• Pediatric Infection and Vaccine
• /
• 제26권2호
• /
• pp.118-123
• /
• 2019

감염 후 사구체신염(postinfectious glomerulonephritis, PIGN)은 주로 Streptococcus pyogenes에 의해 발생하지만, 다른 병원체와 관련된 PIGN도 문헌에서 확인된다. 기침, 발열, 우측 흉통을 주소로 내원한 6세 남아에서 폐구균 및 인플루엔자 A 바이러스의 감염이 확인되었고 항생제와 항바이러스제가 투약되었다. 입원 중 전신 부종, 혈뇨, 단백뇨, 혈압의 상승이 관찰되었고, 따라서 이뇨제가 투약되었다. 환자는 육안적 혈뇨가 관찰되는 상태로 퇴원하였고, 퇴원 후 14주에 현미경적 혈뇨까지 사라졌다. 폐구균 또는 인플루엔자 A 바이러스 감염이 확인된 환아에서 신염의 증상이 보이는 경우 감염 후 사구체신염의 조기발견을 위해 소변검사 및 혈압의 측정이 이루어져야 한다. 본 저자들은 폐구균 및 인플루엔자 A 바이러스에 의한 감염 후 사구체신염 사례를 경험하였기에 이를 보고하는 바이다.

• 대한한방부인과학회지
• /
• 제32권3호
• /
• pp.102-115
• /
• 2019

Objectives: The purpose of this study is to confirm the effectiveness and safety of acupuncture for treating breast cancer-related lymphedema (BCRL), thus providing a clinical basis for acupuncture treatment and helping to develop clinical practice guideline through consideration of used meridians and acupoints. Methods: Clinical studies applying acupuncture on breast cancer-related lymphedema were searched through 7 databases such as The Cochrane Library Central, Embase, Pubmed and CAJ. Interventions and results of the selected clinical studies were analyzed. Results: 8 Clinical studies were finally included according to inclusion and exclusion criteria. There were 6 randomized controlled studies and 2 single-arm pilot studies. All of those studies were searched in The Cochrane Library Central, Embase, Pubmed and CAJ and written in English and Chinese. Treatment group applied acupuncture as a Korean medicine intervention. Interventions of control group were made with non-treatment, upper limb exercise, and oral administration of capillary stabilizer or diuretics. Outcome measurements varied from paper to paper but every study measured reduction in arm circumference. Among 8 studies, 6 studies reported statistically significant reduction in arm circumference in treatment group and there were no serious adverse effects. Conclusions: This study suggested that acupuncture has few side effects as well as statistically significant effects on many aspects in treating breast cancer-related lymphedema. However the results should be taken cautiously as more clinical studies are needed.

• 대한두개안면성형외과학회지
• /
• 제22권4호
• /
• pp.204-208
• /
• 2021

Sebaceous carcinoma is a malignant neoplasm that usually arises in the sebaceous glands of the eyelids. Its pathogenesis is unknown; however, irradiation history, immunosuppression, and use of diuretics are known risk factors. The mainstay of treatment for sebaceous carcinoma of the eyelid is wide surgical resection with a safety margin of 5 to 6 mm, which often results in full-thickness defects. The reconstruction of a full-thickness defect of the eyelid should be approached using a three-lamella method: a mucosal component replacing the conjunctiva, a cartilage component for the tarsal plate, and a flap or skin graft for the skin of the eyelid. In this case, a full-thickness defect of the upper eyelid was reconstructed after tumor removal using a combination of a nasal septum chondromucosal composite graft and a forehead transposition flap, also known as a "Fricke flap." The flap was designed to include a line of the eyebrow on the lower margin of the flap to replace the eyelash removed during tumor excision. The wound healed completely, without any early or late complications, and the outcome was satisfactory.

• Journal of Audiology & Otology
• /
• 제25권4호
• /
• pp.209-216
• /
• 2021

Background and Objectives: We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results. Subjects and Methods: We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital's otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated. Results: Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results. Conclusions: A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.

• 대한청각학회지
• /
• 제25권4호
• /
• pp.209-216
• /
• 2021

Background and Objectives: We aimed to analyze treatment outcomes following different initial management approaches and confirm treatment regimens for acute low-tone sensorineural hearing loss (ALHL) that would yield the best results. Subjects and Methods: We retrospectively analyzed the medical records of 106 patients with ALHL who visited a university hospital's otology clinic from March 2013 to June 2019. Pure-tone averages at the initial visit and at 2 and 4 weeks after the initial visit were evaluated. Results: Forty-nine patients were enrolled in this study; of them, 41 (83.7%) exhibited complete recovery (CR) at 2 weeks and 43 (87.8%) exhibited CR at 1 month after the initial visit. Regression analysis revealed that CR at 2 weeks after the initial visit was associated with diuretic use [Exp(B): 10.309, 95% confidence interval (CI): 1.007-100]. An initial daily low-dose steroid use was marginally significant [Exp(B): 1.042, 95% CI: 0.997-1.092; p=0.066]. Isolated diuretic use [Exp(B): 25.641, 95% CI: 1.121-90.909; p=0.039] was an independent, good prognostic factor at 1 month after the initial visit. However, other treatment regimens did not affect the final results. Conclusions: A combination of initial daily administration of ≤30 mg prednisolone plus diuretics was sufficient as the first-line treatment for ALHL. High-dose steroids and salvage intratympanic steroid injections can be applied as a second choice; however, the predicted outcome would not be good in that case.

• Journal of Medicine and Life Science
• /
• 제18권3호
• /
• pp.61-65
• /
• 2021

Although re-expansion pulmonary edema (RPE) is rare (incidence rate <1%), it is associated with a mortality rate of >20%; therefore, early diagnosis and treatment are important. We report a case of RPE following chest tube insertion in a patient with spontaneous pneumothorax. We have specifically focused on the mechanism underlying RPE and the possible etiology. An 82-year-old man with a history of chronic anemia, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension was referred to the emergency department for management of recurrent right-sided pneumothorax. We performed emergency closed thoracostomy for suspected tension pneumothorax, which led to stabilization of the patient's vital signs; however, he coughed up frothy pink sputum accompanied by severe right-sided chest pain 30 min postoperatively. The patient showed new-onset right pulmonary consolidation on chest radiography, as well as desaturation, tachycardia, and tachypnea and was diagnosed with RPE. He was transferred to the intensive care unit for mechanical ventilation and supportive treatment using diuretics, ionotropic agents, and prophylactic antibiotics. RPE gradually resolved, and the patient was extubated 3 days after admission. He has not experienced recurrent pneumothorax or pulmonary disease for 4 months. We emphasize the importance of RPE prevention and that aggressive ventilator care and supportive treatment can effectively treat RPE following an accurate understanding of the underlying pathogenetic mechanisms and risk factors.

• Journal of Yeungnam Medical Science
• /
• 제24권2호
• /
• pp.275-286
• /
• 2007

연구 배경 : 급성 신부전은 술 후 발생할 수 있는 합병증 중에서 사망률에 큰 영향을 줄 수 있으므로 이 연구를 통해 위험인자를 알아보려 한다. 재료 및 방법 : 2004년 1월부터 2006년 12월까지 3년간 영남대학교 의과대학 부속병원에서 대장 수술을 받은 570명의 환자들을 대상으로 하였다. 환자들의 성별과 연령, 미국 마취과학회 신체등급, 동반질환, 수술의 종류, 응급수술의 여부, 수술 시간, 재수술의 여부, 술 중의 투약 상황, 술 후에 자가 통증 조절기에 사용한 약제, 술 중에 저혈압의 유무, 수혈 여부, 술 후 기계적 환기를 시행한 경우를 비교하였다. 결과 : 비교 결과에서 성별과 수술의 종류, 응급 수술의 여부, 개복여부 등에는 유의한 차이를 보이지 않았다. 반면 환자의 나이와 수술시간, 재수술의 여부, 술중에 이뇨제 등을 사용한 경우, 술 중에 저혈압의 유무, 술 후에 기계적 환기를 시행한 경우 등에는 유의한 차이를 보였다. 결론 : 이상의 결과로 급성신부전의 원인은 어느 한 가지라고 하기 보다는 위험인자에 얼마나 노출되어 있는가가 결정하는 것 같고, 그 원인들이 모여서 상승효과를 내는 것 같다. 그러므로 수술 전부터 많은 위험에 노출된 환자는 술 중 더 적극적인 감시를 시행하여 수술 후의 합병증 발생을 줄이는 노력을 기울여야 하겠다.

• 정신신체의학
• /
• 제19권2호
• /
• pp.57-65
• /
• 2011

많은 심혈관질환약물과 향정신성약물 간에 다양한 약물상호작용이 존재하며 이러한 약물들의 대부분이 시트크롬(cytochrome, CYP)450 효소의 기질, 억제제, 유도제로 작용하면서 약물상호작용이 일어나게 된다. 주로 CYP2D6와 CYP3A4를 억제하는 향정신성약물로 인해 같이 투여되는 심혈관질환약물의 효과가 변할 수 있고 부작용까지 나타날 수 있다. 이런 상황을 고려하고 반대의 경우도 포함하여 흔히 처방되는 두 종류의 약물을 병용 투여하는 경우 고려해야 할 부분에 대해서 심혈관질환약물 분류에 따라 논하였다. 대부분의 베타차단제는 CYP2D6의 대사에 의존하므로 이 대사를 억제하는 bupropion, chlorpromazine, haloperidol, SSRIs, quinidine 등을 사용했을 때 베타차단제의 독성이 나타날 수 있다. 앤지오텐신 관련 약물과 이뇨제가 lithium의 농도를 변화시키는 점도 고려하여야 한다. 칼슘통로차단제 및 콜레스테롤강하제를 CYP3A4의 강력한 억제제인 amiodarone, diltiazem, fluvoxamine, nefazodone, verapamil 등과 함께 사용하였을 때 약물 상호작용에 따른 부작용에 유의하여야 한다. 항부정맥제를 복용하는 환자에서 QT 간격 증가를 야기하는 약물이나 관련 CYP450 효소를 억제하는 약물을 동시에 투여하는 것은 삼가거나 적극적인 관찰이 필요하다. Digoxin과 warfarin이 병용 투여되는 향정신성약물로 인해 혈중 농도가 변하는 것도 임상적으로 중요하다.

• 한국임상약학회지
• /
• 제16권2호
• /
• pp.113-122
• /
• 2006

Purpose: A retrospective study was performed to assess the efficacy and tolerance of ${\beta}-blocker$ administration in patients with heart failure and diabetes. Method: Records of 164 patients who were treated for the heart failure condition more than a year were studied retrospectively. Patients were divided into 4 groups based on their diabetes(DM) status and the administration of ${\beta}-blockers$ ($DM+{\beta}-blocker$ group: 14, DM w/o ${\beta}-blocker$: 19, No DM + ${\beta}-blocker$: 62, No DM + no ${\beta}-blocker$: 69). All patients had been receiving conventional therapy such as digoxin, ACE-I, ARB, diuretics, nitrates, aspirin, anticoagulants or lipid-lowering agents. The primary endpoints (death and hospital admission) were recorded during 1 year period and hemodynamic factors (HR, LVEF, SBP, DBP) were obtained from all patient groups before and after 12 months of ${\beta}-blocker$ treatment. To evaluate toxicity of ${\beta}-blocker$, SCr, BUN, AST, ALT and Alkaline phosphatase were obtained. Result: There were less death and hospital admission in DM + ${\beta}-blocker$ group than in DM without ${\beta}-blocker$ group (p=0.014). Relative risk of hospital admission for $DM+{\beta}-blocker$ group over no DM group was 1.17. Long term ${\beta}-blocker$ administration was associated with an improvement of heart rate in patients with DM (P< 0.02) with no significant improvement of LVEF, SBP, DBP. in DM patient. In patient without DM, ${\beta}-blocker$ was associated with improvement in LVEF, HR and DBP (P<0.01, P<0.03), but not in SBP. The incidence of toxicity was similar between the four group with no significant difference. Conculsion: Treatment of heart failure patients with ${\beta}-blocker$ appears to be beneficial in terms of hospital admission event and several hemodynamic factors. The toxicities of ${\beta}-blocker$ treatment were not significant and the treatment is generally well-tolerated in most of the heart failure patients.

• 동의신경정신과학회지
• /
• 제12권2호
• /
• pp.17-25
• /
• 2001

Objectives: Obesity is related to psychological problems as well as physical problems. This study was designed to investigate the eating attitude and depression of females who participated in a fasting therapy. They were considered to have many eating attitude and psychological problems. Methods: 59 females were selected, they were admitted in Woosuk university hospital of oriental medicine(from August 1st, 2000 to July 31th, 2001) and 42 females were selected, they were college students of Woosuk university, Jeonju, Korea. We checked height, weight and administerd the Korean Eating Attitudes Test-26(KEAT-26), Beck Depression Inventory(BDI) and questions about binge-eating, smoking, drinking, exercise and body weight-wanted to females in two groups. Results: In fasting women group, 2(3.39%) were underweight, 24(40.68%) were average. The average of KEAT-26 in fasting women group$(13.33{\pm}7.65)$ was higher than that in college women group$(4.76{\pm}5.54)$(p<0.001). In fasting women group, 5(8.47%) had mild eating problem, 4(6.78%) had moderate eating problem, and 5(8.47%) had severe eating problem. In fasting women group, 47(79.66%) said 'yes' at the question(A-1, DSM-IV bulimia nervosa diagnosis), 33(55.93%) said 'yes' at the question(A-2, DSM-IV bulimia nervosa diagnosis) about binge eating. In fasting women group, 14(23.73%) had used vomiting, 13(22.03%) enemas, 27(45.76%) laxatives, 7(11.86%) diuretics, 6(10.17%) other drugs, 38(64.41%) fasting, 15(25.42%) severe exercise, and others 2(3.39%) to reduce their weight. The average of BDI in fasting women group$(12.44{\pm}6.70)$ was higher than that in college women group$(7.47{\pm}5.48)$(p<0.001). In fasting women group, 10(16.95%) had mild depression problem, 4(6.78%) had moderate depression problem, and 3(5.08%) had severe depression problem. In fasting women group, 41(64.49%) had under 5Kg-gap, and 18(30.51%) has over 5Kg-gap between weight-reasonable and weight-wanted. In 26 fasting women who were underweight or average-weight, 14 had over 5Kg-gap. Conclusions: These results suggest that the females who participated in a fasting therapy had many depression and eating problems, and we should pay attention to the eating disorders and psychological problems including depression as well as the physical problems when we treat obesity.