• Title/Summary/Keyword: Cardiovascular disorder

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Psychiatric Manifestations of Anti-NMDA Receptor Encephalitis: A Case Report (항-NMDA 수용체 뇌염의 정신증상: 증례보고)

  • Kim, Hyunseuk;Lee, Haeyoung;Lee, Sang-Shin
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.207-212
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    • 2021
  • Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis is a neuroinflammatory disease mediated by autoantibodies to NMDAR. In the initial clinical stages of anti-NMDAR encephalitis, psychiatric symptoms like delusions, perceptual disturbances, and disorganized speech or behaviors are pronounced even without obvious neurological symptoms. Early treatments like immunotherapy and/or tumor removal are central to good clinical outcomes. Hence, it is important to diagnose early anti-NMDAR encephalitis, distinguishing it from mental disorder. In the present case study, the authors described psychiatric symptoms assessed with Positive and Negative Syndrome Scale (PANSS) of Ms. A, a 26-year-old woman, in the early phase of anti-NMDAR encephalitis. We will discuss the characteristic psychopathology of anti-NMDAR encephalitis toward prompt diagnosis and treatment. Ms. A showed a higher negative subscale score than positive one on the PANSS. Compared with mental disorder, negative symptoms and cognitive impairment would be more prominent in the early stage of anti-NMDAR encephalitis. Rituximab and teratoma removal were effective, and quetiapine showed good tolerability. It is recommended to evaluate anti-NMDAR encephalitis when negative symptoms, cognitive impairment, catatonia, changes in consciousness level, and neurological symptoms are observed, especially in young women.

Spontaneous Pneumomediastinum: Clinical Experience of 24 Patients in Two Medical Center (자연성 종격동 기종: 두 병원에서의 임상 경험 24예)

  • Moon, Hyeon-Jong
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.663-668
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    • 2010
  • Background: Spontaneous pneumomediastinum is an uncommon disorder with few cases reported. It usually occurs in young males and has benign self-limiting course without any apparent concomitant factor. It is seen after intrathoracic pressure changes leading to alveolar rupture. The clinical experiences of two medical centers were reviewed to aid in optimal management. Material and Method: Retrospective review between March 2003 and August 2010 with spontaneous pneumomediastinum patients was performed. Result: 24 patients were identified with a diagnosis of spontaneous pneumomediastinum. These 24 patients were comprised of 18 men and 6 women with mean age 18.9 years (range 10 ~ 33). The major initial complaints were chest pain (79.2%), throat pain (62.5%), and subcutaneous emphysema (41.7%). The triggering events were exercise (16.7%), coughing (12.5%) and vomiting (12.5%). No apparent triggering event was noted in 54.2% of patients. In all cases, chest radiograph and computed tomography was done. Diagnostic computed tomography was required in 25%. White blood cell counts and C-reactive protein (CRP) were checked, and their initial mean values were $9,790{\pm}3,240/{\mu}L$ Land $1.31{\pm}1.71mg/dL$, final mean values were $5,440{\pm}1,665/{\mu}L$ Land $0.72{\pm}0.73mg/dL$, respectively. 23 patients were admitted (average $5.0{\pm}1.8$) and the symptoms were self-limiting in all cases without complications. Conclusion: Spontaneous pneumomediastinum is a benign condition with mild inflammatory signs that often presents with chest or throat pain. Secondary causes must be ruled out to avoid an unfavorable outcome with less invasive study. Because of very rare complications and recurrence, outpatient basis and shortened hospitalization may be feasible.

Study on the Health Status of the Residents near Military Airbases in Pyeongtaek City (평택시 군용비행장 주변지역 주민건강조사)

  • Kim, Hyun-Joo;Roh, Sang-Chul;Kwon, Ho-Jang;Paik, Ki-Chung;Rhee, Moo-Yong;Jeong, Jae-Yun;Lim, Myung-Ho;Koo, Mi-Jin;Kim, Chang-Hoon;Kim, Hae-Young;Lim, Jeong-Hun;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.307-314
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    • 2008
  • Objectives : We conducted an epidemiologic survey to evaluate the effect of the aircraft noise exposure on the health of the residents near the military airbases in Pyeongtaek City. Methods : The evaluation of environmental noise level, questionnaire survey, and health examination were performed for 917 residents. The study population consisted of four groups: subjects who lived in the village close to the fighter airbase (high exposure), subjects who lived along the course of fighters (intermediate exposure), and subjects near a helicopter airbase, and the control group. Results : The prevalence of the aircraft noise related accident and irritable bowel syndrome in the exposure groups were higher than that of the control group. The risks of noise induced hearing loss, hypertension and diabetes mellitus were higher in the exposed groups than in the control group. The prevalence of anxiety disorder and primary insomnia were higher in the exposed groups than in the control group. Prevalence odd ratios of the risk for primary insomnia after adjusting age, sex, agricultural noise, and occupation were 4.03 [95% confidence interval (95% Cl) 1.56-10.47] for the subject near the helicopter airbase, 1.23 (95% Cl 0.40-3.76) for those intermediately exposed to fighter noise, and 4.99 (95% Cl 2.14-11.64) for those highly exposed to fighter noise. Conclusions : The results of the present study suggest that the aircraft noise may have adverse effects on hearing function, cardiovascular health and mental health. Therefore, it seems to be needed to take proper measures including the control of the aircraft noise and the management of the exposed people's health.

A CLINICAL STUDY ON THE CARE OF ODONTOGENIC INFECTIONS IN THE PATIENTS WITH MAJOR BLEEDING DISORDERS (주요 출혈성 질환자에서 치성감염 관리에 관한 임상적 연구)

  • Kim, Jong-Bae;Chung, Won-Gyun;Noh, Hie-Jin;Jang, Sun-Ok;Yoo, Jae-Ha;Han, Sang-Kwon;Chung, Jae-Hyung;Kim, Byung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.330-337
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    • 2003
  • This is a retrospective study on the care of odontogenic infections in admission patients with major bleeding disorders. The study was based on a series of 514 patients treated at Dong San Medical Center, Wonju Christian Hospital and Il San Health Insurance Hospital, from Jan. 1, 2000, to Dec. 31, 2002. The obtained results were as follows : 1. The cardiovascular disease was the most frequent cause of the systemic diseases with major bleeding disorders, and liver disease, cerebrovascular disease and renal failure were next in order of frequency. But, there was the most frequent dental consultation in the liver disease, owing to the many odontogenic infectious diseases. 2. Male prediction (66.3%) was almost existed in the odontogenic infectious patients with major bleeding disorders. But, there was slight female prediction (53.4%) in the cardiovascular disease. 3. The most common age group of the odontogenic infectious patients with major bleeding disorders was the fifty decade(27.2%), followed by the forty, sixty & thirty decade in order. 4. In the contents of chief complaints on the odontogenic infectious patients with major bleeding disorder, peak incidence was occurred as toothache (42.2%), followed by intraoral bleeding, ulcer pain, dental extraction in order. 5. In the diagnosis group of odontogenic infectious diseases, periodontitis, pulpitis and periapical abscess were more common. 6. In the treatment group of odontogenic infectious diseases, the most frequent incidence(44.2%) was showed in primary endodontic drainage(pulp extirpation, occlusal reduction & canal opening drainage) and followed by the incision & drainage, the medications & oral hygiene instruction, scaling, indirect pulp capping in order.

Postoperative Changes of Pulmonary Function in Chest Surgery (개흉후 폐기능 변화에 대한 연구)

  • Jo, Gwang-Jo;Jeong, Hwang-Gyu
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1169-1179
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    • 1992
  • To determine the period and degree of full recovery of postoperative pulmonary function, the author performed seiral pulmonry function test with spirometry at preoperative period and 1st, 2nd, 3rd, 4th, 6th and 8th postoperative week in 64 patients who underwent chest surgery form 1990. 1. to 1990. 8. at Dep. of Thoracic & Cardiovascular surgery, Pusan National University Hospitcal, Pusan, Korea 28 patients underwent lung resection[Group A], 14 patients mediastinal and other thoracic surgery[Group B], and 22 patients heart surgery with cardiopulmonary bypass[Group C]. Al of them recovered normally and discharged without any complications. Their serial changes of pulmonary function test were compaired and its results was as follows; l. Over all mean recovery time of restrictive ventilatory function tests[ie, VC, ERV, IC, FEF1, FVC, FEF200-1200, MVV] were 4th & 6th postoperative week, and that of obstructive ventilatory function tests[ie., EFE25-75%, Vmax50] were 2nd postoperative week. 2. In patient who underwent lung resection surgery[Group A], FEF1 recovered in 4th~6th postoperative week and its ratio to preoperative value was 70% in pneumonectomy, and 75% in lobectomy. FVC recovered in 4th~6th postoperative week and its ratio to preoperative value was 65% in pneumonectomy, and 80% in lobectomy. MVV was recovered in 4th~8th postoperative week and recovery ratio was 80%, FEF200-1200 was recovered at 4th~6th postoperative week and its recovery ratio was 70%, FEF25-75% and Vmax50 was recovered in 2nd~4th postoperative week and recovered nearly to preoperative level. 3. In patient who underwent mediastinal and other thoracic surgery[Group B], FEV1 and FVC and recovered in 4th~6th postoperative week and the recovery ratio of FVC in blebectomy was 90%. MVV reached preoperative level in 4th~8th postoperative week. FEF200-1200, FEF25-75% and Vmax50 were recovered in 2nd~4th postoperative week and the recovery of FEF25-75% and Vmax50 in blebectomy was prominant. 4. In patient who underwent heart surgery[Group C], FEV1 and FVC were recovered in 4th~6th postoperative week. The recover ratio of FEF25-75% and Vmax50 was delaied to 6th~8th postoperative week From the above results we concluded that the recovery time of posoperative restrictive ventilatory disorder was 4th postoperative week and pulmonary complication would possibly occure during that period. So more intensive observations will be needed.

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Two Cases of Neonatal Persistent Pulmonary Hypertension Treated by Veno-venous Extracorporeal Membrane Oxygenation (V-V ECMO) (정맥-정맥 도관 체외막형 산소섭취로 치료한 신생아의 지속성 폐동맥 고혈압증 2례)

  • Yu, Hee-Joon;Sung, Se-In;Kim, Jin-Kyu;Seo, Hyun-Joo;Choi, Seo-Heui;Yoo, Hye-Soo;Ahn, So-Yoon;Kim, Eun-Sun;Yang, Ji-Hyuk;Huh, June;Chang, Yun-Sil;Kang, I-Seok;Jun, Tae-Kook;Park, Won-Soon
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.109-115
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    • 2010
  • Persistent pulmonary hypertension in newborns (PPHN) is a disorder of the vascular transition from fetal to neonatal circulation. It results in cyanosis due to right-to-left shunting of the blood through the ductus arteriosus and/or foramen ovale manifesting as hypoxemic respiratory failure. We managed two cases of PPHN after meconium aspiration with high frequency oscillating ventilators and inhaled nitric oxide. They did not respond to conventional management. Veno-venous extracorporeal membrane oxygenation (ECMO) was provided, and ECMO weaning was possible resulting survivals in two cases. We report two PPHN cases, which were treated successfully with veno-venous ECMO for the first time in Korea.

Coronary Artery Disease Affected by Moyamoya Disease - A case report - (관상 동맥 질환을 동반한 모야모야 병 1례의 증례 보고)

  • 김학제;조원민;류세민;황재준;손영상;최영호
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.231-234
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    • 2002
  • Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries as well as other collateral arteries. However, moyamoya diseases are recently being reported as a systemic process. We experienced one case of coronary artery occlusive disease affected by moyamoya disease. The patient was a 35-year-old female, experiencing intermittent NYHA class ll dyspnea and exertional chest pain for 6 months and right paresthesia for 1 month before admission. Cerebral artery angiogram showed abnormal cerebrovascular systems and confirmed moyamoya disease with cerebral infarction of the left frontal lobe. In coronary artery angiogram, left coronary artery was not visualized due to total occlusion of the left main ostium and left coronary blood flow was supplied from normal right coronary artery. CABG was performed with OPCAB. Both internal mammary arteries were used for LAD and LCx. Intraoperative coronary artery findings showed intimal hyperplasia and no definite thrombi, and nondiseased coronary arteries were good and patent. We concluded that this patient's coronary artery disease was affected by moyamoya disease, and moyamoya disease should be evaluated in the extracerebral cardiovascular system.

Effect of Gastrodia elata Blume Extract (TVB-1000) on the Menopausal Disorder Model in Ovariectomized Rats (난소를 적출한 갱년기 장애 모델에 대한 천마추출물(TVB-1000)의 영향)

  • Hae-Ryeong Lim;Eun-Su Ji;Hak-Kyu Byun;So-Min Lee;Hyeon-Yeol Ryu;Deug-Chan Lee
    • Journal of Life Science
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    • v.33 no.3
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    • pp.252-259
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    • 2023
  • A decrease in ovarian function and sex hormone production with aging results in hormone deficiency, which causes menopause in women. Natural products have been investigated to develop estrogen-like substances to improve menopausal status in women. This study was performed to evaluate the efficacy of Gastrodia elata Blume extract (TVB-1000) in ovariectomized rats. After a recovery period of 7 days, the TVB-1000 treatment group was orally administered at 16, 40, and 100 mg/kg for 12 weeks. In the OVX-positive control group, 17β-estradiol was injected subcutaneously into the dorsal region of rats at a dose of 10 ㎍/kg. Results show that TG and LDL-C, which are cardiovascular disease markers, were significantly decreased in all concentrations of TVB-1000 administration in the treatment group, and the LDL-C/HDL-C ratio significantly decreased in the medium and high TVB-1000 concentrations of the treatment group. In addition, in the high concentration TVB-1000 treatment group, the weight of abdominal fat decreased with statistical significance. The low-dose and medium-dose administration groups showed statistical significance and the expression level of their ER-α increased, but ER-β did not show a significant change. The above experiment shows that owing to the estrogen-like effect of TVB-1000, it can be useful as a functional food material to prevent cardiovascular disease, which is one of the menopausal symptoms.

A Case of Pure Red Cell Aplasia with Thymoma (흉선종을 동반한 적혈구 무형성증)

  • 노중기
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.306-311
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    • 1980
  • Pure red cell aplasia is unusual cause of anemia and a selective aplastic disorder that affects the erythroid series of the bone marrow. Fifty percent of all patients with red cell aplasia will have a thymoma. Twenty-five to 30% of those who undergo thymectomy will be cured. A 57-years-old man was admitted to the medical department of Korea University hospital with complaints. Physical examination reveals a sick looking man with a pale lip, anemic conjunctiva and subicteric sclera. On auscultation, coarse breathing sound and moist rale was heard on the right lung field. Neither the liver nor spleen was palpable. A blood count showed the erythrocytes to number 2,640,000/mm3 and hemoglobin to be 7.0gm/dl. A white blood cell count was 5,000/mm3 and a platelet count was 328,000/mm3 Reticulocyte count was 0.7%. Examination of the peripheral blood smear showed the red cell, to be normocytic and normochromic. Urine sugar was three positive and GTT was positive. The anterior-posterior and lateral view of Chest X-ray was suggestive of an anterior mediastinal mass. A bone marrow biopsy reveals absence of red cell precursors and a normal myeloid series and megakaryocytes. At thoracotomy in May 1980 an encapsulated, lobulated, benign thymoma, which measured 5x7x5 cm was removed, microscopic examination showed it was of the spindle cell type. The postoperative course was uneventful, but the patient never had a return of hemoglobin to the blood. The patient was discharged on the postoperative] 3 days. At postoperative 1 month, the patient was readmitted for bone marrow study and had no return of red cells to bone marrow. At now, patient has been treated with steroid and the further follow up study will be needed.

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Tobacco-Related Chronic Illnesses: A Public Health Concern for Jamaica

  • Crawford, Tazhmoye V.;McGrowder, Donovan A.;Barnett, Jasper D.;McGaw, Barbara A.;McKenzie, Irving F.;James, Leslie G.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4733-4738
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    • 2012
  • Background: Tobacco use is a leading cause of preventable morbidity and mortality from non-communicable diseases. The objectives of the study were to determine the percentage of annual income used to purchase tobacco-related products and treat tobacco-related illnesses, and assess the characteristics of smokers and their awareness of the health-related risks of smoking. Method: Stratified and snowball sampling methods were used to obtain information (via a 17-item, close-ended questionnaire) from 85 adult respondents (49 males and 36 females). The instrument comprised of demographic characteristics, smoking behavioural/lifestyle, health, and micro socio-economics. Results: There were no significant differences between individuals who were affected by chronic obstructive pulmonary disorder (COPD) (14.1%) and cardiovascular disease (18.8%). It was found that respondents spend 30-39% of their annual income on tobacco-related products. Forty percent (40.0%) and 41.7% of respondents with lung cancer and COPD respectively spend more than 50% of their annual income to treat these diseases. The majority (80%) of those who continues to consume tobacco-related products were uncertain as to why they were doing it. Not all the smokers were aware of the dangers of tobacco consumption despite their level of education. Conclusion: The majority of the respondents who had tobacco-related illnesses such as lung cancer and COPD spend a significant amount of their income on their health care. Not all the smokers were aware of the dangers of tobacco consumption despite their level of education. This suggests the need for increase public awareness where both smokers and non smokers are being fully or adequately informed about the dangers or health risks of tobacco consumption.