• Clinical and Experimental Pediatrics
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• 제59권3호
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• pp.145-148
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• 2016

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal condition characterized by skin rash, fever, eosinophilia, and multiorgan involvement. Various drugs may be associated with this syndrome including carbamazepine, allopurinol, and sulfasalazine. Renal involvement in DRESS syndrome most commonly presents as acute kidney injury due to interstitial nephritis. An 11-year-old boy was referred to the Children's Hospital of Pusan National University because of persistent fever, rash, abdominal distension, generalized edema, lymphadenopathy, and eosinophilia. He previously received vancomycin and ceftriaxone for 10 days at another hospital. He developed acute kidney injury with nephrotic range proteinuria and hypocomplementemia. A subsequent renal biopsy indicated the presence of acute tubular necrosis (ATN) and late exudative phase of postinfectious glomerulonephritis (PIGN). Systemic symptoms and renal function improved with corticosteroid therapy after the discontinuation of vancomycin. Here, we describe a biopsy-proven case of severe ATN that manifested as a part of vancomycin-induced DRESS syndrome with coincident PIGN. It is important for clinicians to be aware of this syndrome due to its severity and potentially fatal nature.

• 대한임상독성학회지
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• 제10권2호
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• pp.86-90
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• 2012

Purpose: Although Pokeweed intoxication is relatively less severe, there is little data on the clinical presentation of Pokeweed intoxication in Korea. This study examined the clinical aspects to provide basic data for evaluating Pokeweed intoxication. Methods: A retrospective study by a chart review was performed on 19 patients who ingested Pokeweed and presented to an academic emergency department with an annual census of 40,000 between March 2012 and May 2012. Results: Nineteen patients were identified. All patients were intoxicated unintentionally. The most common symptoms were vomiting with diarrhea and abdominal pain. The onset time varied, but occurs 30 minutes to 5 hours post ingestion of Pokeweed. All patients were discharged without fatal complications. Conclusion: Compared to previous reports, most pokeweed poisoning patients complain of gastrointestinal symptoms. Supportive care is the mainstay of the management of pokeweed intoxication. All symptoms were resolved over a 24 to 48 hour period.

• 한국직업건강간호학회지
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• 제11권1호
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• pp.5-12
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• 2002

The purpose of this study, as a project for health management at small workplace by Korean association of occupational health nurse, was to evaluate the program for correction of eating habits to prevent digestive disorders of workers. The study cases were twenty nine workers who voluntarily participated in the above program and they were from small(under fifty employees) workplace at Youngdeungpo-gu, Seoul. The study was done between January, 2000 and May, 2000. This program was concerned with daily menu for correction of eating habits and was composed of individual health education and distributing guide books and video. Nurses visited the workplace for the program once a week or two weeks. The result of this program was evaluated by paired t-test of digestive symptoms, eating habits, and self-efficacy before and after the fulfillment of the program. The result could be summarized as below. 1) There were decrease in digestive symptoms and improvement in eating habits and self-efficacy from study cases after fulfillment of the program. 2) The most common digestive symptoms were heartburn, upper abdominal pain, indigestion. The symptom which had been improved through the program were indigestion, heartburn and anorexia in the order. 3) The most improved eating habit was to eat flat foods instead of salty and spicy foods. The most improved self-efficacy was 'I can follow any helpful guides for my health'. The result indicated the program was successful for workers at small workplace. The continual management by nurses' regular visit once a week or two weeks was the most important thing for the successful program.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.107-113
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• 2017

Purpose: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. Methods: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed. Results: Twenty-four patients (70.6%) were male. The mean age of the patients was $8.5{\pm}6.2$ (range, 1.1-17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p<0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p< 0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen. Conclusion: Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.

• Journal of Yeungnam Medical Science
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• 제25권2호
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• pp.182-186
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• 2008

Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1767-1770
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• 2012

Background: The Asia Pacific consensus for colorectal cancer (CRC) recommends that screening programs should begin by the age of 50. However, there have been reports about increasing incidence of CRC at a younger age (i.e. early-onset CRC). Little is known about the features of early-onset CRC in the Vietnamese population. Aim: To describe the clinical, endoscopic and pathological characteristics of early-onset CRC in Vietnamese. Method: A prospective, cross-sectional study was conducted at the University Medical Center from March 2009 to March 2011. All patients with definite pathological diagnosis of CRC were recruited. The early-onset CRC group were analyzed in comparison with the late-onset (i.e. ${\geq}$ 50-year-old) CRC group. Results: The rate of early-onset CRC was 28% (112/400) with a male-to-female ratio of 1.3. Some 22.3% (25/112) of the patients only experienced abdominal pain and/or change in bowel habit without alarming symptoms, 42.9% (48/112) considering their symptoms intermittent. The rate of familial history of CRC in early-onset group was significantly higher that of the late-onset group (21.4% versus 7.6%, p<0.001). The distribution of CRC lesions in rectum, distal and proximal colon were 51.8% (58/112), 26.8% (30/112) and 21.4% (24/112), respectively; which was not different from that in the late-onset group (${\chi}2$, p = 0.29). The rates for poorly differentiated tumors were also not significantly different between the two groups: 12.4% (14/112) versus 8.3% (24/288) (${\chi}2$, p = 0.25). Conclusion: A high proportion of CRC in Viet Nam appear at an earlier age than that recommended for screening by the Asia Pacific consensus. Family history was a risk factor of early-onset CRC. Diagnosis of early-onset CRC needs more attention because of the lack of alarming symptoms and their intermittent patterns as described by the patients.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3647-3650
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• 2016

Background: Colorectal cancer is one of the major health problems worldwide. However, limited studies have been reported from ASEAN countries. This study was conducted to evaluate clinical characteristics and survival of colorectal cancer cases aged <65 years and ${\geq}65$ years in the central region of Thailand. Materials and Methods: Clinical information, histological features, endoscopic findings and treatment outcome were collected and reviewed from Thammasat University Hospital, Pathumthani, Thailand between November 2011 and October 2015. Results: A total of 121 colorectal cancer patients, comprising 69 men and 52 women with a mean age of 65.8 years, were included. There were 57 aged <65 years and 64 aged ${\geq}65$ years. Common presenting symptoms were abdominal pain (37%), weight loss (34%) and anemia (32%). Mean duration of symptoms prior to diagnosis was 173 days. However, longer diagnosis time was demonstrated in patients aged <65 years than age more than ${\geq}65$ years (119.4 vs 58.4 days, P-value=0.30). Colonic fungating mass was the most common endoscopic finding (64.4%) and the location was significantly more commonly left than right side of the colon, both in younger and elderly groups (87.7% vs 12.3%, P=0.02 and 70.3% vs 29.7%, P=0.02, respectively). Adenocarcinoma with moderated differentiated was the most common histology (67.3%). More than half of the patients presented with advanced stage (28.9% with TNM stage 3 and 38.8% TNM stage 4, respectively). Overall 1-year and 5-year survival rates were 76.9% and 5%. Conclusions: Most colorectal cancer patients in Thailand have adenocarcinomas and present at advanced stage with poor prognosis. Screening of high risk patients and early detection might be essential factors to improve the treatment outcome and overall survival rate of colon cancer patients in Thailand and other ASEAN countries.

• 대한한의학회지
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• 제34권4호
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• pp.56-62
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• 2013

Objectives: Hepatocellular carcinoma patients have a poor prognosis and survival beyond 5 years is very rare in spite of western treatment. We report a case of long-term survival of a hepatocellular carcinoma patient treated by Korean medicine combined with western therapy. Methods: The treatment was provided from November 2004 to July 2012. Herbal medicine, acupuncture and moxibustion treatment were used as main treatment methods. We prescribed herbal medicines three times a day and performed acupuncture and moxibustion an average of 2-3 times a week. Clinical laboratory tests were performed each month and a CT scan was carried out 13 times during the treatment period. In order to evaluate the disease status, we checked the patient's abdominal circumference, weight change and subjective symptoms regularly. Results: During treatment, subjective symptoms of the patient and state of ascites due to hepatocellular carcinoma were relatively stable. The progress of hepatocellular carcinoma was gradual without worsening rapidly. Since the initial diagnosis with hepatocellular carcinoma, the patient survived for a further 7 years and 9 months treated by Korean medicine combined with western treatment. Conclusions: According to the above results, this case indicates that Korean medical treatment combined with western therapy for hepatocellular carcinoma patients has synergistic effects of prolonged survival, relief of symptoms and management of complications.

• 대한한방내과학회지
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• 제28권2호
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• pp.391-398
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• 2007

Objectives and Methods : Chronic pancreatitis is an inflammative disease characterized by both persistent and irreversible progression of pancreatic lesions that accompanies complications and pain which hinders everyday life activities. As the alcohol consuming population increases, chronic pancreatitis is increasing consequently. We retrospectively analyzed the medical record of a chronic pancreatitis patient who had been treated with oriental herbal medicine, acupuncture and moxibustion for 40 days. He complained of anorexia, fatigue, indigestion, weight loss, constipation, abdominal discomfort and pain. We prescribed him Daekumeumja, Bojungikgi-tang and other oriental herbal medicines in order to cure these symptoms. Results and Conclusion : For 40 days he was treated with oriental medicine and the symptoms mostly disappeared. When it comes to the therapeutic effects, it could be suggested that oriental medicine has significant effects on improving symptoms and qualities of lives.

• 대한한방부인과학회지
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• 제28권4호
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• pp.106-117
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• 2015

Objectives : This study is to report the clinical effect of oriental medicine on a patient suffering from endometriosis with chronic pelvic pain and other accompanied various symptoms. Methods : The 32 years old patient had suffered from endometriosis symptoms including pelvic pain, menstrual cramping, disuresia, and other pains over 8 years. The patient received herbal medication, acupuncture, abdominal moxibustion during 5 months of outpatient treatment. The clinical effects were evaluated through TSD (Total Symptom Distress) and EHP-5 (Short-From Endometriosis Health Profile Questionnaire). Results : The various clinical symptoms were improved during the treatment. The TSD and EHP-5 score also noticeably reduced. Conclusions : This case study showed that oriental medicine, acupuncture and moxibustion treatment appeared to effectively reduce various symptom of endometriosis.