• 제목/요약/키워드: Clinical symptoms and signs

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증상이 있는 신생아 자발성 기흉의 관련 질환과 예후 (Symptomatic Spontaneous Pneumothorax in the Newborn : Comorbidities and Outcomes)

  • 주지원;양은미;손영준;김미정;송은송;최영륜;변형석
    • Neonatal Medicine
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    • 제15권2호
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    • pp.166-171
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    • 2008
  • 목 적 : 본 연구를 통하여 신생아 중환자실 환아에서 증상이 있는 자발성 기흉의 빈도와 이들의 임상적 특징과 동반 질환 및 예후에 대해 알아보고자 하였다. 방 법 : 2003년 3월부터 2008년 2월까지 전남대학교병원 신생아 중환자실에 입원한 환아 중 자발성 기흉으로 진단된 총 22명에 대해 인구 역학적 특징과 산과적병력, 임상 소견, 동반된 질환, 치료 및 예후에 대해 의무기록지를 후향적으로 조사하였고, 특히 동반된 질환을 보기위해 신장 초음파와 두부 초음파 검사 결과를 검토하여 다음과 같은 결론을 얻었다. 결 과 : 신생아 중환자실 입원 환아 중 자발성 기흉 환아는 0.55%였고, 총 22명 중 외부에서 이송된 환아가 5명(68.2%), 남아가 12명(54.5%)이었고, 흉벽 함몰과 빠른 호흡 및 청색증이 가장 흔한 증상이었다. 호발 부위는 우측이었고 모두 3일 이내에 진단되었다. 두부 초음파상 31.8%에서, 신장 초음파 상 18.2%에서 이상 소견이 보였다. 치료로 산소만 투여한 경우가 81.8%, 산소 치료 및 흉관 삽관술을 시행한 경우가 18.2%이었으며, 모두 생존하였고 예후는 좋았다. 결 론 : 건강하게 보이는 신생아에서 갑자기 호흡곤란 증상이 발생하면 일단 자발성 기흉을 의심해보아야 하고, 자발성 기흉의 예후는 좋지만 신요로계 기형 동반 가능성이 정상아보다 더 높고 뇌실내 출혈 위험이 있으므로, 두부 및 신장 초음파 검사를 실시하는 것이 환아 치료와 예후 개선에 도움이 될 것으로 사료되었다.

알레르기性 鼻炎(噴체)에 關한 臨床報告 (Clinical Study on Effect for Allergic Rhinitis in 33 Cases.)

  • 최은규;노석선
    • 한방안이비인후피부과학회지
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    • 제5권1호
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    • pp.143-150
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    • 1992
  • The clinical study was carried out the 33 patients with Allergic rhinitis who had been treated by Ga-Mi-tong-Gyu-tang from 1992.1 to 1992.9. The results were summarized as follows. 1. Distribution of sex : male($54.5\%$), female($45.5\%$) In the distribution of age, 30 age group made up $27.3\%$, and 10s, 40s, 20s in descending order. 2. Distribution of illness period : 1 - 5 under years($66.7\%$) , 6month-l under year($18.1\%$), 5-10 under years($15.2\%$). 3. Distribution of symptoms and signs, nasal discharge was $100\%$, sneezing was $93.9\%$, stuffy nose was $84.8\%$, nasal cooling sign was $33.3\%$. 4. Past history : Asthma was $15.1\%$, gastritis was $15.1\%$, genyantritis was $9.0\%$, deviation of the nasal septum was $3.0\%$, bronchitis was $3.0\%$. 5. In the general paranasal sinuses X-ray examination and anterior rhinoscopy : $45.4\%$ have hypertrophy of concha, $9.0\%$ have genyantritis, $6.0\%$ have deviation of the nasal septum. 6. Distribution of period in descending order: 1-10 days($57.6\%$), 11-20 days ($36.4\%$), 21-30 days($6.0\%$) 7. Distribution of Medicine for external in descending order : 11-20($42.4\%$), 21-30($22.7\%$), 31-40 were each $3.0\%$ 8. The improvement rate in symptoms and signs was $88.8\%$ expect None.

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Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management

  • Lee, Yong Hee;Kim, Yu Bin;Koo, Ja Wook;Chung, Ju-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제19권3호
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    • pp.175-185
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    • 2016
  • Purpose: To investigate the epidemiology, clinical manifestations, investigations and management, and prognosis of patients with Henoch-Schonlein purpura (HSP). Methods: We performed a retrospective review of 212 HSP patients under the age of 18 years who were admitted to Inje University Sanggye Paik Hospital between 2004 and 2015. Results: The mean age of the HSP patients was 6.93 years, and the ratio of boys to girls was 1.23:1. HSP occurred most frequently in the winter (33.0%) and least frequently in the summer (11.3%). Palpable purpura spots were found in 208 patients (98.1%), and gastrointestinal (GI) and joint symptoms were observed in 159 (75.0%) and 148 (69.8%) patients, respectively. There were 57 patients (26.9%) with renal involvement and 10 patients (4.7%) with nephrotic syndrome. The incidence of renal involvement and nephrotic syndrome was significantly higher in patients with severe GI symptoms and in those over 7 years old. The majority of patients (88.7%) were treated with steroids. There was no significant difference in the incidence of renal involvement or nephrotic syndrome among patients receiving different doses of steroids. Conclusion: In this study, the epidemiologic features of HSP in children were similar to those described in previous studies, but GI and joint symptoms manifested more frequently. It is essential to carefully monitor renal involvement and progression to chronic renal disease in patients ${\geq}7$ years old and in patients affected by severe GI symptoms. It can be assumed that there is no direct association between early doses of steroids and prognosis.

표치와 본치의 측면에서 경혈 선혈의 원리 (The Principle of Acupoint Selection Based on Branch and Root Treatment)

  • 이인선;류연희;채윤병
    • Korean Journal of Acupuncture
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    • 제37권3호
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    • pp.203-208
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    • 2020
  • Objectives : Since there are complex associations between diseases/symptoms and acupoints, one-to-one correspondence may not be the proper approach. Pattern identification has been being used as a clinical framework to make treatment decisions by extracting and synthesizing clinical data including patients' signs and symptoms. In this article, we propose two different models explaining the relationships between diseases and acupoints based on the branch treatment [Zhibiaofa] and the root treatment [Zhibenfa]. Methods : We explained the relationships between diseases/symptoms and acupoints from the example data from our previous study on traditional acupuncture point selection patterns for pain control. Diseases include low back pain, migraine, irritable bowel syndrome, osteoarthritis, ankle sprain, carpal tunnel syndrome, and dysmenorrhea, and acupoints included LI4, BL23, BL25, SP6, BL60, TE5, and CV4. Results : The relationships between diseases/symptoms and acupoints can be explained directly based on the branch treatment, and also can be explained indirectly through pattern identification based on the root treatment. Pattern identifications included both meridian-based pattern identification based on the spatial information of diseases and visceral organ-based pattern identification based on the characteristics of diseases. Conclusions : In the East Asian traditional medicine, Korean medicine doctors choose the most appropriate acupoints based either on the diseases/symptoms (i.e., branch treatment) or on the results of pattern identifications (i.e., root treatment). It is necessary to understand the two different approaches to choose specific acupoints for the targeted diseases.

살모사 교상 후 발생한 범발성 혈관내 응고장애 2례 (Two Cases of Disseminated Intravascular Coagulation (DIC) Following Pit Viper Envenomation)

  • 김석환;최세민;오영민;박규남;이원재;최경호
    • 대한임상독성학회지
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    • 제4권2호
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    • pp.137-142
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    • 2006
  • Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

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Congenital miliary tuberculosis in an 18-day-old boy

  • Lee, Jue Seong;Lim, Chang Hoon;Kim, Eunji;Lim, Hyunwook;Lee, Yoon;Choung, Ji Tae;Yoo, Young
    • Clinical and Experimental Pediatrics
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    • 제59권sup1호
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    • pp.64-67
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    • 2016
  • Congenital tuberculosis (TB) is a rare disease that is associated with high mortality. Mycobacterium tuberculosis, the causative agent, may be transmitted from the infected mother to the fetus by the transplacental route or by aspiration of infected amniotic fluid. Clinical symptoms and signs are not specific. Miliary patterns are the most common findings in the chest X-rays of many infants with congenital TB. In this case, an 18-day-old boy had jaundice on the fifth day of birth, and fever and respiratory distress appeared on the 18th day. Chest X-ray showed diffuse fine bilateral infiltration. Clinically, pneumonia or sepsis was suspected. Respiratory symptoms and chest X-ray findings worsened despite empirical antibiotic therapy. The lungs showed miliary infiltration suggestive of TB. Gastric aspirates were positive for M. tuberculosis. Respiratory distress and fever were gradually improved after anti-TB medication. Congenital TB is difficult to detect because of minimal or no symptoms during pregnancy and nonspecific symptoms in neonates. Hence, clinicians should suspect the possibility of TB infection even if neonates have non-specific symptoms. Early diagnosis and meticulous treatment are required for the survival of neonates with TB.

New daily persistent headache with isolated sphenoiditis in children

  • Lee, Jeongho;Rhee, Minhee;Suh, Eun Sook
    • Clinical and Experimental Pediatrics
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    • 제58권2호
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    • pp.73-76
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    • 2015
  • Isolated sphenoid sinusitis is a rare disease in children, and its symptoms are often nonspecific and confusing. Rarely, severe headache can be the first or only symptom of isolated sphenoid sinusitis. New daily persistent headache (NDPH) is a form of chronic daily headache that may have features of both migraines and tension-type headaches. NDPH is difficult to diagnose and requires a multifaceted approach. Here, we report on a 10-year-old boy and an 11-year-old girl who both presented with typical NDPH symptoms. These patients had no nasal symptoms or signs of infection. Neither nonsteroidal anti-inflammatory drugs nor topiramate had any effect on the headaches. Their neurological and ophthalmological examinations were normal. The results of routine blood work, including thyroid function tests, inflammatory markers, complete blood count, tests for viral infection, and a metabolic panel, were normal. A brain magnetic resonance imaging scan showed isolated sphenoid sinusitis. Both patients' symptoms resolved completely after approximately 1 month of oral antibiotics for sinusitis.

養陰明目湯加味方으로 호전된 Tolosa-Hunt 증후군 1예 (The effect of Yangyeummyungmoktang-Gamibang on a Case of Tolosa-Hunt Syndrome)

  • 연경진;정현아;류현신;임승환;노석선
    • 한방안이비인후피부과학회지
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    • 제16권1호
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    • pp.220-225
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    • 2003
  • The Tolosa-Hunt syndrome is a symptom complex with unilateral painful ophthalmoplegia associated with retro-orbital pain, proptosis and Ⅲ, Ⅳ, Ⅴ-1, Ⅵ cranial nerves palsy due to nonspecific granulomatous inflammation in the superior orbital fissure or cavernous sinus. We experienced a 50 years old female patient with Tolosa-Hunt syndrome who had several clinical signs and symptoms such as ocular pain, headache, sensory loss of face, diplopia, and visual disturbance. In the point of Differentiation of Syndrome(辨證). this subject was diagnosed as Deficiency of yin in liver and kidney(肝腎陰虛), and was administrated with Yangyeummyungmoktang-Gamibang. After treatment of acupuncture and herbal medicine above symptoms were improved.

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소아의 소장 중첩증의 치료 : 자연 정복 vs 수술적 치료 (Management of Pediatric Small Bowel Intussusception: Spontaneous Reduction vs Operation)

  • 김은영;정규환;박태진;박귀원;정성은;김현영
    • Advances in pediatric surgery
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    • 제16권2호
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    • pp.117-125
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    • 2010
  • Unreduced small bowel intussusception requires operative treatment although the rate of spontaneous reduction is 60 to 70 %. The aim of this study is to compare clinical characteristics and outcome between spontaneous reduction and operation group and to analyze factors related to decisions to treat small bowel intussusceptions. The records of 25 patients with small bowel intussusceptions treated in Seoul National University Children's Hospital from January 1999 to August 2009 were reviewed respectively. Spontaneous reduction group (n=12, 48 %) had signs and symptoms of vomiting, abdominal pain, currant jelly stool, abdominal distension, fever, increased CRP but no rebound tenderness. One of them had been diagnosed with Henoch-Schonlein purpura and no one displayed pathologic leading point by image study. Operation group (n=13, 52 %) consisted of patients who had primary surgery. Their signs and symptoms were similar to spontaneous reduction group. Seven of them had underlying diseases such as Crohn' disease, ALL, Lymphoma, Peutz-Jeghers syndrome (n=3), post-transplanted state of liver and 2 of them displayed Peutz-Jeghers polyp and Meckel's diverticulum as pathologic leading point by preoperative ultrasonography. Mean relieve interval (interval between onset of symptoms and reduction/operation) was 1.78 days in spontaneous reduction group and 2.25 days in operation group (p=0.341). Seven of operation group had manual reduction and 6 out of 7 received segmental resection of the small bowel. No one of them underwent manual reduction and all of them underwent segmental resection were found to have pathologic leading points [Peutz-Jeghers polyp (n=3), Meckel's diverticulum (n=2), lymphoma (n=1)] during operation. In conclusion, 48% of small bowel intussusceptions resolved spontaneously. Patients' symptoms and relieve intervals were not related to the operative decisions. We therefore recommend significant factors for determining treatment plan such as change of clinical symptoms, underlying disease or pathologic leading point by imaging.

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부인과적 어혈(瘀血) 변증(辨證) 설문 개발을 위한 기초 연구 - 중국, 일본, 한국 문헌을 중심으로 - (A Fundamental Study to Make a Questionnaire of Blood Stasis Specially Designed for Korean Obstetrics & Gynecology)

  • 윤영진
    • 대한한방부인과학회지
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    • 제26권1호
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    • pp.92-108
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    • 2013
  • Objectives: The aim of this study is to understand current status in diagnosis of blood stasis for making a questionnaire of blood stasis specially designed for Korean obstetrics & gynecology. Methods: We searched concept of blood stasis presented in the textbook of chinese Korean obstetrics & gynecology and reviewed papers concerning diagnosis of blood stasis published in South Korea, Japan and China recently. Results: From the textbooks & papers concerning diagnosis of blood stasis, there was no specialized diagnostic guidelines with Korean obstetrics & gynecology and some gynecological symptoms, and diseases were contained in each criteria. Conclusions: Recent studies had a relatively unified awareness in diagnosis of blood stasis and we need an additional criteria for signs and symptoms within Korean obstetrics & gynecology to improve clinical efficiency.