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Diffuse Pulmonary Alveolar Hemorrhage and Interstitial Pneumonitis after Subcutaneous Injection of Atelocollagen for Cosmetic Purpose : Two Case Reports (미용 목적으로 Atelocollagen 주입 후에 발생한 미만성 폐포출혈과 간질성 폐렴 2례)

  • Ko, Young Chun;Lim, Sung Chul;Park, Kyung Hwa;Kim, Jeong Soon;Kim, Kyu Sik;Kim, Yu Il;Kim, Young Chul;Yoon, Sung Ho;Lee, Seung Il;Park, Kyung Ok
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.308-314
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    • 2004
  • Atelocollagen have been used recently in skin and other soft tissue defect regions more than silicone fluid because of the low incidence of an immune reaction and complications. Several cases of acute pneumonitis after a subcutaneous injection of silicone have been reported. The symptoms were dyspnea, fever, chest pain and hemoptysis. Previous reports have explained the pathophysiology of acute pneumonitis to a pulmonary microembolism and cellular inflammation. We experienced two cases of an acute interstitial pneumonitis and pulmonary hemorrhage after a subcutaneous injection of atelocollagen. They were all healthy young women and complained of dyspnea, fever and blood tinged sputum. The chest radiography and computerized tomography showed a bilateral ground glass opacity in both lung fields. One case recovered completely with conservative treatment but the clinical course of the other case was aggravated to the degree that invasive positive pressure ventilation therapy was required. We report a rare case of a diffuse pulmonary alveolar hemorrhage and an interstitial pneumonitis after the subcutaneous injection of atelocollagen for cosmetic purposes.

Association of Alcoholic & Nonalcoholic Fatty Liver Disease with Metabolic Syndrome in Health Screen Examinees of Men (남성 건강검진 수진자들에서 알코올성 및 비알코올성 지방간과 대사증후군과의 관련성)

  • Jeong, Eui-Kyeong;Kang, Yeong-Han;Park, Jae-Yong
    • The Journal of the Korea Contents Association
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    • v.9 no.6
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    • pp.237-246
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    • 2009
  • This study was carried out to investigate of the associations of Alcoholic & Nonalcoholic fatty liver disease(AFLD & NAFLD) with metabolic syndrome(MS) defined by IDF criteria. We conducted a cross-sectional study of 799 adult males with alcohol consumption underwent laboratory investigation(control 297, alcoholic 206, nonalcoholic 296). The ultrasound scan of the liver was performed to determine the presence and the severity of FLD. We analyzed the association between the severity of AFLD & NAFLD and MS by logistic regression analysis. The distribution of metabolic syndrome was 7.4%, 48.8%, 34.9% in control, AFLD & NAFLD. The association of blood pressure, glucose, triglycerides, obesity were risk factor in AFLD & NAFLD. According to the severity of FLD, AFLD was significantly increased with MS, Obesity, low HDL-cholesterol. MS, High triglycerides was increased significantly in NAFLD(p<0.05). The prevalence of AFLD & NAFLD was increased with increasing the number of features of metabolic syndrome. This study shows that AFLD & NAFLD was closely associated with MS and its components. The patients of AFLD & NAFLD should managed and monitored to prevent metabolic abnormalities.

Validity of Self-reported Hypertension and Factors Related to Discordance Between Self-reported and Objectively Measured Hypertension: Evidence From a Cohort Study in Iran

  • Najafi, Farid;Pasdar, Yahya;Shakiba, Ebrahim;Hamzeh, Behrooz;Darbandi, Mitra;Moradinazar, Mehdi;Navabi, Jafar;Anvari, Bita;Saidi, Mohammad Reza;Bazargan-Hejazi, Shahrzad
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.2
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    • pp.131-139
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    • 2019
  • Objectives: Self-reporting can be used to determine the incidence and prevalence of hypertension (HTN). The present study was conducted to determine the validity of self-reported HTN and to identify factors affecting discordance between self-reported and objectively measured HTN in participants in the Ravansar Non-Communicable Diseases (RaNCD) cohort. Methods: The RaNCD cohort included permanent residents of Ravansar, Iran aged 35-65 years. Self-reported data were collected before clinical examinations were conducted by well-trained staff members. The gold standard for HTN was anti-hypertensive medication use and blood pressure measurements. The sensitivity, specificity, positive and negative predictive values, and overall accuracy of self-reporting were calculated. Univariate and multivariate logistic regression were used to examine the discordance between self-reported HTN and the gold standard. Results: Of the 10 065 participants in the RaNCD, 4755 (47.4%) were male. The prevalence of HTN was 16.8% based on self-reporting and 15.7% based on medical history and HTN measurements. Of the participants with HTN, 297 (18.8%) had no knowledge of their disease, and 313 (19.9%) had not properly controlled their HTN despite receiving treatment. The sensitivity, specificity, and kappa for self-reported HTN were 75.5%, 96.4%, and 73.4%, respectively. False positives became more likely with age, body mass index (BMI), low socioeconomic status, and female sex, whereas false negatives became more likely with age, BMI, high socioeconomic status, smoking, and urban residency. Conclusions: The sensitivity and specificity of self-reported HTN were acceptable, suggesting that this method can be used for public health initiatives in the absence of countrywide HTN control and detection programs.

Effects of Respiratory Rehabilitation Training Using a Harmonica for Patients With Spinal Cord Injuries (하모니카를 활용한 호흡재활 훈련이 척수손상환자의 호흡기능에 미치는 영향)

  • Kim, Hyuk Gun;Kim, Min Seo;Lim, Han Mil;Joeng, So;Shin, Uk Ju
    • Journal of Music and Human Behavior
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    • v.15 no.2
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    • pp.23-39
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    • 2018
  • The purpose of this research was to investigate the effects of respiratory rehabilitation using a wind instrument for patients suffering from spinal cord injuries. From January 15, 2018 to April 15, 2018, we conducted ten 1-hour sessions of a harmonica program with eight patients with spinal cord injuries with average age of 37 years who could not perform abdominal breathing by themselves. We measured and compared patients' breathing capacity before and after the 10 sessions. Designed particularly for patients with spinal cord injuries resulting in a limited range of neck movement, the study used a 10-hole diatonic harmonica whose length was relatively short. For those patients who had difficulty using their hands, a harmonica holder was provided. Participants were trained to play simple tunes. They were guided to use abdominal breathing to make sounds, with emphasis on those parts requiring long and strong breathing. The results showed that for all eight patients both their breathing volume and their inspiratory volume increased following participation in the harmonica program. Also, the program had psychological benefits (e.g., more life satisfaction and less sadness) and additional physical benefits (e.g., less dizziness due to low blood pressure and better phlegm spitting). This study offers a unique way to help patients with spinal cord injuries to improve their breathing capacity, which may also be associated with a greater quality of life.

A Case of Multisystem Inflammatory Syndrome in Children (MIS-C) with Acute Myocarditis

  • Lim, Jin Gyu;Lee, Da Hye;Oh, Kyung Jin;Choi, Sujin;Song, Young Hwan;Lee, Joowon;Lee, Hyunju
    • Pediatric Infection and Vaccine
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    • v.28 no.3
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    • pp.173-180
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    • 2021
  • After initial reports of multisystem inflammatory syndrome in children (MIS-C) in April 2020 in Europe, this disease has been known to occur in children with recent history of coronavirus disease 2019 (COVID-19) and most cases have been reported in Europe and the Unites States of America. We report a case of a 14-year-old girl who was diagnosed with MIS-C with acute myocarditis and successfully treated with intravenous immunoglobulin (IVIG), methylprednisolone, and anakinra. At initial presentation, she had persistent high fever, generalized rash, generalized swelling, abdominal pain, and low blood pressure. She showed a remarkably elevated level of inflammation and cardiac enzyme markers and had a previous history of COVID-19 5 weeks before the initial presentation. After extensive work up, other infectious and non-infectious causes were excluded. She was diagnosed with MIS-C and initially treated with IVIG and high-dose methylprednisolone; however, despite treatment, her heart function deteriorated and coronary artery dilatation progressed. Therefore, anakinra, an interleukin-1 receptor antagonist, was administered on hospital day 6, after which her cardiac function exhibited improvement. She was discharged on hospital day 19 without any symptoms, and follow-up echocardiography after 1 month revealed fully recovered heart function with normal coronary arteries.

Correlation Analysis of Clinical Risk Factors and Atherosclerosis Diagnosed by Carotid Artery Ultrasonography (경동맥 초음파로 진단된 죽상동맥경화증과 위험인자의 관련성 분석)

  • Jee-Yeon Park;Sung-Hee Yang
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.465-472
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    • 2023
  • In predicting vascular disease, this study attempted to identify changes in the carotid intima-media thickness in patients who underwent carotid artery ultrasonography and hematological tests and to find out the effect of risk factors on the expression of atherosclerotic plaque. A retrospective analysis was conducted on 469 healthy adults who visited the hospital for the purpose of medical examination and performed carotid artery ultrasonography. As a result, carotid intima-media thickness, age, body mass index, waist circumference, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and glucose were analyzed as significant predictors of atherosclerotic plaque (p<0.001). The risk ratio was calculated based on the cut off value of the risk factors of the atherosclerotic plaque determined through ROC curve analysis, followed by 8.06 times the carotid intima-media thickness, 7.53 times the age, 3.97 times the waist circumference and 2.02 times the glucose. Therefore, in this study it was possible to prepare a Korean standard for clinical risk factors that affect the presence of absence of atherosclerotic plaque and observation of carotid artery ultrasonography is thought to help diagnose or predict cardiovascular disease early.

Identification of an effective and safe bolus dose and lockout time for patient-controlled sedation (PCS) using dexmedetomidine in dental treatments: a randomized clinical trial

  • Seung-Hyun Rhee;Young-Seok Kweon;Dong-Ok Won;Seong-Whan Lee;Kwang-Suk Seo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.1
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    • pp.19-35
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    • 2024
  • Background: This study investigated a safe and effective bolus dose and lockout time for patient-controlled sedation (PCS) with dexmedetomidine for dental treatments. The depth of sedation, vital signs, and patient satisfaction were investigated to demonstrate safety. Methods: Thirty patients requiring dental scaling were enrolled and randomly divided into three groups based on bolus doses and lockout times: group 1 (low dose group, bolus dose 0.05 ㎍/kg, 1-minute lockout time), group 2 (middle dose group, 0.1 ㎍/kg, 1-minute), and group 3 (high dose group, 0.2 ㎍/kg, 3-minute) (n = 10 each). ECG, pulse, oxygen saturation, blood pressure, end-tidal CO2, respiratory rate, and bispectral index scores (BIS) were measured and recorded. The study was conducted in two stages: the first involved sedation without dental treatment and the second included sedation with dental scaling. Patients were instructed to press the drug demand button every 10 s, and the process of falling asleep and waking up was repeated 1-5 times. In the second stage, during dental scaling, patients were instructed to press the drug demand button. Loss of responsiveness (LOR) was defined as failure to respond to auditory stimuli six times, determining sleep onset. Patient and dentist satisfaction were assessed before and after experimentation. Results: Thirty patients (22 males) participated in the study. Scaling was performed in 29 patients after excluding one who experienced dizziness during the first stage. The average number of drug administrations until first LOR was significantly lower in group 3 (2.8 times) than groups 1 and 2 (8.0 and 6.5 times, respectively). The time taken to reach the LOR showed no difference between groups. During the second stage, the average time required to reach the LOR during scaling was 583.4 seconds. The effect site concentrations (Ce) was significantly lower in group 1 than groups 2 and 3. In the participant survey on PCS, 8/10 in group 3 reported partial memory loss, whereas 17/20 in groups 1 and 2 recalled the procedure fully or partially. Conclusion: PCS with dexmedetomidine can provide a rapid onset of sedation, safe vital sign management, and minimal side effects, thus facilitating smooth dental sedation.

The Change of The Effect on The Subcutaneous Fat Area and Visceral Fat Area by The Functional Electrical Stimulation and Aerobic Exercise (기능적 전기 자극과 유산소 운동이 복부비만의 피하지방과 내장지방에 미치는 효과)

  • Oh Sung-tae;Lee Mun-hwan;Park Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.16 no.1
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    • pp.85-123
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    • 2004
  • Back ground : Subcutaneous fat area is the main factor involved in replacement disease and arteriosclerosis. Simple weight control is the appropriate medical treatment. It's understood that weight reduction does not only reduce the fat concentrations in blood but also reduces blood pressure, improves glucose levels in diabetes patients and reduces incidents of heart disease. there are several methods for reducing fat in the abdominal region but their effectiveness is not folly understood. one method is electrical stimulation of the problem areas. Method : From May 1st 2002 to October 31st. The 15 subjects who received medical examination were aged between 25 and 53 and were of mixed gender. The subjects were divided into two groups one to received functional electrical stimulation and the other a control group. Using Broca's criterion for judging fat grades. I analysed the differences between the two groups before and after the treatment. Subjects received functional electrical stimulation on the abdominal muscle intensity 50Hz. They received this treatment 4 days a week for 40 minutes a day. In the case of aerobic exercise, at the Treadmill, we used it with the intensity of $75\%$ maximum heart rate (220-age). Result 1)After functional electrical stimulation in the case of male subjects, the weight was reduced 1.93kg, obesity $2.60\%$, fat mass 2.73kg, Percent body fat $4.40\%$, waist circumference 6.53cm, circumference of hips 5.53cm. On the other side, the quality of muscle was increased at the rate of 1.03kg, but it's not attentional level. The subcutaneous fat area was reduced by $26.63cm^2$, the visceral fat area was reduced by $43.00cm^2$, In the female subjects, we can see the reduction of fat grade by $26.63cm^2$, the quantity of body fat by 1.5kg, percent body fat by $1.77\%$, circumference of waist by 4.02cm, circumference of hips by 3.67cm, weight by 1.40kg but was increased 0.72kg at the quantity of muscles. We can see the reduction also in the subcutaneous fat area $24.03cm^2$, the visceral fat area by $25.36cm^2$. 2)After aerobic exercise, on the male subjects, we can see reduction of weight by 3.36kg, obesity by $4.00\%$, fat mass by 2.83kg and we can see increase at the soft lean mass by 2.96kg, but we can see reduction, the percent body fat by $3.03\%$, fat distribution by $0.023\%$, circumference of waist by 3.10cm, circumference of hips by 2.23cm. The female subjects show a reduction in the weight by 2.48kg, percent body fat by $2.20\%$, show an increase in the soft lean mass by 1.54kg. We can see a reduction in the quantity of fat mass by 2.32kg, the percent body fat by $2.80\%$, the circumference of waist by 2.16cm, the circumference of hips by 2.68cm, the fat distribution by $0.016\%$, the subcutaneous fat area by $15.25cm^2$ the visceral fat area by $11.52cm^2$. After aerobic exercise, we can't see the attentional change at the total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. 3)After the application of functional electrical stimulation and aerobic exercise, in result of measurement on the body ingredient, we could see the weight reduction and increase the quantity of muscle with the male group who exercised aerobic. We can see the attentional rate on the electrical stimulation about abdominal fat rate, circumference of waist, circumference of hips. The other hand, I couldn't see the attentional differences between the two groups in the rate of fatness and quantity of body fat and the rate of body fat. There isn't any attentional difference in the area of fat under skin, on the contrary, There is attentional difference in the fat in the internal organs area at the electrical stimulation site. We can't see the attentional change of total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol between electrical stimulation and aerobic exercise. 4)After execution of functional electrical stimulation and aerobic exercise, in result of measurement on change of body ingredient among female objects, We could see weight reduction, increase at muscle quantity in the aerobic exercise group. We could see the attentional differences in the rate of fatness, the rate of abdominal region, the circumference which received electrical stimulation. But, we couldn't see the attentional differences between two groups in the quantity of body fatness, the circumference of hips. The subcutaneous fat area doesn't show the attentional differences. On the Contrary, we could see lots of differences in the visceral fat area of the electrical stimulation group. Conclusion The results show that functional electrical stimulation and aerobic exercise have insignificant differences when if comes to total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol. Though there is affirmative change in body ingredient after both electrical stimulation and aerobic exercise. Functional electrical stimulation is more effective on the subcutaneous fat area and in changing visceral fat area. There fore. It is concluded that the physical therapy is more effective in the treatment of abdominal fatness.

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The Effect of the Histidine-Tryptophan-Ketoglutarate (HTK) Solution on Myocardial Protection in Isolated Rat Heart (흰쥐의 적출심장에서 HTK 용액의 심근보호 효과)

  • 송원영;장봉현;김규태
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.632-643
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    • 2004
  • Background: The Histidine-Tryptophan-Ketoglutarate (HTK) solution has been shown to provide the excellent myocardial protection as a cardioplegia. The HTK solution has relatively low potassium as an arresting agent of myocardium, and low sodium content, and high. concentration of histidine biological buffer which confer a buffering capacity superior to that of blood.. Since HTK solution has an excellent myocardial protective ability, it is reported to protect myocardium from ischemia for a considerable time (120 minutes) with the single infusion of HTK solution as a cardioplegia. The purpose of this study is to evaluate the cardioprotective effect of HTK solution on myocardium when the ischemia is. exceeding 120 minutes at two different temperature (10 to 12$^{\circ}C$, 22 to 24$^{\circ}C$) using the Langendorff apparatus, Material and Method: Hearts from Sprague-Dawley rat, weighing 300 to 340 g, were perfused with Krebs-Henseleit solution at a perfusion pressure of 100 cm $H_2O$. After the stabilization, the heart rate, left ventricular developed pressure (LVDP), and coronary flow were measured. Single dose of HTK solution was infused into the ascending aorta of isolated rat heart and hearts were preserved at four different conditions. In group 1 (n=10), hearts were preserved at deep hypothermia (10∼12$^{\circ}C$) for 2 hours, in group 2 (n=10), hearts were preserved at moderate hypothermia (22∼24$^{\circ}C$) for 2 hours, in group 3 (n=10), hearts were preserved at deep hypothermia for 3 hours, and in group 4 (n=10), hearts were preserved at moderate hypothermia for 3 hours. After the completion of the preservation, the heart rate, left ventricular developed pressure, and coronary flow were measured at 15 minutes, 30 minutes, and 45 minutes after the initiation of reperfusion to assess the cardiac function. Biopsies were also done and mitochondrial scores were counted in two cases of each group for ultrastructural assessment. Result: The present study showed that the change of heart rate was not different between group 1 and group 2, and group 1 and group 3. The heart rate was significantly decreased at 15 minutes in group 4 compared to that of group 1 (p<0.05 by ANCOVA). The heart rate was recovered at 30 minutes and 45 minutes in group 4 with no significant difference compared to that of group 1. The decrease of LVDP was significant at 15 minutes, 30 minutes and 45 minutes in group 4 compared to that of group 1 (p < 0.001 by ANCOVA). Coronary flow was significantly decreased at 15 minutes, 30 minutes, and 45 minutes in group 4 compared to that of group 1 (p < 0.001 by ANCOVA). In ultrastructural assessment, the mean myocardial mitochondrial scores in group 1, group 2, group 3, and group 4 were 1.02$\pm$0.29, 1.52$\pm$0.26, 1.56$\pm$0.45, 2.22$\pm$0.44 respectively. Conclusion: The HTK solution provided excellent myocardial protection regardless of myocardial temperature for 2 hours. But, when ischemic time exceeded 2 hours, the myocardial hemodynamic function and ultrastructural changes were significantly deteriorated at moderate hypotherma (22∼ 24$^{\circ}C$). This indicates that it is recommended to decrease myocardial temperature when myocardial ischemic time exceeds 2 hours with single infusion of HTK solution as a cardioplegia.

Analysis of prognostic factors of laparotomy for necrotizing enterocolitis in extremely low birth weight infants (괴사성 장염으로 수술한 초극소저체중출생아(<1,000 g)의 예후인자 분석)

  • Kim, Jin Kyu;Kim, Yi Sun;Yoo, Hye Soo;Ahn, So Yoon;Seo, Hyun Ju;Choi, Seo Heui;Park, Soo Kyung;Jung, Yu Jin;Kim, Myo Jing;Jeon, Ga Won;Koo, Soo Hyun;Lee, Kyung-Hoon;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.167-172
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    • 2010
  • Purpose : With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC. Methods : We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center. Results : Of 480 ELBWI, 35 required laparotomy for NEC; the mortality rate was 20% (Alive group n=28, Dead group n=7). The values of preoperative score for neonatal acute physiology-II (P =0.022) and fraction of inspired oxygen (P <0.001) were significantly higher in the dead group and values of base excess (P =0.004) were significantly lower in the dead group. Values of preoperative heart rate, respiration rate, mean blood pressure, pH, $CO_2$, and potassium ion were not significantly different between the study groups. Intraoperative fluid volume was significantly higher in the alive group than in the dead group (P =0.045). Postoperative infusion rate was significantly lower in the alive group than in the dead group (P =0.022). Conclusion : Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.