• Title/Summary/Keyword: Life-threatening disease

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Surgical analysis of pulmonary aspergilloma (폐국균종의 외과적 임상분석)

  • 이종국;박승일;서재정;원준호
    • Journal of Chest Surgery
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    • v.33 no.3
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    • pp.245-251
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    • 2000
  • Backround: Pulmonary aspergilloma is a potential life-threatening disease resulting from massive hemoptysis. Pulmonary aspergilloma has been treated surgically for many years, however, it has also had higher risk of mortality and complication rate. The purpose of this study is to analyze the operative methods and the types of complications. Material and Method: Sixty patients who underwent surgical resection for pulmonary their medical reconrds. Result: The mean age was 46.3$\pm$13.4 years(range 20 to 76 years). The most common clinical presentation was hemoptysis which occurred in 48 patients(80%). Pulmonary tuberculosis was the most common pre-existing disease, occurri9ng in 28 patients(46.7%). The other associated lung diseases were bronchiectasis(n=11), silicosis(n=2), and chronic pnumonia(n=1). Operative proceudres wer lobectomy in 35 patients, pneumonectomy in 6, segmentectomy in 5, lobectomy and thoracoplasty in 3, segmentectomy and thoracopasty in 1, and cavernostomy in 10. The operative mortality was 6%(n=3) in lung resection patients but 0% in cavernostomy patients. The most common complications were prolonged air leakage, wound infection and postoperative bleeding. Conclusion: In most cases of pulmonary aspergilloma surgical resectin remains the only effective therapy. However, cavernostomy may be more effective for pulmonary aspergilloma patients with decreased pulmonary functions and for patients with high risk for lung resection.

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Tetanus Developing after a Traumatic Rectal Rupture - A Case Report - (외상에 의한 직장파열로 발생한 파상풍)

  • Kim, Jin Soo;Kim, Ki Hoon;Park, Sung Jin;Nam, So Hyun;Kim, Woon-Won;Kim, Yong Han
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.214-217
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    • 2013
  • Tetanus is a neurologic disorder caused by a tetanospasmin released from Clostridium tetani and usually occurs as a result of a dirty open wound or abrasion. Post traumatic tetanus is a life threatening disease and has a mortality rate of 15~39%. Because of a nationwide active immunization program, tetanus is a rare disease in Korea. Thus, many physicians have little experience with its diagnosis and management, and misdiagnosis and therapeutic delay may have catastrophic consequences. We report a case of tetanus that developed in a patient who had been diagnosed with a traumatic rectal rupture.

Isolated Splenic Vein Thrombosis Associated with Acute Pancreatitis (급성 췌장염에 동반된 고립성 비정맥 혈전증 1예)

  • Song, Hyang-Soon;Yang, Noo-Ri;Jin, So-Hee;Choi, Kyeong-Dan;Jang, Young-Taek
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.221-225
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    • 2009
  • Pancreatic disease is the most frequent cause of isolated splenic vein thrombosis. Splenic vein thrombosis causes a localized form of portal hypertension known as sinistral or left-sided portal hypertension. Splenic vein thrombosis may be complicated by the formation of gastric varices, with the potential of massive upper gastrointestinal bleeding. Whereas splenectomy is considered to be the treatment of choice for symptomatic splenic vein thrombosis, the role of splenectomy in the patient with asymptomatic splenic vein thrombosis remains controversial. We report a rare case of acute pancreatitis complicated by isolated asymptomatic splenic vein thrombosis. Recognition of this disease entity is important because the risk of secondary variceal bleeding, while uncommon, can be life-threatening.

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Pulmonary hemorrhage in pediatric lupus anticoagulant hypoprothrombinemia syndrome

  • Kim, Ji Soo;Kim, Min Jae;Bae, E. Young;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.57 no.4
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    • pp.202-205
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    • 2014
  • Lupus anticoagulant-hypoprothrombinemia syndrome (LAHPS), a very rare disease that is caused by the presence of antifactor II antibodies, is usually counterbalanced by the prothrombotic effect of lupus anticoagulant (LAC). Patients with LAHPS are treated using fresh frozen plasma, steroids, immunosuppressive agents, and immunoglobulins for managing the disease and controlling hemorrhages. Notably, steroids are the important treatment for treating hypoprothrombinemia and controlling the bleeding. However, some patients suffer from severe, life-threatening hemorrhages, when factor II levels remain very low in spite of treatment with steroids. Here, we report a case of LAHPS in a 15-year-old girl who experienced pulmonary hemorrhage with rapid progression. She was referred to our hospital owing to easy bruising and prolonged bleeding. She was diagnosed with LAHPS that presented with pancytopenia, positive antinuclear antibody, proloned prothrombin time, activated partial thromboplastin time, positive LAC antibody, and factor II deficiency. Her treatment included massive blood transfusion, high-dose methylprednisolone, vitamin K, and immunoglobulin. However, she died due to uncontrolled pulmonary hemorrhage.

Treatment of Diabetic Charcot Arthropathy (당뇨병성 샤콧 관절의 치료)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.243-250
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    • 2013
  • Diabetic Charcot arthropathy is a severe joint disease in the foot and ankle that can result in fracture, permanent deformity, limb loss. Although recent research has improved our level of knowledge regarding its etiology and treatment, it still remains a poorly understood disease. It is a serious and potentially limb-threatening lower-extremity late complication of diabetes mellitus and its diagnosis is commonly missed upon initial presentation. Clinicians treating diabetic patients should be vigilant in recognizing early signs of acute Charcot arthropathy, such as pain, warmth, edema, or pathologic fracture in a neuropathic foot. Early detection and prompt treatment can prevent joint and bone destruction. If left untreated, it can reduce overall quality of life and dramatically increase morbidity and mortality of patients. The goal of this manuscript is to evaluate the current concepts of Charcot arthropathy through review of various literature and help clinicians decide the treatment strategy.

Current Prescription Status of Contraindicated Drug Combinations Causing Serotonin Syndrome: Analysis of HIRA-NPS Data

  • Jae Gon Ryu;So Young Kim;Susin Park;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.4
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    • pp.313-320
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    • 2022
  • Background: Serotonin syndrome is a life-threatening disease if not appropriately treated. This study aimed to investigate the prescription status of contraindicated drug combinations that cause serotonin syndrome and identify the related factors. Methods: A cross-sectional study was conducted using nationwide claims data. Adult patients taking serotonergic drugs with Parkinson's disease or mental disorders were selected. Based on international medical databases (MDBs) and the Korean Drug Utilization Review (DUR), the status of prescribing contraindicated drug combinations that induce serotonin syndrome, the related factors, and the difference between international MDBs and the Korean DUR were analyzed. Results: Of the 49,773 study subjects, 163 (0.3%) were prescribed contraindicated serotonergic drug combinations based on international MDBs, and among them, only 105 (64.4%) were contraindicated by the Korean DUR. Positive influencing factors for prescribing contraindicated drug combinations include patient age between 65 and 74 and physician's specialties (neurologists, and orthopedists). Negative influencing factors were physician's specialty (internists) and medical institution (primary institutions). Conclusion: Despite the implementation of DUR, 3 out of 1,000 study subjects received contraindicated drug combinations that caused serotonin syndrome. Hence, it is necessary to comply with the DUR and improve it in accordance with international MDBs.

Comprehensive overview of the role of mitochondrial dysfunction in the pathogenesis of acute kidney ischemia-reperfusion injury: a narrative review

  • Min-Ji Kim;Chang Joo Oh;Chang-Won Hong;Jae-Han Jeon
    • Journal of Yeungnam Medical Science
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    • v.41 no.2
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    • pp.61-73
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    • 2024
  • Acute kidney ischemia-reperfusion (IR) injury is a life-threatening condition that predisposes individuals to chronic kidney disease. Since the kidney is one of the most energy-demanding organs in the human body and mitochondria are the powerhouse of cells, mitochondrial dysfunction plays a central role in the pathogenesis of IR-induced acute kidney injury. Mitochondrial dysfunction causes a reduction in adenosine triphosphate production, loss of mitochondrial dynamics (represented by persistent fragmentation), and impaired mitophagy. Furthermore, the pathological accumulation of succinate resulting from fumarate reduction under oxygen deprivation (ischemia) in the reverse flux of the Krebs cycle can eventually lead to a burst of reactive oxygen species driven by reverse electron transfer during the reperfusion phase. Accumulating evidence indicates that improving mitochondrial function, biogenesis, and dynamics, and normalizing metabolic reprogramming within the mitochondria have the potential to preserve kidney function during IR injury and prevent progression to chronic kidney disease. In this review, we summarize recent advances in understanding the detrimental role of metabolic reprogramming and mitochondrial dysfunction in IR injury and explore potential therapeutic strategies for treating kidney IR injury.

A Case of Massive Hemoptysis due to Dieulafoy's Disease of the Bronchus (기관지 Dieulafoy 질환에 의한 대량 객혈 1예)

  • Kang, Yeh Rim;Lee, Jung Woo;Jeon, Hee Jung;Lee, Shin Yeop;Cha, Seung Ick;Park, Tae Ihn;Park, Jae Yong;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.1
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    • pp.58-61
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    • 2009
  • Dieulafoy's disease of the bronchus is rare but potentially life-threatening, and should be considered in patients with massive hemoptysis, especially from unknown etiology. We report a case of a patient with massive hemoptysis due to bronchial Dieulafoy's disease. He underwent bronchial artery embolization and surgical resection, and the post-operative specimen revealed dilated and tortuous arteries in the submucosa that presented as Dieulafoy's disease of the bronchus.

Massive pulmonary hemorrhage in enterovirus 71-infected hand, foot, and mouth disease

  • Lee, Dong Seong;Lee, Young Il;Ahn, Jeong Bae;Kim, Mi Jin;Kim, Jae Hyun;Kim, Nam Hee;Hwang, Jong Hee;Kim, Dong Wook;Lee, Chong Guk;Song, Tae Won
    • Clinical and Experimental Pediatrics
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    • v.58 no.3
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    • pp.112-115
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    • 2015
  • Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.

A Case of Posttransplant Lymphoproliferative Disease Following Renal Transplantation in a Child (소아에서 신장 이식 후 발생한 Posttransplant Lymphoproliferative Disease 1례)

  • Jhang Won-Kyoung;Hahn Hye-Won;Lee Mee-Jeung;Ghim Thad-T.;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.245-252
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    • 2003
  • Posttransplant lymphoproliferative disease(PTLD) has emerged as a potential life-threatening complication of immunosuppressive therapy after organ transplantation. The occurrence of PTLD is usually associated with an Epstein-Barr virus(EBV) infection in patients who are treated by aggressive immunosuppressive therapy. PTLD is represented by diverse manifestations ranging from reactive lymphoid hyperplasia to high grade malignant lymphoma. This is a case report of a late PTLD in a child. The patient is a 14-year-old girl, who presented as malignant lymphoma 44 months after successful renal transplantation. There was no evidence of EBV infection. On bone marrow study, many neoplastic lymphoid cells were defected. Aggressive chemotherapy for PTLD had resulted in clinical remission. However the patient expired from uncontrolled sepsis and septic shock after 77 days.

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