• Title/Summary/Keyword: 호전환

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The Clinical Study of Clarithromycin for the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 급성 호흡기 감염에 대한 Clarithromycin의 임상 효과)

  • Kim, Ki-Beom;Shin, Chang-Jin;Lee, Hak-Jun;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.94-100
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    • 1997
  • To evaluate the efficacy and safety of clarithromycin in acute exacerbation of chronic obstructive pulmonary disease, we administered clarithromycin(250mg) twice in a day in 30 patients with acute exacerbation of chronic obstructive pulmonary disease from September to November in 1996. Twenty eight cases of 30 patients were cured(93.4%) and 2 cases(6.7%) show clincal improvement. Three cases were improved within 3 days of treatment and 24 cases were improved between 5 days and 12 days of treatment. There were no significant side effects. These results suggest that clarithromycin will be effective as a first line therapy in patients with acute exacerbation of chronic obstructive pulmonary disease.

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Handoff signaling implementation using H.323 rerouting in IP-based network (IP 기반 망에서 H.323 리라우팅을 이용한 핸드오프 시그널링 구현)

  • Lee, Yeong-Sin;Choi, Gi-Moo
    • The KIPS Transactions:PartC
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    • v.8C no.6
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    • pp.821-830
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    • 2001
  • H.323 proposes to use Mobile IP and H.323 ad hoc conference signaling to provide Handoff function to a mobile terminal. But H.323 ad hoc conference signaling has a drawback. It requires an H.323 endpoint to do a complex conference signaling which makes inter-operability between H.323 endpoints difficult and takes the longer signaling time. In this paper, we propose an Handoff signaling using H.323 rerouting(Third party initiated Pause and Rerouting). H.323 rerouting signaling only requires an H.323 endpoint to do H.323 basic signaling in reestablishing media channel, and makes inter-operability more easier and provides the faster Handoff. To do this, our H.323 GK has derived H.245 control channel using tunneling for all H.323 calls including the fast connect calls which enable endpoints communicate each other if they don\`t have H.245 control channel. In order to evaluate the performance of the proposed signaling, we have conducted an experiment that compares a call transfer signaling using H.323 rerouting with ad hoc conference signaling in inter-operability and signaling delay. The results of our experiment shows that the call transfer signaling can inter-operate with four H.323 endpoints among five H.323 endpoints of other vendors and reduces the signaling delay average 1.4 sec.

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A Case of Clinical Improvement after Enzyme Replacement Therapy in Pompe Disease (효소 보충 치료로 호전을 보인 Pompe병 1례)

  • Jeon, You Hoon;Eun, Baik Lin;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.5 no.1
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    • pp.18-22
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    • 2005
  • Pompe disease is a genetic disorder caused by a deficiency of acid ${\alpha}$-glucosidase (GAA). This enzyme defect results in lysosomal glycogen accumulation in multiple tissues and cell types, with cardiac, skeletal, and smooth muscle cells the most seriously affected. Infantile-onset Pompe disease is uniformly lethal. Affected infants present in the first few months of life with hypotonia, generalized muscle weakness, and a hypertrophic cardiomyopathy, followed by death from cardiorespiratory failure or respiratory infection, usually by 1 year of age. Late-onset forms is characterized by a lack of severe cardiac involvement and a less severe short-term prognosis. Enzyme replacement therapy for Pompe disease is intended to address directly the underlying metabolic defect via intravenous infusions of recombinant human GAA to provide the missing enzyme. We experienced one case of Pompe disease in 3-years old boy that has improved his exercise ability and cardiac function after GAA enzyme replacement therapy.

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Ethylmalonic Encephalopathy

  • Yun, Hye-Ran;Han, Si-Hun;An, Yeong-Min;Sin, Yun-Jeong
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.1 no.1
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    • pp.5-12
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    • 2001
  • 아시아 및 한국에서 처음 발견된 3명의 소아 Ethylmalonic encephalopathy (EE) 환자들은 riboflavin을 이용한 치료법에 점진적인 호전을 보인 것으로 나타났다. Ethylmalonic aciduria가 3가지 효소-2-methyl-branched-chain acyl CoA dehydrogenase (2MBCAD), iso-valeryl CoA dehydrogenase (IVCAD), 그리고 short-chain acyl CoA dehydrogenase (SCAD) - 들의 부분적인 결함으로 생긴다는 가설하에 dehydrogenase (탈수효소)의 보조 효소인 riboflavin이 부분적으로 나마 치료 과정에서 어떤 역할을 수행하는지의 여부를 살펴보았다. 다음의 세 증례에서 riboflavin 혹은 coenzyme Q10을 병행하여 치료한 결과 인지 행동(cognitive behavior)과 만성 점액성 설사(chronic mucoid diarrhea)가 호전된 것으로 관찰되었다. 또한, 치료 후 운동 기능도 일부 호전되었다. EE의 질병 발생 기전이 현재까지 완전히 밝혀지지는 않았지만, 세 명의 EE 환자들의 치료경과를 관찰하여 위의 가설을 뒷받침 할 수 있었다.

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Assessment of the Effectiveness of Biofeedback Therapy in Children with Pelvic Floor Dyssynergia (소아 골반저 근실조에서 바이오피드백 치료의 유용성)

  • Park, Kie-Young;Chang, Soo-Hee;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.51-59
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    • 2007
  • Purpose: Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD. Methods: We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later. Results: Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the shortterm improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy. Conclusion: Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.

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Unexpected Aggravation of COVID-19 After Recovery in Three Adolescents With Chronic Neurologic Conditions: A Case Series

  • Dayun Kang;Seung Ha Song;Bin Ahn;Bongjin Lee;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.147-154
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    • 2022
  • The clinical severity of coronavirus disease 2019 (COVID-19) in children is usually mild. Most of the affected patients completely recovered from COVID-19 before being released from approximately 7-day quarantine. However, children with comorbidities are at risk of more severe disease and adverse outcomes. We report three cases of COVID-19-affected adolescents with underlying chronic respiratory difficulty due to neurologic diseases who showed sudden clinical aggravations at the time of discharge, even after full clinical improvement. Patient 1 is a 17-year-old boy with Ullrich congenital muscular dystrophy who had cardiopulmonary arrest 9 days after the initial COVID-19 symptoms. Patient 2 is a 17-year-old girl with intracerebral hemorrhage with infarction in bed-ridden status who had cardiopulmonary arrest 11 days after the initial symptoms. Patient 3 is a 12-year-old boy with intraventricular hemorrhage with hydrocephalus in bed-ridden status who showed multiorgan failure 10 days after the initial symptoms. Remdesivir, dexamethasone, and empirical antibiotics were administered with mechanical ventilation and intensive unit care. Among the three patients, two (patients 1 and 3) were alive, and one (patient 2) expired. Clinicians caring for adolescents with chronic neurologic and/or pulmonary disease should keep in mind that these patients could have sudden deterioration after recovery from the acute phase of COVID-19 around or after the time of discharge.

The Correlation between Acholic Stool and the Result of $Tc^{99m}$ DISIDA Hepatobiliary Scintigraphy and Biochemical Test in Neonatal Cholestasis (신생아 담즙 정체증에서 무담즙변의 유무와 $Tc^{99m}$ DISIDA 간담도 주사 결과간의 상관성과 생화학적 검사의 차이에 관한 연구)

  • Joo, Eun-Young;Ahn, Yeon-Mo;Kim, Yong-Joo;Moon, Soo-Ji;Choi, Yun-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.51-61
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    • 2002
  • Purpose: The most common causes of neonatal cholestasis are neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA). Since neonatal cholestasis presents with variable expression of same pathologic process and has similar clinical, biochemical, and histologic features between EHBA and idiopathic neonatal hepatitis (NH), differential diagnosis is often difficult. We reviewed the differences of clinical characteristics and laboratory data to find out any correlation between the results of $Tc^{99m}$ DISIDA scan and presence of acholic stool. Methods: Between June 1993 and January 2001, total 29 infants younger than 4 month-old underwent $Tc^{99m}$ DISIDA scan. Their biochemical tests and clinical course were reviewed retrospectively. Results: Patients who had negative intestinal activity on $Tc^{99m}$ DISIDA scan showed acholic stool and revealed higher serum direct bilirubin and urine bilirubin level. 18.2% of patients with acholic stool showed intestinal activity on $Tc^{99m}$ DISIDA scan and 81.8% of them did not. All the patients without acholic stool showed positive intestinal activity on $Tc^{99m}$ DISIDA scan. The result of $Tc^{99m}$ DISIDA scan and the presence of acholic stool showed high negative correlation (r :-0.858). Patients with acholic stool and negative intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum total bilirubin level. Patients without acholic stool and positive intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum level of ALT. Conclusion: Patients with acholic stool and negative intestinal activity showed high correlation, but 18.2% of patients with acholic stool showed positive intestinal activity. So operative cholangiogram or transcutaneous liver biopsy should be performed for confirmation.

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