• Asian-Australasian Journal of Animal Sciences
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• 제11권3호
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• pp.323-328
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• 1998

The liver extract of chicks, Gallus domesticus, suffering from hydropericardium syndrome (HPS) was inoculated intraperitoneally into healthy chicks to produce HPS. After inoculation the blood serum and the pericardial fluid of the newly infected chicks were analyzed, at regular intervals for a total period of 72 hours for concentration of proteins, $K^+$ ions, $Na^+$ ions and the LDH activity. The protein content was significantly decreased both in the blood serum (30%) and the pericardial fluid (39%) within 24 hours of inoculation, which was then maintained during the subsequent period. The $K^+$ ions and the LDH activity, on the other hand, were significantly increased in the blood serum (26% and 169%, respectively) as well as the pericardial fluid (131% and 217%, respectively) within 24 hours of inoculation. After 72 hours this increase was, respectively, 43% and 191% in blood serum, and 153% and 200% in the pericardial fluid. Accumulation of $K^+$ ions, and decrease of protein and $Na^+$ ions in the pericardial fluid indicate homoestatic imbalance, which may prove fatal. The increased LDH activity is indicative of heptocytic damage.

• 한국치위생학회지
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• 제8권4호
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• pp.31-41
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• 2008

Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis(TEN) are severe mucocutaneous reaction which are most frequently caused by drugs. Although the incidence of SJS and TEN is known to be relatively low, outcomes may be fatal. A systematic approach is required because morbidity rate is currently increasing and oral lesion is frequent. We investigated the clinical features and outcomes of 6 patients diagnosed as SJS and TEN and referred from the department of dermatology, Chonnam National University Hospital for oral care. Ketoconazol, Ofloxacin, Chlorphenesin, Amoxicillin, Pontal, Harnal, and Ciprofloxacin were suspected as the causative drugs. Average treatment period was 3.2 weeks, and two patients were referred to 'burn-patients' hospital. Most of oral lesion were cured be normal tissue, but scares with discoloration were observed. For intraoral management, antibiotic disinfection and steroid application were performed according to systemic treatment principles. Additionally, ingestion of zinc, antioxidants, and vitamin was recommended. The establishment of oral treatment principles is demanded because it has not been yet. Also, through investigation of drug side effect and careful prescription are required.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.249-252
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• 2023

Neuroleptic malignant syndrome (NMS) is a rare but fatal condition, with a high mortality rate. NMS is characterized by altered mental status, fever, myoclonus, autonomic dysfunctions, and elevated creatinine phosphokinase. The clinical manifestations may be confused with alcohol-related symptoms, trauma, sepsis, postoperative agitation, or malignant hyperthermia. A 69-year-old male patient with alcohol withdrawal was admitted to the operating theatre to rule out septic shock due to mesenteric injury after multiple trauma. He was suspected NMS with abrupt increase body temperature to 41.7℃ after haloperidol administration. Active cooling and rapid fluid infusion was done during anesthesia. Delayed diagnosis and treatment of NMS lead to catastrophic result. Therefore, if the patient's past medical history is unknown or clinical symptoms develop that are suggestive of NMS, early treatment must be considered.

• Journal of Preventive Medicine and Public Health
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• 제49권4호
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• pp.220-229
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• 2016

Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient's educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years). Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.132-137
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• 2015

Adrenocorticotropic hormone (ACTH)-producing pheochromocytoma has been rarely reported, whereas only a few cases of Cushing syndrome accompanied by opportunistic infections have been reported. We experienced a patient with pheochromocytoma with ectopic Cushing syndrome complicated by invasive aspergillosis. A 35-year-old woman presented with typical Cushingoid features. Her basal plasma cortisol, ACTH, and 24-hour urine free cortisol levels were significantly high, and 24-hour urine metanephrine and catecholamine levels were slightly elevated. The endogeneous cortisol secretion was not suppressed by either low- or high-dose dexamethasone. Abdominal computed tomography (CT) revealed a heterogeneous enhancing mass measuring approximately 2.5 cm in size in the left adrenal gland. No definitive mass lesion was observed on sellar magnetic resonance imaging. On fluorine-18 fluorodeoxyglucose positron emission tomography/CT, a hypermetabolic nodule was observed in the left upper lung. Thus, we performed a percutaneous needle biopsy, which revealed inflammation, not malignancy. Thereafter, we performed a laparoscopic left adrenalectomy, and its pathologic finding was a pheochromocytoma with positive immunohistostaining for ACTH. After surgery, the biochemistry was normalized, but the clinical course was fatal despite intensive care because of the invasive aspergillosis that included the lungs, retina, and central nervous system.

• Childhood Kidney Diseases
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• 제18권1호
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• pp.47-50
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• 2014

신증후군 환아에서 감염은 매우 중요한 사망원인이 된다. 독감 바이러스는 매번 겨울철마다 유행하며, 독감 바이러스의 치명률은 건강한 소아에서 호흡기세포융합바이러스의 사망률과 비슷하므로 독감에 의한 감염도 신증후군 환아들에게는 매우 치명적일 수 있다. 독감에 의한 사망률에는 폐렴으로 인한 사망이 많은 부분을 차지한다. 하지만, 독감은 예방접종과 항바이러스 치료제가 존재하므로 치료 및 예방이 가능하다. 그러므로, 적극적인 독감 예방접종과 항바이러스 치료는 신증후군 환자들에게서 치명률을 낮출 수 있을 것으로 생각된다. 저자들은 신증후군 치료중에 A형 독감(H1N1)에 의한 폐렴에 걸린 7세 남아를 경험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제24권1호
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• pp.26-35
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• 1991

From January 1984 to June 1990, 188 patients have undergone cardiac valve replacement [114 MVR, 27 AVR, 47 Multiple valve replacement] with the St. Jude Medical prosthesis. The early mortality rate was 6.9%. The most common cause of early death was low output syndrome. There were no cases of valve-related early death. The risk factors for early death were advanced preoperative NYHA functional class [> IV], and prolonged ECC and ACC time. The 175 early survivors were followed-up for a total 372.7 patient-year over a period of 2 to 74 months [Mean $\pm$SD: 25.6$\pm$18.6 months]. During follow up, 12 patient died and late mortality rate was 6.9%. There were three valve-related late deaths: two were due to valve thrombosis and one was due to hemorrhage. Most late deaths [58%, 7/12] were from cardiac non-valvular causes. Valve-related complications occurred at a linearlized rate of 3.5% /pt-yr. Embolism occurred at a rate of 0.8% /pt-yr. There were three cases of valve thrombosis [0.8% /pt-yr: two fatal]. Hemorrhage due to anticoagulant occurred in 5 patients and a rate of 1.3% pt-yr [one fatal]. Five-year actuarial survival rate was 86.5 $\pm$5.1% and 97% of patient were in NYHA functional class I or II at three months postoperatively.

• Parasites, Hosts and Diseases
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• 제46권4호
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• pp.261-263
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• 2008

Strongyloides stercoralis is a human intestinal parasite which may lead to complicated strongyloidiasis in immunocompromised. Here, a case of complicated strongyloidiasis in a patient with chronic lymphocytic leukemia is reported. Presence of numerous S. stercoralis larvae in feces and sputum confirmed the diagnosis of hyperinfection syndrome in this patient. Following recovery of filariform larvae from agar plate culture of the stool, the isolate was characterized for the ITS1 region of ribosomal DNA gene by nested-PCR and sequencing. Albendazole therapy did not have cure effects; and just at the beginning of taking ivermectin, the patient died. The most important clue to prevent such fatal consequences is early diagnosis and proper treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권1호
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• pp.109-114
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• 1997

악성고열증은 마취중 혹은 마취 후에 나타나는 마취 합병증으로 발병률은 매우 희귀하나 높은 치사율 때문에 일단 발현하면 치명적인 결과를 초래하므로 예방 및 조기 발견에 의한 조기 치료가 매우 중요하다. 예방을 위해서는 보유자의 감별이 무엇보다 중요하고 이를 위해서는 철저한 개인력 및 가족력 조사와 술전 감수성 검사가 이루어져야 한다. 의심이 되는 환자는 마취 전후에 dantrolene sodium을 투여하여야 하고 마취시 유발 마취제 및 유발 인자를 피하며 emotional stress를 피하기 위해 충분한 sedation이 요구된다. 그러나 우리 나라에는 특수 치료제인 dantrolene sodium의 확보가 어려워 조기 발견을 하고도 효과적인 치료를 하지 못하는 경우가 흔히 있으므로 dantrolene sodium을 상비약으로 비치하는 것이 좋을 것으로 사료된다. 저자들은 32세의 건강한 젊은 남자 환자가 악성형수술도중 갑작스런 체온 상승과 빈맥근강직등이 발현하여 술 후 5일만에 급성 신부전증 및 파종성혈액내응고병증(DIC)으로 사망한 악성고열증 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제57권2호
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• pp.96-99
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• 2014

Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in childhood and is primarily diagnosed in up to 4.5% of children who undergo chronic renal replacement therapy. Escherichia coli serotype O157:H7 is the predominant bacterial strain identified in patients with HUS; more than 100 types of Shiga toxin-producing enterohemorrhagic E. coli (EHEC) subtypes have also been isolated. The typical HUS manifestations are microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency. In typical HUS cases, more serious EHEC manifestations include severe hemorrhagic colitis, bowel necrosis and perforation, rectal prolapse, peritonitis, and intussusceptions. Colonic perforation, which has an incidence of 1%-2%, can be a fatal complication. In this study, we report a typical Shiga toxin-associated HUS case complicated by small intestinal perforation with refractory peritonitis that was possibly because of ischemic enteritis. Although the degree of renal damage is the main concern in HUS, extrarenal complications should also be considered in severe cases, as presented in our case.