• Title/Summary/Keyword: 정맥염

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A Case of Hughes-Stovin Syndrome (Hughes-Stovin Syndrome 1예)

  • Kim, Joo-In;Lee, Young-Min;Yum, Ho-Kee;Choi, Soo-Jeon;Choi, Seok-Jin;Yang, Young-Il;Sung, Kyu-Bo;Kim, Dong-Soon;Lee, Bong-Choon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.96-101
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    • 1996
  • Hughes-Stovin Syndrome is an exceedingly rare combination of distal pulmonary arterial aneurysm and deep vein thrombosis, mostly found in young patients. There are striking similarities between the vascular manifestation of Behçet's disease and Hughes-Stovin Syndrome. It has been suggested that they may have a similar pathogenesis. Most patients died of massive hemoptysis due to rupture of aneurysm. Recently we have experienced the first case of Hughes-Stovin Syndrome in Korea. A 37 year old male patient was admitted because of recurrent hemoptysis and intermittent fever. He had a history of recurrent aphthous ulcers and erythema nodosum-like skin rash, But no other findings of Behcet's disease was found. Angiography showed multiple pulmonary arterial aneurysm and deep vein thrombosis in Right lower extremity. Histologic examination of specimens of open lung biopsy revealed leukocytoclastic angiitis. Pulmonary arterial aneurysms were successfully treated by coil embolization and he is in good condition with corticosteroid and cyclophosphamide therapy.

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Immunoglobulin G4-Related Disease in the Thorax: Imaging Findings and Differential Diagnosis (흉부에서 발생한 IgG4 연관 질환: 영상 소견 및 감별진단)

  • Yookyung Kim;Hye Young Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.826-837
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    • 2021
  • Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory condition involving multiple organs, including the salivary or lacrimal glands, orbit, pancreas, bile duct, liver, kidney, retroperitoneum, aorta, lung, and lymph nodes. It is histologically characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, storiform fibrosis, and obliterative phlebitis. In the thoracic involvement of IgG4-RD, mediastinal lymphadenopathy and perilymphangitic interstitial thickening of the lung are the most common findings. Peribronchovascular and septal thickening and paravertebral band-like soft tissue are characteristic findings of IgG4-RD. Other findings include pulmonary nodules or masses, ground-glass opacity, alveolar interstitial thickening, pleural effusion or thickening, mass in the chest wall or mediastinum, and arteritis involving the aorta and coronary artery. Radiologic differential diagnosis of various malignancies, infections, and inflammatory conditions is needed. In this review, we describe the imaging findings of IgG4-RD and the radiologic differential diagnoses in the thorax.

Three Cases of Aseptic Meningitis Following the Use of Intravenous Immune Globulin (정맥용 면역글로불린 투여 후 발생한 무균성 수막염 3례)

  • Lee, Joon Ho;Song, Eun Kyoung;Lee, Jin A;Kim, Nam Hee;Kim, Dong Ho;Park, Ki Won;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.202-207
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    • 2005
  • Intravenous immune globulin(IVIG) is widely used for immune thrombocytopenic purpura (ITP), Kawasaki disease and other autoimmune neuromuscular disease. Aseptic meningitis was one of the most serious neurologic complications reported following the use of IVIG. We experienced 4 episodes of aseptic meningitis associated with IVIG usage in 3 patients from 2003 to 2004. Underlying disease of each patients was ITP, Kawasaki disease and myathenia gravis and all of them received high dose IVIG treatment for their underlying disease. Within a days, they started to complain severe headache and diagnosed meningitis by cerebrospinal fluid analysis. Cerebrospinal fluid leukocyte counts varied from 92 to over a thound per microliter with dominance of polymorphonuclear leukocytes. Microbiologic studies revealed no organisms. All of them were free from headache within 2 days and did not suffer any neurological sequelae.

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Definitive Surgical Management for Deep-Seated Mediastinitis and Sternal Osteomyelitis Following Tracheal Reconstruction -Sternectomy, Free or In-Situ Omental Transfer, Myocutaneous Flap- (기관재건술 후 발생한 심부 종격염 -흉골 절제, 위망 이식, 근피성형을 병합한 근치술-)

  • Lee, Seo-Won;Kim, Jung-Taek;Kim, Kwang-Ho;Lee, Choong-Jae;Kim, Young-Mo;Lim, Hyun-Kyoung;Sun, Kyung
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.206-210
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    • 1999
  • We report here 2 cases of deep-seated mediastinitis combined with sternal osteomyelitis after tracheal reconstruction which were successfully treated with sternectomy, in-situ or free omental transfer, and pectoralis major myocutaneous flap. In case I, an 8 year-old boy with deep seated mediastinitis and sternal osteomyelitis that developed after anterior tracheoplasty through a standard midline sternotomy. In case II, a 50 year-old female patient with mediastinal abcess and sternal osteomyelitis that developed after resection and end-to-end anastomosis of the trachea through an upper midline sternotomy. Treatments consisted of drainage and irrigation followed by wide resection of the infected sternum, placement of the viable omentum into the anterior mediastinal space, and chest wall reconstruction with a pectoralis major myocutaneous flap. The omentum was transferred as an in-situ pedicled graft in case I and a free graft in case II. Both patients have recovered smoothly wit out any events and have been doing well postoperatively.

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Effects of Cyclobuxine D on Carrageenin-induced Pleurisy and Croton Oil-induced Granuloma Pouch in Rats (흰쥐의 Carrageenin 유발 늑막염과 Croton oil 유발 육아종양에 미치는 Cyclobuxine D의 영향)

  • Lee, Jong-Hwoa;Park, Young-Hyun;Cho, Byung-Heon;Kim, Yu-Jae;Kim, Jong-Bae;Kim, Chung-Mok;Kim, Chun-Sook;Cha, Young-Deog;Kim, Young-Suk
    • The Korean Journal of Pharmacology
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    • v.23 no.2
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    • pp.151-157
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    • 1987
  • Cyclobuxine D, a steroidal alkaloid, was extracted from Buxus microphylla var. koreana Nakai. The effects of cyclobuxine D on carrageenin-induced pleurisy and croton oil-induced granuloma pouch in rats was investigated and compared with those of aspirin, hydrocortisone ana dexamethasone. Intrapleural injection of 2% carrageenin caused the accumulation of exudate. The rate of plasma exudation, measured by the exuded dye amounts for 20 min in the pleural cavity after intravenous injection of pontamine sky blue, showed a peak at 5 hr. Cyclobuxine D (5, 20 and 50 mg/kg, i.p.) suppressed dose-dependently the accumulation of the pleural exudate and the exudation of dye. Among several methods used for screening and evaluation anti-inflammatory agents, granuloma pouch technic introduced by Hans Selye (Hans seyle, 1953) is considered as a simple and reliable method. An air pocket was produced in the subcutaneous tissue of the interscapular region by injection of 1 ml of 1% croton oil as irritant. Inflammatory exudate accumulated in the pouch during the succeding 14 days. Cyclobuxine D (5 and 20 mg/kg) decreased fluid volume in pouch and weight of pouch wall in granulomatous inflammation.

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Efficacy and Safety of Intraveous Iron Sucrose in the Perioperatively Anemic Patients of Gastrectomy (위 절제 수술 전후 빈혈 환자에 있어 철수크로오스의 유효성 및 안전성)

  • Yoo, Moon-Won;Cho, Jae-Jin;Lee, In-Kyu;Ahn, Hye-Seong;Jeong, Sang-Ho;Lee, Hyuk-Joon;Kim, Hyung-Ho;Lee, Kuhn-Uk;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.8 no.1
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    • pp.35-39
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    • 2008
  • Purpose: This study was aimed to evaluate the efficacy and safety of of intravenous iron sucrose ($Venoferrum^{(R)}$) for treating the perioperative anemic gastrectomy patients. Materials and Methods: From September 2006 to February 2007 at Seoul National University Hospital, the gastrectomy patients who displayed perioperative anemia (7.0 g/dl $\leq$ hemoglobin levels (Hb) < 11.0 g/dl) and who were admitted or visited the outpatient clinic of the Department of surgery, were divided into two groups. The preoperative (${\leq}\;2{\sim}3$ weeks before gastrectomy) or postoperative ($\geq$ 1 month after gastrectomy) patients without evidence of acute bleeding were included into Group 1. The immediate postoperative (< 1 month after gastrectomy) patients with stable vital signs were included into Group 2. The age, gender, diagnosis, Hb, hematocrit (Hct), mean corpuscular volume (MCV), serum ferritin (SF), total iron binding capacity (TIBC), serum iron and reticulocyte counts (RC) were evaluated before and after intravenous iron sucrose administration. The adverse effects of drugs were investigated. Results: The number of patients of group 1 and group 2 was 79 and 46, respectively. In group 1, there was a statistically significant difference in the Hb, Hct, MCV, SF, RC and TIBC with each mean change of 1.3 g/dl, 4.1%, 3.1ft, 195 ng/ml, 0.2% and -86.4 ug/dl, respectively. In group 2, there was a statistically significant difference in the Hb, Hct, MCV, SF and RC with each mean change of 1.8 g/dl, 6.1%, 3.4fl, 260 ng/ml and 0.3%, respectively. Two patients (1.6%) suffered local thrombophlebitis as an adverse effect. Conclusion: Intravenous iron sucrose for the perioperative anemia of gastrectomy patients was efficacious in the short period without significant adverse effects.

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Intravenous immunoglobulin for severe gastrointestinal manifestation of Henoch-Schönlein purpura refractory to corticosteroid therapy (스테로이드 치료에 반응하지 않는 심한 위장관 증세의 Henoch-Schönlein 자반증 환아에서 정맥 면역글로불린 치료)

  • Yang, Hye Ran;Choi, Won Jung;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.784-789
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    • 2006
  • Purpose : $Henoch-Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis involving small vessels of skin, gastrointestinal(GI) tract and kidney. Digestive involvement of HSP can be serious with massive GI bleeding, perforation, and intussusception. However, some patients do not respond to conventional corticosteroid therapy. In this study, we investigated the efficacy of intravenous immunoglobulin (IVIG) for serious digestive manifestations not responding to steroid. Methods : From April 1999 to January 2005, 22 children diagnosed as HSP with severe GI symptoms were included. Initially, all patients were treated with intravenous methylprednisolone. IVIG 2 g/kg of body weight was infused in children refractory to steroid therapy. Clinical data were reviewed retrospectively. Results : Among 22 children, 12 children underwent IVIG therapy. The mean duration of corticosteroid therapy was $5.61{\pm}4.9$ days before IVIG therapy, and 11 of 12 patients experienced disappearance of GI manifestations after the initiation of IVIG infusion. In one patient, IVIG was ineffective in relieving abdominal pain, but melena subsided. Comparison of the duration of hospitalization between IVIG group and corticosteroid group revealed no significant difference($12.8{\pm}7.6$ days vs. $13.2{\pm}7.8$ days, P=0.777). But, the total duration of abdominal pain decreased in IVIG group although the difference between two groups was not significant($8.8{\pm}8.1$ days vs. $14.8{\pm}16.9$ days, P=0.306). Among 10 children treated with steroid only, 2 children were operated for bowel perforation and intussusception. In contrast, there was no perforation in 12 children who underwent IVIG therapy. Conclusion : IVIG could be the alternative therapy to corticosteroids in children with severe digestive manifestations of HSP.

Macroamylasemia in a 4-year-old girl with abdominal pain (복통을 주소로 내원한 4세 여아에서 진단된 마크로아밀라제혈증 1예)

  • Ko, Jeong Hee;Lee, Dae Hyoung
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1283-1285
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    • 2009
  • Macroamylasemia is a benign condition characterized by abnormally large-sized serum amylase; it has been reported to occur in 1-2% of the population. In macroamylasemia, a macromolecular complex consisting of amylase linked to immunoglobulins circulates in the plasma and usually causes hyperamylasemia with low or normal amylasuria. Macroamylasemia is extremely rare in children. We report a case of a 4-year-old girl with abdominal pain and macroamylasemia, who was initially misdiagnosed as having acute pancreatitis. Failure to immediately identify macroamylase as the cause of the unexplained but benign hyperamylasemia can lead to the misdiagnosis of the condition, necessitating costly analyses for ruling out pancreatic disease and unnecessary prescriptions such as fasting and intravenous replacement therapies, as was observed in our patient.

Thoracodorsal Artery as an Alternative in Complete Arterial Coronary Revascularization -3 Cases- (완전동맥도관 관상동맥 우회술에서 대체동맥편으로 사용한 흉배동맥 -3례보고-)

  • 정철현;허재학;장지민;김욱성;장우익;이윤석
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.898-901
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    • 2002
  • It is now widely accepted that the complete arterial coronary revascularization has better short and long term results compared to coronary bypass surgery using arterial graft mixed with vein graft mainly due to its superior patency rate. However, sometimes the internal thoracic artery and other conventionally used grafts might be unavailable or it may require caution in using bilateral internal thoracic artery especially in diabetic patient because of the possible risk of the mediastinitis or other associated morbidities. Moreover, there could also be a shortage for arterial graft in case of coronary reoperation. We report our first three cases using thoracodorsal artery(TDA) as an alternative graft in complete arterial coronary revascularization.

심실근세포 계산모델을 활용한 지질산화물의 전기생리학적 영향 평가 및 예측

  • Choe, Seong-U;Kim, Seong-Jun;Yeom, Jae-Beom
    • Proceeding of EDISON Challenge
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    • 2017.03a
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    • pp.643-649
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    • 2017
  • 심장 이온통로의 변화는 활동전압의 모양과 길이에 영향을 주어 심부정맥을 유발한다. 산화적 스트레스의 증가로 인해 생체에 침착이 증가하는 지질산화물 (4-HNE, 4-ONE)는 여러 단백질 및 이온통로에 영향을 주는 독성이차전달자로 알려져 있다. 본 연구자는 선행 연구를 통해 4-HNE와 4-ONE의 단기간 노출이 심실근세포에 발현되는 3종류의 이온통로 ($I_{Kr}$, $I_{Ks}$, $I_{Ca,L}$)의 전류감소와 kinetics변화를 일으키고, 심실근세포의 활동전압길이가 증가하는 것을 확인하였다. 두 물질이 이온통로들에 준 영향은 유사하였으나, 활동전압길이의 증가 정도가 4-ONE에서 더 크게 나타났다. 활동전압의 연장에 차이가 나는 원인과, 두 지질산화물이 또 다른 이온통로에 미치는 영향 유무를 예측하기 위해서 Grandi and Bers human ventricular model[1]을 적용한 Integrated human ventricular myocyte model 프로그램 (developed by prof. Youm)을 활용하였다. 시뮬레이션으로 재현한 4-HNE와 4-ONE에 의한 활동전압은 실험으로 기록된 것보다 연장 정도가 작았다. 시뮬레이션 모델의 background $Na^+$ 전류의 크기를 크게 하였을 경우, 실험에서 기록된 활동전압 길이에 상응하는 연장을 가져왔다. 그러므로, 4-HNE와 4-ONE는 실험으로 확인한 $I_{Kr}$, $I_{Ks}$, $I_{Ca,L}$ 이외에 심장세포에 존재하는 내향전류 (Late $Na^+$ current)의 크기를 증가하는 효과가 있음을 예측할 수 있으며, 실험적 검증이 요구된다.

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