• Title/Summary/Keyword: treatment failure

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Terminalia arjuna Bark and inotropic therapy for heart failure

  • Liu, Shi Jesse
    • CELLMED
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    • v.2 no.3
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    • pp.21.1-21.8
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    • 2012
  • Heart disease that ultimately leads to heart failure (HF) has been the number one cause of death in the United States as well as in many other countries for over a century. Inotropic therapy utilizing cardiotonics to increase cardiac contractility remains a significant component of the management of HF. However, adverse effects of currently available cardiotonics have been compromising their therapeutic value and often lead to further myocardial dysfunction. Thus, discovery of safe cardiotonics remains a main challenge to improvement of inotropic therapy for HF. This review briefly summarized cellular mechanisms underlying the inotropic action of currently available cardiotonics, newly-developed carditonics and the bark of Terminalia arjuna (TA), a tropical tree used in ayurvedic medicine. The potential of TA bark as a new cardiotonic in inotropic treatment for HF was also discussed.

A Case Report on Cardiac Asthma due to Congestive Heart Failure (울혈성 심부전으로 인한 심장성 천식환자 치험 1례)

  • Jung Wun-Suk;Shin Jeong-In;Sea Un-Kyo
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1093-1102
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    • 2003
  • Congestive heart failure is a cardiac dysfunction that can't supply sufficient amount of blood. The disorder usually causes hypertension, ischemic cardiac disease and give rise to pulmonary congestion and pulmonary epileptic edema. The symptoms of the disease are dyspnea, palpitation, edema, etc. We treated a 82 year-old female patient who had severe dyspnea, nausea, and dizziness. At the point of differentiation of syndromes(辨證), the case was diagnosed as Su-Cheon(水喘) induced by Yang-deficiency of Both Spleen and Kidney(脾腎陽虛) and was administered Yerunpang(胃?湯). After two weeks of the treatment, we witnessed improvement in the symptoms of CHF and general depressed condition. This report describes the process and contents about the way the patient was treated.

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Acute Respiratory Insufficiency Following Blunt Chest Trauma -2 Case Report- (흉부손상에 병발한 급성호흡부전증 -2예 보고-)

  • Wang, Young Pil;Lee, Hong Kyun
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.148-156
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    • 1976
  • Acute respiratory failure has become an increasingly frequent cause of death following shock or trauma. Interstitial or diffuse alveolar edema, as chief pathophysiologic change of acute respiratory insufficiency, can be the result of sepsis, fat embolism, cardiac failure, lung congestion, and oxygen toxicity. These pulmonary problems are extremely difficult to treat without early recognition of their development and aggressive management. If the treatment is delayed, the progressive respiratory failure is almost uniformly fatal. Authors have experienced two cases of acute respiratory insufficiency following the blunt chest trauma, which were healed uneventfully. Literatures were briefly reviewed.

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Plasmaphresis therapy for pulmonary hemorrhage in a pediatric patient with IgA nephropathy

  • Yim, Dae-Kyoon;Lee, Sang-Taek;Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.10
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    • pp.402-405
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    • 2015
  • IgA nephropathy usually presents as asymptomatic microscopic hematuria or proteinuria or episodic gross hematuria after upper respiratory infection. It is an uncommon cause of end-stage renal failure in childhood. Pulmonary hemorrhage associated with IgA nephropathy is an unusual life-threatening manifestation in pediatric patients and is usually treated with aggressive immunosuppression. Pulmonary hemorrhage and renal failure usually occur concurrently, and the pulmonary manifestation is believed to be caused by the same immune process. We present the case of a 14-year-old patient with IgA nephropathy who had already progressed to end-stage renal failure in spite of immunosuppression and presented with pulmonary hemorrhage during oral prednisone treatment. His lung disease was comparable to diffuse alveolar hemorrhage and was successfully treated with plasmapheresis followed by oral prednisone. This case suggests that pulmonary hemorrhage may develop independently of renal manifestation, and that plasmapheresis should be considered as adjunctive therapy to immunosuppressive medication for treating IgA nephropathy with pulmonary hemorrhage.

Acute Kidney Injury in the Newborn: Etiology, Pathophysiology and Diagnosis (신생아의 급성신손상)

  • Kim, So-Young
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.161-167
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    • 2010
  • Acute kidney injury (AKI), formerly referred to as acute renal failure (ARF) is defined as the sudden impairment of kidney function (estimated from the glomerular filtration rate [GFR]) that results in the lack of excretion of waste products. More than 30 definitions of AKI exist in the literature, most of which are based on serum creatinine. Lack of a uniform and multidimensional AKI definition has led to failure to recognize significant renal injury, delays in treatment, and inability to generalize single-study results. The RIFLE criteria were developed to standardize the diagnosis of ARF and in the process the term AKI has been proposed to encompass the entire spectrum of the syndrome from minor changes in renal function to requirement for renal replacement therapy. Large prospective studies are needed to test definitions and to better understand risk factors, incidence, independent outcomes, and mechanisms that lead to poor short- and long-term outcomes. Early biomarkers of AKI need to be explored in critically ill neonates.

Failure of Ammonia Synthesis Converter Due to Hydrogen Attack and Its On-Stream Assessment Using ToFD Method

  • Albiruni, Farabirazy;Lee, Joon-Hyun
    • Proceedings of the KSME Conference
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    • 2008.11a
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    • pp.132-137
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    • 2008
  • A failure analysis of ammonia converter which suffered hydrogen attack in two years since its initial operating time was presented. It is constructed from 2.25 Cr.1 Mo steel. Analysis showed that the failure on closing seam weld joint was due to local improper post weld heat treatment (PWHT). Improper PWHT can introduce high residual stresses in thick-walled pressure vessel. High residual stress level in weld joint is very prone to hydrogen attack for any components which are operating in hydrogen gas environment. The repair procedures based on the principle to decrease the residual stress then proposed. The repair was controlled very carefully by applying several nondestructive tests in the each stage of repair. To assure the successful of the proposed repair, after one year since repair time, high temperature ultrasonic and TOFD methods were applied on-stream to this equipment in order to evaluate its post repair condition. The two methods showed good results on the repaired area.

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Renal replacement therapy in children with acute renal failure (소아 급성 신부전증의 신장 대체 요법)

  • Paik, Kyung Hoon
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.938-947
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    • 2007
  • Many dialysis modalities such as peritoneal dialysis (PD), hemodialysis (HD) and continuous hemofiltration or hemodialysis (CRRT) are available for the management of pediatric patients with acute renal failure (ARF). PD is a relatively simple, inexpensive modality and can be used in hemodynamically unstable patients. But, it may not be the optimal therapy for patients with severe volume overload or life threatening hyperkalemia. HD is the preferred modality for the treatment of severe volume overload, severe hyperkalemia, but it needs vascular access. Improvements in the HD equipment have allowed HD to be performend in small children. Recents technological improvements in CRRT therapies have enabled pediatric patients who are less stable to be treated. CRRT is becoming the preferred method of acute therapy in pediatric intensive care units. A sound knowledge of the underlying principles of dialysis and awareness of recent technological advancements in differnet dialysis modalities will hopefully result in improved management of children with ARF.

Lower Leg Amputation by Calciphylaxis in Diabetic Nephropathy Patient (A Case Report) (당뇨병성 신부전증 환자의 선단 궤양에 의한 하지절단(1예 보고))

  • Lee, Jun-Young;Yu, Jae-Cheol
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.109-112
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    • 2009
  • Calciphylaxis is a rare disease that appear in patients with secondary hyper-parathyroidism or chronic renal failure or that show defect in calcium phosphate metabolism which is characterized by fibrin deposit or calcification of medial wall of vessels causing gradual ischemic skin necrosis. Calciphylaxis is a disease with poor prognosis as skin necrosis can progress rapidly. If left untreated, calciphylaxis will progress to sepsis with high mortality. The treatment is controversial but kidney transplantation or parathyroidectomy is suggested to recover calcium-phosphate metabolism. The authors have experienced calciphylaxis in a patient with chronic renal failure caused by DM nephropathy with characteristic skin lesion and rapid skin necrosis. We describe this case with documentary reviews.

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Clinical experience of ventilator therapy in chest trauma (인공호흡기 치료를 받은 흉부외상 환자의 임상적 고찰)

  • 서강석
    • Journal of Chest Surgery
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    • v.26 no.1
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    • pp.59-63
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    • 1993
  • A clinical evaluation was performed with a population of 49 patients of chest trauma, who were diagnosed to undergo ventilator therapy, and had gone through ventilator therapy at the Department of Thoracic and Cardiovascular Surgery, Kyungpook University Hospital. One of most common causes of chest trauma was vehicle accidents [77.5%] with the prevalent age group being their forties. The common findings were multiple rib fractures [89.8%], hemopneumothrax [81.6%], lung contusion [61.2%] and flail chest [44.9%]. Their common combined injuries were the orthopedics and neurosugical injuries [86.7%]. Complications caused by chest trauma were pneumonia, respiratory failure, atelectasis, barotrauma and empyema. Pulmonary infections were commonly associated with mechanical ventilation in the long term group and were best prevented by using bronchial hygiene therapy.The mortality rate was 5.8% of the total patients and that was 38.8% of the patients, who needed ventilator therapy. The causes of death were pneumonia, respiratory failure, acute renal failure and hypovolemic shock. Mechanical ventilation has an important place in the treatment of patients with severe chest trauma.

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Treatment of Large Arteriovenous Malformation in Right Lower Limb

  • Lee, Young Ok;Hong, Seong Wook
    • Journal of Chest Surgery
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    • v.47 no.1
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    • pp.66-70
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    • 2014
  • A 10-year-old boy with arteriovenous malformation (AVM) of the right lower limb was scheduled for an amputation of the affected limb. Limb amputation was necessary because of the ineffectiveness of previous sclerotherapy and the rapid progression of AVM causing pain and heart failure. Right hip disarticulation was considered the best option to improve his quality of life. To prevent congestive heart failure and uncontrollable hemorrhage during surgery, the disarticulation was done under a partial cardiopulmonary bypass. The patient underwent surgery successfully without complications.