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Atypical Hemolytic Uremic Syndrome after Traumatic Rectal Injury: A Case Report

  • Kang, Ji-Hyoun;Lee, Donghyun;Park, Yunchul
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.299-304
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    • 2021
  • Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

Studies on the Breeding of Cold Hardiness and Technique of Overwintering Cultivation in Citrus (감귤(柑橘)의 내한성(耐寒性) 품종육성(品種育成) 및 내한(耐寒) 재배기술(栽培技術)에 관(關)한 연구(硏究))

  • Kim, Chi-moon;Song, Ho-kyung;Kim, Chung-suk
    • Korean Journal of Agricultural Science
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    • v.4 no.2
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    • pp.126-140
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    • 1977
  • Present studies were carried out for breeding cold resistant clones of Citrus, improving overwintering techniques of Citrus in Jeju island as well as other southern region, Result obtained were as follows 1. In the vinyl house covered with two sheets of straw mat, 12 indivuals were found as non-injury and 15 were slightly injured by leaf freeging test at $-9^{\circ}C$ for 2 hours treatment. 2. In the condition of vinyl house covered with straw mat and viny film mulching and heat-in by sun-light, the inside temperature of vinyl house were not lowered below $-3^{\circ}C$ and the ground temperatura in vinyl house keeps above $0^{\circ}C$ during winter though outdoor temperature were lower by $-15^{\circ}C$(Daejeon area). 3. The vinyl tunnel inside the vinyl house and vinyl film mulching on ground position showed greater effectiveness for preventing heat loss from house but there were no significant difference between the color of vinyl film covered the tunnel. 4. In the vertical distribution of maximum temperature in vinyl house, the upper space was slightly higher than the lower position at high temperature condition, while minimum temperature was distributed as higher as the middle position, ground surface and upper position in order at low temperature condition 5. In the horizontal distribution of temperature in vinyl house, ground and surface-temperature of north side was lower than the other sides, and citrus planted within 30cm from north side wall died by cold injury and in the other side near wall appeared slight symptom of cold injury. 6. The insulating trench ($30{\times}30{\times}30cm$) packed with straw bundle installed under north wall might be effective to prevent heat loss of ground temperature. 7. In cloudy and snowy day, the temperature difference between indoor and outdoor were less, and the indoor temperature were maintained highly during night due to the effect of prevention of heat loss. 8. The highest temperature in a day was observed at about P.M. 3 both inside and outside of vinyl house and the lowest temperature was observed at about A.M. 6. The difference between the highest and lowest temperature of indoor in a sunny day was $19^{\circ}C$, compared with $9^{\circ}C$ on a cloudy or snowy day in late November. Especially, lowering of temperature in a snowy day was so less that the curve of temperature change was comparatively constant, 9. If the effective methods of citrus cultivation in vinyl house with improved clone such as hardiness. semi-dwarf and spur type are applied, it might be possible to cultivate the citrus tree safely in Jeju island as well as other southern rejion and to magnity the cultivation of citrus tree.

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Analysis of Current Status and Utilization of Protected Trees in Gyeongsan City (경산시 보호수의 현황분석 및 활용방안)

  • Kim, Keun-Ho
    • Journal of agriculture & life science
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    • v.45 no.2
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    • pp.69-83
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    • 2011
  • The aim of the research was to provide basic information for a suitable management and utilization of protected trees by law. To achieve this aim, this study investigated the current state, management status and utilization of protected trees by law in Gyeongsan city. The result of the current state of protected trees indicated that there were 55 protected trees designated since 1982. These trees consisted of 8 species which were located at 41 places. Major species was Sophora japonica (30.9%), followed by Zelkova serrata (23.6%). The protected trees have been used as sacred trees (45.5%) in the villages, followed by scenic trees (36.7%). 38.2% of the protected trees were 200 to 300 years old and 54.6% of the trees were 15 to 30 m in height. 34% of the protected trees were located in the villages, followed by beside road (19.5%). Single trees (78%) were mostly planted. The result of the management status indicated that 58.5% of the root area in protected trees were covered with bare ground, followed by gravel mulch (19.5%). The average of soil hardness was 9.64 mm. The safety fence of tree was installed at 9 places (22%) and a stone wall was built at 22 places (53.7%). 70.9% of the protected trees had a surgical operation to prevent cavities and to cure decay. Granite stone signs were installed at 33 places. The result of the utilization of protected trees indicated that 13 places were used as a rest area in the villages. It consisted of shelters, benches, athletic facilities and outdoor tables. The research suggested potential places for a mini park(pocket park) to recover a local community by using surrounding available land and improving current rest areas of protected trees. The research presented here is a first step towards a more comprehensive analysis of protected trees in Gyeongsan and further research is needed.

A Study on the Space Planning and Landscape of 'Unjoru(雲鳥樓)' as Illustrated in the Family Hereditary Drawing, "Jeolla Gurye Ohmidong Gado(全羅求禮五美洞家圖)" ('전라구례오미동가도(全羅求禮五美洞家圖)'를 통해 본 운조루(雲鳥樓)의 공간배치계획과 경관 고찰)

  • Shin, Sang-sup
    • Korean Journal of Heritage: History & Science
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    • v.46 no.4
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    • pp.48-63
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    • 2013
  • The results of the study on the space planning and landscape design of Unjoru(雲鳥樓) through the 'Jeolla Gurye Omidong Gado(全羅求禮五美洞家圖)' drawn using GyeHwa(界畵) technique are as follows. First, 'Omidong Gado' is believed to date back to the period when Unjoru(1776~1783) was established for the following reasons: (1) The founder, Yoo-IJu(柳爾?), sent the drawing for the house while he was serving as the governor of YongCheon county(龍川府史). (2) It shows the typical dwelling houses' space division and its location is in a good spot with mountain in the back and water in front(背山臨水) and there is every indication of scheme drawing. (3) Front gate was changed and remodeled to a lofty gate in 1804. Second, Nogodan & Hyeongjebong of Jiri Mountain sit at the back of Unjoru, and faces Obong mountain and Gyejok mountain. In addition, the Dongbang stream flowing to the east well illustrates the Pungsu theory of mountain in the back and water in the front. Third, the house is structured in the shape resembling the character 品, divided into 5 areas by hierarchical order in the cross line from all directions. The site, which includes the outdoor yard and the back garden, consists of 5 blocks, 6 yards and 2 gardens. Fourth, the outdoor yard with aesthetical value and anti-fire function, is an ecological garden influenced by Confucianism and Taoism with a pond (BangJiWonDo Type, 方池圓島形) at the center. Fifth, the Sarang yard(舍廊庭) is decorated with terrace garden and flower garden, and the landscaping components such as oddly shaped stone, crane, plum, pine tree, tamarisk tree and flowering plants were used to depict the ideal fairy land and centrally placed tree for metaphysical symbolism. The upper floor of Sarangchae commands distant and medium range view, as well as upwards and downwards. The natural landscape intrudes inside, and at the same time, connects with the outside. Sixth, pine forest over the northern wall and the intentionally developed low hill are one of the traditional landscaping techniques that promotes pleasant residential environment as well as the aesthetics of balanced fullness.

Studies on the Manufacture of Fiber Pot and its Effect for the Good Transplanting (이식용(移植用)Pot의 제조(製造) 및 그 효과(効果)에 관(關)한 연구(硏究))

  • Kim, Ji Moon;Lee, Hwa Hyung;Kwon, Ki Won;Song, Ho Kyong
    • Journal of Korean Society of Forest Science
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    • v.46 no.1
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    • pp.1-9
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    • 1980
  • This study was carried out to examine the substitution possibility into fiber pot instead of Jiffy pot for the good transplanting. Fiber pot was made of fiber, wood waste particle, and bark powder (10% of the particle weight) and also latex was added into the furnish as a binder. The pots were sprayed with just enough urea solution to prevent nitrogen deficiency of pot media coming from the breakdown of wood fiber in the pot wan during the plant growing. The utility of fiber pot was compared with that of Jiffy pot in the service test of two tree species under a green-house condition. The results obtained can be summarized as follows ; 1. Fiber pot made of 30% wood fiber+70% particle including 10% of bark powder, and 3%-latex has shown a good results like that of Jiffy pot in the sp. gr., tear factor and burst factor. For water absorption, fiber pot made of 50% fiber+50% particle, and 3%-latex got the best result. In the consideration of the above physical and mechanical properties of the fiber pot for good root penetration through the pot wall and facile handling, fiber pot made of 30% fiber+70% particle, and 3%-latex may be seemed to be good. 2. There were no harms in sapling growth in fiber pot as well as in Jiffy pot. The root penetration ability through the fiber pot was slightly inferior to that of Jiffy pot, and yet the pot damage through transportation seemed to be slighter in fiber pot than in Jiffy pot.

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The Differences between Ruptured and Unruptured Mediastinal Teratoma (파열된 종격동 기형종과 단순 기형종과의 차이)

  • Cho, Suk-Ki;Lee, Eung-Bae
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.355-360
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    • 2009
  • Background: Benign teratoma is mostly asymptomatic, but this tumor rarely ruptures into the adjacent structure such as the pleural space, pericardium, lung parenchyma or tracheobronchial tree. Thus, it is important to differentiate ruptured teratoma from unruptured teratoma. This study evaluated the difference between ruptured and unruptured benign teratoma. Material and Method: Twenty-four cases of surgically resected benign teratomas were reviewed retrospectively. The clinical symptoms, chest CT findings and operative findings of the ruptured teratoma were compared with those of the unruptured teratoma. Especially, the tumor size, wall thickness, location of the mass, internal septation, homogeneity, calcification and ancillary findings were evaluated on CT. Result: Of the 24 patients, 7 patients were diagnosed with ruptured teratoma. Severe symptoms were more commonly found for ruptured teratoma than for unruptured teratoma. The ruptured teratoma had a tendency to display calcification and such ancillary findings as collapse or consolidation of the lung parenchyma. For the ruptured teratoma, the resection was performed by sternotomy or thoracotomy, and more lung resection was included. Conclusion: Calcification within the mass and changes in the lung parenchyma on the preoperative CT findings can be diagnostic signs of a ruptured teratoma. The demonstration of ruptured teratoma is important not only for making the early diagnosis, but also for the surgical planning.

A case of recurrent respiratory infection resulting from a congenital anomaly of the bronchial tree tracheal bronchus (반복적인 호흡기 감염을 가진 환아에서 진단된선천성 기도 기형, 기관기관지 1예)

  • Choi, Ah-Reum;Choi, Sun-Hee;Kim, Seong-Wan;Sung, Dong-Wook;Rha, Yeong-Ho
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.660-664
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    • 2008
  • The term tracheal bronchus refers to an abnormal bronchus that comes directly off of the lateral wall of the trachea (above the carina) and supplies ventilation to the upper lobe. Tracheal bronchi occur almost exclusively on the right trachea and are associated with other congenital anomalies. In addition, tracheai bronchus may be related to other inflammatory conditions with persistent wheezing, such as recurrent pneumonia, chronic bronchitis and bronchiectasis, which is a result of the relatively poor local drainage of the involved bronchi. An infant with recurrent wheezing is likely to be a challenge for a clinician in the evaluation of the etiology of airway obstruction and in the differential diagnosis of wheezy breathing. The authors report a case of an 8-month-old female infant with a ventricular septal defect, who presented with stridor and recurrent respiratory infection and finally was finally diagnosed with a tracheal bronchus using computed tomography and a bronchoscopy. Therefore, tracheal bronchus should be included in the differential diagnosis of any child who presents with chronic or recurrent respiratory tract symptoms such as coughing, wheezing, stridor and recurrent respiratory infection, particularly in children with other congenital deformities.

Wood Anatomical Characteristics of Domestic Red Pine (Pinus densiflora) Infested by Pine wood Nematode (Bursaphelenchus xylophilus) (소나무재선충 감염 소나무의 목재해부학적 특성)

  • Ahn, Sye-Hee;Jeon, Mun-Jang;Eom, Young-Geun;Oh, Sei-Chang;Lee, Mi-Rim
    • Journal of the Korean Wood Science and Technology
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    • v.39 no.1
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    • pp.15-20
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    • 2011
  • The pine wilt disease is one of the most serious forest diseases that kill the pine trees, and the study on the invasion and movement of the pine wood nematode within the tree is very important for understanding the inhabitation of pine wood nematode. In this relation, the microscopic observation was carried out to study the place of inhabitation and movement of pine wood nematode within the infested wood. In result, the rays were mainly infested by pine wood nematode and showed dark discoloration due to their necrosis in cross, radial and tangential surface. Also, the intensive damage was found in the resin canals. On the other hand, some traumatic resin canals in tangential band were identified in the sapwood near the cambium. In the ray, the pine wood nematode occurred more commonly in the ray parenchyma cell and fusiform ray with horizontal resin canal than in the ray tracheid and uniseriate ray without horizontal resin canal, respectively. The pine wood nematode was thought to move from ray to tracheid through the large natural opening, window-like pit, in the cross-field, neither through the small natural opening, bordered pit, in the tracheid nor through the tracheid wall by creating a bore hole.

Chemical Properties and Fiber Dimension of Eucalyptus pellita from The 2nd Generation of Progeny Tests in Pelaihari, South Borneo, Indonesia

  • Lukmandaru, Ganis;Zumaini, Umi Farah;Soeprijadi, Djoko;Nugroho, Widyanto Dwi;Susanto, Mudji
    • Journal of the Korean Wood Science and Technology
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    • v.44 no.4
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    • pp.571-588
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    • 2016
  • Eucalyptus pellita F. Muell is one of pulp woods that is being developed through breeding plantation programs in Indonesia. The research aimed at exploring the chemical and morphological characteristics of fiber, and to determine the rank of plus trees from 4 provenances based on the suitability for pulps. The materials included the plus trees of E. pellita (9 years) from the 2nd generation of progeny tests in Pelaihari, South Borneo. Wood properties under investigation included the chemical properties and morphological fiber characteristics (fiber dimensions and its derived properties). In the present study, data were analyzed using descriptive statistic, Analytic Hierarchy Process (AHP) and Pearson's correlation. Results showed that the chemical properties of E. pellita, i.e. the contents of ethanol-toluene extractives, hot water soluble extractives, holocellulose, alphacelullose, and lignin were $3.08{\pm}1.00%$, $1.41{\pm}0.38%$, $75.26{\pm}2.58%$, $49.02{\pm}2.88%$, and $29.49{\pm}1.86%$, respectively. The average values of wood fiber morphology were $1.02{\pm}0.08$ mm (fiber length), $13.25{\pm}1.64{\mu}m$ (fiber diameter), of $6.94{\pm}1.70{\mu}m$ (lumen diameter), $3.15{\pm}0.52{\mu}m$ (fiber wall thickness), $0.97{\pm}0.30$ (Runkel ratio), $0.57{\pm}0.10$ (Luce's shape factor), $78.21{\pm}10.34$ (slenderness ratio) and $130.91{\pm}33.77{\times}10^3{\mu}m^3$ (solids factor). The AHP scoring rank indicated that the best individuals were 28.4.3.28 (Kiriwo Utara), 12.1.5.28 (North Kiriwo), 19.11.5.45 (Serisa Village), 3.8.4.9 (South Kiriwo), and 6.6.3.15 (South Kiriwo). Pearson correlation analysis showed significant correlations between the levels of fiber length with alpha-cellulose content (r = 0.39) as well as the fiber length with ethanol-toluene extractive contents (r = -0.41).

Seasonal Change of Cambium Activity of Pine Trees at Different Growth Sites (생장지역에 따른 소나무 형성층 활동의 계절적 변화)

  • Park, So-Yeon;Eom, Chang-Deuk;Seo, Jeong-Wook
    • Journal of the Korean Wood Science and Technology
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    • v.43 no.4
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    • pp.411-420
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    • 2015
  • Despite of the same species there is a difference in the tree shape and its wood property due to quantitatiVe and qualitatiVe differences in wood cells by the intra-annual cambial actiVity. The purpose of this study was to proVide the fundamental database of intra-annual cambial seasonal actiVity for red pine in Sokwang-ri and Anmyondo for the determination of their wood qualities. As the results of intra-annual cambial actiVity, the initiation of cambial actiVity of red pine in the plots with Age Class V in Sokwang-ri was in the middle of April and it was at the beginning of April in all plots in Anmyondo. Only the plots with Age Class IX in Sokwang-ri showed relatiVely late initiation of cambial actiVity as between middle of May and middle of June. Except one plot with Age Class IX in Sokwang-ri all plots in both sites showed the same cessation of cambial actiVity as between middle and end of October. According to intra-annual cambial actiVity, the duration of cambial actiVity in Sokwang-ri is shorter than that of Anmyondo. On the other hand, the number of cell diVision of cambial actiVity in Sokwang-ri was more than those of Anmyondo. We could establish the database for intra-annual cambial actiVity for Sokwang-ri and Anmyondo to estimate their wood quality.