• Journal of Chest Surgery
• /
• v.28 no.12
• /
• pp.1132-1138
• /
• 1995

From 1991 to 1994, we experienced 24 cases of neonatal pneumothorax who were admitted to the Neonatal Intensive Care Unit[NICU , Chosun University Hospital. The Following results were obtained.1 The incidence of neonatal pneumothorax was 0.70%, and there were 8 spontaneous pneumothoraces and 16 secondary pneumothoraces. 2 The clinical manifestation of neonatal pneumothorax was as followed. Male infant was dominant[M:F=2:1 , the onset was within 24 hours in the majority[83% , and the right side[62% was more frequent than the left side. The gestation duration and birth weight show no correlation with underlying neonatal pneumothorax. The pulmonary diseases were meconium aspiration syndrome and hyaline membrane disease, and the incidence of those was 58%. Meconium aspiration syndrome occurred earlier than hyaline membrane disease. Symptoms and signs were tachypnea[46% , cyanosis[21% , irritability[13% , chest retraction[8% and apnea[8% .3 The treatments performed were oxygen therapy[17% , thoracentesis[4% and closed thoracostomy with underwater seal drainage[79% . The Mean duration of air leakage was 11.7 hours, and the mean drainage time was 4.35$\pm$1.3day. 4 The overall hospital mortality was 33%, and the rate of complication was 46%. The complications were metabolic acidosis, atelectasis, pleural effusion, pulmonary hemorrhage and pneumonia. We concluded that the prognosis was related to the underlying pulmonary disease.

• Journal of Chest Surgery
• /
• v.45 no.2
• /
• pp.116-119
• /
• 2012

A 61-year-old female patient was diagnosed with dilated cardiomyopathy with severe left ventricle dysfunction. Two days after admission, continuous renal replacement therapy was performed due to oliguria and lactic acidosis. On the fifth day, an intra-aortic balloon pump was inserted due to low cardiac output syndrome. Beginning 4 days after admission, she was supported for 15 days thereafter with an extracorporeal left ventricular assist device (LVAD) because of heart failure with multi-organ failure. A heart transplant was performed while the patient was stabilized with the LVAD. She developed several complications after the surgery, such as cytomegalovirus pneumonia, pulmonary tuberculosis, wound dehiscence, and H1N1 infection. On postoperative day 19, she was discharged from the hospital with close follow-up and treatment for infection. She received follow-up care for 10 months without any immune rejection reaction.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.20 no.1
• /
• pp.61-64
• /
• 2017

Recurrent acute pancreatic attacks is a rare clinical condition (2-5% of all acute pancreatis) in children and is mainly idiopathic in most cases. Sometimes it may be associated with congenital anomalies, metabolic diseases or hereditary conditions. Isovaleric acidemia (IVA) is a rare autosomal recessive amino acid metabolism disorder associated with isovaleryl coenzyme A dehydrogenase deficiency presenting the clinical findings such metabolic acidosis with increased anion gap, hyperammonemia, ketonemia, hypoglycemia, "the odor of sweaty feet," abdominal pain, vomiting, feeding intolerance, shock and coma. Recurrent acute pancreatitis associated with IVA have been rarely reported. Herein; we report a child who admitted with recurrent acute pancreatic attacks and had the final diagnosis of IVA. Mutation analysis revealed a novel homozygous mutation of (p.E117K [c.349G>A]) in the IVA gene. Organic acidemias must kept in mind in the differential diagnosis of recurrent acute pancreatic attacks in children.

• Journal of Chest Surgery
• /
• v.21 no.1
• /
• pp.175-183
• /
• 1988

Congenital diaphragmatic hernia [CDH] is a surgical emergency in the newborn infant because it causes severe cardiorespiratory distress. Congenital diaphragmatic eventration [CDE] may also produce severe cardiorespiratory distress in the newborn infant. CDH is an anatomically simple defect that can be easily repaired by reduction of the displaced viscera from the pleural cavity and closure of the diaphragmatic defect. But these infants mortality has not been reduced and still remains very high. The barrier to survival is pulmonary parenchymal and vascular hypoplasia as well as the complex syndrome of persistent fetal circulation. Between May, 1985 and Oct, 1987, 4 neonates with CDH and 1 neonate with CDE were seen in respiratory distress within 12 hrs of birth at St. Francisco general hospital. Each had severe acidosis and hypoxia. And was transferred from a local clinic. They were surgically repaired within 24 hrs of birth. Three neonates lived and two died. Two of the three neonates with CDH operated in the first 6 hrs died. The remaining two [one with CDH, the other with CDE] operated between 6hrs and 24 hrs lived. One case of mortality was combined with bilateral pulmonary hypoplasia and contralateral pneumothorax. The other one case of mortality was combined with complex syndrome of persistent fetal circulation after honeymoon period.

• Annals of Clinical Neurophysiology
• /
• v.8 no.1
• /
• pp.84-87
• /
• 2006

The MELAS (Mitochondrial Encephalomyopathy with Lactic Acidosis, and Stroke-like episodes) syndrome is one of the inherited mitochondrial disorder. We have experienced a 16-year-old girl with headaches and left hemianopsia. Diagnosis of MELAS syndrome with multiple brain parenchymal lesions was confirmed by gene study. The stroke-like lesion of MELAS syndrome showed significant improvement in radiological follow up study. Therefore, MRI findings in MELAS could be interpreted as metabolic cellular dysfunction rather than ischemic vasculopathy.

• Journal of Life Science
• /
• v.14 no.2
• /
• pp.296-300
• /
• 2004

We investigated feasibility of using the formalin-fixed and paraffin-embedded tissue to study mitochondrial mutations in the case that fresh or frozen tissue, or blood samples are not available. Four paraffin blocks of muscle biopsies in Korean MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes) patients were chosen. Total DNA was extracted from these blocks for PCR/RFLP analysis, and sequencing was performed to study the most common mutation, A to G transition at nucleotide position 3243 underlying MELAS in the mitochondrial tRN $A^{Leu(UUR)}$ gene. We could identify the A to G mutation at nt.3243 in three MELAS patients. Our results show that the mitochondrial genome of our paraffin blocks is presumably in good condition. Our results are in accordance with the previous findings by other investigators that PCR allows molecular genetic analysis of paraffin-embedded tissues stored in most histopathology laboratories.s.

• Food Science and Biotechnology
• /
• v.14 no.1
• /
• pp.64-67
• /
• 2005

Commercial kimchi and sauerkraut were analyzed for their D- and L-lactic acid contents. Ranges of D- and L-lactic acid contents in commercial kimchi were 17-57 (38.51 mean) and 25-87 (64.47 mean) mM, respectively. Ratio of D-lactic acid on L-lactic acid (D/L) was 0.50-0.80 (0.60 mean). Ranges of D- and L-lactic acid contents in commercial sauerkraut were 68.96-103.62 (88.97 mean) and 74.46-82.26 (78.91 mean) mM, respectively, with D/L of 0.90-1.26 (1.13 mean). Results reveal kimchi and sauerkraut contained a significant amount of D-lactic acid, with sauerkraut showing a higher content than kimchi, while L-lactic acid contents were not significantly different.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.2
• /
• pp.234-237
• /
• 2002

A 77-year-old female was admitted 3 hours after intentionally ingesting 5g of aluminum ammonium sulfate ('Alum') powder dissolved in water. Gastric lavage with normal saline, activated charcoal chelation, and supportive therapies were performed. She showed a high anion gap metabolic acidosis, which rapidly progressed to multiple organ failure including ARDS. The patient subsequently progressed to a refractory shock which eventually led to death.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.5 no.2
• /
• pp.119-122
• /
• 2007

Paraquat poisoning is a fatal type of herbicide intoxication. It is characterized by multi-organ failure and pulmonary fibrosis with respiratory failure. Intravenous and intramuscular injection of paraquat is rarely described. However, We encountered two fatal cases of acute poisoning caused by paraquat injection. Two patients were admitted to our emergency unit after intravenous and intramuscular injection of 23.8% paraquat (about 476 mg of paraquat). A 37-year-old man diluted 2 ml of 23.8% paraquat solution with 1 ml of normal saline and injected it both intravenously into his left antecubital fossa and intramuscularly into his abdomen in a suicide attempt. He died 5 days later from respiratory failure and acute renal failure. A 92-year-old man was injected intravenously into his right antecubital fossa by his grandson with 2 ml of 23.8% paraquat solution diluted with 1 ml of normal saline. He died 2 days later from early circulatory collapse and multi-organ failure (metabolic acidosis, acute renal failure, coagulopathy). Intravenous and intramuscular injection with a small quantity of paraquat resulted in fatal toxicity in our patients.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.2 no.1
• /
• pp.58-62
• /
• 2004

Acid ingestion can cause not only caustic injury on esophagus and stomach but also fatal outcome through systemic complications. We report the case of a patient who died early after severe caustic injury with strong acid. A 38-year-old man who ingested about 400ml of hydrochloric acid of unknown concentration was transferred to our hospital from a private clinic, in which he was managed with gastric irrigation through a nasogastric tube. He was complaining dyspnea and abdominal pain. Physical examination demonstrated tenderness and rebound tenderness on epigastric region. Severe metabolic acidosis and leukocytosis were noted. Radiological findings suggested perforation of gastrointestinal tract, although the physical signs were not typical. Endoscopy revealed caustic injuries of grade I on esophagus and of grade Ⅲ on stomach, which indicate more severe injury on the stomach than on the esophagus. Exploratory surgery was recommended but unfortunately not permitted by his family. Despite intensive measures, his vital signs deteriorated rapidly and he died 50 hours after the ingestion.