Mohamed Fares Mahjoubi;Anis Ben Dhaou;Mohamed Maatouk;Nada Essid;Bochra Rezgui;Yasser Karoui;Mounir Ben Moussa
Annals of Hepato-Biliary-Pancreatic Surgery
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v.27
no.4
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pp.388-393
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2023
Backgrounds/Aims: Acute cholecystitis is a rare condition in pregnant women, potentially affecting the maternal and fetal prognosis. Our aim was to report the main clinical and paraclinical features of acute cholecystitis during pregnancy and therapeutic modalities. Methods: We conducted a case series analysis recording pregnant patients with acute cholecystitis admitted to our surgery department over a period of 11 years. We collected clinical data, paraclinical features, and management modalities related to cholecystitis. Results: There were 47 patients. Twenty-eight percent was in the first trimester of pregnancy, 40% in the second, and 32% in the third trimester. Abdominal pain was located in the right hypochondrium in 75% of cases. Fever was noted in 21% of cases. C-reactive protein was elevated in 39% of patients. Cholestasis markers were high in four patients. Abdominal ultrasound showed a distended gallbladder in 39 patients, with thickened wall in 34 patients, and gallbladder lithiasis in all cases. No patient had a dilated main bile duct. All patients received intravenous antibiotic therapy. Tocolysis was indicated in 32 patients. Laparoscopic cholecystectomy was performed in 32 cases (68%), and open cholecystectomy in 15 cases (32%). Postoperative course was uneventful in 42 patients, and complicated in 5 patients. Rate of complications was statistically higher after open cholecystectomy (p = 0.003). Morbidity rate was higher in the third trimester (p = 0.003). Conclusions: Delay in the diagnosis of acute cholecystitis during pregnancy can lead to serious complications. Management is based on antibiotic therapy and cholecystectomy. Laparoscopic cholecystectomy appears to be less morbid than open cholecystectomy.
Sunny Kang;Ju-hwan Song;Sang-ho Ji;Cheol-hyun Kim;Sang-kwan Lee
The Journal of Internal Korean Medicine
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v.44
no.6
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pp.1318-1326
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2023
Introduction: Pressure ulcers, often found in patients with mobility issues, particularly elderly patients, are increasing in prevalence. Their treatment is complex, with recovery more challenging in advanced stages, and certain factors can delay healing. Case Presentation: An 87-year-old male developed a grade IV pressure ulcer on his left greater trochanter following lumbar fractures and subsequent percutaneous vertebroplasty in 2021. Despite potential surgical recommendations, his treatment consisted of daily wet dressings, acupuncture from July 2021 to February 2022, and Gami-sipjeondaebo-tang beginning August 2021. The ulcer, initially measuring 6 cm×6 cm and showing a red wound without necrosis, healed completely and showed no signs of recurrence as of August 2023. Conclusion: A grade IV pressure ulcer was effectively treated using wet dressing, acupuncture, and Gami-sipjeondaebo-tang, demonstrating no recurrence over a 1.5-year period.
Purpose : As a result of advances in neonatal intensive care and perinatal care, neurodevelopmental outcomes of very low birth weight infant(VLBWIS) is expected to lead to improvement. The aim of this study was to report neurodevelopmental outcomes and risk factors of neurologic impairment of very low birth weight infants during the past 10 years. Method : We performed a retrospective study of 447 newborn infants below 1,500 gm admitted to neonatal intensive care unit of Taegu Fatima Hospital between Janury 1996 and December 2004. Infants were subdivided into group 1(Jan. 1996 to Dec. 1998), group 2(Jan. 1999 to Dec. 2001), and group3(Jan. 2002 to Dec. 2004). We analyzed epidemiologic data to study changes of neurodevelopmental outcomes and risk factors of neurologic impairment. Result : The incidence of cerebral palsy and developmental delay decreased significantly in periods 2 and 3(vs period 1; cerebral palsy 10 percent, developmental delay; 18 percent, P<0.05). Periventricular leukomalacia incidence decreased in period 3(vs period 1; 14.5 percent, P<0.05). The overall survival rate of VLBWIS increased significantly in period 2 and 3(vs period 1; 90.0 percent, P<0.05). The risk factors of neurologic impairment are long-term ventilator care(above 1 wk), low Apgar score, low gestational age and low birth weight. Conclusion : In the most recent 10 years, neurologic impairments of VLBWIS significantly decreased, as a result of advances in neonatal intensive care and perinatal care.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.18
no.1
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pp.10-15
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2007
Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.
Lee, Jin Sook;Kim, Man Jin;Kim, Soo Yeon;Lim, Byung Chan;Kim, Ki Joong;Choi, Murim;Seong, Moon-Woo;Chae, Jong-Hee
Journal of Genetic Medicine
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v.16
no.2
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pp.55-61
/
2019
Purpose: Genetic defects in the nuclear-encoded mitochondrial aminoacyl-tRNA synthetases were first identified as causes of various disorders in 2007. Variants in IARS2, which encodes a mitochondrial isoleucyl-tRNA synthetase, were first reported in 2014. These variants are associated with diverse phenotypes ranging from CAGSSS (CAtaracts, Growth hormone deficiency, Sensory neuropathy, Sensorineural hearing loss, and Skeletal dysplasia) and Leigh syndrome to isolated nonsyndromic cataracts. Here, we describe the phenotypic and genetic spectrum of Korean patients with IARS2-related disorders. Materials and Methods: Using whole-exome sequencing followed by Sanger sequencing, we identified five patients with IARS2 mutations. Their medical records and brain magnetic resonance images were reviewed retrospectively. Results: All five patients presented with developmental delay or regression before 18 months of age. Three patients had bilateral cataracts, but none had hearing loss or sensory neuropathy. No evidence of skeletal dysplasia was noted, but two had short stature. One patient had cardiomyopathy and another exhibited renal tubulopathy and hypoparathyroidism. Their brain imaging findings were consistent with Leigh syndrome. Interestingly, we found the recurrent mutations p.R817H and p.V105Dfs*7 in IARS2. Conclusion: To our knowledge, this is the first report of Korean patients with IARS2-related disorders. Our findings broaden the phenotypic and genotypic spectrum of IARS2-related disorders in Korea and will help to increase clinical awareness of IARS2-related neurodegenerative diseases.
Kim, Ji-Hee;Choi, Byung-Jai;Lee, Jae-Ho;Son, Heung-Kyu;Kim, Seong-Oh;Choi, Hyung-Jun
Journal of the korean academy of Pediatric Dentistry
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v.36
no.1
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pp.96-101
/
2009
Regional odontodysplasia(ROD) is relatively rare localized developmental anomaly of tooth formation in which hard tissue is affected. The maxilla is typically affected than the mandible, and especially the maxillary left quadrant is the most commonly involved. Females are affected twice as often as males, and there is no association with race. Its etiology remains undetermined, but local circulatory disorders, somatic mutations, virus infections, local trauma, hyperpyrexia, irradiation, metabolic disturbances, and hereditary transmission are considered as possible etiologic factors. The affected teeth are likely to be small, hypoplastic, brown, and grooved. Eruption failure or delay is frequently seen as well as abscess or fistulae formation in absence of caries. Radiographically, there is a lack of contrast between the enamel and dentin, both of which are less radiopaque than unaffected counterparts. Moreover, enamel and dentin layers are thin, giving the teeth a “ghost-like appearance”. The pulp chambers and canals are large, the roots seem like to be short and indistinct. A 2-year-3-month old boy came to the department of pediatric dentistry, Yonsei University, with the chief complaint of delayed eruption and abnormal tooth shape on the lower left quadrant. He was diagnosed as regional odontodysplasia based on the clinical and radiographic findings.
A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.
Multicast Protocol for multimedia service on the Internet can be classified into two types, e.g., source based tree and shared tree according to difference of tree construction method. Shared tree based multicast is known to show outstanding results in the aspect of scalability than source based tree. Generally, There have been lots of researches on the method to satisfy QoS constraints through proper Rendezvous Point (RP) in the shared tree. In addition, as the multicast group members join and leave dynamically in the service time, RP of the shared tree should b be reselected for guranteeing Qos to new member, But, RP reselection method has not been considered generally as the solution to satisfy QoS C constraints. In this paper, new initial RP selection and RP reselection method are proposed, which utilize RTCP (Real Time Control Protocol) report packet fields. Proposed initial RP selection and RP reselection method use RTCP protocol which underlying multimedia application service So, the proposed method does not need any special process for collecting network information to calculate RP. New initial RP selection method s shows better performance than random and topology based one by 40-50% in simulation. Also, RP reselection method improves delay p performance by 50% after initial RP selection according to the member’s dynamicity.
This paper implements a web - based production monitoring system that can be used efficiently by small - scale manufacturers. Small-scale enterprises, especially small-sized enterprises with less than 5 employees, need an efficient production management system because productivity is important. However, in reality, the manager and the worker verbally report work orders and production, and when one of the members is absent, the delay in the work process increases. If the time required for the work process increases, the productivity will be affected and the sales of the enterprise will be affected. In this paper, we have designed and implemented a web - based production monitoring system that can be used efficiently by small - sized manufacturers with less than 5 employees. We implemented a web based browser to operate with only a browser and applied the UI for convenience of the field worker. The proposed system is applied to less than 5 automobile parts manufacturers and the system effectiveness is confirmed. The system can be economically applied to more small enterprises with only a few modifications according to the products of each company.
Asia-Pacific Journal of Business Venturing and Entrepreneurship
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v.12
no.1
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pp.25-31
/
2017
The objective of this study is to find the failure factors of venture companies. We analyze 210 troubled venture companies, all of which have been under guarantee from the Korea Technology Finance Corporation over the last three years. Methods of analysis for failure factors are as follows. First, we categorize the failure factors into the four different types based on growth and profitability indicators in the financial statements of targeted venture companies. Then we analyzed the failure factors of the subject companies based on the troubled guarantee reports made by the Korea Technology Finance Corporation. If a venture company under its guarantee program falls into insolvency, the Korea Technology Finance Corporation make the troubled guarantee report to find out the failure factors and evaluate the recovery potentials. We identify 374 failure factors of venture companies through the analysis. The most prominent among them are deteriorating of business environments (79 factors) and decreasing or withdrawing orders from major suppliers (54 factors) due to bankruptcies or change in business plans. They are followed by slowing collection of accounts receivable (31 factors), dropping or frozen product price (24 factors) due to intensifying competition and escalating pressures from major suppliers, rising raw material costs both at home and abroad (21 factors). In addition, the nuclear power plant disaster in Japan, shut-down of the Kaesong Industrial Complex and subsequent lawsuits, delay in technology development projects, high cost-low efficiency management structure, etc., are also revealed as new factors causing trouble for venture companies.
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