징적인 질환이며 막성 사구체 신염은 IgG가 사구체 기저막의 상피하에 미만성으로 침착하는 질환이다. 원발성 사구체 질환중 IgA 신병증과 막성 사구체신염은 비교적 흔한 질환이나 전체적인 빈도는 낮은 편으로, 한 환자의 사구체에서 두 질환이 동시에 발생하는 경우는 매우 드물다. IgA 신병증과 막성 사구체신염의 중복 신염은 Doi등이 1983년 원발성 신질환으로서 처음 보고한 이래, 성인에서 20여례가 보고되었다. 저자들은 신증후군이 발생한 환아에서 신생검을 시행한 결과 원발성 신질환으로서 IgA 신병증과 막성 사구체신염의 소견이 동시에 보이는 중복신염의 드문 예를 경험하였기에 보고하는 바이다. 환아는 7세된 남아로 내원 한달 전부터 발생한 전신부종을 주소로 내원하였다. 가족력과 과거력상 특이 소견없었으며, 내원시 이학적 소견상 전신적인 허약감과 안와부종, 복부팽만, 하지의 함요부종이 관찰되었고, 검사소견에서는 WBC $19,800/mm^3$, Hb 14.1g/dL, Platelet $397,000/mm^3$, BUN/Cr 10/0.4mg/dL, protein/albumin 4.43/2.73g/dL, cholesterol 429mg/dL, IgA 85mg/dL, $C_3$ 68.8mg/dL, $C_4$ 13.4mg/dL, ANA(-), ANCA(-), RF(-), HBsAg/Ab(-/-)이었다. 뇨검사에서는 RBC many/HPF, WBC 2-3/HPF, protein ${\le}\;300mg/dL$ 였으며, 24시간 소변 검사상 protein 9.18g/day, Ccr 66.67ml/min의 소견을 보였다. 신생검을 시행한 결과 광학현미경상에서 몇몇 사구체의 분절성 경화와 중맥역의 증식이 관찰되었고, 면역형광현미경검사에서는 IgA(3+)가 과립상으로 미만성 분포를 보이며 중맥역에 침착되어 있고, 미세한 과립상과 위선의 양상으로 IgG(1+)가 모세혈관벽에 침착되어 있었으며, 전자현미경 소견상 중맥역과 모세혈관 기저막 상피하에 소량의 전자 고밀도 침착이 함께 관찰되었다. 환아는 prednisolone을 경구 투여 받았으나 단백뇨와 혈뇨가 지속되어 solumedrol pulse therapy, captopril과 cyclophophamide로 치료 받은 후, 전신 상태 호전되고, 혈뇨가 사라졌으며, 24시간 소변 검사상 단백뇨가 487.5mg/day로 감소하여 외래에서 추적 관찰 중이다.

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