• Journal of Chest Surgery
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• v.11 no.4
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• pp.516-522
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• 1978

In spite of recent improvement of the medical and surgical treatments, there are many significant problems in the management of thoracic empyema. This is a clinical analysis of 49 cases of thoracic empyema who underwent lung decortication for a period of 6 years and 5 months extending from May, 1972 to Aug. 1975. The following results were obtained: Male to female ratio was 2. S to 1. The age ranged between Sand 69, bnt was mostly 2r.d and 5th decade. The underlying diseases were pulmonary tuberculosis (30 cases, 61. 1 SO, , ), posttraumatic hemothorax (7 cases, 14.396). pneumonia (6 cases, 12.2%), lung abscess (2 cases, 4.2%), paragonimiasis (2 cases, 4.2%). spontaneous pneumothorax (1 case, 2.1%), and unknown origin (1 case, 2.1%). In 13 cases (26.5%), positive bacterial growth on culture was reported. There were single infection in 11 cases and mixed infection in 2 cases. The organisms grown were Staphylococcus, alpha-hemolytIc Streptococcus, Alkaligenes fecalis, Escherichia coli, Pseudomonas, SerratIa, Enterobacter agglomerans, and Enterococcus in order of frequency. Staphylococcus, Streptococcus, and Serratia were sensitive to several different kinds of antibiotics. But Pseudomonas, Escherichia co:i, and Enterococcus were sensitive to only one or two antibiotics. Leukocytosis was observed In acute empyema, but not in chronic empyema. Hemoglobin and hematocrit were all within normal limits. Preoperative liver function tests were within normal limits in most of the cases. In 49 cases, lung decortication alone was performed in 40 cases (S1. 696), and for the remaining 9 cases (1S. 4%), additional surgical procedures were necessary, i. e., lobectomy (6cases). partial thoracoplasty (2 cases), and lobectomy & partial thoracoplasty (1 cases). The results of lung decortication in thoracic empyema were goed. 38 cases (77.5%) healed with no complication, and 10 cases (20.4%) were complicated by bleeding, wownd infection, pleural infection, chondritis, and psychosis. These complications resolved ultimately leaving no sequelae. One death was recorded (2.1%), and the causes of death were postoperative pleural infection, sepsis and hepatic insufficiency.

• Journal of Veterinary Clinics
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• v.33 no.1
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• pp.39-42
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• 2016

A 10 months old, male Poongsan dog was referred with a history of right forelimb lameness due to hit by a car a few hours before presentation. On the physical examination, the dog showed pale mucous membrane, respiration distress, and skin abrasions. The main laboratory finding was leukocytosis, while hematocrit was normal. Abdominal radiography revealed the loss of abdominal serosal detail, which was diagnosed as peritoneal hemorrhage on ultrasonography (US) and aspiration. On computed tomography (CT), hepatic and splenic injuries were seen characterized by the discontinuity of the capsule with irregular margin and lower density lesions than parenchyma. No contrast enhancing area were shown in the laceration lesion. The accessory spleen was incidentally found by US and CT. In this case, acute intra-abdominal hemorrhage from splenic and hepatic laceration was diagnosed using CT.

• Journal of Veterinary Clinics
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• v.27 no.4
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• pp.453-456
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• 2010

A one-month-old, 0.9 kg BW, male Korean Sapsal dog with anorexia, anuria, ataxia and depression was referred. On physical examination, the dog was showed tachycardia, hypothermia and pale mucous membrane. Hematologic values showed leukocytosis and mild anemia. Serum chemistry profile results revealed increased BUN (57.3 mg/dl) and $NH_3$ ($584\;{\mu}g/dl$), decreased albumin, sodium and potassium. Urinalysis showed hematuria, proteinuria, glucosuria, bacteriuria (Staphylococcus spp.) and magnesium ammonium phosphate crystalluria. On radiographic finding, urinary bladder was enlarged and 2 mm diameter radiopaque urolith was showed between os penis and prescrotal region. Urolithiasis was surgically corrected by urethrostomy.

• Korean Journal of Veterinary Research
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• v.34 no.2
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• pp.407-415
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• 1994

Present experiments were undertaken in order to find out the most available diagnostic method for acute pancreatitis. Experimental dogs were divided into experimental group and control group. The experimental dogs were laparotomized and their pancreatic ducts were ligated for the induction of pancreatitis. The control dogs were laparotomized only for comparison. In addition to the complete blood count, serum amylase and lipase activities, serum glucose, total protein and albumin contents were measured daily for 11 days after the operation. Fecal fat droplet count by Sudan III staining and fecal trypsin activity examination by x-ray film digetion test were also undertaken daily. The results obtained were summarized as follows; 1. Serum amylase activities of the experimental group increased to peak on the third day and returned to the preoperative values on the eighth day. 2. Serum lipase activities of the experimental group increased to peak on the first day and returned to the preopertive values within six to eight days. 3. Serum glucose contents of the experimental group showed significant increse only on the first day. 4. Serum albumin contents of the experimental group decreased significantly during the experimental period. Whereas those of the control group significantly decreased only on the first day. 5. The experimental group showed marked leukocytosis, neutrophilia, and lymphopenia for the first 5 or 8 days. Whereas the control group showed only neutrophilia for the first 3 days. 6. The results of fecal fat droplet count showed some diagnostic value on the third and fourth day in only one experimental dog(No 1). No significant changes in the fecal trypsin activity were noticed in all dogs. 7. Histopathologically. all dogs of experimental group showed changes of pancreatitis. However the degree of the pancreatic lesion was not pararell to the degree of the serum amylase or lipase activity changes.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.113-120
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• 2009

Purpose: Though caustic injury of the upper digestive tract can lead to severe sequelae, there are few clinical studies on this subject. This study was undertaken to evaluate the clinical characteristics, the endoscopic findings and the risk factors of the upper digestive lesions in patient with caustic ingestion injury. Methods: We retrospectively reviewed the medical records of 137 patients who ingested caustic materials and who visited to our emergency room from January, 2000 to June, 2009. Results: The most common ingested agent was sodium hypochlorite (44.5%), followed by acetic acid (19.7%), hydrochloric acid (11.7%) and lye (8.0%). Ingestion for suicidal attempt (62.0%) was more frequent than accidental ingestion (30.7%). Grade IIa injury was the most frequent finding on endoscopy of the esophagus and Grade 1 injury was the most frequent finding on endoscopy of the stomach. For the late sequelae, there were 9 cases (6.6%) of esophageal stricture and 2 cases (1.5%) of gastric outlet obstruction. The initial signs and symptoms did not correlate with the development of stricture, but leukocytosis, and grade III injury were related to the risk of developing stricture. Conclusion: Caustic injury of the upper gastrointestinal tract is frequently observed on early endoscopy and it can cause significant late sequelae such as stricture. Therefore, it is necessary to evaluate these patients with regular follow up endoscopic examinations for the management of late sequelae.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.2
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• pp.126-130
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• 2007

Metformin is antihyperglycemic, not hypoglycemic. It causes neither insulin release from the pancreas nor hypo glycemia, even when taken in large doses. But, there are several reports of metformin-associated lactic acidosis (MALT). We present a case report of severe lactic acidosis most probably resulting from high doses of metformin in a patient with no known contraindications for metformin. A 43-year-old female was admitted to the emergency department due to a metformin overdose. She had diabetes for 6 years, well-controlled with metformin and novolet. One hour before admission, she impulsively took 50g metformin (100 mg or 100 tablets). Physical examination for symptoms revealed only irritability, and laboratory evaluation revealed only mild leukocytosis. After one hour the patient was drowsy, and arterial blood gas analysis showed severe lactic acidemia Seven hours after ED arrival, she commenced hemofiltration treatment and was admitted to the intensive care unit. Continuous venovenous hemodiafiltration was initiated. Forty-eight hours later, full clinical recovery was observed, with return to a normal serum lactate level. The patient was discharged from the intensive care unit on the third day. A progressive recovery was observed and she was discharged from the general word on the thirteenth day.

• Journal of Veterinary Clinics
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• v.26 no.3
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• pp.268-272
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• 2009

An-11-year-old male Shih-tzu was admitted to emergency care unit of Haemaru Referral Animal Hospital with signs of dyspnea, anuria and depression. There were abnormalities on complete blood count and serum chemistry included leukocytosis with mild left shift, mild azotemia, and increased ALT activity. Fluid therapy(0.9% saline, 40 ml/hr) and antibiotics were immediately initiated. The patient began to vomit after 5 hours' rest and pale mucous membrane, bradycardia, and hypertension were noted. Abdominal ultrasonography revealed enlarged left adrenal gland and thrombus in caudal vena cava(CVC). Result of ACTH stimulation test was normal. Cytology of ultrasound-guided FNA smears showed numerous naked nuclei, which was suggestive of adrenal medullar tumor. Concentrations of 24 hour urine metanephrine and normetanephrine was moderately increased compared to those of a control dog. Adrenal mass was surgically removed, and biopsy of the CVC mass was obtained. After surgery the patient began to recover but the dog acutely developed cardiopulmonary arrest and died. On histopathology the adrenal mass and biopsy of the CVC mass were consistent with pheochromocytoma. On electron microscopic view norepinephrine specific granules were found in the cytoplasm of tumor cells.

• Korean Journal of Veterinary Research
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• v.45 no.2
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• pp.251-254
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• 2005

An 11-year-old, 3.3 kg, male Maltese dog was referred to Veterinary Teaching Hospital of Konkuk University because of diarrhea and severe anemia. Abnormal physical examination findings included left submandibular lymph node enlargement, pale mucous membrane, cataract, and bloody diarrhea. Results of hematologic examination revealed a marked lymphocytosis resulting in leukocytosis and the markedly increased numbers of small, well-differentiated lymphocytes in the peripheral blood. Serum biochemical abnormalities consisted of elevated AST and ALP, hyperphosphatemia, hypoglycemia, and hypoalbuminemia. Radiographic examination showed cardiomegaly and hepatosplenomegaly. Results of urinalysis included bilirubinuria and proteinuria. Based on results of examination described above, chronic lymphocytic leukemia was diagnosed. Chemotherapy was initiated with cyclophosphamide ($300mg/m^2$, IV once every 2 weeks), vincristine ($0.75mg/m^2$, IV once every 2 weeks, alternating weeks with the cyclophosphamide), and plus prednisolone ($50mg/m^2$, PO, SID for a week, then $20mg/m^2$, PO every other day). The response to chemotherapy was partially present. This study first demonstrates clinicopathological findings and chemotherapeutic response of chronic lymphocytic leukemia in Korea.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.346-350
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• 2010

Purpose: Diagnosis of diabetic foot infection is sometimes difficult, since the classical inflammatory signs and leukocytosis may be absent due to the decreased host immune response in diabetics. Therefore inflammatory blood markers, such as white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) have been commonly needed to confirm the diagnosis of infection. The purpose of this study is to evaluate the diagnostic usefulness of WBC, ESR and CRP for detection of diabetic foot infection. Methods: Peripheral blood samples were taken from 113 patients with diabetic foot ulcers admitted from June 2007 to April 2009. Diabetic foot infection was diagnosed according to the microbiological culture from soft tissue and bone specimens. Reference values of tests were 4500-11000 /${\mu}L$ for WBC count, 0-20 mm/hr for ESR, and 0-5 mg/L for $CRP^{13,14}$. Sensitivities, specificities, positive and negative predictive values of laboratory tests were calculated and analysed. Receiver-operator characteristic (ROC) curve was also created. Results: There was a significant difference in WBC, ESR, and CRP between infectious group and noninfectious group (p<0.05). The sensitivity of WBC>11,000 /${\mu}L$ ESR > 20 mm/hr, and CRP > 5 mg/L was 30%, 96%, and 84%. The specificity was 86%, 14%, and 50% for WBC, ESR, and CRP, respectively. Positive predictive value was 88%, 78%, and 84%, and negative predictive value was 28%, 50%, and 50% respectively. The areas under the ROC curve for WBC, ESR and CRP were 0.72, 0.75, and 0.78 respectively. Conclusion: Based on the results of this study, we conclude that CRP is more useful method in predicting and diagnosing infection than WBC, ESR in diabetic foot ulcer patients.

• Journal of Veterinary Clinics
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• v.20 no.4
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• pp.489-492
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• 2003

A 12-year-old, intact male Labrador Retriever was admitted to the Veterinary Teaching Hospital of Konkuk University for the evaluation of bleeding mass in the oral cavity. The mass was first noted 2 years ago and has been growing up to a size of $5{\times}6$ cm. On complete blood count(CBC), leukocytosis and mild anemia were observed. Pulmonary metastasis was found in the thoracic radiographic examination. Blackish necrotic oral mass at the left mandibular area was diagnosed as a malignant melanoma based on the histopathological examination. Thus hemimadibulectomy and chemotherapy (carboplatin) were performed. The patient eventually died due to severe secondary infection 3 months after the last treatment.