• 제목/요약/키워드: Multi-organ failure

검색결과 44건 처리시간 0.031초

대동맥궁 단절을 동반한 Taussig-Bing 기형에서 새로운 일차적 완전 교정술 - 1례 보고 - (A New Method of One Stage Correction of Taussig-Bing Anomaly with Interrupted Aortic Arch -1 case report-)

  • 정종필;서동만
    • Journal of Chest Surgery
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    • 제30권1호
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    • pp.83-87
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    • 1997
  • Tausslg-Bing 기형은 드물게 대동맥궁 중단과 병발되며, 이 경우 양대혈관의 크기 가 현저히 달라 대동맥 전환술을 시행함에 어려움이 있다. 생후 20일 된 환아가 상기 진단으로 내원하여, 다장기부전에 대한 3주간의 집중관리 후 수술을 받았다. 수술은 심실중격 결손의 복원, 대동맥 전환술 및 광범위한 대동맥궁형성술로 이루어졌으며, 대혈관들의 크기 차이는 상행 및 하행 대동맥의 절편을 이용하여 원위신대동맥(distal neoaorta)를 형성하므로써 극복하였다. 환아는 큰 문제 없이 회복하였으며, 수술후 시행한 심도자상의 결과도 양호한 상태로 16개월간 추적 관찰중이다.

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Human umbilical cord mesenchymal stem cell-derived mitochondria (PN-101) attenuate LPS-induced inflammatory responses by inhibiting NFκB signaling pathway

  • Yu, Shin-Hye;Kim, Soomin;Kim, Yujin;Lee, Seo-Eun;Park, Jong Hyeok;Cho, Gayoung;Ha, Jong-Cheon;Jung, Hahnsun;Lim, Sang-Min;Han, Kyuboem;Lee, Hong Kyu;Kang, Young Cheol;Kim, Chun-Hyung
    • BMB Reports
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    • 제55권3호
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    • pp.136-141
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    • 2022
  • Inflammation is one of the body's natural responses to injury and illness as part of the healing process. However, persistent inflammation can lead to chronic inflammatory diseases and multi-organ failure. Altered mitochondrial function has been implicated in several acute and chronic inflammatory diseases by inducing an abnormal inflammatory response. Therefore, treating inflammatory diseases by recovering mitochondrial function may be a potential therapeutic approach. Recently, mitochondrial transplantation has been proven to be beneficial in hyperinflammatory animal models. However, it is unclear how mitochondrial transplantation attenuates inflammatory responses induced by external stimuli. Here, we isolated mitochondria from umbilical cord-derived mesenchymal stem cells, referred as to PN-101. We found that PN-101 could significantly reduce LPS-induced mortality in mice. In addition, in phorbol 12-myristate 13-acetate (PMA)-treated THP-1 macrophages, PN-101 attenuated LPS-induced increase production of pro-inflammatory cytokines. Furthermore, the anti-inflammatory effect of PN-101 was mediated by blockade of phosphorylation, nuclear translocation, and trans-activity of NFκB. Taken together, our results demonstrate that PN-101 has therapeutic potential to attenuate pathological inflammatory responses.

국내 급성 dichlorvos 중독 현황과 임상상 분석 (Clinical Characteristics of Acute Dichlorvos Poisoning in Korea)

  • 이미진;박준석;권운용;어은경;오범진;이성우;서주현;노형근
    • 대한임상독성학회지
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    • 제6권1호
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    • pp.9-15
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    • 2008
  • Purpose: Dichlorvos has been in widespread use as an organophosphate (OP) insecticide compound. The purpose of this study was to access the epidemiology and clinical features of dichlorvos in Korea. Methods: This was a 38 multi-center prospective study of dichlorvos poisoning using surveys, a structural reporting system and review of hospital records from August 2005 to July 2006. A total of 54 patients with acute dichlorvos poisoning on a national basis were enrolled. We analyzed the epidemiologic characteristics and clinical manifestations of dichlorvos poisoning. In addition, the clinical features of dichlorvos poisoning were compared with others OP compounds. Results: During the study period, compounds involving pure OP poisoning were dichlorvos (22.7%), methidathion (8.4%), and phosphamidon (6.7%). In acute dichlorvos poisoning, all ingestion routes were oral. Intentional poisoning involved 74.1% of cases. The common initial complaints involved gastrointestinal (64.8%), systemic (61.1%), central or peripheral nervous system (53.7%), and respiratory symptoms (50.0%). The median arrival time to hospital after dichlorvos poisoning was 2.6 hours and mean hospitalization duration was 7.1 days. 2-PAM was administered in 35 patients in mean doses of 6.3 g/day intravenously. Atropine was administered in 30 patients with a mean dose of 62.8 mg/day (maximal 240 mg/day). Overall mortality rate for dichlorvos poisonings were 14.8% (8/54). Immediate causes for death included sudden cardiac arrest or ventricular dysrhythmias (50%), multi-organ failure (25%), acute renal failure (12.5%), and unknown causes (12.5%). Conclusion: When compared to previous reports, dichlorvos poisoning displayed relatively moderate severity. The presence of a lower GCS score, altered mental status, serious dysrhythmias, systemic shock, acute renal failure, and respiratory complications upon presentation were associated with a more serious and fatal poisoning.

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Liver transplantation in pediatric patients with progressive familial intrahepatic cholestasis: Single center experience of seven cases

  • Jung-Man Namgoong;Shin Hwang;Hyunhee Kwon;Suhyeon Ha;Kyung Mo Kim;Seak Hee Oh;Seung-Mo Hong
    • 한국간담췌외과학회지
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    • 제26권1호
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    • pp.69-75
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    • 2022
  • Backgrounds/Aims: Progressive familial intrahepatic cholestasis (PFIC) is an autosomal recessive inherited disease requiring liver transplantation (LT). The objective of this study was to investigate the clinicopathological features and posttransplant courses of seven LT recipients with PFIC. Methods: This was a retrospective single-center study of patients with PFIC who underwent LT from January 2013 to June 2020. Results: Two and five patients were diagnosed with PFIC type 1 and type 2, respectively. For all seven patients, age of PFIC onset was at birth. Jaundice was present in all cases. Mean pretransplant total and direct bilirubin levels were 16.1 ± 8.1 mg/dL and 12.4 ± 6.2 mg/dL, respectively. Median patient age and body weight at LT were 10 months and 7 kg, respectively. Types of donors were mothers of patients in four and deceased donors in three. All five patients with PFIC type 2 recovered uneventfully. One patient each with PFIC type 1 underwent retransplantation due to graft failure or died due to multi-organ failure. Overall graft and patient survival rates at five years were 66.7% and 83.3%, respectively. Bile salt export pump immunohistochemical staining showed normal canalicular expression in two patients with PFIC type 1, focal loss in two patients with PFIC type 2, and total loss in three patients with PFIC type 2. Conclusions: LT is currently the only effective treatment for PFIC-associated end-stage liver diseases. It is mandatory to perform regular follow-up due to the risk of complications including steatohepatitis, especially for patients with PFIC type 1.

The Role of Radiosurgery in Patients with Brain Metastasis from Small Cell Lung Carcinoma

  • Jo, Kwang-Wook;Kong, Doo-Sik;Lim, Do-Hoon;Ahn, Yong-Chan;Nam, Do-Hyun;Lee, Jung-Il
    • Journal of Korean Neurosurgical Society
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    • 제50권2호
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    • pp.99-102
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    • 2011
  • Objective : The purpose of this retrospective study was to evaluate the outcome of gamma knife radiosurgery (GKRS) and/or whole brain radiation therapy (WBRT) for the treatment of small cell lung carcinoma (SCLC) metastasis to the brain. Methods : From 2000 to 2010, 50 patients underwent GKRS for metastatic brain lesions originating from SCLC. Among these patients, 11 received prophylactic cranial irradiation (PCI) before the development of metastatic lesions (PCI group), and GKRS was performed as an initial treatment for newly diagnosed lesions in 12 patients who had not received PCI (primary GKRS group). In addition, GKRS was performed as a salvage treatment for progressive lesions after WBRT in 27 patients (salvage GKRS group). The medical records and imaging data of all patients were retrospectively analyzed. Results : The overall survival of the 50 patients was 20.8 months (range 1-53) after the diagnosis of primary tumor and 12.0 months (range 1-47) after the development of cerebral metastasis. Median survival after GKRS was 4.8 months (range 1-15) in the PCI group, 4.6 months (range 0-18) in the primary GKRS group, and 7.6 months (range 0-33) in the salvage GKRS group. Further treatment for progressive lesions after GKRS was necessary in 15 patients, after a mean interval of 3.8 months. Causes of death were systemic organ failure in 15 patients, deterioration of neurological state in 13 patients, and unknown or combined causes in 16 patients. The local control rate of the lesions treated with GKRS was 76.4% (decreased in 13 patients and stable in 16 patients at the final imaging follow-up (mean 5.60 months). Conclusion : GKRS is an effective local treatment for brain metastasis from SCLC both as an initial treatment for newly diagnosed lesions after PCI and as a salvage treatment for recurrent or progressive lesions. However, the survival benefit is not significant because most patients die of systemic multi-organ failure with a short life expectancy.

WT1 유전자 돌연변이에 의해 선천성 가로막 탈장이 동반되고 조기 신부전이 초래된 선천성 신증후군 1례 (Early Onset Renal Failure in Congenital Nephrotic Syndrome associated with Congenital Diaphragmatic Hernia by WT1 Gene Mutation)

  • 박용준;오진원;최경민;김병길;이종인;송지선
    • Childhood Kidney Diseases
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    • 제13권1호
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    • pp.84-91
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    • 2009
  • 저자들은 선천성 가로막 탈장을 동반한 선천성 신증후군 신생아에서 WT1 유전자 돌연변이와 범발성맥관막 경화증으로 진단하였기에 문헌 고찰과 함께 보고하는 바이다. 본 여아는 출생 직후 선천성 가로막 탈장이 발견되어 응급 교정수술을 받았고 전신부종, 핍뇨, 단백뇨, 저알부민혈증, 고뇨소질소혈증, 고크레아티닌혈증이 지속되어 선천성 신증후군에 의한 조기 신부전으로 진단되었다. 생후 22일째부터 복막투석 시작하였으나 뇌출혈과 다기관부전으로 생후 34일째 사망하였다. 사후 신생검에서 범발성 맥관막 경화증으로 확인되었다. 염색체 검사에서 정상소견(46,XX) 보였고 사후 유전자 검사에서 Arg366Hisin WT1 과오 돌연변이를 보였다. 본 예는 선천성 신증후군에 선천성 가로막 탈장이 동반된 드문 예로 WT1 유전자의 Arg366His 과오 돌연변이가 DDS와 CDH의 발생에 병인으로 관여할 것이라는 가설을 지지하는 4번째 증례라는 점에서 중요한 의미가 있다.

식이 식초 음독 후 발생한 부식성 손상 (Corrosive Injury Due to Edible Vinegar)

  • 김도현;이성우;남궁인;박종학;김수진;홍윤식
    • 대한임상독성학회지
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    • 제9권1호
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    • pp.34-38
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    • 2011
  • Vinegar is a very popular ingredient used in many cuisines. It is also known for its beneficial health, beauty and possible weight-loss properties. The authors report on a patient who presented to the emergency department with unstable vital signs complaining of generalized abdominal pain after ingestion of 450 ml of apple cider vinegar. We documented a case of corrosive gastrointestinal injury with persistent metabolic acidosis occurring after ingesting apple cider vinegar with an acetic acid concentration of 12~14%. Toxic damage to the liver and kidney were also observed, peaking on post-ingestion day 3. The patient received supportive care and hemoperfusion for three days without much clinical improvement and died in the seventh day of intensive care due to disseminated intravascular coagulation and multi organ failure. Edible vinegar, when taken in large amounts, is capable of inducing corrosive injuries of the GI tract as well as severe systemic toxicities, such as metabolic acidosis. Safety precautions regarding vinegar deserve more public attention and clinicians also should be astute enough to recognize the potential damage accompanying vinegar ingestion.

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Mirror Syndrome Resulting from Metastatic Congenital Neuroblastoma to Placenta

  • Park, Sung Hyeon;Namgoong, Jung-Man;Ko, Kyeong Nam;Kim, Chong Jai;Lee, Pil-Ryang;Jung, Euiseok;Lee, Byong Sop;Kim, Ki-Soo;Kim, Ellen Ai-Rhan
    • Perinatology
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    • 제29권4호
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    • pp.189-194
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    • 2018
  • Congenital neuroblastoma is a rare disease. Placental metastasis is extremely rare and poor prognosis has been reported in neonates. Mirror syndrome could occur in mother with placental metastasis with possibilities of hypertension and edema. We report a case of detection of left suprarenal mass in fetus at $31^{+5}weeks^{\prime}$ gestation. Mother presented with palpitation, edema, headache, and hypertension. Maternal 24 hours urine vanillylmandelic acid (VMA) and normetanephrine (NME) level at 34 weeks' gestation were elevated. Consequently, emergent cesarean section was done. Based on abdominal ultrasonography and whole body magnetic resonance imaging, left adrenal tumor with liver metastasis was suspected. Neuroblastoma was confirmed by liver and placenta biopsy. Chemotherapy was started with Pediatric Oncology Group 9243 at day 7 and changed into Children's Oncology Group 3961 due to cholestasis and poor response during 2nd cycle. Plasma exchange was done for aggravated direct hyperbilirubinemia. The baby expired at 73 days due to multi-organ failure. Maternal symptoms were completely resolved in 2 weeks after delivery along with normalization of the elevated level of VMA and NME. We report a first case of mirror syndrome in Korean mother and fetus resulting from metastatic congenital neuroblastoma to placenta.

Can Panax ginseng help control cytokine storm in COVID-19?

  • Choi, Jong Hee;Lee, Young Hyun;Kwon, Tae Woo;Ko, Seong-Gyu;Nah, Seung-Yeol;Cho, Ik-Hyun
    • Journal of Ginseng Research
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    • 제46권3호
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    • pp.337-347
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    • 2022
  • Coronavirus disease 2019 (COVID-19) is currently a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 are directly associated with hyper-activation of innate immune response that excessively produce pro-inflammatory cytokines and induce cytokine storm, leading to multi-organ-failure and significant morbidity/mortality. Currently, several antiviral drugs such as Paxlovid (nirmatrelvir and ritonavir) and molnupiravir are authorized to treat mild to moderate COVID-19, however, there are still no drugs that can specifically fight against challenges of SARS-CoV-2 variants. Panax ginseng, a medicinal plant widely used for treating various conditions, might be appropriate for this need due to its anti-inflammatory/cytokine/viral activities, fewer side effects, and cost efficiency. To review Panax ginseng and its pharmacologically active-ingredients as potential phytopharmaceuticals for treating cytokine storm of COVID-19, articles that reporting its positive effects on the cytokine production were searched from academic databases. Experimental/clinical evidences for the effectiveness of Panax ginseng and its active-ingredients in preventing or mitigating cytokine storm, especially for the cascade of cytokine storm, suggest that they might be beneficial as an adjunct treatment for cytokine storm of COVID-19. This review may provide a new approach to discover specific medications using Panax ginseng to control cytokine storm of COVID-19.

전이성 췌장암 환자에서 Gemcitabine과 Nanoparticle Albumin Bound (nab)-Paclitaxel로 인한 허혈성 심독성 발생 1례 (A Case of Gemcitabine Plus Nanoparticle Albumin Bound (nab)-paclitaxel Induced Cardiotoxicity in Patient of Metastatic Pancreatic Cancer)

  • 김미강;박세우
    • Journal of Digestive Cancer Research
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    • 제5권1호
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    • pp.62-65
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    • 2017
  • 2013년 실제 임상에 Gemcitabine과 nab-paclitaxel 병용요법이 적용된 후 NCCN Guideline에서 절제 불가능한 췌장암 환자에서 일차적으로 선택할 수 있는 약제로 제시하고 있다. 이 병용요법으로 인한 가장 흔한 Grade 3 부작용으로는 호중구감소증, 피로, 말초신경병증이 보고되었으며, 심장독성은 흔하지 않다. 본 증례에서는 심장표지자의 상승 및 심초음파에서의 우측관상동맥의 허혈 손상이 확인되어 병용요법으로 인한 심장 허혈 손상 및 심낭삼출물이 발생하여, 심장성 쇼크로 사망하였을 것으로 추정해 볼 수 있다. Gemcitabine과 nab-paclitaxel에 의한 심장 허혈 손상의 더 많은 증례 보고 및 연구가 필요하며, 병용요법을 투여 받는 환자들에 대한 심장독성에 대하여 주의 깊은 관찰이 필요할 것으로 생각된다.

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