• Childhood Kidney Diseases
• /
• 제28권2호
• /
• pp.80-85
• /
• 2024

Lupus anticoagulant hypoprothrombinemia syndrome (LAHPS) is a rare entity characterized by the presence of lupus anticoagulant (LA) and prothrombin (factor II) deficiency. It may cause severe bleeding contrary to classical antiphospholipid syndrome. Here, we report a case of LAHPS presenting with a hemorrhagic ovarian cyst in a 17-year-old girl with systemic lupus erythematosus (SLE) nephritis. She had been followed up for 8 years. Her first manifestation of SLE was prolonged gingival bleeding after tooth extraction at 9 years of age. During the follow-up period, she had neither severe bleeding nor thrombotic complications despite a positive LA and a prolonged activated partial thromboplastin time (aPTT). At this visit, the patient presented with colicky abdominal pain, a hemorrhagic ovarian cyst, a prolonged prothrombin time, a prolonged aPTT, a low factor II level, and a positive LA, leading to the diagnosis of LAHPS. While a hemorrhagic ovarian cyst resolved completely in 3 months, she received oral pill, transfusions of red blood cells and plasma, and intravenous cyclophosphamide pulse therapy in combination with glucocorticoids due to persistent menorrhagia, anemia, prolonged aPTT, and lupus flaring. Thus, LAHPS needs to be considered in SLE patients with positive LA and prolonged aPTT.

• 한국임상수의학회지
• /
• 제25권4호
• /
• pp.310-313
• /
• 2008

C. perfringens is the most important enteric clostridial pathogen of animals. C. perfringens type A has been associated with hemorrhagic enteritis in a wide lange of domestic and wild mammals. But all types of C. perfringens can be normal inhabitants of the intestine of most mammals. We have a special case that showed C. perfringens type A infection in a hippopotamus (Hippopotamus amphibius) cub at Seoul Grand Park Zoo. Male, hippopotamus cub died in 3 days after birth. Clinical features of the hippopotamus cub have showed lethargy and anorexia before death. Gross post-mortem findings of the hippopotamus were hemorrhagic enteritis of intestine. Histopathologically, ruminant stomach and intestine showed hemorrhagic lesions and the lumen of the small intestine was filled with mucoid and hemorrhagic fluid. Also, intestine and stomach of hippopotamus were distended with gas and hemorrhagic fluid. C. perfringens was isolated in culture of small intestine and the presence of C. perfringens type A was confirmed by PCR. This case indicated that C. perfringens type A could be considered as a virulence factor responsible for causing death of a newborn hippopotamus.

• 대한한방내과학회지
• /
• 제28권4호
• /
• pp.872-885
• /
• 2007

Objective : Stroke is one of the most common causes of death in Korea. This study was done to evaluate the association of complete blood count (CBC) with the risk of hemorrhagic stroke and ischemic stroke. Methods : In 217-case patients with ischemic stroke or hemorrhagic stroke and 146 healthy control subjects without stroke, hypertension, diabetes mellitus, hyperlipidemia, or ischemic heart disease and 160 controls without ischemic stroke or hemorrhagic stroke, we tested and compared white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hgb), hematocrit (Hct) and platelet. These data were statically analyzed by general linear models and binary logistic regression analysis to get each adjusted odds ratio. Results :The level of WBC was significantly higher in all cases. The level of RBC, Hct and Hgb was significantly lower in patients of ischemic stroke. The level of platelet was significantly higher in patients of ischemic stroke. Conclusion : These results suggest high WBC may be a risk factor of hemorrhagic stroke and ischemic stroke and low RBC, low Hct, low Hgb and high platelet may be risk factors of ischemic stroke in Koreans.

• Journal of Korean Neurosurgical Society
• /
• 제29권8호
• /
• pp.995-1000
• /
• 2000

Objective : The authors reviewed 280 cases with intracranial arteriovenous malformations(AVMs) to identify risk factors of hemorrhage. Patients and Methods : From 1983 to 1997, a total 280 patients with AVMs were treated. Among them, 64% had a history of hemorrhage. Angiograms were retrospectively analyzed with particular attention to the size of the AVM, venous drainage, the location of the AVM and presence of associated aneurysm or varix. These characteristics were statistically analysed in relation to occurrence of hemorrhage. Results : A single variate analysis demonstrated that small size(p=0.0003), deep venous drainage(p=0.025) and periventricular location(p<0.0001) had a strong positive correlation. Associated aneurysms and varices were not found as hemorrhagic risk factors. A multivariate analysis revealed that the size of the AVM was most significant hemorrhagic factor(p=0.0003) followed by deep venous drainage(p=0.025). AVMs with small size and deep venous drainage bled more frequently regardless of their locations. Conclusion : These data would be useful in identifying patients at higher risk for developing hemorrhage of intracranial AVMs.

• 대한물리치료과학회지
• /
• 제9권3호
• /
• pp.19-29
• /
• 2002

This study questionnaires 166 inpatients and outpatients with stroke in 8 hospitals, including Wonkwang University Gwangju Korean Hospital from July 2 to 31, 2001 in order to find out the influence of general nature, smoking, drinking, obesity, and perception of saltness of patients with stork on the outbreak of stroke and to examine important factors by dividing into hemorrhagic and ischemic stroke. Finally, collected data is analyzed statistically, using SPSS 7.5 statistics package. This study reaches a conclusion as follows. 1. For general nature, 86(51.8%) patients have hemorrhagic stroke and 80(48.2%), ischemic stroke in the rate of 1.59:1(male:female), suggesting that male's outbreak is more than female's. Outbreak age is ranged from 20 years to 90 years in order of 60's, 50's, and 40's. 50's-60's accounts for more than half percentage. 2. For smoking, 73(71.6%) of male patients has smoking experience and their 562% has ischemic stroke. Their cross-analysis for hemorrhagic and ischemic stroke shows significant difference with $x^2=3.90$(p<0.05). 48.6% of patients with smoking experience is ranged from 1 to 10 a day in smoking quantity. 3. For drinking, 90(88.2%) of male patients has drinking experience and their 53.3% has hemorrhagicstroke. Their cross-analysis for hemorrhagic and ischemic stroke shows no significant difference with x2=3.40(p<0.1). 59.3% of patients with drinking experience is classified as a overdrinking group. 4. For obesity, low weight is 8(4.8%): normal, 111(66.9%): excessive, 40(24.1%), and obesity, 7(4.2%). In patients with hemorrhagic stroke, excessive weight and obesity are somewhat high(33.7%). The cross-analysis for male's hemorrhagic and ischemic stork by dividing BMI into more and less than 25 shows no significant difference with x=3.52(p<0.1). 5. For perception of saltness, 21(12.7%) patients eat flat: 76(45.8%) normally, and 69(41.5%), saltily. Many patients with ischemic stroke are classified as a group who eat saltily. The cross-analysis for male's hemorrhagic and ischemic stroke shows signifiant difference with x2=10.99(p<0.05). As this study has small sample and selects inpatient and outpatient in certain local hospital, it is difficult to generalize. But the cross-analysis of male's hemorrhagic and ischemic stroke shows signifiant difference in smoking and perception of saltness. Drinking and obesity are more important factors in hemorrhagic stroke and smoking and perception of saltness in ischemic stroke.

• 대한한의학회지
• /
• 제22권4호
• /
• pp.69-78
• /
• 2001

Objectives : It is known that cigarette smoking is associated with increased risk of both thrombotic and hemorrhagic stroke. However, in Korea, especially in the academic world of Korean Medicine, there is a lack of study about the relation between cigarette smoking and stroke. We carried out a case-control study to clarify the relation between cigarette smoking and stroke. Method : We interviewed 441 stroke patients (236 men, 205 women) as a case group and 432 non-stroke patients (208 men, 224 women) as a control group. We investigated the smoking pattern of all patients and stroke-subtype of the case group. Smoking pattern is classed into two (Class I), four (Class II) and five groups (Class III). Class I consists of current non-smokers and current smokers. Class II consists of non-smokers, former smokers, current light smokers and current heavy smokers. Class III consists of never smoked, secondhand smokers, former smokers, Current light smokers and current heavy smokers. Stroke-subtype consists of cerebral infarction and cerebral hemorrhage. Results : The percentage of current smokers of case group is higher significantly than that of control group. The number of cigarettes smoked per day is associated positively with the risk of stroke. According to our study, generally cigarette smoking is related with ischemic stroke. The percentage of secondhand smokers of the case group is lower than that of the control group. According to our study, characteristically secondhand smoking is associated with hemorrhagic stroke. Conclusions : From the above results we found that cigarette smoking is an important risk factor of stroke - especially cerebral infarction - and the number of cigarettes smoked per day is associated positively with the risk of stroke. Characteristically according to our study, secondhand smoking is associated with hemorrhagic stroke. Overall we conclude that cigarette smoking may be an important preventable factor for stroke.

• 재활복지
• /
• 제21권2호
• /
• pp.247-259
• /
• 2017

출혈성 뇌졸중 후 인지기능의 저하는 장기적 기능회복에 영향을 주는 주요한 인자이다. 이에 저자들은 출혈성 뇌졸중 환자에서 주요 회복시기에 따른 인지기능의 변화와 일상생활활동 독립수준 및 삶의 질의 변화를 추적하고, 인지 기능 변화와 관련된 연관 요인을 파악하며, 이를 통한 향후 관리방안 제시를 위한 기초자료를 마련하고자 이 연구를 시행하였다. 1개 상급종합병원에 입원한 초발 출혈성 뇌졸중 환자 25명의 환자를 대상으로 발병 후 7일, 발병 후 3개월, 발병 후 6개월, 발병 후 12개월 시점에 Glasgow Coma Scale (GCS), 한국형 정신상태 간이검사(K-MMSE), 한국판 수정바델 지수(K-MBI), 건강관련 삶의 질 지수(EQ-5D)를 사용하여 연구 대상자의 인지기능을 포함한 전반적인 기능 변화와 관련한 평가를 시행하였다. K-MMSE는 발병 후 7일 $13.32{\pm}11.80$점, 3개월 15점, 6개월 17점, 12개월에 18점으로 의미 있는 회복을 보였으며(p=0.007), GCS, K-MBI, EQ-5D와 같은 다른 기능평가에서도 시간의 경과에 따라 의미 있는 개선을 보였다(p<0.01). 발병 12개월의 인지기능에 영향을 미치는 요인 분석에서 발병 당시의 연령 및 출혈성 뇌졸중의 유형, 발병 7일의 GCS이 통계적으로 유의한 연관성을 나타내었다. 본 연구를 통해 출혈성 뇌졸중 환자에 있어서 지속적으로 인지 기능을 포함한 전반적인 기능 회복이 발병 후 1년까지도 이루어짐을 확인하였고, 이에 관련된 연관 요인을 확인함으로써, 출혈성 뇌졸중 환자의 기능회복에 대한 이해와 그에 대한 지속적인 관리 및 치료의 필요성을 높일 수 있는 근거가 될 수 있을 것으로 보인다.

• 한국어병학회지
• /
• 제31권1호
• /
• pp.49-55
• /
• 2018

Tendency of viral hemorrhagic septicemia virus (VHSV) detection from 2001 to 2016 in Korea was studied based on 15 reported cases. Since the VHSV was first detected from cultured olive flounder (Paralichthys olivaceus) in Pohang in 2001, it has been continuously reported from olive flounder farms in various regions of the Korean coastal area. So far, the virus has been detected from 2 farmed fishes, 12 wild marine fishes and 2 marine bivalves. All the 67 isolates were belong to VHSV genotype IVa. The predisposing factor analysis from different olive flounder farms revealed that the VHSV were highly detected from the juveniles under 40 g in body weight, in the temperature range from 9.5 to $17^{\circ}C$ and during the period of March to June. Therefore, we recommend that farmers, need to exercise caution against VHSV infection in Spring.

• Journal of Korean Neurosurgical Society
• /
• 제64권5호
• /
• pp.763-775
• /
• 2021

Objective : Hemorrhagic transformation (HT) can be occurred after acute cerebral infarction. HT can worse symptoms in severe cases and adversely affect long-term prognosis. As bone and vascular smooth muscle are composed of type 1 collagen, we aimed to identify a potential relationship between bone mineral density (BMD) and HT after acute cardioembolic stroke. Methods : As an indicator of BMD, we used mean frontal skull Hounsfield unit (HU) values on brain computed tomography (CT). Multivariative hazard ratios were calculated using Cox regression analysis to identify whether the osteoporotic condition was an independent predictor of HT after acute cardioembolic stroke. Results : This 11-year analysis enrolled 506 patients who diagnosed as acute cardioembolic infarction. The first tertile of skull HU value was an independent predictor of HT development compared to the third tertile (hazard ratio, 2.12; 95% confidence interval, 1.13-3.98; p=0.020). We observed no interactions between age and skull HU with respect to HT statistically. Conclusion : The results of this study revealed an association between osteoporotic conditions and HT development after acute cardioembolic stroke. A convenient method to measure the cancellous bone HU value of the frontal skull using brain CT images may be useful for predicting HT in patients with acute cerebral infarction.

• Childhood Kidney Diseases
• /
• 제16권1호
• /
• pp.51-53
• /
• 2012

헤노흐-쇤라인 자반증(HSP)은 소아에서 가장 흔한 혈관염으로 피부 자반증, 관절염, 복통, 그리고 신염 등을 특징으로 한다. HSP 소아에서 물집을 동반하는 경우는 매우 드물다. 관절염을 동반한 HSP를 보인 9세 여아에서 경구용 스테로이드 치료를 시작했음에도 불구하고 피부 자반이 빠르게 출혈성 물집 병변으로 진행되었다. 치료 7일 후 몇몇 궤양성 병변은 경미한 흉터로 남았으나 관찰 6개월 후 흉터는 완전히 소멸되었다. 현미경적 혈뇨는 관찰 6개월간 지속되었으나 단백뇨는 관찰되지 않았다. HSP 소아에서 물집이 동반되었을 경우, 신장의 예후에는 직접적인 연관은 없었다. 임상적으로 HSP 진단기준을 만족한다면 HSP 진단을 위해 피부조직검사는 필요 없을 것으로 보이며, 더 많은 증례가 모이면 정확한 결론을 내릴 수 있을 것으로 사료된다. 관절염을 동반한 HSP 9세 여자 소아에서 경구용 스테로이드 치료를 시작했음에도 불구하고 피부 자반이 빠르게 출혈성 물집 병변으로 진행되는 HSP 증례를 경험하였기에 보고하는 바이다.