• Title/Summary/Keyword: Acute hypotension

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Death after Ingestion of MCPP -A Case Report- (MCPP 음독 후 발생한 사망 1례)

  • So Byung Hak;Lee Won Jae;Shim Byoung Yong;Kim Hoon-Kyo;Kim Chi Hong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.45-47
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    • 2005
  • MCPP (2-(2-methyl-4-chlorophenoxy)propionic acid; mecoprop), a hormonal weedkiller has been widely used. Although chronic exposure is generally considered to be mildly toxic to man, acute intoxication can be severe and should thus be taken seriously. We report the case of a patient who died after ingestion of MCPP. A 64-year-old man ingested about 400 ml of $50\%$ MCPP solution. He was stuporous and had an inadequate respiration. He had an hypotension which did not respond to vasopressors and died about twelve hours after ingestion.

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The Clinical Observation of Anaphylaxis on Bee-Venom Acupuncture (봉약침요법으로 발생한 Anaphylaxis에 대한 임상보고)

  • Youn, Hyoun-Min
    • Journal of Acupuncture Research
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    • v.22 no.4
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    • pp.179-188
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    • 2005
  • Objectives : This study is designed to observe anaphylatic reaction In two patients, who visited Dong-Eui University Oriental Medicine Center for Bee-Venom Acupuncture. Methods : Anaphylaxis is a clinical syndrome cheracterized by the acute system reaction of multiple organ systems to an IgE-mediated immunologic mediator release in previously sensitized individuals. Anaphylatic reaction of two patients treated by Bee-Venom Acupuncture were observed in order to analysis the clinical form. Results & Conclusion : STZ One case of Anaphylatic reaction was expressed clinically hypotension drowsy mentality, dizziness muscle contraction and so on. The other case was expressed ulticaria, itching sensation, nausea and erythema. Especially ulticaria erythema are end points of increased vascular permeability and vasodilatation at the extreme of the clinical spectrum.

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General Pharmacology of DA-7101, a New Antibiotic Composition (새로운 복합항생제 DA-7101의 일반약리작용)

  • 김정훈;오태영;배은주;손문호;김순회;김원배
    • Biomolecules & Therapeutics
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    • v.7 no.3
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    • pp.285-291
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    • 1999
  • DA-7101 is a new combined formulation of cefatrizine:clavulanic acid (2:1) under development as oral abtibiotics. The general pharmacological properties of DA-7101 on central nervous, cardiovascular, gas-trointestinal and other organ systems were studied by oral administration, in vivo and in vitro. DA-7101 had no marked effects all tests studied such as general behavior, hexobarbital-induced sleeping, spontaneous activity, anticonvulsion, body temperature, acetic acid-induced writhing, rotarod performance, heart rate and blood pressure in cats, isolated ileum movement, intestinal transition, gastric juice secretion and urine volume and electrolytes in rats. But exceptionally at the highest dose of 900 mg/kg, DA-7101 increased hexobarbital-induced sleeping time, caused a slight hypotension and decreased the secretion of gastric juice. These results suggest that at the estimated clinical dose DA-7101 would not bring about any serious acute adverse effects clinically.

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Type 4 Tetralogy of Fallot with Pulmonary Hypertension in an American Shorthair Cat

  • Hyeon-Jin Kim;Jihyun Kim;Tae Jung Kim;Ha-Jung Kim
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.366-372
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    • 2022
  • A 2-year-old, spayed female, American shorthair cat presented with acute weight loss, tachypnea, and dyspnea. The cat had grade V holosystolic murmur and systemic hypotension. Echocardiography showed a 9 mm defect in the ventricular septum, left-to-right dominant bi-directional shunt, right ventricular hypertrophy, pulmonary stenosis, pulmonary hypertension, and overriding aorta. The cat was diagnosed with a Tetralogy of Fallot. The cat was treated with furosemide, pimobendan, ramipril, and sildenafil. Treatment reduced pulmonary infiltration, pulmonary vessel enlargement, and main pulmonary artery bulging. However, right-to-left flow increased over time and right ventricular outflow tract velocity was elevated. Currently, the patient has maintained an improved state for 1 year. This case report described a severe inherited feline Tetralogy of Fallot case that was successfully managed for a long time.

A Clinical Analysis on Traumatic Subarachnoid Hemorrhage (두부외상 후 발생한 지주막하 출혈에 대한 임상분석)

  • Goo, Tae Heon;Kim, Han Sik;Mok, Jin Ho;Lee, Kyu Chun;Park, Yong Seok;Lee, Young Bae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.1
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    • pp.108-112
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    • 2000
  • Objective : Many authors suggest that patients with traumatic subarachnoid hemorrhage(tSAH) visible on first CT after heve injury had a significantly worse prognosis than patients who do not. The aim of this study is to identify patients with tSAH who present with a bad prognosis by reviewing their clinicoradiological features and plan appropriate treatments. Patients and Methods : We reviewed and analysed the factors that influenced discharge outcomes in 172 patients with tSAH for a 3-year period. The outcome was divided into good(good recovery and moderate disability of glasgow outcome scale) and good(severe disability, vegetative state and death). Results : A regression analysis of statistical significant factors(p<0.05) among the clinical and CT features ranked them by descending order of contribution to Glasgow Outcome Scale(GOS) scores at the time of discharge from acute hospitalization as follows 1) clinical : admission Glasgow Coma Scale(GCS), hypotension, CT grade, abnormal APTT, skull fracture, hyperglycemia(>160mg/dl), hypoxia, operation, 2) CT : basal cistern effacement(BCE), mass lesion, cortical sulcal effacement(CSE), midline shift. Conclusion : We have also experienced that the CT grading scale proposed by Green et al is a simple and useful prognostic factor. The authors believe that the patients with high CT grade need adjuvant therapies as of well surgery but it seems mandatory to consider early identification and correction of hypotension, hyperglycemia, and hypoxia in emergency setting.

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Bradycardia after Dobutamine Administration in a Dog (Dobutamine 투여 후 발생한 개의 서맥 1례)

  • Jang, Min;Son, Won-Gyun;Hwang, Hyeshin;Jo, Sang-Min;Yi, Kang-Jae;Yoon, Junghee;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.350-353
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    • 2014
  • A 13-year-old, castrated male, Shih Tzu dog with a history of acute ataxia was referred to veterinary medical teaching hospital and anesthetized for diagnostic magnetic resonance imaging of cervical intervertebral disk disease. After preanesthetic evaluation including physical examination, blood chemistry, radiography and ultrasound, the patient was premedicated with intravenous butorphanol (0.2 mg/kg). Anesthesia was induced by intravenous propofol (6 mg/kg) and maintained with isoflurane at 1.2 minimal alveolar concentrations. Because the mean arterial pressure (MAP) decreased from 70 to 58 mmHg at 70 minutes after induction, dobutamine was administered by constant rate infusion ($5{\mu}g/kg/min$) to treat hypotension. However MAP did not increase, and heart rate rapidly decreased from 100 to 55 beats per minute (bpm). To treat bradycardia, intravenous glycopyrrolate ($5{\mu}g/kg$) was administered, and heart rate increased to 165 bpm. After extubation of endotracheal tube, the patient showed normal recovery without any problems related to cardiovascular system. Unexpected dobutamine-induced bradycardia was considered as Bezold-Jarisch reflex. It is recommended that clinicians know and prepare the possibility of bradycardia during dobutamine therapy under general anesthesia.

A Case of Cerebral Salt Wasting Syndrome Associated with Tuberculous Meningitis (결핵성 뇌수막염에 동반된 뇌성 염분소실증후군(Cerebral salt wasting syndrome) 1예)

  • Lee, Ja Young;Lee, Eun Sil;Lee, Jae Hyong;Lim, Eun Ju;Kim, Hyoung Su;Jang, Ji Seon;Kim, Hyeon Kyu;Kim, Doo-Man;Park, Yong Bum;Lee, Jae Young;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.3
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    • pp.306-310
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    • 2005
  • Hyponatremia which is due to excessive sodium loss in the urine and decrease in extracellular fluid volume following an acute or chronic central nervous system injury, has been conjunctively described as cerebral salt wasting syndrome (CSWS). This syndrome is often confused with dilutional hyponatremia due to inappropriate secretion of antidiuretic hormone. Accurate diagnosis and management are mandatory for improvement of the course of the disease. This report describes a case of a 31-year-old male patient with CSWS associated with tuberculous meningitis. The patient exhibited hyponatremia, polyuria, excessive natriuresis, volume depletion, and hypotension. He was diagnosed to manifest CSWS and was treated by administration of fluids, salt, and fludrocortisone. After the respective treatments, symptoms of polyuria and hypotension were gradually resolved and hyponatremia was corrected.

Clinical and Epidemiological Characteristics of Severe Poisoning Patients and Analysis of Prognostic Factors (중증 중독환자의 임상 역학적 특징과 예후에 영향을 주는 요인분석)

  • Jung, Young Yun;Ha, Chul Min;Jung, Sung Tae;Lee, Hyoung Ju
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.94-101
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    • 2020
  • Purpose: This study examined the clinical and epidemiological characteristics of intensive care unit (ICU) patients admitted or died in the emergency medical center with acute-poisoning to investigate the variables related to the prognosis. Methods: The data were collected from poisoning patients admitted or died in the emergency medical center of a general hospital located in Seoul, from January 2014 to February 2020. The subjects of this study were 190 patients. The medical records were screened retrospectively, and the clinical and epidemiological characteristics of the patients in the emergency room (ER) and ICU were examined to investigate the contributing factors that influence the poor prognosis. Results: The study analyzed 182 patients who survived after being admitted to the intensive care unit (ICU). The results are as follows. The mental change (87.4%) was the most common symptom. Sedative poisoning (49.5%) was the commonest cause. For most patients, pneumonia (26.9%) was the most common complication. Hypotension (23.7%), tachycardia (42.1%), fever (15.8%), seizures (10.5%), dyspnea (2.6%), high poisoning severity score (PSS), type of toxic material, mechanical ventilator application (39.5%), inotropes application (39.5%), and pneumonia (55.3%) were correlated the LOS over 5 days in the ICU. 8 patients died. In the case of death pesticides and carbon monoxide were the main toxic materials; tachycardia, bradycardia, and hypotension were the main symptoms, and a mechanical ventilator and inotropes were applied. Conclusion: Patients with unstable vital signs, high PSS, and non-pharmaceutical poisoning had a prolonged LOS in the ICU and a poor prognosis.

Treatment-Induced Neuropathy of Diabetes (타입 1형 당뇨 환자에서 급작스런 혈당조절에 의해 발생한 신경염)

  • Kim, Kee Hoon;Leem, Min Jeong;Yi, Tae Im;Kim, Joo Sup;Yoon, Seo Yeon
    • Clinical Pain
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    • v.19 no.1
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    • pp.32-35
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    • 2020
  • Treatment-induced neuropathy in diabetes (TIND) is a reversible neuropathy that occurs in patients with diabetes, usually after a fast improvement in glycemic control. TIND is defined as the sudden onset of neuropathic pain or autonomic dysfunction with a large improvement in glycemic control (glycated hemoglobin [HbA1c] level of ≥ 2% over 3 months). We report the first case of a 24-year-old woman with type 1 diabetes mellitus who developed TIND in Korea. Her HbA1c level had decreased from 16.7% to 7.3% within a 3-month period. She developed acute-onset, severe, and continuous burning pain affecting her back and lower extremities. She was administered tapentadol (50 mg), pregabalin (75 mg), and vitamin B with minerals twice daily for neuropathic pain. She complained of orthostatic hypotension; thus, midodrine (2.5 mg) and anti-embolic stockings were prescribed. She almost completely recovered 6 months after the onset. A physician should be aware of TIND and gradually reduce HbA1c levels to prevent the occurrence of TIDN. They must also try to provide relief from severe pain or autonomic dysfunction and emphasize on an almost complete recovery.

A Case of Pyomyositis and Toxic Shock Syndrome Caused by Methicillin Resistant Staphylococcus aureus (독성 쇼크 증후군을 동반한 Methicillin 저항성 황색 포도알균 화농성 근염 1례)

  • Kim, Yang Kyong;Kim, Dal Hyon;Kim, Soon Ki;Son, Byong Kwan;Hong, Young Jin
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.88-92
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    • 2005
  • Pyomysitis is a primary acute bacterial infection of large skeletal muscule, usually occuring in the absence of specific cause of infection. Pyomyositis has been reported mainly in tropical countries and was rare in temperate climates. but it has been recognized with increasing frequency. Toxic shock syndrome(TSS) is an acute mutisystemic disease characterized by high fever, hypotension, multisystem dysfunction and erythematous rash followed by skin desquamation 8-12 days after onset. Especially, TSS and pyomyositis are rare conditions in the pediatric population. We experienced one case in a healthy 13-year-girl who developed pyomyositis of the right ileac and gluteal muscles associated with TSS caused by methicillin resistant Staphylococcus aureus. We reports a case of acute pyomyositis with TSS, in which the diagnosis was difficult because of the relative rare incidence in temperate climates and its vague symptoms. To our knowledge, this is the first reported case of pyomyositis with TSS in Korean pediatric population.