Kim, Min-Ji;Kang, Kyung-Won;Yu, Byeong-Chan;Choi, Sun-Mi;Kang, Ji-Sun;Moon, Seung-Hee;Lee, Jae-Hwi;Kim, Yoon-Sik;Seol, In-Chan
Journal of Physiology & Pathology in Korean Medicine
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v.22
no.4
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pp.968-974
/
2008
This study was aimed to investigate the electrolytes and its relationship with acute stroke patients in each stroke type by case-control study. 217 patients with first-ever acute stroke within 2 weeks as the case group(Cases), 146 people without four major risk factors(hypertension, diabetes mellitus, hyperlipidema and ischemic heart disease) as the healthy control group(Normals), and 160 people as the general control group(Controls) were recruited at the Stroke Medical Center in Daejeon University Oriental Medicine Hospital from july 2005 to march 2007 for this case-control study. We analyzed the odds ratio of electrolytes in binary logistic analysis and evaluated each stroke type and general characteristics such as age, sex etc. The level of sodium(Na+) and potassium(K+) were significantly lower in LAA, SVO type of ischemic stroke and hemorrhagic stroke. But the level of chloride(Cl-) had no significant relation with stroke occurance. In this study we demonstrated that low sodium(Na+) and potassium(K+) have an influence on stoke occurance than chloride(Cl-). And we think that the electrolytes must be considered in risk factors of ischemic stroke in Korean and more prospective studies are needed.
Parasitic leeches could directly (through causing poor growth, anemia and wound in the fish) and indirectly (by predisposition of the fish to secondary bacterial and fungal infections) affects their hosts. In the present study, fishes that were attacked by leeches in natural and experimental environment were studied. Pathologic samples were obtained from damages at the site of leech bite, as well as kidney and liver of the fish. Histopathological examination revealed numerous lesions at the site of leech bite including tissue demolition, detachment at the site of leech bite in the epidermis of epithelial tissue in the skin, destructed nucleus in epithelial cells of the skin plus necrosis in the damaged skin and weak inflammatory penetration to acute necrotic damages along with piercing dermis layer. Pathologic lesions in the kidney included some changes such as proliferation by increasing glomerular cells and membrane cells in capillary vein of the kidney, blood cell necrosis in kidney with infiltration of white blood cells mainly mononuclear and less polymorphonuclear which are the symptoms of anemia due to blood feeding and sucking by leeches. There was also a chronic kidney infection probably originated from another part of body such as skin. Moreover, leeches caused hemorrhagic anemia due to blood consumption of the hosts, which led to observation of immature red blood cells. Also results showed that diseases induced by leeched in fish could be acute or chronic, which depends on size of fish, species of leech and severity of infection.
The hemolytic uremic syndrome (HUS) is a rare disease of microangiopathic hemolytic anemia, low platelet count and renal impairment. HUS usually occurs in young children after hemorrhagic colitis by shigatoxin-producing enterohemorrhagic E. coli (D+HUS). HUS is the most common cause of acute renal failure in infants and young children, and is a substantial cause of acute mortality and morbidity; however, renal function recovers in most of them. About 10% of children with HUS do not reveal preceding diarrheal illness, and is referred to as D- HUS or atypical HUS. Atypical HUS comprises a heterogeneous group of thrombomicroangiopathy (TMA) triggered by non-enteric infection, virus, drug, malignancies, transplantation, and other underlying medical condition. Emerging data indicate dysregulation of alternative complement pathway in atypical HUS, and genetic analyses have identified mutations of several regulatory genes; i.e. the fluid phase complement regulator Factor H (CFH), the integral membrane regulator membrane cofactor protein (MCP; CD46) and the serine protease Factor I (IF). The uncontrolled activation of the complement alternative pathway results in the excessive consumption of C3. Plasma exchange or plasma infusion is recommended for treatment of, and has dropped the mortality rate. However, overall prognosis is poor, and many patients succumb to end-stage renal disease. Clinical presentations, response to plasma therapy, and outcome after renal transplantation are influenced by the genotype of the complement regulators. Thrombotic thrombocytopenic purpura (TTP), another type of TMA, occurs mainly in adults as an acquired disease accompanied by fever, neurologic deficits and renal abnormalities. However, less frequent cases of congenital or hereditary TTP associated with ADAMTS-13 (a disintegrin and metalloprotease, with thrombospondin 1-like domains 13) gene mutations have been reported, also. Recent advances in molecular genetics better allow various HUS to be distinguished on the basis of their pathogenesis. The genetic analysis of HUS is important in defining the underlying etiology, predicting the genotype-related outcome and optimizing the management of the patients.
Actinobacillus (A.) pleuropneumoniae is the etiological agent of a porcine pleuropneumonia and have great economic importance to the global swine industry. For recent 5 years, a total of 50 pleuropneumonia cases of 24 pig farms were selected from pig lungs submitted to the College of Veterinary Medicine, Jeju National University using polymerase chain reaction (PCR) analysis. Collected lungs were fixed in 10% neutral phosphate-buffered formalin and processed for histological examination. Serotypes of A. pleuropneumoniae in pneumonic lesions were analyzed by PCR methods. And the antimicrobial susceptibility of A. pleuropneumoniae isolates was determined by a disc diffusion test. Grossly, unilateral distribution of hemorrhagic or necrotic pneumonic lesions was more common than bilateral distribution in lungs. In peracute or acute cases, histopathologic changes were characterized by necrosis, hemorrhage, neutrophils infiltration, vascular thrombosis, widespread edema and fibrinous exudates. Following the acute response, macrophage infiltration, marked fibrosis around zonal necrotic areas, and marked fibrous pleuritis were characteristic in chronic cases. A total of 50 pleuropneumonia were associated with A. pleuropneumoniae serotype 5 in 46 cases (92%), serotype 2 in 3 cases (6%), and both 2 and 5 in 1 case (2%). More than 90% of collected isolates showed high sensitivity to ceftiofur, amoxicillin, and colistin. However, ampicillin, penicillin, and tylosin showed low susceptibility. The results of this study demonstrated that A. pleuropneumoniae serotype 5 was predominant at porcine pleuropneumonia cases in Jeju.
Kim, Go Woon;Lee, Woo Jin;Hong, Won Ki;Lee, Sung Hoa;Lee, Chang Youl;Lee, Myung Goo;Hyun, In Gyu;Jung, Ki Suck
Tuberculosis and Respiratory Diseases
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v.66
no.2
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pp.116-121
/
2009
Background: Tsutsugamushi, leptospirosis and hemorrhagic fever with renal syndrome (HFRS) are the prevalent diseases among the acute febrile illnesses in Korea. Pulmonary involvement in the patients with these diseases remains poorly recognized in endemic regions, and this is despite reports of recent outbreaks and epidemic episodes. Pulmonary involvement and a higher CRP level as clinical manifestations show a more severe form of infection. The aim of this study is to analyze the correlation of pulmonary involvement and the CRP level in patients with acute febrile illnesses. Methods: We retrospectively reviewed the clinical records of 105 patients who were diagnosed with tsutsugamushi, HFRS and leptospirosis from January 2002 to May 2008 in Chuncheon Sacred Heart Hospital. The radiographic images were retrospectively analyzed by two radiologists. We analyzed the pulmonary complications of the patients with these febrile diseases and we checked the CRP level at admission. Results: The study included 105 patients who were diagnosed with febrile diseases. Of these patients, 32 patients had hantaan, 10 patients had leptospirosis and 63 patients had tsutsugamushi disease. 42 (40%) patients had pulmonary complications, 20 patients had pulmonary edema, 20 patients had pleural effusion and 2 patients had interstitial pneumonitis. The patients with pulmonary involvement showed a more severe form of infection and a higher CRP level than that of those patients without pulmonary involvement (p=0.0073). Conclusion: Pulmonary involvement in patients with acute febrile diseases might be correlated with a higher CRP level. Identification of this factor on admission might provide useful selection criteria for the patients who need early intensive care.
Two polyethylene tubes were inserted into the esophagus of anesthetized rabbit in order to record the fluctuation of the intraluminal pressure through the orifices located near the tips of the tubes. The orifice of the first tube was 10 cm apart from the incisor of the rabbit and the orifice of the second tube was 5 cm below that of the first one. The tubes were filled with saline solution running at various rates ranging from 1.5 ml/min. to 4.2 ml/min. The tubes were connected to the pressure transducers and the electrical signals were recorded by the physiograph. When the peristaltic wave approached to the orifice a rise in the pressure was recorded, returning to the base line when the portion of the orifice was quiescent. The frequency of the peristaltic motion and the velocity of the wave were studied in connection with the flow rate of saline solution through the tubes and in the case of massive acute hemorrhage. The results obtained were as follows: 1. There was reflux of fluid induced during the procedure of the experiment. This outwrad flow through the pharynx seemed to elicite swallowing reflexes. Accordingly, the frequency of peristalsis of the esophagus was largely dependent on the flow rate of the fluid through the inserted tubes. By the flow rate of 1.5 ml/min., 2.5 ml/min., or 4.2 ml/min., the frequencies of the peristalsis were revealed to be $8.6{\pm}3.6/10min.,\;14.5{\pm}4.8/10min.\;or\;21.1{\pm}6.3/10min.,$ respectively. The velocity of peristalsis also coincided with the enhanced motility of the esophagus, showing $6.6{\pm}1.5\;cm/sec.,\;8.9{\pm}3.9\;cm/sec.,\;or\;12.4{\pm}4.6\;cm/sec.,$ respectively. 2. By acute hemorrhage, amounting to 2% of the body weight, the frequency of the peristalsis increased to twofold of the control and the propagation velocity also increased by 52 percent. 3. Retransfusion of the shed blood resulted in divergent responses. In some cases there were noticable ameliorations of the effects brought by acute hemorrhage, and in the others there were still increasing tendenies of the motility after the transfusion. 4. Some speculation was made about the possibility of a kind of relationship between the irreversibility of the hemorrhagic shock and the absence of responses by transfusion. 5. The peristalsis persisted even after complete disconnection at the midportion of the esophagus, reaffirming the view of a central regulation of the spatiotemporally coordinated motility, peristalsis.
Seung Hwan Kim;Ji Hwan Jang;Young Zoon Kim;Kyu Hong Kim;Taek Min Nam
Journal of Korean Neurosurgical Society
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v.67
no.1
/
pp.73-83
/
2024
Objective : The Act on Life-Sustaining Treatment (LST) decisions for end-of-life patients has been effective since February 2018. An increasing number of patients and their families want to withhold or withdraw from LST when medical futility is expected. This study aimed to investigate the status of the Act on LST decisions for patients with acute cerebrovascular disease at a single hospital. Methods : Between January 2017 and December 2021, 227 patients with acute cerebrovascular diseases, including hemorrhagic stroke (n=184) and ischemic stroke (n=43), died at the hospital. The study period was divided into the periods before and after the Act. Results : The duration of hospitalization decreased after the Act was implemented compared to before (15.9±16.1 vs. 11.2±18.6 days, p=0.127). The rate of obtaining consent for the LST plan tended to increase after the Act (139/183 [76.0%] vs. 27/44 [61.4%], p=0.077). Notably, none of the patients made an LST decision independently. Ventilator withdrawal was more frequently performed after the Act than before (52/183 [28.4%] vs. 0/44 [0%], p<0.001). Conversely, the rate of organ donation decreased after the Act was implemented (5/183 [2.7%] vs. 6/44 [13.6%], p=0.008). Refusal to undergo surgery was more common after the Act was implemented than before (87/149 [58.4%] vs. 15/41 [36.6%], p=0.021) among the 190 patients who required surgery. Conclusion : After the Act on LST decisions was implemented, the rate of LST withdrawal increased in patients with acute cerebrovascular disease. However, the decision to withdraw LST was made by the patient's family rather than the patient themselves. After the execution of the Act, we also observed an increased rate of refusal to undergo surgery and a decreased rate of organ donation. The Act on LST decisions may reduce unnecessary treatments that prolong end-of-life processes without a curative effect. However, the widespread application of this law may also reduce beneficial treatments and contribute to a decline in organ donation.
Kim, Ok-jin;Bak, Ung-bok;An, Soo-hwan;Kim, Du-hee;Shin, Jin-ho
Korean Journal of Veterinary Research
/
v.32
no.2
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pp.217-225
/
1992
Five puppies, 14 days old in the same litter showed acute symptoms such as painful crying, anorexia, abdominal pain and depression with fatal terminations. Necropsy of a puppy revealed hemorrhagic and necrotic foci in the lungs and kidney. The histological lesions were characterized with fibro-necrotizing foci in the lungs, nonsuppurative encephalitis and intranuclear inclusions of liver cells. A cytopathogenic agent was isolated from the thoracic fluid of a dead puppy by cell culture with primary dog kidney cells. The puppies inoculated with the field isolate showed the same clinical signs and lesions as those of the spontaneous cases. Viral particles were observed in suspension of the isolated agent by electron microscopy. The primary dog kidney cells infected with the field isolate showed fluorescent foci against anti-CHV monoclonal antibody after FA stain. On these findings of the disease it was diagnosed as CHV infection. The report signifies the first description of an epizootic of CHV infection in Korea.
Hypertension is one of the most common chronic diseases in childhood and adolescence. Untreated hypertension adversely affects many organs including heart, brain, kidney and peripheral arteries. We reviewed the complication of central nervous system caused by pediatric hypertension. Cerebral blood flows are maintained constantly in response to changes in blood pressure by cerebral autoregulation. Severe hypertension which destructs cerebral autoregulation results in acute hypertensive encephalopathy syndrome, ischemic or hemorrhagic stroke. Chronic pediatric hypertension induces learning disability and cognitive defect which are subclinical symptom prior to brain damage caused by severe hypertension. We should consider the effect of hypertension on pediatric brain because appropriate antihypertensive drugs could prevent these complications.
Ham, Tong-Il;Lee, Soo-Kyung;Ko, Byung-Hee;Choi, Kyung-Ju
The Journal of Korean Oriental Chronic Disease
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v.10
no.1
/
pp.39-45
/
2005
Objectives It is the case study of a critically ill patient with cerebral infarction and acute edematous change at femur due to a hematoma, of whom taken care with herb medicine according to the diagnosis of SCM(Sasang Constitutional Medicine). Methods The syndrome of the patient was diagnosed as a superficial disease of Taeumin. So after the on-set of the femoral edema, Jowiseungchung-tang added Castanea mollissima(Gunyul) and Maladera castanea(Jejo) was used. And we checked the change of the circumferencial size her thigh and followed up the sonography. Results and conclusions The therapy was significantly effective, and the edema was rapidly absorbed. The circumferential size was 83cm at on-set time, but got smaller to 57cm almost same to the healthy side of her thigh, and there was no more hematoma or systemic hemorrhagic sign on the body.
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