• Title/Summary/Keyword: Patient transport

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A Case of Cystinuria with Multiple Renal Stones in an 8-month-old Girl (8개월 여아에서 다발성 결석으로 진단된 시스틴뇨증 1례)

  • Kang, Eun Gu;Lee, Joo Hoon;Lee, Beom Hee;Kim, Gu-Hwan;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.122-126
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    • 2013
  • Cystinuria is an autosomal recessive disease characterized by impaired transport of cystine and dibasic amino acids in the proximal renal tubule, resulting in the formation of cystine stones. It is believed to account for about 1% of all kidney stones and up to 10% of pediatric stones. Here we report a case of cystinuria with multiple renal stones confirmed by genetic mutational analysis. An 8-month-old girl was admitted to AMC with persistent fever and multiple renal stones. A renal sonogram showed multiple stones at the right renal pelvis, right distal ureter, and left renal medullary portion. An approximately 1 cm renal stone was extracted spontaneously, and stone analysis revealed it to be composed entirely of cystine. Cystinuria was confirmed by increased urine dibasic amino acid levels, including cysteine, and genetic mutational analysis showed the patient to be a homozygote for the pathogenic c. 1820del (p.L607fs) of SLC3A1. Despite treatment with oral hydration and urinary alkalinization, and restricted intake of animal protein, the stones increased in size and number. The patient has since been treated with tiopronin.

An exploratory study on the development of a device for isolation unit in CBRNE disaster (CBRNE 재난 시 격리이송을 위한 장치 개발에 관한 탐색적 연구)

  • Ham, Seung Hee;Park, Namkwun;Yoon, Myong O
    • Journal of the Society of Disaster Information
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    • v.14 no.1
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    • pp.65-71
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    • 2018
  • In this study, it is aimed to prevent the spread of pollutants in the event of a major disaster caused by CBRNE accidents and attacks and build up system to provide optimal transport environment for each patient condition By identifying characteristics of existing products and make them immediately applicable in the field. The purpose of this study is suggesting essential consideration in both functional and performance in the development of the isolation unit. As a result of the study, it suggests (1) basic function, (2) efficient field utilization, (3) isolation unit interface and combination of modules in development of isolation unit.

A Case of Activated Charcoal Aspiration Treated by Early and Repeated Bronchoalveolar Lavage (기관지내시경을 통해 치료한 활성탄 흡인 1예)

  • Lee, Han-Min;Park, Jae-Seok;Kim, Jae-Yun;Lee, Ji-Yeon;Ahn, Byung-Kyu;Gil, Hyo-Wook;Choi, Jae-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.177-181
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    • 2012
  • Activated charcoal is an inert substance and it is used in standard therapy in patients with acute intoxication. Charcoal has some side effects such as pulmonary aspiration, gastrointestinal complications, and electrolyte abnormalities. Although aspiration of charcoal is a rare complication, it can cause fatal sequelae. We report a 69-year old man who developed acute respiratory failure associated with charcoal aspiration after management of glyphosate poisoning. The patient was drowsy and suffered severe vomiting during transport to our hospital. On arrival, acute respiratory failure was observed due to charcoal aspiration, but the clinical state was improved with repeated bronchoscopy with a bronchoalveolar lavage (BAL). We presumed that the aspirated charcoal was an important factor in evoking a lung injury. Early bronchoscopy with a BAL might be an effective method for eliminating charcoal from the lung, especially in the case of a large amount of aspiration, and be helpful in decreasing respiratory failure due to charcoal aspiration.

Intracardiac Foreign Body by Penetrating Cardiac Injury (관통성 손상에 의한 심장내 이물 - 수술 치험 1례 -)

  • 정진용
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.929-935
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    • 1990
  • Violence in our society, combined with improving transport system, resulted in increased numbers of patients with cardiac wounds reaching the hospital alive. Most patients with penetrating cardiac injury, rather than blunt injury, present with a syndrome of either hemorrhagic shock or cardiac tamponade. And they should be operated upon as soon as possible. Often the atrioventricular valves and other important cardiac structures are also damaged by the penetrating instruments or missile. Both intracardiac communications and atrioventricular fistulas may result in significant left-to-right shunts accompanied by congestive heart failure, necessitating surgical correction. Usually, retained cardiac foreign bodies, which are almost always bullets or fragments of missiles, may lie within a cardiac chamber or in the myocardium. Emboli of bullets or other missiles from distant sites to the right side of the heart are numerous enough to require attention. Recently we experienced a case with intracardiac foreign body due to penetrating cardiac injury. A 19 year-old man was admitted to our hospital due to penetrating anterior chest wound by iron segment. The roentgenogram of the chest revealed a radio-opaque metallic shadow in left lower chest around the cardiac apex, mild blunting of left costophrenic space, but no cardiomegaly. During operation the foreign body was noted to be present in the cardiac chamber by the portable C-arm fluoroscopy. But during the manipulation it moved into left inferior pulmonary vein from left ventricle by way of left atrium. So we could manage to remove it from left inferior pulmonary vein by direct approach to the vein. It was iron segment, sized 0.lcm x0.6cmx0.5cm, with sharp margins. The patient had an uneventful postoperative recovery except for chylopericardium and was discharged.

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Genetic Variation in the ABCB1 Gene May Lead to mRNA Level Chabge: Application to Gastric Cancer Cases

  • Mansoori, Maryam;Golalipour, Masoud;Alizadeh, Shahriar;Jahangirerad, Ataollah;Khandozi, Seyed Reza;Fakharai, Habibollah;Shahbazi, Majid
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8467-8471
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    • 2016
  • Background: One of the major mechanisms for drug resistance is associated with altered anticancer drug transport, mediated by the human-adenosine triphosphate binding cassette (ABC) transporter superfamily proteins. The overexpression of adenosine triphosphate binding cassette, sub-family B, member 1 (ABCB1) by multidrug-resistant cancer cells is a serious impediment to chemotherapy. In our study we have studied the possibility that structural single-nucleotide polymorphisms (SNP) are the mechanism of ABCB1 overexpression. Materials and Methods: A total of 101 gastric cancer multidrug resistant cases and 100 controls were genotyped with sequence-specific primed PCR (SSP-PCR). Gene expression was evaluated for 70 multidrug resistant cases and 54 controls by real time PCR. The correlation between the two groups was based on secondary structures of RNA predicted by bioinformatics tool. Results: The results of genotyping showed that among 3 studied SNPs, rs28381943 and rs2032586 had significant differences between patient and control groups but there were no differences in the two groups for C3435T. The results of real time PCR showed over-expression of ABCB1 when we compared our data with each of the genotypes in average mode. Prediction of secondary structures in the existence of 2 related SNPs (rs28381943 and rs2032586) showed that the amount of ${\Delta}G$ for original mRNA is higher than the amount of ${\Delta}G$ for the two mentioned SNPs. Conclusions: We have observed that 2 of our studied SNPs (rs283821943 and rs2032586) may elevate the expression of ABCB1 gene, through increase in mRNA stability, while this was not the case for C3435T.

A case of Menkes disease with unusual hepatomegaly (멘케스병에서 간비대를 보인 1례)

  • Jeong, Go Un;Cho, Anna;Hwang, Hee;Hwang, Yong Seung;Kim, Ki Joong;Chae, Jong Hee;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.538-541
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    • 2008
  • Menkes disease is an X-linked recessive copper transport disorder characterized by neurological deterioration, connective-tissue damage, and abnormal hair growth. It is caused by the mutation of the ATP7A gene. This report describes a four-month-old boy with neurological symptoms typical of Menkes disease plus unusual liver involvement. He developed seizures at three months of age and exhibited hypotonia, cephalhematoma, a sagging face, redundant and hypopigmented skin, and abnormal hair growth. In addition, he had unexplained hepatomegaly and high hepatic transaminase. We confirmed the diagnosis of Menkes disease by mutation analysis of the ATP7A gene. To exclude other possible causes for the hepatic abnormalities, a liver biopsy was performed, revealing intracytoplasmic cholestasis, focal spotty necrosis, and minimal lobular activity. The patient's liver involvement may be an underestimated complication of Menkes disease.

Down-regulated MYH11 Expression Correlates with Poor Prognosis in Stage II and III Colorectal Cancer

  • Wang, Ren-Jie;Wu, Peng;Cai, Guo-Xiang;Wang, Zhi-Min;Xu, Ye;Peng, Jun-Jie;Sheng, Wei-Qi;Lu, Hong-Fen;Cai, San-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7223-7228
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    • 2014
  • The MYH11 gene may be related to cell migration and adhesion, intracellular transport, and signal transduction. However, its relationship with prognosis is still uncertain. The aim of this study was to investigate correlations between MYH11 gene expression and prognosis in 58 patients with stage II and III colorectal cancer. Quantitative real-time polymerase chain reaction was performed in fresh CRC tissues to examine mRNA expression, and immunohistochemistry was performed with paraffin-embedded specimens for protein expression. On univariate analysis, MYH11 expression at both mRNA and protein levels, perineural invasion and lymphovascular invasion were related to disease-free survival (p<0.05; log-rank test). Cancers with lower MYH11 expression were more likely to have a poor prognosis. Otherwise, MYH11 expression was unrelated to patient clinicopathological features. On multivariate analysis, low MYH11 expression proved to be an independent adverse prognosticator (p<0.05). These findings show that MYH11 can contribute to predicting prognosis in stage II and III colorectal cancers.

Exercise Intervention on Blood Glucose Control of Type 2 Diabetes with Obesity : A Systematic Review (비만을 동반한 제 2형 당뇨병환자의 혈당 조절을 위한 운동 중재 : 체계적 문헌고찰)

  • Jung, Su-Ryun;Kim, Wan-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.1
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    • pp.11-26
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    • 2018
  • PURPOSE: The aim of this study was to review the effects of exercise intervention on blood glucose control in obese type 2 diabetic patients. METHODS: The PubMed and KERISS search engines were used and 61 papers that met the key questions were selected. RESULTS: Exercise is an effective intervention for the control of blood glucose in type 2 diabetic patients because it does not impair glucose transport in the skeletal muscle induced by muscle contractions. Insulin resistance, which is characteristic of type 2 diabetes, is caused by decreased insulin sensitivity or insulin responsiveness. Acute exercise improves the glucose metabolism by increasing the insulin-independent signaling pathways and insulin sensitivity in the skeletal muscle, and regular long-term exercise improves the skeletal muscle insulin responsiveness and systemic glucose metabolism by increasing the mitochondrial and GLUT4 protein expression in the skeletal muscle. CONCLUSION: The improvement of the glucose metabolism through exercise shows a dose-response pattern, and if exercise consumes the same number of calories, high intensity exercise will be more effective for the glucose metabolism. On the other hand, it is practically difficult for a patient with obese type 2 diabetes to control their blood glucose with high intensity or long-term exercise. Therefore, it will be necessary to study safe adjuvants (cinnamic acid, lithium) that can produce similar effects to high-intensity and high-volume exercises in low-intensity and low-volume exercises.

A Psychotherapy of Oriental Medicine -Focus on Psychoanalysis- (급성일산화탄소 중독 후 발생한 중독정신병환자 1례에 대한 임상적 고찰)

  • Lee, Dong-Won;Kim, Kyong-Soo;Koo, Byung-Soo;Kim, Su-Youn
    • Journal of Oriental Neuropsychiatry
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    • v.15 no.1
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    • pp.143-148
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    • 2004
  • Objectives : In order to make a new psychotherapeutic model in the theory of oriental medicine by means of psychoanalysis method. Methods : The research was done by comparing the contents of the Tong-Ui Po-Kam, techniques of Yang Saeng(養生術), with the psychoanalysis Results : 1. There's no difference in the mind state which a doctor has to have between the oriental doctor and the occidental doctor. You should make effort not to project yourself on a patient. A conception of 'doctor' in oriental medicine is one who trains one's mind rather than just healer. 2. Heart(心) in oriental medical conception is revealed by circulation structure of Jeong(精), Gi(氣), and Sin(神). A healthy mind comes from harmony and smooth transport of Jeong(精), Gi(氣), and Sin(神). 3. The conception similar to unconsciousness doesn't exist in oriental medicine, but the contents about the attitudes or the methods of training one’s mind correspond to unconsciousness. 4. The psychotherapy of oriental medicine emphasized mutual dynamics between emotions at present, and presented a way of treatment by describing emotions from standpoint of 'Gi(氣)'. 5. The special feature of psychological treatment in oriental medicine is that treatment is done by understanding emotions of present time as Gi (氣), and using dynamics of Gi (氣)(; 相生相剋). Also the balanced state can be kept even after treatment and prevention can be done by observing one's own unconsciousness(; training one's mind helps circulation of Jeong(精), Gi(氣), and Sin(神)) I think that we need a new realistic therapy model to develop these psychotherapy methods in oriental neuropsychiatry, through studying emotions in the theory of oriental medicine, especially Korean's emotions and spiritual training.

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Analysis of Vulnerability of Emergency Transport Service for Flooded Area (침수피해지역의 응급이송서비스 취약성 분석)

  • Lee, Yoon-Ha;Hong, Won-Hwa;Lee, Ji-Soo;Choi, Jun-Ho
    • Fire Science and Engineering
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    • v.32 no.4
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    • pp.122-130
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    • 2018
  • Recent urbanization, population densification, and the impact of global climate change are causing disasters to become larger and more complex. Meanwhile, in Korea, there is an emphasis on preventing, restoring, and recovering from disasters. However, disaster medical care, which is absolutely necessary to maintain life in a disaster, is being ignored. Therefore, in this study, we selected Seoul as the study area where flood damage is frequent and underground housing is densely populated. Assuming underground housing in the immersion history area as the emergency patient site, transfer distance and transfer time were analyzed. This study considered both accessibility to emergency medical facilities and disaster sites and accessibility from emergency services to disaster sites. Therefore, it seems to be meaningful as basic data for the improvement of emergency medical services.