• Title/Summary/Keyword: Septic shock

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Idiopathic severe hypermagnesemia in an extremely low birth weight infant on the first day of life

  • Hyun, Hye-Sun;Choi, Hyun-Sin;Kim, Jin-Kyu;Ahn, So-Yoon;Yoo, Hey-Soo;Kim, Eun-Sun;Chang, Yun-Sil;Park, Won-Soon
    • Clinical and Experimental Pediatrics
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    • 제54권7호
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    • pp.310-312
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    • 2011
  • A preterm female infant born at 27 weeks of gestation with a birth weight of 990 g developed acute hypotonia, apnea, hypotension and bradycardia mimicking septic shock syndrome at 14h after birth. Laboratory tests indicated a severe hypermagnesemia of 45 mg/dL. The renal function, complete blood count and maternal blood concentrations of magnesium were normal, and the blood cultures were negative. The patient recovered with treatment including exchange transfusion. However, the etiology of the severe hypermagnesemia remains unknown.

체외순환 없이 시행한 관상동맥 우회로 조성술 후 부신성 위기 (Adrenal Crisis after Off-pump Coronary Artery Bypass Surgery)

  • 최용선;류상완;홍성범;정명호;김상형;안병희
    • Journal of Chest Surgery
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    • 제37권7호
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    • pp.601-605
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    • 2004
  • 부신성 위기라 불리는 Addisonian crisis는 스트레스 호르몬의 일종인 cortisol이 분비되어야 하는 상황에서 정상적으로 분비되지 못함으로써 발생한다. 뇌하수체 선중은 기존에 있던 뇌하수체 선종이 어떤 원인에 의해 출혈성 또는 허혈성 변성에 의해 발생하는 것으로 알려져 있으며 심혈관계 수술에 있어 매우 드문 합병증이다. 더구나 심혈관제 수술에서 발생하는 대부분의 뇌하수체 졸중은 체외순환과 연관이 있는 것으로 알려져 있다. 본 증례는 체외순환 없이 시행한 관상동맥 우회로 조성술 후에 뇌하수체 졸중이 발생한 경우로 처음 보였던 여러 증상이 마치 폐혈성 쇼크와 유사하여 진단이 늦어지게 되었다. 그러나 일단 진단이 된 후에는 스트레스 용량의 부신 호르몬을 투여함으로써 급격한 증상 호전을 보였다.

근치적 수술 후 소장으로 단독 전이된 폐의 다형성 암종 1예 (Single Small Bowel Metastasis after Curative Operation in a Pleomorphic Lung Carcinoma)

  • 김기원;이호성;최재성;서기현;오미혜;조성식;김용훈;나주옥
    • Tuberculosis and Respiratory Diseases
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    • 제71권2호
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    • pp.139-143
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    • 2011
  • Small bowel metastasis of pleomorphic carcinoma of the lung is very rare. A 58-year-old man was admitted to our hospital with abdominal palpable mass in the right upper quadrant area. He underwent right middle and lower lobectomy for early stage pleomorphic carcinoma of the lung approximately 3 months ago. USG-guided biopsy was performed for abdominal mass. Pathologic examination revealed a metastatic pleomorphic carcinoma from the lung. He received chemotherapy followed by radiation therapy but died due to septic shock caused by intestinal stenosis and adhesion. We report the first case of small bowel metastasis by pleomorphic carcinoma of the lung after curative surgery.

Inhibitory Activity of Chinese Medicinal Plants on Nitric Oxide Synthesis in Lipopolysaccharide -Activated Macrophages

  • Ryu, Jae-Ha;Ahn, Han-Na;Lee, Hwa-Jin;Feng, Li;Qun, Wen-He;Han, Yong-Nam;Han, Byung-Hoon
    • Biomolecules & Therapeutics
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    • 제9권3호
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    • pp.183-187
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    • 2001
  • Nitric oxide (NO) produced in large amounts by the inducible nitric oxide synthase (iNOS) is known to be responsible for the vasodilation and hypotension observed in septic shock and inflammation. The inhibitors of iNOS, thus, may be useful candidate for the treatment of inflammatory diseases accompanied by the overproduction of NO. We prepared alcoholic extracts of Chinese medicinal plants and screened their inhibitory activity against NO production in lipopolysaccharide (LPS)-activated macrophages. Among the 80 kinds of extracts of herbal drugs, 15 extracts showed potent inhibitory activity of NO production above 80% at the concentration o$50\mu\textrm{g}/ml$. These potent extracts showed dose dependent inhibition of NO production of LPS-activated macrophages at the concentration of 50, 30,$10\mu\textrm{g}/ml$. Especially, Rhus chinensis, Senecio scandens and Wikstroemia indica showed most potent inhibition above 50% at the concentration of $10\mu\textrm{g}/ml$. These plants are promising candidates for the study of the activity-guided purification of active compounds and would be useful for the treatment of inflammatory diseases and endotoxemia accompanying the overproduction of NO.

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Clostridium difficile 감염에 의한 위막성 대장염 1례 (A Case of Clostridium difficile Pseudomembranous Colitis)

  • 서정호;이종원;이창한;정기섭
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제3권1호
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    • pp.98-104
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    • 2000
  • Pseudomembranous colitis, thought to be uncommon in children, is a bacterial, toxin-mediated inflammatory process resulting in acute or chronic diarrhea and is characterized by colonic pseudomembranes. It is mediated by toxins produced by Clostridium difficile and is increasingly recognized in pediatric population. Diagnosis is based on positive culture of C. difficile in selective media and positive test of C. difficile toxin. Oral metronidazole or vancomycin are the main treatment options but avoidance of further antibiotics should also be encouraged where possible. We have experienced a case of pseudomembranous colitis in a 4-year-old female presented with septic shock and colitis. This case was diagnosed with positive test of C. difficile toxin B and confirmed by isolation of the organism on cultire in selective media. Symptoms have been ameliorated by discontinuation of antibiotics and administration of metronidazole and oral vancomycin, and ICU care.

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침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴 1예 (A Case of Acute Interstitial Pneumonia with Invasive Pulmonary Aspergillosis)

  • 이영민;윤혜경;김주인
    • Tuberculosis and Respiratory Diseases
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    • 제52권1호
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    • pp.62-69
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    • 2002
  • 저자들은 호흡곤란을 주소로 내원한 환자에서 미만성 간질성 폐질환 의심하에 고용량의 부신 피질 호르몬제 투여도중 폐병변 악화로 흉강경을 이용한 폐생검을 실시하여 침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Community-Acquired Acinetobacter 폐염 1예 (A Case of Community-Acquried Acinetobacter calcoaceticus Pneumonia)

  • 유병무;임병성;최완영;신동호;박성수;이정희;최태열
    • Tuberculosis and Respiratory Diseases
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    • 제38권1호
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    • pp.53-58
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    • 1991
  • Acinetobacter calcoaceticus var anitratus, a non-fermentative gram negative bacillus, has been infrequently reported as a cause of community-acquired pneumonia. Bacteremic community-acquired pneumonia caused by Acinetobacter is a fulminant disease with a high mortality (above 40 per cent in the reported case). The onset of the illness is rapid but nonspecific with fever, productive cough, pleuritic pain and rapid prostration. And the patients frequently present with respiratory distress, severe hypoxemia, leukopenia and septic shock. We experienced a case of community-acquired Acinetobacter pneumonia who underwent respiratory support with mechanical ventilator for about 4 weeks and survived. We report the case with review of literature.

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경구투여한 V. vulnificus 백신의 면역원성 및 감염방어효능 (Immunogenicity and Protective Efficacy of an Oral Vaccine against Vibrio vulnificus Infection)

  • 이나경;정상보;안보영;김영지;이윤하
    • Biomolecules & Therapeutics
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    • 제6권2호
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    • pp.191-198
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    • 1998
  • Vsrio vulnificus is an estuarine gram-negative human pathogen that affects people with chronic hepatitis, alcoholic cirrhosis, diabetes mellitus or other underlying diseases. V. vulnificus infection is mediated primarily by consumption of raw fish or by exposure of pre-existing wounds to seawater, causing permanent tissue damages or fatal septic shock. We have been developing a vaccine against V. vulnificus composed of whole cell Iysate of a V. vulnificus O-antigen serotype 4 strain. Oral administration of the V. vulnificus;oral vaccine;immunogenicity;protective efficacy vaccine elicited a high serum antibody response in rabbits. The induced antibodies were reactive not only to the homologous strain but also to heterologous O-antigen serotype strains, indicating cross-reactivities among serotypes. Western blot analysis revealed that the antibodies are mainly specific for outer membrane proteins (OMPs) and reacted equally well with OMPs purified from 9 O-antigen serotypes. The rabbit antisera showed opsonophagocytic killing activity against heterologous strains as well as the homologous strain. Passively transferred rabbit antisera into mice were protective against a lethal V. vulnificus infection. These data demonstrate that oral administration of the V. vulnificus vaccine induced a systemic antibody response which had a protective efficacy against V. vulnificus infections, suggesting that this vaccine preparation could be used to develop an oral vaccine against V. vulnificus.

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기내배양한 은행 유식물에서의 Ginkgolide의 생산 (Ginkgolides Production in Embryo-derived Ginkgo biloba Plantlet)

  • 전미희;성상현;전순화;허훈;김영중
    • 생약학회지
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    • 제24권4호
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    • pp.304-308
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    • 1993
  • A platelet activating factor(PAF) antagonist ginkgolides produced from Ginkgo biloba are well known for their potential usage in septic shock and other PAF related diseases. Even though they are extracted from the leaves and on occasion the root bark, the exact biosynthetic site and pathway have not proved yet. In order to locate the enzymes involved and elucidate the biosynthetic site of the compounds, embryo-derived aseptic intact plantlet and plantlet without root have been cultured on 0.3% active carbon-containing solid Murashige and Skoog's medium. The leaves from the six-week-old normal plantlet contained similar amount of ginkgolide B to that of outdoor plant leaves, while the plantlets without root had less than 30% of the ginkgolide B compared to the in vitro intact plantlets. The results suggest that the ginkgolides may be synthesized in the root and transported to the aerial part.

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Bowel Perforation Due to Immobilization after Resurfacing Thumb with Anterolateral Thigh Free Flap in an Elderly Diabetic Woman

  • Park, Seong Hoon;Kim, Joo Hyun;Suh, In Suck;Kim, Kwang Yong;Jeong, Hii Sun
    • Archives of Reconstructive Microsurgery
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    • 제26권1호
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    • pp.18-22
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    • 2017
  • Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.