• Title/Summary/Keyword: 신증후군

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Obesity Related Glomerulopathy Progressed to Chronic Renal Failure (만성 신부전으로 진행된 비만 연관 사구체병증 1례)

  • Ahn, Jung-Hee;Yoon, Jung-Rim;Moon, Kyung-Chul;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.94-99
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    • 2010
  • Obesity-related glomerulopathy (ORG) is a secondary form of focal and segmental glomerulosclerosis (FSGS) manifesting as proteinuria and progressive renal dysfunction that results from maladaptive glomerular response to increasing adiposity. Reports of ORG progressing to end stage renal diseases in rare in the pediatric population. We report a 9-year-old boy with obesity (body mass index $35\;kg/m^2$) who was diagnosed with ORG presenting with proteinuria. He was diagnosed with obesity-related glomerulopathy based on the laboratory, urinary, and kidney biopsy finding. In spite of treatment with angiotensin- converting enzyme (ACE) inhibitor and/or, angiotensin-receptor blocking agent, the degree or amount of proteinuria increased and renal function declined continuously. His BMI did not decrease and eventually progressed to chronic renal failure. Consequently, obese patients should be monitored for proteinuria, which may be the first manifestation of FSGS, a lesion that may be associated with serious renal sequelae.

Airway Management with Reinforced Laryngeal in Mask Airway in a Child with Hypoplastic Left Heart Syndrome (좌심실형성부전증후군 환아의 치과치료를 위한 전신마취 시 강화 후두마스크를 이용한 기도 유지)

  • Kim, Kyung Jin;Shin, Teo-Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Seo, Kwang-Suk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.221-224
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    • 2013
  • Despite the laryngeal mask airway (LMA) has been widely used in anesthesia, its use is rare in the field of dentistry. Placing LMA in the oral cavity may interrupt dental treatment. However, there are some circumstances in which LMA is more advantageous than tracheal intubation for managing the airway. Especially, the reinforced LMA has a flexible tube shaft, rendering it more accessible for dental treatment. We report a case of dental treatment of a 3-year-old patient with hypoplastic left heart syndrome combined with pulmonary hypertension using reinforced LMA for airway management under general anesthesia. We also discuss the considerations of utilizing the reinforced LMA for dental treatment.

Dental Treatment of a 3-Year-Old Male Patient with Haddad Syndrome under Outpatient General Anesthesia (Haddad 증후군 환아의 외래 전신마취 하 치과 치료)

  • Jang, Jun-Hyuk;Shin, Teo-Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Hyun, Hong-Keun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.215-220
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    • 2013
  • The co-occurrence of congenital central hypoventilation syndrome (CCHS) and Hirschsprung's disease (HD) is termed Haddad syndrome, which is an extremely rare discorder. It was reported first by Haddad in 1978 and there are approximately 60 cases reported in the worldwide literature. Recent studies described that congenital central hypoventilation syndrome had deep relation to the mutation of the PHOX2B gene in its diagnosis and phenotype. This article presents a case report: Dental treatment of a 3-year-old male patient with Haddad syndrome under outpatient general anesthesia. The special considerations of dental care, especially caries theatment of the patient with Haddad syndrome are discussed.

General Anesthesia for Dental Treatment of a Pediatric Patient with Marfan Syndrome (마판 증후군 소아 환자의 전신마취 하 치과치료)

  • Kim, Kyung Jin;Bak, Soyeon;Hyun, Hong-Keun;Shin, Teo-Jeon;Kim, Jung-Wook
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.4
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    • pp.209-214
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    • 2013
  • Multiple caries in a pediatric patient often requires dental treatment under general anesthesia, especially when the patient is suffering from a systemic disease. The patient was a 6-year-old boy with Marfan syndrome and needed extensive dental treatment. Marfan syndrome is an inherited disorder resulting from mutations in Fibrillin-1 gene. Patients are known to have mainly cardiovascular, ocular, and musculoskeletal problems. Although clinical symptoms of the syndrome are age-realted, thus hindering early diagnosis of the disease in young children, our patient had been confirmed by a gene study at a younger age. Medical history of the patient revealed moderate to severe mitral regurgitation and aortic root dilatation, which required mitral valve replacement surgery with a mechanical valve. As a result, the patient was taking warfarin post-operatively and changes in medication had to be made before the dental treatment. Also, prophyalctic antibiotics had to be given before the treatment for prevention of (to prevent the) infective endocarditis. With careful control of the medications and bleeding tendency, general anesthesia and the treatment were done successfully without any complications.

A Case of Delayed Facial Palsy and Dizziness in Miller-Fisher Syndrome (Miller-Fisher 증후군에서 나타난 지연형 안면마비 및 현훈 치험 1례)

  • Song, Mi-Sa;Yoon, Hwa-Jung;Ko, Woo-Shin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.3
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    • pp.254-261
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    • 2019
  • Objective : Miller-Fisher syndrome(MFS) is a type of acute inflammatory polyneuropathy, a disease characterized by abnormal muscle coordination, absence of tendon reflexes, and paralysis of the eye muscle. This study is to report a case of delayed facial palsy and dizziness in Miller-Fisher syndrome, treated with traditional Korean medicine. Methods : A 57-year-old male was diagnosed with Miller-Fisher syndrome accompanied by neurological symptoms such as right facial palsy and dizziness. He received traditional Korean medicine treatment such as acupuncture(including pharmacopuncture, needle embedding therapy, electroacupuncture) and herbal medicine for 17 days. Results : Each neurological symptoms were improved after traditional Korean medicine. In case of facial palsy, House Brackmann Grading System was reduced form grade 3 to grade 2, and Sunnybrook Scale was improved from 39 to 55. Also, other symptoms such as dizziness and headache was also improved. Conclusions : This case report suggests that traditional Korean medicine may have a role in treating neurological symptoms such as facial palsy and dizziness in patient diagnosed with Miller-Fisher syndrome.

A Study on the Relationship Between Metabolic Syndrome and the Number of Work Hours Based on Data from the 6th Korea National Health and Nutrition Examination Survey (2015) (제 6기 국민건강영양조사 자료(2015)를 활용한 대사증후군 유병과 근로시간에 관한 연구)

  • Kim, Kyoung Yun;Shin, Hyunji;Yun, Jung-Mi
    • Journal of the Korean Society of Food Culture
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    • v.34 no.4
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    • pp.486-494
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    • 2019
  • There are an increasing number of reports that job related factors are associated with hypertension, sleep deprivation, obesity and diabetes. This study analyzed the relationship of working type, working hours and the prevalence of metabolic syndrome. The study's subjects were 2,777 employees (1,446 males and 1,331 females) over 19 years old and their data was from the Korea National Health and Nutrition Survey (2015). The type of work was divided into day work and shift work. The working hours were divided into less than 40 hours, 40 to 49 hours, 50 to 59 hours and 60 hours or more per week. As a result of this study, the prevalence of metabolic syndrome was 26.4% of the males and 19.1% of the females. Generally there was no relationship between metabolic syndrome and type of work (day work and shift work). As a result of analysis of working hours and metabolic syndrome, the workers who worked 40-49 hr were associated with a decreased prevalence of metabolic syndrome as compared to that of workers who worked less than 40 hr (odds ratio: 0.47, 95% confidence interval: 0.24-0.95, p<0.05). Further, positive relationships were found between the number of work hours and the prevalence metabolic syndrome for specific females who worked over 40 hr/wk. It can be concluded from the results that it is important to help workers avoid metabolic syndrome through setting appropriate work hours.

Acute Kidney Injury after Dose-Titration of Liraglutide in an Obese Patient (비만 환자에서 리라글루티드 증량 과정에서 발생한 급성 신손상)

  • Lee, Hee Jin;Park, Hye Soon
    • Archives of Obesity and Metabolism
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    • v.1 no.2
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    • pp.78-82
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    • 2022
  • Liraglutide (SaxendaR) is prescribed to induce and sustain weight loss in obese patients. The starting dose of liraglutide is 0.6 mg/day for 1 week, which is increased by 0.6 mg/day every week until the full maintenance dose of 3 mg/day is achieved. Such dose titration is needed to prevent side effects, which primarily include gastrointestinal problems such as nausea, diarrhea, constipation, vomiting, dyspepsia, and abdominal pain. A 35-year-old, reportedly healthy obese man receiving liraglutide treatment for obesity visited the emergency room complaining of generalized weakness and dizziness accompanied by repeated diarrhea and vomiting. He reported over 20 episodes of diarrhea starting the day after liraglutide dose escalation from 1.2 mg/day to 1.8 mg/day. Laboratory findings suggested pre-renal acute kidney injury, including serum creatinine 4.77 mg/dl, blood urea nitrogen (BUN) 37 mg/dl, estimated glomerular filtration rate (eGFR) 15 ml/min/1.73 m2, and Fractional excretion of sodium 0.08. After volume repletion therapy, his renal function recovered to a normal range with laboratory values of creatinine 1.08 mg/dl, BUN 14 mg/dl, and eGFR 88 ml/min/1.73 m2. This case emphasizes the need for caution when prescribing glucagon-like peptide-1 receptor agonists, including liraglutide, given the risk of serious renal impairments induced by volume depletion and dehydration through severe-grade diarrhea and vomiting.

A Review of Clinical Studies for Chinese Medicine Treatment of Post-concussion Syndrome Using the CNKI Database (뇌진탕 후 증후군의 중의치료에 대한 임상연구 동향 - CNKI검색을 중심으로)

  • Park, Mi-so;Ju, Ah-ra;Choi, Yo-sup;Baek, Hye-kyung;Hwang, Bo-kyung;Shin, Dong-guk;Jang, Seung-won
    • The Journal of Internal Korean Medicine
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    • v.42 no.6
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    • pp.1184-1198
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    • 2021
  • Objectives: The aim of this study was to investigate the latest clinical studies on Korean medicine treatment of post-concussion syndrome (PCS) in the Chinese National Knowledge Infrastructure Database (CNKI). Methods: We searched the last 10 years of clinical studies discussing Oriental medicine-based treatments for PCS in the CNKI database. The search focused on the authors, publication year, type of study, purpose of the study, method and duration of treatment, evaluation criteria, and results of each article. Results: Of the 22 selected studies, 1 was a non-randomized controlled trial (nRCT), 2 were case series, and 19 were randomized controlled trials (RCTs). Treatments included oral herbal medicine in 16 studies, oriental medicine through external use in 2 studies, acupuncture in 3 studies, and traditional Chinese medicine injection in 2 studies. The most frequently used herb was Cnidii Rhizoma (川芎). All 22 studies confirmed the efficacy of Oriental medicine treatments. Conclusion: More varied and scientifically designed clinical studies are required to develop treatments for PCS. The results of this study could be used as basic data for further PCS studies.

Severe SARS-CoV-2 Infection With Multiorgan Involvement Followed by MIS-C in an Adolescent

  • Bomi Lim;Su-Mi Shin;Mi Seon Han
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.155-160
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    • 2022
  • Children and adolescents with coronavirus disease 2019 (COVID-19) generally have mild symptoms. Severe infection due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) involving multiorgan dysfunction is rare in this population. Herein, we present an unusual case of severe SARS-CoV-2 infection with multiorgan involvement followed by multisystem inflammatory syndrome in children (MIS-C) in a vaccinated 16-year-old boy. The patient was unconscious on initial presentation, and had severe paralytic ileus. On laboratory examination, there was severe metabolic acidosis, lymphocytopenia, thrombocytopenia, elevated inflammatory markers, elevated liver enzymes, and evidence of acute kidney injury with proteinuria and hematuria. His symptoms improved with the administration of remdesivir and dexamethasone. The patient briefly experienced MIS-C 2 weeks after the diagnosis of COVID-19, but the patient was discharged without any complications.

Common Disease Codes in Pediatric Inpatients (1997-2008) (소아청소년과 입원환자의 흔한 질병 코드들(1997-2008): 감염질환 중심의 단일기관 연구)

  • Park, Ji-Eun;Lee, Soo-Young;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.54-60
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    • 2011
  • Purpose : In this study, we listed common diseases in pediatric inpatients and evaluated the distribution of diseases by period and age group, in order to estimate the epidemiologic trend. Methods : Patients who were admitted to the Department of Pediatrics between 1997 and 2008 were included. Demographic characteristics, date of admission, and International Classification of Diseases (ICD) code of patients were indentified. Study period was divided into two; early (1997-2002) and late (2003-2008), and age of patients were grouped into four; infancy, early childhood, late childhood, and adolescence. Results : A total of 33,513 patients were admitted for 12 years. In the list of ICD code, Pneumonia (J12-J18; 21.2%) was the most prevalent, followed by gastroenteritis (A00-A09; 17.8%), bronchiolitis (J21; 11.9%), and so on. Common diseases ranked from 1 to 10 comprised the majority (79.1%) of all the inpatients. There was increase in the number of inpatients with respiratory infectious disease (bronchiolitis, otitis media, and sinusitis), enlarged lymph node, or impetigo/cellulitis, but decrease in the number of inpatients with aseptic meningitis, intussusceptions, measles, or nephritic/nephrotic syndrome. The distribution of diseases also showed age group-specific difference. Conclusion : The distribution of diseases by period and age group was different. The epidemiologic trend should be considered in developing the management of strategy for the Department of Pediatrics.