• Title/Summary/Keyword: fatal cases

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Erdheim Chester Disease (ECD): A Case Report (Erdheim Chester Disease (ECD): 증례 보고)

  • Lee, Jin-Ho;Jung, Sung-Taek;Choi, Yoo Duk
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.1
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    • pp.28-32
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    • 2013
  • Erdheim Chester disease (ECD) is very rare non-Langerhans cell histiocytosis (LCH) which occurs in the skeletal system and multiple organs. As it is progressive, sometimes it causes fatal results. However, it is often misdiagnosed as LCH or multiple bone metastasis and, thus, is very difficult to diagnose. In Korea, only 10 cases were first reported in 1999. In particular, there have been a few orthopedic approaches or reports in English-speaking literatures, and no report has been issued in Korea. The authors performed bone biopsy in patients with knee and lower extremity pain who were referred for the integrated treatment. We attempts to report this diagnosis experience with literature review.

Anaphylactic Shock after Intravenous Injection of Penicillin in a Patient with Maxillary Osteonecrosis: Report of a Case (상악골괴사 환자에서 페니실린 정주 후 아나필락틱 쇼크: 증례보고)

  • Oh, Ji-Hyeon;Son, Jeong-Seog;Choi, Byung-Ho;Lee, Jeong-Sub;Kim, Ji-Hun;Yoo, Jae-Ha
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.4
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    • pp.243-250
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    • 2014
  • Generalized anaphylaxis is a most dramatic and acutely life-threatening allergic reaction and may cause death within a few minutes. Differential diagnosis of anaphylaxis is made by clinical signs, such as, mental change, respiratory distress, hypotension, hypoglycemia, urticaria and angioedema. Especially, insulin reaction, myocardial infarction and vasovagal syncope are considered as differential diagnosis. In cases of fatal anaphylaxis, respiratory and cardiovascular disturbances predominate and are evident early in the reaction. This is a case report of the intensive care of anaphylactic shock after intravenous injection of the penicillin in a old medically compromised patient with the maxillary osteonecrosis. The anaphylactic shock symptoms, such as, unconsciousness, respiratory disorder, no pulsation on carotid artery and cardiopulmonary arrest are occurred in intravenous injection of augmentin 1.2 g after the skin test. In spite of immediate emergency cares, such as intravenous injection of epinephrine, endotracheal intubation, cardiopulmonary resuscitation, and continuous intensive care, the patient is expired in 58 hours after anaphylactic shock attack.

Developing the Accident Injury Severity on a Field of Construction Work Using Ordered Probit Model (순서형 프로빗 모형을 적용한 공사장 교통 사고심각도 분석)

  • Hong, Ji-Yeon;Kim, Kyung-Tae;Lee, Soo-Beom
    • Journal of the Korean Society of Safety
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    • v.26 no.2
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    • pp.89-98
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    • 2011
  • The traffic accidents at a construction site, which happen due to construction vehicles' frequent access to a construction site, its subsequent conflicts with ordinary vehicles and pedestrians, and inappropriate installation & management of traffic security facilities, have not many proportions in all traffic accidents, but obviously, the accident damage is quite serious when comparing the level of the fatal per one accident. This research conducted an analysis of traffic accident injury severity using Ordered Probit Model in relation to 241 traffic accident cases that occurred caused by construction sites among the traffic accidents that took place in Seoul and Gyeoggi-do region for two years from 2006 until 2007. As a result, the significant variables enough to explain traffic accident injury severity were analyzed to be the state of road surface, linear shape of an accident spot & whether the damaging car belongs to the vehicle for construction, and whether vehicles have access to a construction site at the time of an accident. Through this, this research found out some fact as follows: first, there need to be more aggressive management of the vehicles for construction and a year-round placement of the manpower who can control vehicular access to a construction site. Second, it is necessary to get drivers to recognize the fact that there exists a construction site on the construction section which is on the border of curved roads in advance to prevent a traffic accident, helping to reduce socioeconomic loss & costs incurred by a traffic accident.

A Parametric Study on Tensile Stress of a Hybrid Floating Structure System (매개변수 연구를 통한 하이브리드형 부유식 구조물의 인장응력 발생 분석)

  • Zi, Goangseup;Lee, Seung-Jung;Kwak, Yeon-Min;Jeong, Youn
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.32 no.5B
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    • pp.313-320
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    • 2012
  • A hybrid floating structure system combined with pontoon and semi-submersible type modules is proposed. This new system can reduce tensile forces of bottom slabs which could cause fatal damage of concrete floating structures. We performed a parametric study on the dimensions of this new system and investigate the sensitivity of the parameters to the behavior. In order to investigate various cases efficiently, we developed a simple two-step static analysis method for the fluid-structure interaction. An optimum system is derived from the investigation of the analysis results, weights and drafts of the hybrid structure. This study shows that introducing this new system to concrete floating structures is an effective way to reduce the tensile force of the bottm slab of such a floating structure. Also, it was found that when the length of the semi-submersible module is about 15%, the behavior would be optimal in the considered case.

Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma presented as Cushing syndrome and complicated by invasive aspergillosis

  • Cho, Jae Ho;Jeong, Da Eun;Lee, Jae Young;Jang, Jong Geol;Moon, Jun Sung;Kim, Mi Jin;Yoon, Ji Sung;Won, Kyu Chang;Lee, Hyoung Woo
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.132-137
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    • 2015
  • Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma has been rarely reported, whereas only a few cases of Cushing syndrome accompanied by opportunistic infections have been reported. We experienced a patient with pheochromocytoma with ectopic Cushing syndrome complicated by invasive aspergillosis. A 35-year-old woman presented with typical Cushingoid features. Her basal plasma cortisol, ACTH, and 24-hour urine free cortisol levels were significantly high, and 24-hour urine metanephrine and catecholamine levels were slightly elevated. The endogeneous cortisol secretion was not suppressed by either low- or high-dose dexamethasone. Abdominal computed tomography (CT) revealed a heterogeneous enhancing mass measuring approximately 2.5 cm in size in the left adrenal gland. No definitive mass lesion was observed on sellar magnetic resonance imaging. On fluorine-18 fluorodeoxyglucose positron emission tomography/CT, a hypermetabolic nodule was observed in the left upper lung. Thus, we performed a percutaneous needle biopsy, which revealed inflammation, not malignancy. Thereafter, we performed a laparoscopic left adrenalectomy, and its pathologic finding was a pheochromocytoma with positive immunohistostaining for ACTH. After surgery, the biochemistry was normalized, but the clinical course was fatal despite intensive care because of the invasive aspergillosis that included the lungs, retina, and central nervous system.

Massive pulmonary hemorrhage in enterovirus 71-infected hand, foot, and mouth disease

  • Lee, Dong Seong;Lee, Young Il;Ahn, Jeong Bae;Kim, Mi Jin;Kim, Jae Hyun;Kim, Nam Hee;Hwang, Jong Hee;Kim, Dong Wook;Lee, Chong Guk;Song, Tae Won
    • Clinical and Experimental Pediatrics
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    • v.58 no.3
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    • pp.112-115
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    • 2015
  • Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.

Epidemiology of Pancreatic Cancer in Vojvodina Province in Serbia

  • Smiljana, Rajcevic;Mikov, Marica Miladinov;Petrovic, Vasa;Jasna, Trifunovic;Tihomir, Dugandzija;Milanka, Tatic
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10779-10782
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    • 2015
  • Purpose: Analysis of descriptive epidemiological characteristics of pancreatic cancer in Vojvodina, Serbia. Materials and Methods: The study covers population of Vojvodina in the period from 2000 to 2009. The method used for data processing was the descriptive. The data, referring to a specified period of time, were analyzed from chronological and demographic aspects and according to histological diagnosis. Results: In the period from 2000 to 2009, there were 2,108 registered cases of pancreatic cancer of which 1,886 had a fatal outcome. Standardized incidence rates varied between 5.7 and 9.1 per 100,000 population in males and between 4.2 and 5.3 in females. Linear incidence trends in males in the specified period of time, based on crude (r=0.7883, p<0.05) and standardized (r=0,6373, p<0,05) incidence rates, demonstrated increase. Annual percent increase in the crude incidence rate was 4.5% in males, and 2.8% in females. Age-standardized mortality rates varied between 5.2 and 7.5 per 100,000 population in males and 3.6 and 4.7 in females. Linear mortality trends in males in the specified period of time, based on crude (r=0.8795, p<0.05) and standardized (r=0.7669, p<0.05) mortality rates, also demonstrated annual percent increase. Conclusions: Data analysis shows unfavorable onco-epidemiological situation related to pancreatic cancer in Vojvodina, in aspects of both incidence and mortality. Absence of primary and secondary prevention does not allow medical institutions to successfully fight against this disease.

A CLINICAL STUDY OF THE BLOOD LOSS AND TRANSFUSION ON ORTHOGNATHIC SURGER (악교정 수술시 출혈량과 수혈에 관한 임상적 연구)

  • Bae, Jun-Soo;Lyoo, Jong-Ho;You, Jun-Young;Kim, Yong-Kwan;Shin, Dong-Yong;Lee, Chang-Sun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.4
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    • pp.300-304
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    • 1998
  • Moderns have desire likely to be further good-looking concomitant with a qualitative advancement of the life. With one of this phenomenon, an orthognathic surgery performing at the dept. of oral and maxillofacial surgery have been becoming a more extensively. It's possible to occur many complications during the operations and especially, an excessive bleeding of those may be fatal and so a transfusion is performing for the prevention &management of that. But, because of the rate of increase of an blood-born infection like AIDS via transfusion, nowadays an autologous blood transfusion is interesting to us. We made a comparative study of an amount of blood loss &transfusion using hemoglobin value after classifying the orthognathic surgeries from Feb. '97 to Mar. '98 in single-jaw and doublejaw surgery. And we intended to set a standard against of a routine preoperative cross-matching deciding the amount of predictive homologous blood transfusion according to operative method. Simultaneously, we studied the realization &effectiveness of autologous blood transfusion with some cases, so would like to present. Results: 1. Single-jaw operation can be performed without blood transfusion or with homologous blood transfusion through only blood typing & screening. 2. We commonly transfuse two units of blood with double-jaw operation and an autologous blood transfusion has much more advantage than an homologous blood transfusion. 3. We can reduce charge associated with blood transfusion through precisely preoperative evaluation of patients and proper type of blood transfusion.

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Clinical Study of Gamdutang Complex Formula on Patients of Acute Renal Failure due to Paraquat Intoxication

  • Kim Dong Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.3
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    • pp.588-593
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    • 2002
  • Paraquat, one of the potent herbicides, causes fatal damage to many vital organs, when orally ingested, resulting in circulatory failure, respiratory distress syndrome, and a few other serious problems, but there is no known specific antidote against it. Of the possible problems related to paraquat intoxication, oliguric acute renal failure, which has been known to develop within 24 or 48 hours after intoxication, are notoriously life-threatening. So we attempted to investigate the clinical characteristics and progress of paraquat-induced acute renal failure and the therapeutic possibilities of herbal medicines. All of the fifteen subjects were treated with intravenous fluid injection of 5% dextrose saline or 10% dextrose water in conjunction with herbal medicines which were used for oral administration or gargling. Gamdutang, a decoction of Semen Glycin(黑豆 200g) and Radix Glycyrrhizae(甘草 100g) with addition of other herbs when necessary, was administered orally. At the same time, gargling fluid, consisted of Chinese ink(墨汁), char-frying powder of Rhei Rhizoma(大黃炒炭末), Succus phyllostachyos(竹瀝), was used to detoxify the oral cavity. Serum levels of Blood Urea Nitrogen(BUN) and Creatinine reached its peak on the third day of hospitalization, but then decreased and fell within the normal range on the 7th day and remained there. Serum levels of Na+ and K+ decreased down below the lower limits of normal range on the 7th day and on the 3rd day, respectively. Then they returned back within normal limits. Mean urine output on the 1st day of hospitalization was 1,050ml and it continuously increased to reach more than 2,000ml on the 14th day. From that day on, it stayed over 2,000ml. Fifteen cases of acute renal failure caused by paraquat intoxication were treated with combined treatments of oriental and western medicine in our hospital. However, we think that it is necessary to study further about the way to combine oriental and western medicine, to find out a more effective treatment method.

Fatal Balamuthia Amebic Encephalitis in a Healthy Child: A Case Report with Review of Survival Cases

  • Krasaelap, A.;Prechawit, S.;Chansaenroj, J.;Punyahotra, P.;Puthanakit, T.;Chomtho, K.;Shuangshoti, S.;Amornfa, J.;Poovorawan, Y.
    • Parasites, Hosts and Diseases
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    • v.51 no.3
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    • pp.335-341
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    • 2013
  • Balamuthia mandrillaris is one of the 4 amebas in fresh water and soil that cause diseases in humans. Granulomatous amebic encephalitis (GAE), caused by B. mandrillaris, is a rare but life-threatening condition. A 4-year-old, previously healthy, Thai girl presented with progressive headache and ataxia for over a month. Neuroimaging studies showed an infiltrative mass at the right cerebellar hemisphere mimicking a malignant cerebellar tumor. The pathological finding after total mass removal revealed severe necrotizing inflammation, with presence of scattered amebic trophozoites. Cerebrospinal fluid (CSF) obtained from lumbar puncture showed evidence of non-specific inflammation without identifiable organisms. A combination of pentamidine, sulfasalazine, fluconazole, and clarithromycin had been initiated promptly before PCR confirmed the diagnosis of Balamuthia amebic encephalitis (BAE). The patient showed initial improvement after the surgery and combined medical treatment, but gradually deteriorated and died of multiple organ failure within 46 days upon admission despite early diagnosis and treatment. In addition to the case, 10 survivors of BAE reported in the PubMed database were briefly reviewed in an attempt to identify the possible factors leading to survival of the patients diagnosed with this rare disease.