• Childhood Kidney Diseases
• /
• 제22권2호
• /
• pp.91-96
• /
• 2018

Nephrotic syndrome in the first year of life, characterized by renal dysfunction and proteinuria, is associated with a heterogeneous group of disorders. These disorders are often related to genetic mutations, but the syndrome can also be caused by a variety of other diseases. We report an infant with nephrotic syndrome associated with a neuroblastoma. A 6-month-old girl was admitted with a 10% weight loss over 10 days and nephrotic-range proteinuria. She was ill-looking, and her blood pressure was higher than normal for her age. Her cystatin-C glomerular filtration rate was decreased, and levels of plasma renin, aldosterone, and catecholamines were elevated. Renal ultrasonography and abdominal computed tomography showed a retroperitoneal prevertebral mass encasing both renal arteries and the left renal vein. The mass was partially resected laparoscopically, and the pathologic diagnosis was neuroblastoma. Findings on a simultaneous renal biopsy were unremarkable. The patient was treated with chemotherapy and several anti-hypertensive drugs, including an alpha blocker. Two months later, the mass had decreased in size and the proteinuria and hypertension were gradually improving. In an infant with abnormal renin-angiotensin system activation, severe hypertension, and nephrotic-range proteinuria, neuroblastoma can be considered in the differential diagnosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제19권2호
• /
• pp.147-151
• /
• 2016

Neonatal hemochromatosis (NH) is a severe neonatal liver injury that is confirmed by extra-hepatic iron accumulation. Although a recent study described treating NH with exchange transfusions and intravenous immunoglobulin, liver transplantation should be considered for patients with severe liver failure that does not respond to other medical treatment. Herein, we report the case of a two-month-old female infant who presented with persistent ascites and hyperbilirubinemia. Her laboratory findings demonstrated severe coagulopathy, high indirect and direct bilirubin levels, and high ferritin levels. Abdominal magnetic resonance imaging presented low signal intensity in the liver on T2-weighted images, suggesting iron deposition. The infant was diagnosed with NH as a result of the clinical findings and after congenital infection and metabolic diseases were excluded. The infant was successfully treated with a living-donor liver transplantation. Living related liver transplantation should be considered as a treatment option for NH in infants.

• 동의생리병리학회지
• /
• 제19권3호
• /
• pp.590-595
• /
• 2005

The following conclusions are produced by the consideration of Bojungikki-tang(補中益氣湯) from the view point of Hyungsang medicine. A review on the explanation and provisions of Bojungikki-tang stipulated in 'Donguibogam(東醫寶鑑)' results in the idea that the main purpose of Dongwon(東垣) and various application in clinic by Jeesan(芝山) cannot be understood without the deep comprehension of ki(especially Jungki and Wonki) and the fire. Jungki(中氣, the middle warmer ki) is the ki of stomach. Wonki(元氣, the original ki) is a combination of innate Jung(先天之精, Ki stored between the two kidneys) and acquired Jung(後天之精, Ki of the stomach) and the sources of five Jang and six Bu, twelve meridians and triple warmer. Yin fire is referred to the ministerial fire of spleen, liver and kidney. Excess or lack of the ministerial fire can cause a disease and especially the excess of it is harmful to original ki. Deficiency of original ki is thought to be a cause of allergic diseases. Damages on the original ki by the abdominal surgery lead to a disease. Pale complexion, long face and the long limbs are considered as the Hyungsang of deficiency of Jung ki by Jeesan. Clinical cases of Bojungikki-tang in Hyungsang medicine draw the following conclusions ; Bojungikki-tang is usually prescribed to the person who has one of the following Hyungsang : Bangkwang type, pale complexion, long face, short-sight, astigmatism and wrinkles on face. Bojungikki-tang can be applied to the every disease caused by the deficiency of original ki regardless of name and symptoms of disease.

• 한국임상수의학회지
• /
• 제37권2호
• /
• pp.106-108
• /
• 2020

An eight-month-old, outdoor, intact male English Pointer dog weighing 23.5 kg presented to the hospital with signs of hematochezia, soft stools, and weight-loss. There were no remarkable findings on physical examination, complete blood count, serum biochemistry, electrolyte and gas analysis, and radiography. The serologic and Polymerase Chain Reaction (PCR) tests for canine parvovirus were negative. A fecal smear examination showed rod-shaped, sporeforming bacteria. Additionally, a fecal flotation test showed ova of Ancylostoma spp. The size of ova was 60 × 40 ㎛, and it was identified as Ancylostoma caninum using light microscopy. The PCR test indicated a Clostridial perfringens infection and the presence of C. perfringens alpha toxin. The diagnosis given was C. perfringens enterotoxicosis with ancylostomiasis. Treatment included antibiotics (metronidazole, trimethoprim-sulfamethoxazole) and anthelmintics (afoxolaner, milbemycin oxime). After two weeks, the clostridial infection resolved, but ancylostomiasis persisted for six weeks. The anthelmintic was changed to Drontal^â plus (praziquantel/pyrantel pamoate/febantel). After four weeks, there were no remarkable findings in the fecal samples, but the patient still presented with watery stools and hematochezia. Survey of abdominal ultrasound had performed, and a target-like sign with multiple rings was seen in the cecocolic region. The patient was diagnosed with A. caninum-induced cecocolic intussusception from the history and clinical signs. After a surgery, he recovered fully. This is the first clinical case report of Ancylostoma caninum parasitizing from the small intestine and causing an intussusception in the large intestine.

• The Korean Journal of Pain
• /
• 제12권1호
• /
• pp.70-74
• /
• 1999

Background: Preemptive analgesia has been suggested recently as an another technique of postoperative pain control. Combination of low dose opioid and NSAIDs was used to lessen systemic opioid side effect, however, the use of NSAIDs may hinder their side effects in perioperative period. The local application of small dose at the target site can be effective without systemic effect. The aim of this study is evaluating the additive effect and side effect of transdermal piroxicam as preemptive adjuvant to intravenous nalbuphine on pain relief after major abdominal surgery. Methods: We reviewed the records of patients received piroxicam patch for preemptive analgesia before operation and compared it with control group. Two sheets of piroxicam patch to the skin incision site for 12 hours before operation were attached (Group 1, n=20) and no patch were applied (Group 2, n=20). Both groups were received nalbuphine continuously after operation using two days infuser (2 ml/hr) containing 80 mg (96 ml). Pain is evaluated by VAS score at each time; 30 min, 1, 6, 12, 24, 36, 48 hours after operation and side effects of NSAIDs were observed for 3days postoperatively. Results: There was no significant VAS score difference between two groups following time in progress. And no significant side effect was noted in both groups, either. Conclusion: There is no preemptive or synergistic analgesic effect of piroxicam patch attached at planned operation site before operation.

• Tuberculosis and Respiratory Diseases
• /
• 제68권6호
• /
• pp.358-362
• /
• 2010

Intralobar pulmonary sequestration is a rare congenital lung anomaly. It is defined as a portion of nonfunctioning lung parenchyma that receives its blood supply from an anomalous systemic artery. Patients often present with chronic or recurrent pneumonia. A chest radiograph may show a cystic lesion with air-fluid levels in the lung base. A high index of suspicion is needed for a diagnosis. Surgical removal of a symptomatic intralobar pulmonary sequestration is generally the treatment of choice. Identifying the aberrant artery is a difficult problem when resecting a pulmonary sequestration. The thoracic and abdominal aortas are the most common origins for the abnormal blood supply. However, arterial supply from the celiac artery is quite rare. We present a case of intralobar pulmonary sequestration with the blood supply originating from the celiac artery.

• 한국임상수의학회지
• /
• 제26권3호
• /
• pp.268-272
• /
• 2009

An-11-year-old male Shih-tzu was admitted to emergency care unit of Haemaru Referral Animal Hospital with signs of dyspnea, anuria and depression. There were abnormalities on complete blood count and serum chemistry included leukocytosis with mild left shift, mild azotemia, and increased ALT activity. Fluid therapy(0.9% saline, 40 ml/hr) and antibiotics were immediately initiated. The patient began to vomit after 5 hours' rest and pale mucous membrane, bradycardia, and hypertension were noted. Abdominal ultrasonography revealed enlarged left adrenal gland and thrombus in caudal vena cava(CVC). Result of ACTH stimulation test was normal. Cytology of ultrasound-guided FNA smears showed numerous naked nuclei, which was suggestive of adrenal medullar tumor. Concentrations of 24 hour urine metanephrine and normetanephrine was moderately increased compared to those of a control dog. Adrenal mass was surgically removed, and biopsy of the CVC mass was obtained. After surgery the patient began to recover but the dog acutely developed cardiopulmonary arrest and died. On histopathology the adrenal mass and biopsy of the CVC mass were consistent with pheochromocytoma. On electron microscopic view norepinephrine specific granules were found in the cytoplasm of tumor cells.

• 한국임상수의학회지
• /
• 제27권5호
• /
• pp.605-609
• /
• 2010

10년령의 중성화 암컷 요크셔 테리어가 구토와 식욕부진으로 내원하였다. 신체검사, 혈액검사 및 복부 방사선 초음파검사와 컴퓨터단층촬영 검사 결과 췌장염, 간신증후군을 동반한 폐쇄성 총담관결석으로 진단되었다. 수술적으로 총담관결적을 제거하였으나, 10일 후 사망하였다. 본 증례를 통하여 담낭절제술을 한 환자에서 재발성 담관 결석, 췌장염과 같은 합병증에 대한 정기적인 모니터링이 필요하고, 진단 및 수술에 대한 정확한 평가를 위해 CT가 유용함을 알수 있었다.

• Journal of Korean Biological Nursing Science
• /
• 제19권2호
• /
• pp.76-85
• /
• 2017

Purpose: The purpose of this study was to compare the effects of $21^{\circ}C\;CO_2$ and $37^{\circ}C\;CO_2$ pneumoperitoneum on body temperature, blood pressure, heart rate, and acid-base balance. Methods: Data were collected at a 1300-bed university hospital in Incheon, from February through September 2012. A total of 74 patients who underwent laparoscopic colectomy under general anesthesia with desflurane were randomly allocated to either a control group or an experimental group. The control group received $21^{\circ}C\;CO_2$ pneumoperitoneum; the experimental group received $37^{\circ}C\;CO_2$ pneumoperitoneum. The pneumoperitoneum of the two groups was under abdominal pressure 15 mmHg. Body temperature, systolic blood pressure, heart rate and acid-base balance were assessed at 30 minutes and 90 minutes after pneumoperitoneum, and again at 30 minutes after arriving at the Post Anesthesia Care Unit. Results: Body temperature in the $37^{\circ}C\;CO_2$ pneumoperitoneum group was significantly higher (F= 9.43, p< .001) compared to the $21^{\circ}C\;CO_2$ group. However, there were no statistically significant differences in systolic blood pressure (p= .895), heart rate (p= .340), pH (p= .231), PaCO2 (p= .490) and HCO3- (p= .768) between the two groups. Conclusion: Pneumoperitoneum of $37^{\circ}C\;CO_2$ is effective for the increase of body temperature compared to pneumoperitonium of $21^{\circ}C\;CO_2$, and it does not result in a decrease of blood pressure, heart rate or acid-base imbalance.

• Tuberculosis and Respiratory Diseases
• /
• 제46권3호
• /
• pp.409-413
• /
• 1999

Malignant melanoma develops from the melanocyte and the most common primary site is skin, followed by mucosa and retina. Even though any other tissue where melanocytes reside could be the primary site of the malignant melanoma, the one developed in the mediastinum is rarely reported. We experienced a patients of 54 years old woman whose initial symptom was progressive dyspnea for one month, and proved to have the anterior mediastinal mass with pleural effusion and the small mass in the abdominal soft tissue. The needle aspiration biopsy from the mediastinal mass showed the consistent findings with malignant melanoma. We concluded the mediastinum was the primary site of the malignant melanoma of this patient because we couldn't find any other evidence of primary tumor in skin, oral and gastrointestinal mucosa, and retina. She has been treated with combined chemotherapy with dacarbazine, cisplatin and vinblastine. Her symptom was improved after chemotherapy and follow up chest CT after three cycles of chemotherapy showed the decreased tumor size in the mediastinum.