• Title/Summary/Keyword: Gastrointestinal illness

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A Case of Intestinal Perforation in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 발생된 장천공 1례)

  • Kang, Won Sik;Oh, Chang Hwan;Kim, Jae Young;Lee, Young Taek;Lee, Hye Jin;Kim, Hee Jin;Kim, Sung Won
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.406-412
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    • 2002
  • Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is one of the most common vasculitic diseases of childhood, referred to as a leukocytoclastic vasculitis affecting small vessels. Although HSP related gastrointestinal symptoms are seen in up to 80% of patients during acute illness, these symptoms are usually transient. However, some patients with HSP have gastrointestinal major surgical complications such as intussusception, bowel infarction, necrosis, stricture, and perforation. We experienced a rare case of HSP-related ileal perforation developed after corticosteroid treatment. We report a case with HSP-related intestinal perforation and assess the effect of corticosteroid on the outcome of abdominal pain in children with HSP.

Clinical characteristics of COVID-19 (코로나바이러스감염증-19의 임상적 특징)

  • Yoo, Jung Rae;Heo, Sang Taek
    • Journal of Medicine and Life Science
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    • v.17 no.2
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    • pp.33-40
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    • 2020
  • Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Genetic sequencing of the virus suggests that it is a beta coronavirus closely linked to the SARS virus. This disease has non-specific symptoms such as fever, dry cough, sore throat, and gastrointestinal symptoms. This virus can transmit via aerosol and need to droplet precaution to prevent spreading in public areas. Most people with COVID-19 develop only mild or uncomplicated illness. However, about 20% patients require hospitalization, oxygen supply, and intensive care. There is no currently effective treatment available for COVID-19 unresponsive to supportive care. This is review about the recently published epidemiologic, and clinical features, diagnosis, treatment and prevention of COVID-19.

Psychological Factors Affecting Gastrointestinal Disorders : Functional GI Disorders (위장관장애에 영향을 미치는 심리적 요인)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.210-220
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    • 1998
  • The relationships between emotion, stress and gastro-intestinal dysfunction were briefly reviewed. Until now, several kinds of theories on about pathophysiology, such as motility dysfunction, changes of pain perception on the lumen, dysregulations on the central nervous system associated with psychosocial factors were reported. However, none of those factors could'nt give any clues for the causes of the functional bowel disorders. For understanding the meaning of the symptoms and for the treatment approach, clinicians should give attention to the comprehensive point of view, i.e., not only biological but also psychological aspects of the patients with non-organic bowel dysfunctions. Giving warm and kind explanations to the patient about symptom formation and progression and understanding the patient's illness behaviors, and good and strong doctor-patient relationship is essentials for the treatment.

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A Case of Fatal Arrhythmia after Propafenone Overdose (Propafenone 음독 후 발생한 치명적인 부정맥 1례 - 증례 보고-)

  • Kyong, Yeon-Young;Choi, Kyoung-Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.2
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    • pp.123-129
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    • 2008
  • A 36-year-old female was transferred to our emergency medical center with decreased mental status after a 6.0 g propafenone overdose because of domestic disturbance. She had no previous history of epilepsy, diabetes mellitus, hypertension or psychiatric illness. Before presenting to our center, gastrointestinal decontamination, charcoal administration, and endotracheal intubation due to bradycardia and generalized seizure had been performed. Soon after hospital arrival, at 5 h after ingestion, she collapsed into shock and fatal arrhythmia. We successfully resuscitated the patient with amiodarone, sodium bicarbonate, a large volume of normal saline, calcium, and ventilator care. At 23 h after ingestion, she was fully recovered and had no subjective signs or symptoms. To our knowledge, this is the first case report of intentional propafenone overdose in Korea, which we report with reviews of the previous literature.

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The Epidemiological Characteristics of Health Problems of Middle School Students Based on School Health Clinic Service (보건실 이용을 중심으로 본 중학생 건강문제의 역학적 특성)

  • Um, Jeong-Im;Lee, Sung-Eun
    • Journal of the Korean Society of School Health
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    • v.20 no.1
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    • pp.25-35
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    • 2007
  • Purpose: This study was to identify the types and characteristics of health problems of middle school students in Gangwondo. Methods: The subjects of the study were 11 middle schools from 47 schools with nurse teachers in Gangwondo. The anecdotal records of the school health clinics were collected from March to December in 1998 with the agreement of nurse teachers of the schools. Results: 71.0% of the middle students visited the school health care clinics once or more than once. The mean frequency of health problems was 2.03 times per one year. The rate of health problems did not show any statistical differences by sex, school location, age, the day of the week and weather. However, there were statistical differences of the rate by month. The highest rate was showed in September, followed by June and April (F=2.52, p=0.01). Health problems were classified into 11 types. Gastrointestinal illness showed the largest proportion (60.6%). The oral illness showed statistical differences among the location of school, between municipal and rural area (t=-2.97, p=0.016). There were 411 types of signs and symptoms recorded. Among them, headache was showed the highest proportion with 2,122 cases (11.2%). Conclusion : The incidence rate of health problems was higher than that of earlier studies. It showed that the incidence rates and the types of diseasps in middle school students were different by school locations, characteristics of students, and months. To improve the qualities of primary cares in school health services, the reformed and unified anecdotal record system and the standardized guidelines for primary care are necessary.

The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study

  • El Koofy, Nehal Mohamed;Rady, Hanaa Ibrahim;Abdallah, Shrouk Moataz;Bazaraa, Hafez Mahmoud;Rabie, Walaa Ahmed;El-Ayadi, Ahmed Ali
    • Clinical and Experimental Pediatrics
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    • v.62 no.9
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    • pp.344-352
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    • 2019
  • Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. Purpose: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. Methods: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. Results: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. Conclusion: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.

Illness Associated with Contamination of Drinking Water Supplies with Phenol (상수도(上水道) 페놀오염으로 인한 노출-비노출(露出-比露出) 지역주민(地域住民)의 호소증상(呼訴症狀) 비교(比較))

  • Kim, Doo-Hie;Lee, Sung-Kook;Chun, Byung-Yeol;Lee, Duk-Hee;Hong, Sung-Chul;Jang, Bong-Ki
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.2 s.42
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    • pp.202-209
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    • 1993
  • A accidental spills of phenol(100%) to the river Nakdong with subsequent contamination of the tap water fer about two million consumers in Taegu city of Korea were occurred in March 1991. A historical cohort study of 6,913 individuals was undertaken to determine the associated with illness. Population subjects were divided into two groups of exposed and unexposed. Exposed subjects were reported to be phenol associated symptoms significantly higher than those in a nearby unexposed area(39.6% vs 9.4%, p<0.01). Especially, in the related symptoms, highly significant differences were noted in the number of subjects reporting gastrointestinal illness such as nausea, vomiting, diarrhea, or abdominal pain. During the accident, study subjects who experienced peculiar taste or odor in the tap water were significantly higher in the exposed areas(92% vs 34.3%). Chlorophenols formed from chlorination of water may have aggravated the problem.

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Pseudomembranous Colitis in a Child of Chronic Diarrhea (만성 설사 환아에서의 위막성 대장염 1례)

  • Lee, Jin;Kim, Jong-Wan;Kim, Seung-Il
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.138-143
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    • 1998
  • Chronic diarrhea in children is a common problem with numerous causes. Although most of these causes are benign, critical illness may present as chronic diarrhea. In a patient of chronic diarrhea, gastrointestinal infections are the most common causes in children of all ages and antibiotics may cause chronic diarrhea by altering intestinal microflora, which can result in the emergence of bacterial overgrowth. Overgrowth of Clostridium difficile may cause pseudomembranous colitis. We experienced 25-month-old boy who suffered from chronic diarrhea and partially treated with antibiotics irregularly. Colonoscopic findings of this child showed multiple plaques with white to yellowish exudate which adhere to the mucosal surface of a variable length of rectum. Histollogically, each plaque comprised a pseudomembrane of mucous debris, inflammatory cells, and exudate overlying groups of partially disrupted glands. A latex agglutination test on patient's stool was positive to toxin A of Clostridium difficile. He was recovered after stopping the antibiotics he has been prescribed, and being given vancomycin for 2 weeks. We report this case with brief review of literature.

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A Study on Visiting Nursing Service in Primary Health Care Units (일차보건의료조직에서의 방문간호사업 실태조사연구)

  • Lim, Young-Ok;So, Ae-Young
    • Research in Community and Public Health Nursing
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    • v.10 no.2
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    • pp.480-493
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    • 1999
  • The visiting nursing service is an essential part of public health. The purpose of this study was to analyze the visiting nursing service in primary health service centers. The data were collected from visiting nurse records in Wonju City Health Center, Myun Health Center and Community Health Subcenters. The period of data collection was from April 6 to July 15, 1998. The major findings were as follows: 1. Characteristics of 36 service providers. 1) Age : Over 40 years old - 66.7% 2) Educational level: The proportion of registered nurses was 47.2% and nurse aids 52.8% 3) Career: The proportion of providers who worked over 11 years in Public Health Service was 7.8% 2. Characteristics of Subjects 1) The major health problems were cerebro vascular attack, hypertension, D. M., arthritis, gastrointestinal problems and psychiatric problems. The prevalence of chronic health problems increased with age, except for mental illness. 2) The prevalence of cancer was 4.3/1000. 3. Contents of Home Visiting Nursing Services. 1) The major service was education and counseling. 2) The other services were Direct Care(ROM exercise, wound care, physical therapy, basic nursing care etc,) as 56.5%, of the work involved Indirect Care(teaching, counseling, emotional support, etc,) 30.3%, medication - 11.7%, and referral to hospitals - 1.5%.

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Radiological Accident and Acute Radiation Syndrome (방사선 사고와 급성 방사선 증후군)

  • Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.2
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    • pp.39-48
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    • 2011
  • In mass casualty situation due to radiological accidents, it is important to start aggressive management with rapid triage decisions. External contamination needs immediate decontamination and internal contamination should be treated with special expertise and equipment to prevent the rapid uptake of radionuclides by target organs. Acute radiation syndrome shows a sequence of events that varies with the severity of the exposure. More severe exposures generally lead to more rapid onset of symptoms and severe clinical findings. After the massive exposure, various systems of the body reflect their severe damages that can lead to death within hours or up to several months. The disease progression has classically been divided into four stages: prodromal, latent, manifest illness, and recovery or death. Three characteristic clusters of symptoms including the hematopoietic syndrome, the gastrointestinal syndrome and the cerebrovascular syndrome are all associated with the acute radiation syndrome. The standard medical management of the patients with a potentially survivable radiation exposure includes good medical, surgical and supportive measures. Specific treatment with cytokines and bone marrow transplantation should be considered. The management of internal contamination is much the same as the treatment of poisoning. The standard decontamination should be applied to reduce uptake, and the chelating agents can be administered to enhance the clearance of radioisotopes. Radioactive iodine ($^{131}I$) as one of the nuclear fission products can increase the incidence of thyroid cancer in children. Potential benefit of potassium iodide prophylaxis is greater especially in neonates, infants and small children.

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