• 제목/요약/키워드: Disseminated intravascular coagulation

검색결과 59건 처리시간 0.033초

정상 면역 성인에서 발생한 수두 폐렴 1예 (Varicella-Zoster Virus Pneumonia in Immunocompetent Adults)

  • 오지연;최정우;김세중;신철;김제형
    • Tuberculosis and Respiratory Diseases
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    • 제71권4호
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    • pp.291-295
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    • 2011
  • Varicella, more commonly known as chickenpox, is caused by the varicella-zoster virus. It is a common benign childhood illness. In adults, Varicella is uncommon but is more severely associated with complications including pneumonia, hepatitis, disseminated intravascular coagulation, encephalitis and myocarditis. A serious and life-threatening complication is the development of varicella-zoster virus pneumonia (VZVP). Although VZVP is well described in immunocompromised hosts, it is rarely seen in immunocompetent adults. The VZVP in healthy adults is more prevalent in cigarette smokers and during pregnancy. However, reports of VZVP in healthy adults are scarce in Korea. The authors report here a case of VZVP in an immunocompetent adult and present a literature review.

구강저에 발생한 편평세포암에서 심장골회선동맥피판을 이용한 재건의 치험례 (Reconstruction with Deep Circumflex Iliac Artery Flap on Squamous Cell Carcinoma on the Floor of the Mouth: Case Report)

  • 장한성;김수관;문성용;오지수;윤영은
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권6호
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    • pp.525-528
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    • 2011
  • A deep circumflex iliac artery (DCIA) flap is usually used for reconstruction in oral and maxillo-facial surgery department since introduced by O'Brien in 1975. Various flap designs are possible for osteomusculocutaneous, musculocutaneous, musculosseous and vascularized bone types. Iliac crest shape is similar to contour of mandible. Moreover, though a fibular flap has only 15~20 mm of cutting plane width, a DCIA flap contains much more bone amount, making this a similar reconstruction compare with normal mandible. A 68 year-old male with squamous cell carcinoma on the anterior floor of the mouth had an impression with T2N0Mx and the treatment procedure was DCIA reconstruction after wide resection and marginal mandibulectomy, with both supraomohyoid neck dissection. We present an experience of DCIA flap for reconstruction with a literature review.

소아 장티푸스에서 병발된 사구체 신염 (A Case of Childhood Typhoid Fever Complicated with Acute Nephritis)

  • 오은민;심지현;황지현;임형은;김윤경
    • Pediatric Infection and Vaccine
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    • 제22권1호
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    • pp.36-39
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    • 2015
  • 장티푸스는 10-15%에서 수막염, 폐렴, 심근염, 간염, 골수염, 파종성 혈관내 응고병증등의 심각한 합병증을 유발할수 있다. 소아에서 장티푸스 병발 후 신장에 발생되는 합병증은 국내외 모두 매우 드물다. 우리는 장티푸스 병발후 단백뇨, 고혈압, 신기능 저하가 동반된 급성 사구체 신염 케이스를 경험후 보고하는 바이다. 이 케이스는 대변 배양검사에서 병원체를 확인할 수는 없었지만 상승하는 Widal 수치로 장티푸스를 진단할 수 있었다. 장티푸스는 유병률은 감소하였지만 고열이 있는 경우 여전히 고려해보아야 하는 중요한 질환이다.

인터페론 투여 후 완전 절제를 시행한 거대 선천성 간내 혈관내피종 (A Congenital Giant Hepatic Hemangioendothelioma Treated with Interferon-$\alpha$ and Complete Tumor Resection)

  • 조민아;유재은;박문성;박준은;홍정;김영배
    • Neonatal Medicine
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    • 제15권2호
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    • pp.183-189
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    • 2008
  • 신생아의 선천성 거대 간내 혈관내피종을 복부 단층 촬영과 $^{99m}Tc$-RBC 간스캔을 통해 진단하고, 대증요법과 함께 IFN$\alpha$를 11개월간 단독으로 피하 투여하여 크기 감소를 유도한 후 남은 병변의 완전한 수술적 제거와 조직학적 확진을 시행하였음을 보고하는 바이다.

In situ Hybridization에 의한 토끼출혈증(rabbit haemorrhagic disease)의 신속.간편한 진단 (Rapid and Easy Diagnosis of Rabbit Haemorrhagic Disease by In Situ Hybridization)

  • 박남용;조호성;조경오;김상집;박형선
    • 한국수의병리학회지
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    • 제5권2호
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    • pp.57-62
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    • 2001
  • Recently various molecular diagnostic techniques have been used to identify rabbit hemorrhagic disease virus (RHDV), a causative agent responsible for acute hepatitis and disseminated intravascular coagulation in rabbit. But they were hard to perform and time consuming. To detect RHDV in a rapid and easy way, we developed biotinylated oligonucleotide probe within ORF 1 region encoding the polyprotein of RHDV in formalin-fixed and paraffin-embedded tissues from various tissues of 20 rabbits naturally infected with RHDV, Our in situ hybridization (ISH) was quickly carried out within two hours by MicroProbe capillary action system. The ISH produced a positive reaction in liver, kidney and lung. In conclusion, ISH with a biotintlated oligonucleotide probe provided a useful diagnostic method for detecting RHDV.

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빙초산 음독과 합병된 간괴사 1례 (A Case Report of Glacial Acetic Acid Ingestion Complicated with Hepatic Necrosis)

  • 경연영;이미진;최승필;박규남;이원재;김세경
    • 대한임상독성학회지
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    • 제2권1호
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    • pp.23-26
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    • 2004
  • Caustic ingestion can produce a progressive and fatal injuries to esophagus, stomach and other organs. Reported exposure to acetic acid results injuries to gastrointestinal tract, hemolysis and disseminated intravascular coagulation is general, but causing hepatic necrosis by direct injuries are rare. A 47-year-old man visited our emergency medical center complaining odynophagia and abdominal pain after ingesting glacial acetic acid ($99\%$) with suicidal ideation. At the time of arrival, the patient complained mild abdominal pain but a few hours later the patient complained severe abdominal pain with markedly elevated liver enzymes. The Abdominal Computerized Tomography showed diffuse gastric wall edema and density of wedge shaped hypodense area in right hepatic dome showing focal hepatic necrosis without significant inflammation. This seems likely to be a direct effect of the noxious agent on hepatocyte involving the portal circulation.

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일개 상급종합병원 응급중환자실 내 심정지 후 저체온요법을 적용한 환자의 말초 청색증 발생 현황 (Incidence of Peripheral Cyanosis in Patients with Therapeutic Hypothermia after Cardiac Arrest in the Acute Care Unit of a Tertiary General Hospital)

  • 방수연;이영희
    • 중환자간호학회지
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    • 제14권3호
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    • pp.128-140
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    • 2021
  • Purpose : This study aimed to identify the incidence of peripheral cyanosis and the characteristics and clinical results of patients with therapeutic hypothermia after a cardiac arrest. Methods : Data were collected from April to June 2021 via the electrical medical records of 95 patients with therapeutic hypothermia for 72 hours after a cardiac arrest admitted to an acute care unit at a tertiary hospital between January 1, 2016, and December 31, 2019. The data were analyzed using descriptive statistics and a t-test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, and logistic regression using SPSS/WIN. Results : The incidence of peripheral cyanosis was 20%. In the peripheral cyanosis group, peripheral vascular disease, fibrinogen, vasopressor, infection, disseminated intravascular coagulation, acute physiology, chronic health evaluation II score on the second hospital day, nursing intervention, and mortality on the seventh hospital day were higher. The level of fibrinogen and use of vasopressors affected the occurrence of peripheral cyanosis. Conclusion : Considering the influencing variables, careful observation is necessary for patients with high fibrinogen levels and vasopressor use. These results provide basic data to recognize the need for nursing intervention for peripheral cyanosis and encourage nurses to deliver them during therapeutic hypothermia.

Association of vitamin D deficiency with clinical outcomes in critically ill Korean children

  • Jhang, Won Kyoung;Kim, Da Hyun;Park, Seong Jong
    • Nutrition Research and Practice
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    • 제14권1호
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    • pp.12-19
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    • 2020
  • BACKGROUND/OBJECTIVES: Vitamin D is a pleiotropic hormone that affects various body organ systems. We evaluated the prevalence of a vitamin D deficiency (VDD) and its potential role in the clinical condition of critically ill Korean children. SUBJECTS/METHODS: Patients under 18 years old with a 25(OH) vitamin D measurement on the first day of PICU admission were included from among the children admitted to the pediatric intensive care unit (PICU) of our tertiary children's hospital between October 2017 and January 2019. RESULTS: A total of 172 pediatric patients were enrolled. The mean 25(OH) vitamin D level was 17.5 ± 12.8 ng/mL. There was a 65.1% prevalence of VDD (25(OH) vitamin D level < 20 ng/mL). VDD was associated with age at PICU admission, gastrointestinal/hepatobiliary disorders, International Society of Thrombosis and Hemostasis disseminated intravascular coagulation (ISTH DIC) score, pediatric multiple organ dysfunction syndrome (pMODS) score and with several laboratory test findings including hemoglobin, platelet, C-reactive protein, serum albumin, total bilirubin, prothrombin time, and anti-thrombin III levels. Most of these parameters also showed significant linear correlations with the 25(OH) vitamin D level (P < 0.05). However, no statistically meaningful association was found between VDD and other clinical conditions such as the need for a mechanical ventilator, requirement for vasoactive drugs, duration of the PICU and hospital stays, or PICU mortality. CONCLUSION: There is a high prevalence of VDD in critically ill Korean children. There were significant associations between the 25(OH) vitamin D level and gastrointestinal/hepatobiliary disorders, the pMODS score and with coagulation related factors. Further large-scale studies with more specific subgroup analyses are required to more precisely assess the clinical implications of VDD in critically ill pediatric patients.

치성감염으로 인한 패혈증: 증례보고 (Sepsis Developed from an Odontogenic Infection: Case Report)

  • 김문섭;김수관;문성용;오지수;박진주;정미애;양석진;정종원;김정선
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권5호
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    • pp.445-448
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    • 2011
  • Mortality associated with maxillofacial infection is relatively low due to the development of antibiotics, and improved oral care. However, inappropriate treatment, delayed treatment, old age, underlying systemic disease, and drug-resistant microorganisms can potentially result in life threatening situations such as cavernous sinus thrombosis, mediastinitis, and sepsis. Sepsis is the most dangerous state with high mortality, ranging from 20~60%. The treatment of sepsis involves properly monitoring vital functions, fluid resuscitation, surgical drainage, and empirical use of high doses of antibiotics until culture results are available. Ventilatory support maybe be required as well. We encountered a 64-year-old patient who died from sepsis that developed as the result of an odontogenic infection. The initial diagnosis was right temporal, infraorbital, buccal, pterygomandibular space abscess. Despite surgical and medical supportive care, the condition progressed to sepsis and after four days the patient died due to multiple organ failure.

항정신병약물악성증후군에 동반한 횡문근융해증으로 인한 급성 신부전 1례 (A Case of Acute Renal Failure due to Rhabdomyolysis Associated with Neuroleptic Malignant Syndrome)

  • 박규희;정성관;임형은;유기환;홍영숙;이주원
    • Childhood Kidney Diseases
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    • 제13권2호
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    • pp.267-270
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    • 2009
  • 항정신병약물악성증후군은 항정신병약물의 사용과 관련하여 드물게 발생하는 부작용으로 생명을 위협하는 질환으로 의식변화, 고열증, 근육강직의 특징적 증상을 보인다. 항정신병약물악성증후군 환자에서 고열증과 근육강직으로 인하여 횡문근융해증이 발생하여 합병증으로 급성 신부전이 생기는 경우가 드물게 발생하며 심한 경우 투석 등의 치료가 필요하며 생명에 위협이 되므로 빠른 진단과 치료가 요구된다. 저자들은 소아에서 보고되지 않던 항정신병약물악성증후군에 동반하여 횡문근융해증을 보인 급성 신부전의 예를 경험하였기에 보고하는 바이다.