• Title/Summary/Keyword: 임상 경과

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Resuscitation Outcomes and Clinical Characteristics of Out-of-Hospital Drug Induced Cardiac Arrest (약물중독에 의한 내원 전 심정지 환자의 특성과 심폐소생술 결과)

  • Kim Yun Kwon;Kim Hyun;Won Ho Kyong;Lee Kwon Il;Oh Sung Bum;Moon Joong Bum;Lee Kang Hyun;Hwang Sung Oh
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.93-98
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    • 2005
  • Purpose: This study was to investigate the resuscitation outcomes and the clinical characteristics of non-traumatic drug-induced out-of-hospital cardiac arrest by analyzing data from a single institution's registry. Method: We conducted a retrospective study of 795 patients who came to the emergency department with non-traumatic drug-induced out-of-hospital cardiac arrest during the period $1991{\~}2004$. Only patients over 18 years of age were included. Clinical characteristics. variables associated with cardiac arrest, and data during resuscitation were obtained from our cardiac arrest database. Patients were divided into two groups: drug-induced cardiac arrest (drug group, n=33), and non drug-induced cardiac arrest (non-drug group, n=762). Results: Spontaneous circulation was restored in 23 ($72{\%}$) patients in the drug group and in 314 ($45{\%}$) patients in the non-drug group ($x^2=0.020$). The patients who discharged alive number were 46 ($6{\%}$) in the non-drug group and 0 ($0{\%}$) in the drug group ($x^2=0.005$). The witnessed arrest, the epinephrine doses, and total defibrillation energy were not different between two groups. Conclusion: The return of spontaneous circulation rate was higher in the drug group than the non-drug group. However the drug group was lower survival discharge rate than in the non-drug group.

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A CASE OF PERVASIVE DEVELOPMENTAL DISORDER NOS WITH REPETATIVE SELF-INJURIOUS BEHAVIOR (반복적으로 머리를 때리는 전반성발달장애 환아 1례)

  • Kim, Jeong-Lim;Chung, Bo-In;Cho, Soo-Churl;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.244-251
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    • 1999
  • Self-injurious behavior is often showed in mental retardation, especially in autism. Self-injurious behavior has been regarded as a symptom cluster rather than a disease but it is an emergent clinical situation that can directly affect mortality. This case is about a refractory autistic patient who showed a self-injurious behavior of hitting the head repetitively. He was hospitalized and was treated by pharmacotherapy and behavior therapy and for this reason this clinical experience is reported with literature review. The patient is a 7-year old boy who was ward admitted from 1999 April 20 till July 10 into OO hospital OO ward because of self-injurious behavior. During the 12 weeks he had admission treatment. As for the pharmacotherapy, haloperidol was dosed up from 0.5mg to 1.0mg from the 4th week and combination drug therapy was done during the admission with naltrexone 25-50mg. As for the behavioral therapy, Differential Reinforcement of Other behavior was used and regular play therapy was done. To remove the physical restraint, headgear and hard sleeve was used. Currently, OPD follow up treatment is being done and haloperidol 0.5mg and naltrexone 50mg is maintained. The patient’s mother is educated and play therapy is done an hour daily at home. When the patient was released form the hospital, self-injurious behavior was decreased more than the moderate state and remission state is still being maintained at the outpatient clinic.

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A Case of Idiopathic Bronchiolitis Obliterans Organizing Pneumonia (원발성 Bronchiolitis Obliterans Organizing Pneumonia 1예)

  • Lee, Cheol-Whan;Koh, Youn-Suck;Kim, Woo-Sung;Gong, Kyeong-Yub;Song, Kun-Sik;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.536-541
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    • 1992
  • Bronchiolitis obliterans organizing pneumonia (BOOP) is a type of diffuse interstitial lung disease that primarily affects the small conducting airways and characterized by the presence of granulation tissue plugs within the lumen of small airways often extending into alveolar ducts. It is associated with a number of different causes, including a variety of infections, fume exposures, drugs, collagen diseases and idiopathic. Recently we have experienced one patient with idiopathic BOOP. The patient was a 58 year old man presented with 2 months' history of dry cough and exertional dyspnea. The phyical examination showed inspiratory crackles at both lower lung field. Chest X-ray showed bilateral multiple patchy alveolar density. Pulmonary function studies showed a moderate degree of restrictive lung disease. Open lung biopsy carried out and revealed findings characteristic of BOOP. There was a dramatic response clinically and radiologically to high dose predinisolone therapy. Chest X-ray and pulmonary function test under-taken one year later showed marked improvement. New lesion on chest PA was developed during the period of tapering of prednisolone dose, but it was soon disappeared after increasing of prednisolone dose. One year later, he is well without steroid therapy.

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A Case of Primary Pulmonary Low-grade B-cell Lymphoma of Bronchus-associated lymphoid tissue with Bilateral Consolidation and Indolent Clinical Course (양측성 고형질화 음영을 보인 무증상의 기관지-관련 림프양 조직의 저등급 B-세포 원발성 폐 림프종 1례)

  • Kim, Yang-Ki;Kim, Chul;Jean, Jin;Jean, Ki-Won;Kim, Dong-Won;Lee, Dong-Wha;Hong, Dae-Sik;Park, Hee-Sook;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1073-1081
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    • 1998
  • Primary pulmonary lymphoma (PPL) is an uncommon tumor, which constitutes 3-4% of all extranodal lymphomas and 0.3-0.5 % of all primary pulmonary malignant tumors. Low-grade B-cell lymphomas of bronchus-associated lymphoid tissue (BALT) accounted for the majority of PPL. This BALT lymphomas are frequently asymptomatic and have an excellent prognosis and an indolent clinical course by contrast with T-cell type. Therefore, determination of the B- or T-immunophenotype of the tumor cells is known to be very important from a clinical aspect. Recent advances in immunohistochemical techniques, cytogenetics, and molecular biology have allowed better definition of type, maturation, and clonality of lymphoma cells and have made it possible to better understand the PPL. We experienced an asymptomatic 43-year-old man who was evaluated for infiltrates on both sides discovered incidentallly after a routine chest roentgenogram. He was eventually diagnosed as low-grade B-cell lymphoma of BALT by immunohistochemical staining from specimens obtained by open lung biopsy. He was treated with combination chemotherapy. At follow up 12 mons following initial diagnosis, he remains in stable. We report this case, who showed a relatively favorable prognosis and indolent clinical course compatible with low-grade B-cell lymphoma.

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A clinical study of Soyangin Yangkyuksanwhatang (양격산화탕(凉膈散火湯) 활용(活用)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Park, Seong-sik;Kim, Ji-yong;Choi, Jae-young
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.2
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    • pp.455-471
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    • 1998
  • Background and Purpose : We intended to be helpful to understand constitutional symptoms of a disease and an application of the prescription through a clinical study of Soyangin Yangkyuksanwhatang. Methods : We studied 65 patients(40 men and 25 women) treated with Soyangin Yangkyuksanwhatang in constitutional clinic of Dongguk Pundang Oriental Hospital. And then we investigated the characteristics of Yangkyuksanwhatang treated patients, remedial values, onset of action and side effects. Results: Soyangin Yangkyuksanwhatang was used in all age groups both men and women. There were 37 kinds of chief complaints including chest discomfort, numbness of hands and feet, motor disturbance and skin disease etc. The distributions of remedial values were slightly improved(58.5%), much improved(12.3%), no improved(29.3%) and there was no aggravated patient. Using the prescription, mostly I prescribed only Soyangin Yangkyuksanwhatang without any changing, and added some herbs to the prescription according to the symptoms of a disease. Soyangin Yangkyuksanwhatang was affected in remedial values by the addition and subtraction of herbs. The onset of action in young age group was shorter than old age group. Side effects were palpitation, abdominal pain and indigestion etc.

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A Clinical Study for 157 Cases of CVA by Sasang Constitutional Medicine (사상의학적(四象醫學的) 중풍치험(中風治驗) 157례(例)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Choi, Jae-young;Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.2
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    • pp.431-453
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    • 1998
  • 1. Background and Purpose: We intended to make the standards of CVA management of Sasang Constitutional Medicine and be helpful to understand the constitutional symptoms through a clinical study of CVA. 2. Methods: We studied 157 CVA inpatients(79 men and 78 women) who were in constitutional clinic of Dongguk Pundang Oriental Hospital during 1 year from March 1997 to February 1998. We investigated and analysed the characteristics, past histories, symptoms and progresses of patients. 3. Results: The results of constitutional analysis showed 88 Taeumin(56.1%), 48 Soyangin(30.6%) and 21 Soeumin(13.4%). The frequency of strokes was much the same between male and female and the greater part of cases were 50-70 of age. The CVA cases were classified into 119 cerebral infarction(75.8%), 11 cerebral hemorrhage(7.0%), 1 subarachnoid hemorrhage(0.6%) and 26 trasient ischemic attack. From the standards of symptom management, there were abnormality of a coated tongue(63.1%) in most cases, sleeping disorders(48.4%), excremental disorders(44.7%) and urinary disorders(36.9%) on admission. With regard to the rate of improvement in the standards of CVA management, excremental disorders improved 87.1% and emotional disorder 81.0%, swallowing disorder 78.7% and so on.

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Enhanced Extraction of Bioactive Compounds from Bee Pollen by Wet-grinding Technology (벌 화분에서 습식 나노화 공정에 의한 유효성분의 추출)

  • Choi, Yun-Sik;Suh, Hwa-Jin;Chung, Il Kyung
    • Journal of Life Science
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    • v.26 no.6
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    • pp.651-656
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    • 2016
  • Bee pollen is produced by honeybees and is considered one of the most balanced and nourishing nutritional supplements available. Historically, bee pollen has been prescribed for its healing properties and consumed for its high-energy supply. Recent research has provided evidence that bee pollen has diverse biological activities, such as anti-oxidant, anti-inflammatory, anti-bacterial, and even anti-cancer effects. However, the outer membrane of the pollen grain, exine, is highly resistant to most acidic solutions, high pressure, and even digestive enzymes, and the resulting low bioavailability limits its nutritional and clinical applications. This study applied a wet-grinding method to destroy the exine effectively, and it then examined the pollen's enhanced biological activity. First, microscopic observations provided strong evidence that wet grinding destroyed the exine time-dependently. In addition, the content of polyphenols, well-known ingredients of bee pollen and used as internal standards for the quality control of commercial pollen preparations, increased up to 11-fold with wet grinding. Further, the anti-oxidant activity demonstrated on the ABTS anti-oxidant assay, as well as the DPPH radical scavenging assay, was also dramatically increased. Together, the results presented here support a new technology by which bee pollen can be used as a resource for medical, nutritional, and cosmetic applications.

Preventive Effects of Zinc Pretreatment in the Time-course of Cadmium-induced Testicular Toxicity in the Rat (아연 전처리가 시간 경과에 따른 카드뮴 유도 고환 독성에 미치는 보호 효과)

  • Jekal, Seung-Joo;Lee, Kyung-Sun;Chung, Ok-Bong;Im, Hyo-Bin
    • Korean Journal of Clinical Laboratory Science
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    • v.42 no.3
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    • pp.136-148
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    • 2010
  • Cadmium (Cd) is known to exert gonadotoxic and spermiotoxic effects. The present study was performed to investigate the morphological effects and metallothionein (MT) expression by zinc pretreatment in the course of time of cadmium-induced testicular injury in rat. Fifty male Spraque-Dawley rats weighing 160-180 g were divided into two groups: saline-pretreated cadmium group and zinc-pretreated cadmium group. Rats of two groups received subcutaneous injection of saline and 100 mg/kg $ZnSO_4$ at 0, 2, 5 and 8 hrs intervals respectively. Cadmium chloride (4.5 mg/kg $CdCl_2$) was administrated intraperitoneally at 2 hr after zinc injection and rats were killed 0, 12, 24, 48 and 72 hrs later. Testicular tissue damages, Interstitial (Leydig) cells status and MT expression were determined using hematoxylin-eosin stained sections and a computerized image analysis system on sections immunostained with a mouse anti-metallothionein respectively. Zinc pretreatment was significantly reduced testicular damages in five pathological categories after cadmium administation. The number of surviving interstitial cells was significantly higher in the zinc-pretreated group than in the saline-preatreated group at 48 and 72 hrs after cadmium administration. Non-damaged testis showed the positivity of MT staining in spermatogenic cells, Sertoli cells and endothelium of blood vessel, but not in the Leydig cells. The potitivity of MT staining in saline-pretreated group was significantly reduced at 24 hrs after cadmium administration, whereas zinc-pretreated group showed strong MT positive staining similar to the 0 hr by 42 hrs after cadmium administration. In damaged testis, MT positive staining was also observed in the Leydig cells of both groups. These results suggest a major preventive effect of zinc against cadmium-induced testiculat toxicity may be due to its ability to reduce the cytotoxicity of cadmium in spermatogenic cells and Leydig cells by inhibiting the susceptibility of the testis to cadmium but not MT production by cadmium.

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Primary bone tumors of fibula (비골에 발생한 원발성 골 종양)

  • Park, Jang-Won;Lee, Seung-Hwan;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.112-117
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    • 2006
  • Purpose: The purpose of this study was to investigate on primary bone tumors of fibula. Materials and Methods: Patients who received operative treatment from January 1993 to December 2005 for primary bone tumors of fibula were analyzed for clinical outcomes. Results: There were 17 patients(10 males, 7 females) who were diagnosed for primary bone tumors of fibula. Osteochondroma was the most common diagnosis and others were osteosarcoma, fibrous dysplasia. The malignant bone tumors were 10.5% of all fibula tumors. There were 12 cases on proximal, 4 cases on mid shaft, and 1 cases on distal part of fibula. At the final follow up, 14 patients reported patient satisfaction of either excellent or good. Conclusion: Bone tumor of fibula doesn't need reconstruction after the resection unless it invades tibia or its site distal, which enables easy surgical resection. However, generally it is rare and accompany with vague symptoms, so careful approach to diagnosis is necessary because late diagnosis can mean the needs for amputation.

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Pelvic Symphyseal Distraction Osteotomy for Constipation Management Secondary to Pelvic Stenosis (골반강 협착증으로 인해 발생한 변비를 가진 고양이에서의 골반강 확장술을 이용한 치료 증례)

  • Oh, Kwang-Seon;Choi, Sung-Jin;Kim, Nam-Soo;Kim, Min-Su;Lee, Ki-Chang;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.527-530
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    • 2014
  • A 7-year-old neutered male Korean domestic short-haired cat was referred to our clinic to treat constipation which had persisted for 6 months. The rectal examination revealed narrowing of the right lateral portion of the pelvic canal. A reduced pelvic canal diameter by pelvic fracture malunion was revealed on radiography. The pelvic canal diameter ratio measured from preoperative was 0.68. Based on rectal and radiographic examinations, constipation caused by pelvic canal narrowing was confirmed. Pelvic symphyseal distraction-osteotomy and iliac wedge osteotomy were performed. An iliac osteotomy of the ilium was performed to ease the pelvic symphyseal distraction. After the symphysis was split longitudinally, pelvic symphyseal distraction was maintained by using a spacer made of poly-methyl-methacrylate. The osteotomy of the ilium was fixed using a bone plate and screws. Increased pelvic canal diameter was confirmed on post-operative radiography and the postoperative pelvic canal diameter ratio was 0.91. The patient received antibiotics, NSAIDs, crystalloids and Lactulose for post-operative care. The cat recovered normal defecation abilities and did not have constipation at one week postoperatively. No episodes of constipation persisting longer than 6 months have been reported by owners in previous studies. Pelvic symphyseal distraction osteotomy and iliac wedge osteotomy may prove to be a useful surgical procedure to treat pelvic canal stenosis that is caused by pelvic fracture malunion.