• Title/Summary/Keyword: 기저질환

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Two Cases Report of Recurrent Miscarriage with Old Age and Underlying Diseases (자궁 내 기저질환을 가진 고령의 반복 유산 환자 2례에 관한 고찰)

  • Kim, Su-Hyun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.3
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    • pp.78-90
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    • 2016
  • Objectives: The purpose of these cases is to report the effects of Korean medicine on two women with recurrent miscarriage.Methods: One women who had recurrent miscarriage with myoma uteri was 39 years old. She was treated with herbal medicine and acupuncture until intrauterine pregnancy (IUP) 14 wks. the other who had recurrent miscarriage with adenomyosis was 40 years old. she was also treated with these until IUP 11 wks.Results: After treatment, one women delivered successfully by normal full term spontaneous delivery. The other succeeded in normal pregnancy and she is 15 weeks pregnant.Conclusions: Two cases show that Korean Medicine has effects on recurrent miscarriage with old age and underlying diseases.

Successful Treatment of Vancomycin-Resistant Enterococcus Bacteremia With a Combination of Daptomycin and Tigecycline in an Infant who Underwent Heart-Lung Transplantation

  • Kang, Jeong Eun;Byun, Joung-Hee;Kim, Younga;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.29 no.2
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    • pp.105-109
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    • 2022
  • The treatment of invasive infections caused by multidrug-resistant vancomycin-resistant enterococci (VRE) is challenging, particularly in pediatric patients with underlying medical conditions. Newer antibiotics used to treat VRE infections in pediatric patients are insufficiently studied. This report presents the case of a 6-month-old infant who underwent heart-lung transplantation and was successfully treated with a combination of daptomycin and tigecycline for recurrent VRE bacteremia shortly after the discontinuation of linezolid.

Characteristics of patients with decreased mental status while staying in an emergency department: Comparative study with alert patients (응급실 체류 중에 의식이 저하된 환자의 특성: 의식명료 환자와의 비교연구)

  • Moon, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.10
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    • pp.222-230
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    • 2018
  • This was a retrospective study that compared the characteristics of patients with decreased mental status (DMS) during their stays in an emergency department (ED) with that of patients with alert mental status (AMS). The participants in this study consisted of 90 patients with DMS who were staying in an ED along with 100 randomly selected patients with AMS. The DMS group contained more instances of cerebrovascular disease, liver disease, diabetes, and hypertension compared to the AMS group (p=0.001, p=0.003, p<0.001, and p=0.002, respectively). With regard to triage, the DMS group had higher severity than the AMS group (p<.001). The final diagnosis for the DMS group was as follows: 64.9% neurological and 63.3% related to the digestive system, which differed from that of the AMS group (p<.001). Fifty-six (62.2%) patients with DMS had their statuses discovered by nurses, while nine patients in the DMS group had received cardiopulmonary resuscitation. These results suggest that ED nurses frequently assess the consciousness of patients who they suspect may have neurologic or digestive diseases and are classified as high severity, even when the patients are alert.

Expression of Superoxide Dismutase Isoforms in Inflamed Gingiva (염증성 치은에서 superoxide dismutase isoform의 발현에 대한 연구)

  • Na, Hei-Jin;Kim, Ok-Su;Park, Byung-Ju
    • Journal of Periodontal and Implant Science
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    • v.36 no.1
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    • pp.97-112
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    • 2006
  • 유리 라디칼과 활성 산소종, 산화방지제 간의 불균형이 염증성 구강내 질환의 발생과 진행에 있어 중요한 역할을 한다는 주장이 제기되었고 최근에는 만성 염증성 치주질환에서도 산화에 의한 소실이 관찰되었다. 다양한 내적인 항산화 방어 기전 중 superoxide dismutase 가 $O_2$$H_2O_2$로 효과적으로 전환시킴으로써 활성산소종에 대한 일차적인 방어를 맡고 있다. 현재까지 인간에서 발견된 superoxide dismutase 는 cytoplasmic copper-zinc SOD와 mitochondrial manganase SOD, extracellular SOD의 3가지 아형이다. 이번 연구는 만성 치주질환을 가전 환자의 치주조직에서 효소 항산화제인 SOD의 발현정도를 알아봄으로써 질환조직 내의 산화자극 정도를 평가해 보고자하였다. 전남대학교 치주과에 내원한 33명의 만성 치주질환자와 20명 의 임상적으로 건강한 대상으로부터 조직을 얻어 Cu/Zn-SOD와 Mn-SOD, EC-SOD를 이용한 면역조직화학 염색을 시행하였다. 임상적 소견과 조직학적 소견이 일치하지 않아 조직학적 소견을 기준으로 건강한 조직, 경도, 중등도, 중도 치주질환 조직으로 그룹을 나누고 완전한 상피와 결합조직을 가진 27개의 표본에 대한 분석을 시행하였다. 치주질환 조직에서 건강한 조직에 비해 Cu/Zn-SOD가 상피의 기저층과 상피에 근접한 결합조직에서 발현되고 Mn-SOD는 염증이 증가함에 따라 크게 상피의 과립증과 각화층, 그리고 상피에 근접한 결합조직에서 발현됨으로써 활성산소종이 치주조직 파괴에 관여한다는 것을 알 수 있었다. 세 아형 모두 혈관주위에서 발현되었고 특히 EC-SOD는 작은 모세혈관주위에서만 발현되었으나 염증에 의해 혈관벽이 두꺼워지고 혈관 수가 증가한 곳에서 뚜렷하게 염색되었다. 이번 연구는 염증성 치주조직내 증가된 SOD의 활성이 치주질환자의 산화자극 정도와 관련되어 있음을 시사하였다.

Etiology and Risk Factors of Community-Acquired Pneumonia in Hospitalized Children During the COVID-19 Pandemic in South Korea (국내 코로나19 판데믹 기간 발생한 입원을 요하는 소아청소년 지역사회폐렴의 원인과 위험 인자)

  • Hae Min Kang;Seung Ha Song;Bin Ahn;Ji Young Park;Hyunmi Kang;Byung Ok Kwak;Dong Hyun Kim;Joon Kee Lee;Soo-Han Choi ;Jae Hong Choi;Eun Hwa Choi;Ki Wook Yun
    • Pediatric Infection and Vaccine
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    • v.30 no.1
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    • pp.20-32
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    • 2023
  • Purpose: This study aimed to identify the etiology and risk factors of community-acquired pneumonia (CAP) requiring hospitalization in Korean children during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Clinical information of children admitted with CAP to Seoul National University Children's Hospital (SNUCH) between January 1, 2021, and February 28, 2022, was retrospectively collected and analyzed. In addition, the etiologic diagnosis and demographic data of children with CAP who were discharged at the other seven hospitals between January and February 2022 were collected. Pneumonia was diagnosed using strict criteria comprising clinical symptoms, physical examination findings, and chest radiographic findings. Results: Among 91 children hospitalized with CAP at SNUCH during the 14-month period, 68.4% were aged <5 years and 79.1% had underlying diseases. Among the 95 CAP cases, respiratory assistance was required in 70.5%, and the use of a ventilator was required in 20.0%. A total of five patients expired, all of whom were either immunocompromised or had underlying neurological diseases. Neurological diseases and immunosuppression were significantly correlated with respiratory assistance (P=0.003) and death (P=0.014). A total of 55% of the detected respiratory pathogens were viruses, the most common of which was rhinovirus at 35.9%. Among the 169 children hospitalized for CAP at the eight institutions, ≥1 respiratory virus was detected in 92.3%, among which respiratory syncytial virus (79.8%) was the most prevalent. Conclusions: Even during the COVID-19 pandemic, Korean children were hospitalized with CAP caused by seasonal respiratory viral pathogens. Although atypical and pyogenic bacteria were not detected, continuous clinical monitoring and further prospective studies should be conducted.

Three Cases of Aseptic Meningitis Following the Use of Intravenous Immune Globulin (정맥용 면역글로불린 투여 후 발생한 무균성 수막염 3례)

  • Lee, Joon Ho;Song, Eun Kyoung;Lee, Jin A;Kim, Nam Hee;Kim, Dong Ho;Park, Ki Won;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.202-207
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    • 2005
  • Intravenous immune globulin(IVIG) is widely used for immune thrombocytopenic purpura (ITP), Kawasaki disease and other autoimmune neuromuscular disease. Aseptic meningitis was one of the most serious neurologic complications reported following the use of IVIG. We experienced 4 episodes of aseptic meningitis associated with IVIG usage in 3 patients from 2003 to 2004. Underlying disease of each patients was ITP, Kawasaki disease and myathenia gravis and all of them received high dose IVIG treatment for their underlying disease. Within a days, they started to complain severe headache and diagnosed meningitis by cerebrospinal fluid analysis. Cerebrospinal fluid leukocyte counts varied from 92 to over a thound per microliter with dominance of polymorphonuclear leukocytes. Microbiologic studies revealed no organisms. All of them were free from headache within 2 days and did not suffer any neurological sequelae.

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Guidelines for Determining Length of Tunneled Dialysis Catheter (터널식 투석관의 길이 결정 가이드라인)

  • Park, Ho-Sung;Kim, Jae-Seok
    • Journal of the Korean Society of Radiology
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    • v.16 no.3
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    • pp.241-248
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    • 2022
  • A guideline for determining the optimal catheter length according to the patient's physique during tunnel-type dialysis catheter insertion used in renal failure patients is presented, and the maintenance of the function of the dialysis catheter is evaluated. From October 1, 2015 to February 31, 2016, a total of 110 (male : female = 73 : 37) patients who underwent tunnel-type dialysis catheterization performed at our hospital were treated without using guidelines. The group was divided into A group, and the group treated using the guideline into B group. Results were analyzed statistically using SPSS 20.0. As a result of the dialysis catheter insertion procedure according to the use of guidelines, the function maintenance rate of group A was 81.8%, and the function maintenance rate of group B was 96.3%. In the case of tunnel dialysis catheter procedure, the function maintenance effect was statistically significant in the group treated using the guideline compared to the group not using it (p<0.05). It can be said that it is more effective when information on the patient's underlying disease is reflected in addition to the use of guidelines.

Airway Compression or Airway Anomaly Causing Respiratory Symptoms in Infants and Children with Cardiovascular Diseases (심혈관계 질환 환아에서 동반된 기도 압박 및 기도 기형의 임상적 특성)

  • Kim, Ja-Hyeong;Lee, So-Yeon;Kim, Hyo-Bin;Koo, So-Eun;Park, Sung-Jong;Kim, Young-Hui;Park, In-Suk;Ko, Jae-Gon;Seo, Dong-Man;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.737-744
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    • 2005
  • Purpose : Infants and children with cardiovascular diseases often present with respiratory symptoms. However, missed or delayed evaluation for potential airway problem may complicate overall prognosis. The aim of this study is to determine the clinical characteristics of these patients and explore the cause of airway problem. Methods : We reviewed the medical records of 64 patients(M : F=33:31, mean age : $6.3{\pm}7.5$ months) whose airway problems were proven by computed tomography or bronchoscopy in perioperative periods at the Asan Medical Center from January 1997 to June 2004. Patients were divided into two groups based on the duration of ventilator care : ${\leq}7$ days(group 1 : 23 cases, M : F=10 : 13) and >7 days(group 2 : 41 cases, M : F=23 : 18). Results : The patients in group 2 significantly developed more post-operative respiratory symptoms than group 1(P<0.001) and had more airway problems including extrinsic obstruction, intrinsic anomaly, and combined problem than group 1 although not significantly different(P=0.082). Among underlying diseases, the most common diseases were vascular anomaly(26.2 percent) and aortic arch anomaly(26.2 percent) in group 1 and pulmonary atresia with ventricular septal defect(22.4 percent) in group 2. The most frequent respiratory symptoms were recurrent wheezing pre-operatively and failure of ventilator weaning post-operatively. The major types of airway anomaly were tracheomalacia and tracheal stenosis(in each case 18.2 percent). Nineteen patients with persistent airway problems underwent aortopexy or other vascular correction. Of the 19 patients, 13(68.4 percent) were improved, but 2 failed in weaning ventilator and 4 died of non-airway problems. Conclusion : Early evaluation and treatment for potential airway problems may affect natural or surgical prognosis in patients with cardiovascular diseases presenting with respiratory symptoms.

The Potential Therapeutic Effects of Endothelial Progenitor Cells in Ischemic Cardiovascular Disease (허혈성 심혈관 질환의 치료제로서 혈관내피전구세포(EPC)의 가능성에 대한 고찰)

  • Kim, Da Yeon;Kim, Bo Min;Kim, So Jung;Choi, Jin Hee;Kwon, Sang-Mo
    • Journal of Life Science
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    • v.30 no.7
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    • pp.651-659
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    • 2020
  • Cardiovascular disease is one of the leading causes of death across the world, and gold-standard treatments such as percutaneous coronary intervention and artery bypass grafting have various limitations including myocardial damage and subsequent maladaptive cardiac remodeling. To overcome this, stem-cell therapies are emerging as a promising strategy for cardiovascular regeneration. Endothelial progenitor cells (EPCs) have high potential to proliferate and differentiate into endothelial cells for vascularization and tissue regeneration, and several clinical trials have explored EPC function in tissue repair in relation to clinical safety and improving cardiac function. Consequently, EPC has been suggested as a feasible stem-cell therapy. However, autologous EPC transplantation in cardiovascular disease patients is restricted by risk factors such as age, smoking status, and hypertension that lead to reduced bioactivity in the EPCs. New approaches for improving EPC function and stem-cell efficacy have therefore been suggested, including cell priming, organoid culture systems, and enhancing transplantation efficiency through 3D bioprinting methods. In this review, we provide a comprehensive understanding of EPC characteristics, therapeutic approaches, and the current state of clinical research into EPCs as stem-cell therapy for cardiovascular disease.

Immunoglobulin G4-Related Disease Involving the Pterygopalatine Fossa, Mimicking Invasive Aspergillosis: A Case Report and Literature Review (침습아스페르길루스증으로 오인된 날개입천장오목에 발생한 면역글로불린 G4 관련 질환: 증례 보고 및 문헌 고찰)

  • Jin Young Son;Jee Young Kim;Jin Hee Cho;Eun Jung Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.1005-1010
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    • 2021
  • We report a case of Immunoglobulin G4 (IgG4) related disease involving the pterygoplataine fossa. A 83-year-old male presented with left ocular pain and visual disturbance. CT showed an isodense soft tissue lesion in the left pterygopalatine fossa with bony sclerotic changes and erosion. MRI revealed an infiltrative soft tissue mass in the left pterygopalatine fossa as a T2 slightly low signal intensity and heterogeneous enhancement. The patient underwent left ethmoidectomy, and biopsy of the mass was conducted. The histopathological diagnosis was IgG4-related disease. In this case, it was difficult to differentiate invasive aspergillosis, which is common in immunocompromised patients, considering the patient's clinical history of diabetes mellitus. This report describes the imaging findings of IgG4-related disease mimicking invasive sinusitis such as invasive aspergillosis.