• Title/Summary/Keyword: progressive failure

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Bilateral Inguinal Hernias Detected by Peritoneal Scintigraphy during the Evaluation of Scrotal Swelling in a Patient on Continuous Ambulatory Peritoneal Dialysis (지속적 복막 투석 환자의 음낭부종 검사시 복막 신티그라피에 의해 발견된 양측성 서혜부 탈장)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.1
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    • pp.81-82
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    • 2001
  • A 47-year-old man with end-stage renal disease due to diabetic nephropathy underwent a peritoneal scintigraphy to evaluate the cause of recently developed scrotal swelling. Two liters of dialysate mixed with 111 MBq of Tc-99m sulfur colloid were administered into the peritoneal cavity via the dialysis catheter. Various anterior images of the abdomen and pelvis were obtained at 15 min, 2 hr and 4 hr after the tracer instillation. At 15 min, anterior images of the abdomen and pelvis demonstrated linear tracts of activity through both inguinal canals, which were more prominent in the right side (A). Images at 2 hr revealed a passage of the radioactive fluid into the right hemiscrotum. At the same time, there was a considerable accumulation of activity in the right inguinal canal (B). In the delayed image, there was a progressive accumulation of activity in the inguinal canals and a prominent passage of the tracer into the scrotum (C). Both abdominal and inguinal hernias are commonly associated with continuous ambulatory peritoneal dialysis (CAPD). Overall incidence of CAPD-induced hernia ranges from 2.7% to 25%.$^{1)}$ Inguinal hernias were frequently manifested as scrotal swelling. Leakages of dialysate fluid into the scrotum has been noted in CAPD patients with scrotal swelling, with or without clinical findings of inguinal hernia.$^{1,2)}$ In the present case, the right side had leakage from a clinical inguinal hernia and the left side, leakage from a subclinial inguinal hernia. A subclinical inguinal hernia was easily demonstrable with peritoneal scintigraphy. Peritoneal scintigraphy is extremely helpful in the evaluation of scrotal swelling in a patient on CAPD.

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New De-interlacing Algorithm Combining Edge Dependent Interpolation and Global Motion Compensation Based on Horizontal and Vertical Patterns (수평, 수직 패턴에 기반 한 경계 방향 보간과 전역 움직임 보상을 고려한 새로운 순차주사화 알고리즘)

  • 박민규;이태윤;강문기
    • Journal of Broadcast Engineering
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    • v.9 no.1
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    • pp.43-53
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    • 2004
  • In this paper, we propose a robust deinterlacing algorithm which combines edge dependent interpolation (EDI) and global motion compensation (GMC). Generally, EDI algorithm shows a visually better performance than any other deinterlacing algorithm using one field. However, due to the restriction of information in one field, a high duality progressive image from Interlaced sources cannot be acquired by intrafield methods. On the contrary, since algorithms based on motion compensation make use of not only spatial information but also temporal information, they yield better results than those of using one field. However, performance of algorithms based on motion compensation depends on the performance of motion estimation. Hence, the proposed algorithm makes use of mixing process of EDI and GMC. In order to obtain the best result, an adaptive thresholding algorithm for detecting the failure of GMC is proposed. Experimental results indicate that the proposed algorithm outperforms the conventional approaches with respect to both objective and subjective criteria.

Surgical Rrepair of Ebsteins Anomaly with Ventricular Septal Defect in the Infant (영아에서 시행한 심실중격결손이 동반된 Ebsein's 기형의 삼첨판막 성형수술)

  • 유지훈;박표원;성기익;박계현;이영탁;전태국
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.890-893
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    • 2002
  • Ebsteins anomaly is a rare congenital cardiac malformation that is the downward displacement of the septal and posterior leaflets of the tricuspid valve into the ventricular apex, aresulting in the formation of an atrialized portion of the right ventricle. In most patients, symptoms such as cyanosis and progressive heart failure occur during the adolescence or young adulthood. The associated anomalies include ventricular septal defect, transposition of the great arteries, and malformation of the mitral valve. An 8-months-old male with Ebsteins anomaly, ventricular septal defect, and duplication of the mitral valve orifice successfully underwent operation with VSD patch closure. Postoperatively, cardiac size was significantly reduced and tricuspid regurgitation was trivial in echocardiography He has been doing well without any cardiac medication during the 18 months follow up after operation.

Modified Starnes Operation for Neonatal Stenotic Ebstein Anomaly (신생아 폐쇄성 엡스타인 기형에 대한 변형 Starnes 술식)

  • Lee Seung Hyun;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.633-636
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    • 2005
  • Sixteen-day-old baby with severe Ebstein anomaly underwent emergency operation to relieve progressive hypoxia and congestive heart failure. Operative findings showed huge right atrium and atrialized right ventricle (aRV) with very small functional RV by distal displacemcent of tricuspid valve mechanism. We elected to perform modified Starness operation because biventricular repair was deemed unattainable. After pulmonary and tricuspid valves were primarily closed, aRV was obliterated with multiple sutures from RV apex to the base. Then a PTFE (Gore-Tex, USA) vascular graft was interposed between innominate artery and main pulmonary artery for systemic to pulmonary shunt. The patient was discharged uneventfully, and received bi-directional cavopulmonary shunt 6 months later.

Systemic lupus erythematosus (전신성 홍반성 루푸스)

  • Kim, Kwang-Nam
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1180-1187
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    • 2007
  • Systemic lupus erythematosus (SLE) is an episodic, multi-system, autoimmune disease characterized by widespread inflammation of blood vessels and connective tissues and by the presence of antinuclear antibodies (ANAs), especially antibodies to native (double-stranded) DNA (dsDNA). Its clinical manifestations are extremely variable, and its natural history is unpredictable. Untreated, SLE is often progressive and has a significant fatality rate. The most widely used criteria for the classification of SLE are those of the American College of Rheumatology (ACR), which were revised in 1982 and modified in 1997. The presence of four criteria have been diagnosed as a SLE. Rashes are common at onset and during active disease. The oral mucosa is the site of ulceration with SLE. Arthralgia and arthritis affect most children and these symptoms are short in duration and can be migratory. Lupus nephritis may be more frequent and of greater severity in children than in adults. The initial manifestation of nephritis is microscopic hematuria, followed by proteinuria. The most common neuropsychiatric symptoms are depression, psychosis(hallucination and paranoia) and headache. CNS disease is a major cause of morbidity and mortality. Pericarditis is the most common cardiac manifestation. Libman-Sacks endocarditis is less common in children. The most frequently described pleuropulmonary manifestations are pleural effusions, pleuritis, pneunonitis and pulmonary hemorrhage. During the active phase ESR, CRP, gamma globulin, ferritin and anti-dsDNA are elevated. Antibodies to dsDNA occur in children with active nephritis. Antibodies to the extractable nuclear antigens (Sm, Ro/SS-A, La/SS-B) are strongly associated with SLE. Specific treatment should be individualized and based on the severity of the disease. Sepsis has replaced renal failure as the most common cause of death.

Experimental investigation of long-term characteristics of greenschist

  • Zhang, Qing-Zhao;Shen, Ming-Rong;Ding, Wen-Qi;Jang, Hyun-Sic;Jang, Bo-An
    • Geomechanics and Engineering
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    • v.11 no.4
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    • pp.531-552
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    • 2016
  • The greenschist in the Jinping II Hydropower Station in southwest China exhibits continuous creep behaviour because of the geological conditions in the region. This phenomenon illustrates the time-dependent deformation and progressive damage that occurs after excavation. In this study, the responses of greenschist to stress over time were determined in a series of laboratory tests on samples collected from the access tunnel walls at the construction site. The results showed that the greenschist presented time-dependent behaviour under long-term loading. The samples generally experienced two stages: transient creep and steady creep, but no accelerating creep. The periods of transient creep and steady creep increased with increasing stress levels. The long-term strength of the greenschist was identified based on the variation of creep strain and creep rate. The ratio of long-term strength to conventional strength was around 80% and did not vary much with confining pressures. A quantitative method for predicting the failure period of greenschist, based on analysis of the stress-strain curve, is presented and implemented. At a confining pressure of 40 MPa, greenschist was predicted to fail in 5000 days under a stress of 290 MPa and to fail in 85 days under the stress of 320 MPa, indicating that the long-term strength identified by the creep rate and creep strain is a reliable estimate.

Pulmonary Artery Sarcoma - One Case Report - (폐동맥에서 발생한 육종 - 1례보고 -)

  • Kim, Hyeong-Ryul;Kim, Kyung-Hwan;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.692-696
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    • 2002
  • Pulmonary artery sarcoma is a rare disease and hard to diagnose; therefore, suspicion is very important for the diagnosis and treatment. Surgical resection is almost always needed because of progressive right heart failure. Adjuvant chemotherapy and radiation therapy are still controversial. We report a case of a 42-year-old man who had a right pulmonary arterial tumor Curative resection was impossible because the tumor invaded the left pulmonary artery. Palliative endarterectomy was performed followed by radiation therapy. The patient refused the chemotherapy. Until the postoperative 6th month, the residual tumor was stable. However, 15 months later, follow-up chest computed tomography revealed a metastatic pulmonary nodule at left lower lobe and the increased residual tumor. The patient received chemotherapy with limited tumor response. The metastatic nodule and residual tumor did not increase but bone scan revealed a rib metastasis at postoperative 24 months. He will be receiving additional chemotherapy.

A Case of Organophosphate Insecticide Intoxication by Repetitive Parenteral Exposure, Complicated with Intermediate Syndrome and Acute Pancreatitis (반복적인 비경구노출에 의한 유기인계 중독: 중간형증후군과 급성췌장염 1례)

  • Oh, Se-Hyun;Kang, Hui-Dong;Lee, Boo-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.161-165
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    • 2006
  • Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.

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A Case of Diffuse Pan bronchiolitis Diagnosed by Thoracoscopic Biopsy (흉강경으로 진단한 미만성 범세기관지염 1예)

  • Seo, Hae-Sook;Rhee, Myung-Seon;Paik, Soo-Hum;Cho, Dong-Ill;Kim, Jae-Won;Rhu, Nam-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.3
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    • pp.271-277
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    • 1992
  • Diffuse panbronchiollitis (DPB), a rare progressive disorder, has lately been receiving increasing attention. DPB is a disease of obscure etiology, characterized by chronic inflammation localized mainly in the region of respiratory bronchiole just distal to the terminal bronchioles. In 1983, Homma and coworkers reported 82 cases of a new clinicopathological entity, DPB, in Japan. Also DPB is a disease largely restricted geographically to Japan but the prevalence in other countries is extremely low. Histoloically, it is characterized by a suppurative bronchiolitis involving primarily the respiratory and terminal bronchioles with subsequent progression to bronchiectasis. The disease progresses rapidly and results in respiratory failure due to repeated respiratory infections. We experienced a cases of DPB accompanied with chronic maxillary sinusitis in both sinuses. Diagnosis of DPB was comfirmed by pathological results from thoracoscopic lung biopsy, typical radiological findings, clinical symptoms and pulmonary function test. After treatment with erythromycin for 6 months, the patient's condition and the typical micronodular densities on the chest radiography improved. A few case of DPB was reported in Korea. We report a case of DPB through thoracoscopic lung biopsy.

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An Elderly Man with Fatal Respiratory Failure after Eating a Poisonous Mushroom Podostroma cornu-damae

  • Jang, Juah;Kim, Cheol-Hong;Yoo, Jun Jae;Kim, Mi Kang;Lee, Jae Eun;Lim, Ah Leum;Choi, Jeong-Hee;Hyun, In Gyu;Shim, Jung Weon;Shin, Ho-Seung;Han, Joungho;Seok, Soon Ja
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.6
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    • pp.264-268
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    • 2013
  • A 73-year-old, previously healthy man presented with nausea, vomiting, diarrhea, dry mouth and febrile sensation 3 hours after eating boiled wild mushrooms. After admission, he showed progressive severe respiratory distress, pancytopenia, azotemia, hypotension, hypoxemia and consolidation of the entire left lung on chest radiography. With a preliminary diagnosis of necrotizing pneumonia, he underwent left pneumonectomy in order to remove all necrotic lung tissue. Lung histology showed extensive hemorrhagic necrosis, massive inflammatory cell infiltration, prominent proliferation of young fibroblasts and the formation of an early-stage hyaline membrane along the alveolar wall. Despite aggressive treatment, including mechanical ventilation, continuous renal replacement therapy and administration of granulocyte colony stimulating factor and broad spectrum antibiotics, he died on hospitalization day 13. Subsequently, the mushroom was identified as Podostroma cornu-damae. This is the first case of a histological evidence of lung involvement by Podostroma cornu-damae poisoning in Korea.