• 제목/요약/키워드: acute jaundice

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맥경(脈經) 권제팔(卷第八)의 황달(黃疸). 학질(?疾). 옹종(癰腫). 장옹(腸癰) 등증맥(等證脈)에 대한 연구 (Study on the Symptom & the Pulse of Jaundice, Intermittent Fever, Carbuncle, Intestines Carbuncle, & c. of the Maek Kyoung Vol. VIII)

  • 임동국;조경종;최경석;두자성;김종회;정헌영;금경수;박경
    • 동의생리병리학회지
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    • 제22권5호
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    • pp.1001-1034
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    • 2008
  • This thesis is a study composed of eight chapters from 9. to 16. of the Maek Kyoung(脈經) Vol. VIII. ; the symptom & the pulse of Jaundice(黃疸), Malarial Disease(?疾). Carbuncle(癰腫) Intestines Carbuncle(腸癰), & c. It is as follows : Chapter 9 refers to the symptom, pulse, treatment and prognosis of Jaundice(黃疸) and Malarial Disease(?疾). Chapter 10 refers to the cause, symptom, pulse and treatment of Cardialgia(胸痺), Cardiagra(心痛) and Nephric Accumulation(賁豚). Chapter 11 refers to the symptom, pulse and treatment of Abdominal Fuliness(腹滿), Cold Mounting(寒疝) and Abiding Food(宿食). Chapter 12 refers to the symptom and pulse of Accumulation and Mass of the Five Viscera(五臟積聚). Chapter 13 refers to the cause, pathogenesis, symptom, pulse, treatment and prognosis of Terror and Palpitation due to Fright(驚悸), Hematemesis(吐血), Nasal Hemorrhage(?血), Metrorrhagia(下血) and Extravasated Blood(瘀血). Chapter 14 refers to the cause, pathogenesis, symptom, pulse and treatment of Vomiting(嘔吐), Hiccough(?) and Diarrhea(下利). Chapter 15 refers to the cause, pathogenesis, symptom, pulse and treatment of Atrophy of Lung(肺?), Pulmonary Abscess(肺癰), Lung-distention(咳逆上氣) and Phlegm(痰飮). Chapter 16 refers to the cause, pathogenesis, symptom, pulse. treatment and prognosis of Carbuncle(癰腫), Intestines Carbuncle(腸癰), Wound(金瘡) and Acute Eczema(侵淫瘡). There have been abundant investigations in China. But we couldn't find a clear result yet, and they were written in archaic texts and colloquial Chinese, therefore it is needed to be translated into Korean. And there was only one inaccurate translation with insufficient annotation. So I hope this study will be useful to develope Oriental Medical Diagnostics.

A Pediatric Case of Toxic Hepatitis Induced by Hovenia Dulcis

  • Kim, Yun Ji;Ryu, Seung Lok;Shim, Jae Won;Kim, Duk Soo;Shim, Jung Yeon;Park, Moon Soo;Jung, Hye Lim
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제15권2호
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    • pp.111-116
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    • 2012
  • Toxic hepatitis is a rare but devastating disease in children. Herbs are widely used in oriental medicine to treat various symptoms in Korea, however, several herbs have been reported to induce liver injury. We report a case of toxic hepatitis induced by Hovenia dulcis in a 3-year-old boy. He complained of nausea, abdominal discomfort, and jaundice. The patient had consumed water boiled with hovenia dulcis for about 1 year prior to presentation. A diagnosis of toxic hepatitis was made based on his history, laboratory data, viral markers, ultrasonography, and biopsied liver tissue. We administered supportive management for acute fulminant hepatitis but his symptoms and liver function progressed. He was transferred to another hospital for further evaluation and consideration for liver transplantation. Because acute liver failure due to herbs or dietary supplement taken for a long time is often fetal, it is important to make early diagnosis and stop taking the drug as soon as drug induced liver injury is suspected.

급성담낭염에서 담낭신티그라피의 임상적 이용 (Clinical Use of Cholescintigraphy in Aeute Cholecystitis: A Comparative Study with Ultrasonography)

  • 서광휘;정혜경;김명곤;정덕수;성낙관;김옥동
    • 대한핵의학회지
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    • 제27권1호
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    • pp.81-87
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    • 1993
  • Retrospective analysis of cholescintigraphy and ultrasonography was done in 76 patients with clinically suspected acute cholecystitis to assess the relative value of the two modalities. Excluding the Patients with obstructive jaundice, the overall results of cholescintigraphy(sensitivity 100%, specificity 95%, false positive rate 5%, false negative rate 0%, accuracy 97%) are nearly identical with or rather superior to those of the ultrasonography(sensitivity 94%, specificity 100%, false positive rate 0%, false negative rate 5%, accuracy 97%). We recommend the cholescintigraphy as the initial modality in patients with clinically suspected acute cholecystitis, and ultrasonography can be used in jaundiced patients to exclude the possibility of the false positive of cholescintigraphy.

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대상포진후 신경통 치료중 발생한 급성간염 -증례 보고- (Acute Hepatitis during the Treatment of Postherpetic Neuralgia -A case report-)

  • 박희정;정미향;이철승;김원태
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.244-247
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    • 1996
  • A 67 year old male with postherpetic neuralgia complained of right anterior chest throbbing pain and also allodynia. We performed thoracic epidural block with 0.25% bupivacaine and 1% lidocaine. Oral carbamazepine and imipramine were also administred concomitantly. One month later, patient complained of fatigue, anorexia, pruritis, jaundice, and dark urine. Liver function test values were significantly elevated then. Therefore we removed the epidural catheter and ceased all medication. Liver function test values decreased rapidly after discontinuation of medication. Hepatitis might have developed as result of drugs administered and could have been prevented if the patient had been monitored with regular clinical laboratory follow up. The purpose of this case report is emphasize the importance of early regular laboratory test to detect any possible side effect that may occur by administration of drugs during treatment of chronic pain.

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Tc-99m Galactosylated Serum Albumin (GSA)을 이용한 정량적 간수용체 영상술 (Quantitative Evaluation of Liver Function with Hepatic Receptor Scintigraphy using Tc-99m Galactosylated Serum Albumin (GSA))

  • 이재태
    • 대한핵의학회지
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    • 제32권4호
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    • pp.305-313
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    • 1998
  • The reduction in the amount of asialoglycoprotein (ASGP) receptor, which resides exclusively on the plasma membrane of functioning mammalian hepatocytes, as a consequence of hepato-cellular damage has been demonstrated in various pathologic conditions of the liver. Galac-tosylated human serum albumin (GSA) is a newly developed receptor-binding agent, specific for the ASGP receptor. Tc-99m GSA binds quantitatively to liver ASGP receptors and the rate of accumulation in the liver is dependent on hepatic function represented as the amount of receptor, as well as the amount of ligand injected, its affinity to the receptor and the hepatic blood flow. The findings of Tc-99m GSA scintigraphy were reported to reflect the hepatic function of the patients with large hepatic tumors, obstructive jaundice, acute and chronic liver disease. Tc-99m GSA scintigraphy is an easy and reliable test and has the clinical potentials to evaluate the liver function in the patients with hepatic disorders.

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Cholecystectomy is Feasible in Children with Small-Sized or Large Numbers of Gallstones and in Those with Persistent Symptoms Despite Medical Treatment

  • Lee, Yeoun Joo;Park, Yeh Seul;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권5호
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    • pp.430-438
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    • 2020
  • Purpose: We investigated the clinical features and factors affecting the choice of treatment modality and the course of pediatric gallstone (GS) disease. Methods: We retrospectively analyzed the medical records of 65 patients diagnosed with GS using imaging studies between January 2009 and December 2017 were included. Results: This study included 65 patients (33 boys and 32 girls; mean age, 8.5±5.3 years; range, 0.2-18 years) who primarily presented with abdominal pain (34%), jaundice (18%), and vomiting (8%). Idiopathic GS occurred in 36 patients (55.4%). The risk factors for GS included antibiotic use, obesity, hemolytic disease, and chemotherapy in 8 (12.3%), 7 (10.8%), 6 (9.2%), and 4 patients (6.2%), respectively. We observed multiple stones (including sandy stones) in 31 patients (47.7%), a single stone in 17 (26.2%), and several stones in 17 (26.2%). GS with a diameter of <5 mm occurred in 45 patients (69.2%). Comorbidities included hepatitis, choledocholithiasis, cholecystitis, and acute pancreatitis in 20 (30.8%), 11 (16.9%), 11 (16.9%), and 4 patients (6.2%), respectively. Ursodeoxycholic acid (UDCA) was administered to 54 patients (83.1%), leading to stone dissolution in 22 patients (33.8%) within 6 months. Cholecystectomy was performed in 18 patients (27.7%) (mean age, 11.9±5.1 years). Most patients treated surgically had multiple stones (83%) and stones measuring <5 mm in size (89%), and 66.7% of patients had cholesterol stones. Conclusion: Cholecystectomy is feasible in patients with small-sized or large numbers of GS and those with persistent abdominal pain and/or jaundice. UDCA administration with close follow-up is recommended in patients with uncomplicated GS.

군소 알을 섭취한 후 발생한 급성 독선간염 2예 (Two Patients of Acute Liver Damage following the Ingestion of a Sea Hare Eggs)

  • 이원재;임현술
    • 농촌의학ㆍ지역보건
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    • 제30권2호
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    • pp.241-249
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    • 2005
  • 군소(Aplysia Kurodai, sea hare)의 내장 또는 알을 섭취한 후 아플리시아닌(aplysianin) 자연독에 의해 독성간염이 발생할 수 있다. 저자들은 경상북도 울릉군 울릉의료원을 방문한 군소 알을 섭취한 후 급성 독성간염이 발생한 2예를 경험 하였기에 문헌 고찰과 함께 보고하는 바이다. 환자 A는 47세 남자로 2003년 5월 17일 울릉도 바닷가에서 군소와 알을 직접 채취하여 내장을 제거하고 삶아 먹은 10시간 30분 후 구역 및 구토, 복통, 수양성설사와 급성 독성간염이 발생하였다. 환자 B는 48세 남자로 2004년 5월 16일 울릉도 바닷가에서 군소와 알을 직접 채취하여 내장을 제거하고 삶아 먹은 10시간 30분 후 구역 및 구토, 복통, 수양성설사와 급성 독성간염이 발생하였다. 환자들은 내원 당시 탈수 소견을 보여 수액공급 및 혈청 전해질 불균형을 교정하고 전격간염으로 진행 여부를 관찰하면서 보존적 치료를 시행하여 호전되었다. 저자가 파악하기로는, 본 사례 보고가 군소 알을 섭취한 후 독성간염이 발생한 국내 첫 보고이다. 군소의 내장 또는 알을 섭취한 후 중독증이 발생할 수 있다는 사실을 의료인과 일반인이 인지하고 정확한 진단과 예방을 위하여 노력하여야 할 것이다.

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A Case of Vivax Malaria Complicated by Adult Respiratory Distress Syndrome and Successful Management with Extracorporeal Membrane Oxygenation

  • Lee, Hyun-Jung;Baek, Ji-Hyeon;Chae, Myoung-Hun;Joo, Hoyeon;Lee, Jin-Soo;Chung, Moon-Hyun;Park, Yun-Kyu;Kim, Joung-Teak
    • Parasites, Hosts and Diseases
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    • 제51권5호
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    • pp.551-555
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    • 2013
  • Complicated malaria is mainly caused by Plasmodium falciparum, but, increasingly, Plasmodium vivax is also being reported as a cause. Since the reemergence of indigenous vivax malaria in 1993, cases of severe malaria have been steadily reported in Korea. Herein, we report a case of vivax malaria complicated by adult respiratory distress syndrome (ARDS) that was successfully managed with extracorporeal membrane oxygenation (ECMO). A 59-year-old man presented at our hospital with fever and abdominal pain, which had persisted for 10 days. On admission, the patient had impaired consciousness, shock, hypoxia and haziness in both lungs, jaundice, thrombocytopenia and disseminated intravascular coagulation, metabolic acidosis, and acute kidney injury. A peripheral blood smear and a rapid diagnostic test verified P. vivax mono-infection. Ten hours after admission, hypoxia became more severe, despite providing maximal ventilatory support. The administration of antimalarial agents, ECMO, and continuous venovenous hemofiltration resulted in an improvement of his vital signs and laboratory findings. He was discharged from the hospital 7 weeks later, without any sequelae.

만성 B형 간질환 환자에서 심한 황달을 동반한 급성 악화 (Acute Exacerbation with Severe Jaundice in Chronic Hepatitis B Patient)

  • 이헌주
    • Journal of Yeungnam Medical Science
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    • 제14권2호
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    • pp.483-496
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    • 1997
  • 만성 B형 간염의 경과중 흔히 볼 수 있는 간기능의 이상은 대부분 심한 황달의 동반없이 혈청 AST와 ALT의 증가만 보이면서 악화되는 것이다. 저자는 심한 황달을 동반한 16명의 만성 B형 간염 악화 환자(연구군)와 심한 황달없이 AST와 ALT치만 증가된 13명의 환자(비교군)를 비교관찰하였다. PMC 제재를 복용했던 환자는 연구군에서 11명(68.8%), 대조군에서 1명(7.7.%)으로 나타났으며 PMC를 포함하여 각종 약제 및 알콜 섭취가 저명했던 환자가 연구군에서 15명(93.8%), 대조군에서는 2명(15.4%)이었다. 혈청 HBeAg 양성율은 급성 악화전에는 연구군에서 14명 중 7명(50.0%), 비교군에서는 13명 모두 (100%)에서 양성이었으며, 급성 악화 경과후에는 연구군에서는 변함없었고 비교군에서는 13명중 3명(23.1%)에만 양성이었다. 연구군 중 anti-HBe 양성화는 한 사람도 생기지 않았고 6명이 사망하였으며 대조군에서는 8명의 환자에서 anti-HBe 양성화가 생겼고 아무도 간기능 부전으로 사망하지 않았다. 만성 B형 간질환에서 심한 황달을 동반한 급성 악화와 관련있는 요인은 진행된 만성 활동성 간염, 간경변 등 근본적으로 진행된 간기능 저하와 동반된 부적절한 약제나 알콜 복용이 확실히 관계있을 것으로 사료되며 간기능 부전도 그리 드물지 않다. 반면에 간경변으로 진행되기 전 상대적으로 진행이 덜 된 비교군의 만성 B형 간염 환자에서는 황달의 저명한 증가없이 간기능이 갑자기 악화될 때는 자연적인 혈청 anti-HBe 양성전환의 동반이 흔한 것으로 나타났다.

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