• Title/Summary/Keyword: Multiorgan

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Tumour Lysis Syndrome: Implications for Cancer Therapy

  • Mika, Denish;Ahmad, Sabrina;Guruvayoorappan, C.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3555-3560
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    • 2012
  • The tumour lysis syndrome (TLS) is a group of metabolic abnormalities caused by rapid and unexpected release of cellular components into the circulation as a result of massive destruction of rapidly proliferating malignant cells. It usually develops in patients with hematologic malignancies like acute lymphoid leukemia, non-Hodgkin and Burkitt's lymphoma after initiation of chemotherapy or may, rarely, occur spontaneously. Though TLS is seldom observed in relation to solid tumours, there have been reports of connections with examples such as lung, liver, breast, gastric carcinomas. The clinical manifestations of TLS include hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. These indications if untreated lead to life-threatening complications such as acute renal failure, cardiac arrhythmias, seizures, and eventually death due to multiorgan failure. Therefore early detection of TLS is of vital importance. This can be accomplished by identification of high risk patients, implementation of suitable prophylactic measures andmonitoring of the electrolyte levels in patients undergoing chemotherapy.

Treatment of Deep Thrombosis (심부정맥혈전증의 치료)

  • 왕옥보
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1358-1361
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    • 1992
  • During the past 4 years, 18 cases of deep vein thrombosis were treated. Diagnosis was based on clinical symptoms, phlebography and vascular Doppler examination. Etiologic factors were mainly trauma, operation and immobilization of the lower extremities. Seven patients were treated surgically and eleven patients medically. The indications for surgical thrombectomy included phlegmasia cerulea dolens [N=6], and phlemasia cerulea dolens with focal venous gangrene[N=1]. The comparative analysis of each treatment methods was done after a mean observation period of 6 months. Good clincal results were observation in 4 patents in surgically treated [57.1%], and 4 in conservative management group[36.3%]. There were no mortality in the both surgical and medically treated group but one patient with phlegmasia cerulea dolens and focal venous gangrene was dischared in moribund state at the third postoperation day due to sepsis and multiorgan failure. We believe that aggressive early surgical thrombectomy should be stronly considered for patients of phlegmasia cerulea dolena.

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A case of bisphosphonate-related osteonecrosis of the jaw with a particularly unfavourable course: a case report

  • Viviano, Massimo;Addamo, Alessandra;Cocca, Serena
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.4
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    • pp.272-275
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    • 2017
  • Bisphosphonates are drugs used to treat osteoclast-mediated bone resorption, including osteoporosis, Paget disease, multiple myeloma, cancer-related osteolysis, and malignant hypercalcemia. The use of these drugs has increased in recent years as have their complications, especially bisphosphonate-related osteonecrosis of the jaw (BRONJ), which more frequently affects the mandible. Here we report a case of BRONJ with a particularly unfavorable course due to cervical inflammation that developed into necrotizing fasciitis, followed by multiorgan involvement leading to septic shock and death.

Overview on Inborn Error of Metabolism involving Hepatic System (간기능 이상을 초래하는 유전성 대사질환)

  • Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.13 no.1
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    • pp.20-29
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    • 2013
  • Inborn error of metabolism usually presents with a constellation of clinical pictures involving multiorgan systems. Because of its rarity and clinical diversity, it is difficult to make diagnosis accurately and efficiently. Many inborn error of metabolism shows predominantly hepatic symptoms and signs. The onset of symptoms is also varying depending the disease. The onset might be even prenatal, either neonatal or infantile, and late childhood. The major manifestation patterns are jaundice or cholestasis, hepatomegaly with or without splenomegaly, hypoglycemia and acute or chronic hepatocellular dysfunction. Based on pronounced hepatic symptoms and onset of symptoms, differential diagnosis can be more easily made with subsequent further laboratory investigation. In this review paper, major inborn error of metabolism with hepatic symptoms are described from the perspective of mode of clinical presentations.

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Unusual Presentation of Miliary Tuberculosis (드문 형태의 속립성 결핵)

  • Ko, Kyoung Tae;Na, Dong Jib;Han, Sang Hoon;Jung, Sung Soo;Moon, Kyoung Min;Kim, Dong Jin;Lee, Yang Deok;Cho, Yong Seon;Han, Min Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.67-71
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    • 2007
  • 결핵은 일차적으로 폐에 주로 발생하지만 혈행성 전파를 통하여 모든 기관에 나타날 수 있으며 면역 억제자의 경우 특히 가능성이 높다. 저자들은 평소 건강했던 속립성 폐결핵 환자에서 간, 비장, 신장, 뇌막 및 뇌실질에 동시에 나타난 다발성 결핵을 보고한다.

Clinical Evaluation of Multiple Valve Replacement (심장다판치환술의 임상적 고찰)

  • 오상기
    • Journal of Chest Surgery
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    • v.33 no.2
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    • pp.160-166
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    • 2000
  • Background: The purpose of this study is to evaluate and analyze the surgical results in patients undergoing operations for multiple for multiple valvular heart diseases. Material and method: From April 1982 to June 1997 multiple valve replacement was performed in 150 patients mitral and aortic valve replacement were done in 135 patients mitral and tricuspid valve replacements in 10 patients triple replacements in 4 patients and aortic and tricuspid valve replacement in 1 patient. Of the valves implanted 157 were St. Jude 104 Duromedics 20 Carpenter-Edwards 6 Bjork-Shiley 6 Ionescu-Shiley and 2 Medtronics. Result: The hospital mortality rate was 10.7% (16/150) and the late mortality rate was 7.2% (8/134) The mortality rate was high in early operative period but decreased with time. The causes of death were low cardiac output in 9 sudden death in 3 congestive heart failure in 3 bleeding in 2 cerebral thrombosis in 1 leukemia in 1 multiorgan failure in 1 and so on . The actuarial survival rate excluding operative death was 83.1% at 15 years. Conclusion: With a follow-up now extending to 15 years the multiple valve replacement continues to be reliable procedure with relatively low mortality and morbidity.

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Very Long Chain Acyl-coenzyme A Dehydrogenase Deficiency: A Review of Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment (장쇄 수산화 아세틸코에이 탈수소효소 결핍증에 대한 고찰)

  • Kang, Seokjin
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.22 no.1
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    • pp.21-27
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    • 2022
  • Very long-chain acyl-coenzyme A dehydrogenase (VLCAD) deficiency (VLCADD) leads to a defective 𝛽-oxidation, specifically during prolonged fasting, infection, or exercise. Patients with VLCADD usually suffer from cardiomyopathy, hypoketotic hypoglycemia, hepatic dysfunction, exercise intolerance, muscle pain, and rhabdomyolysis, and sometimes succumb to sudden death. VLCADD is generally classified into three phenotypes: severe early-onset cardiac and multiorgan failure, hypoketotic hypoglycemia, and later-onset episodic myopathy. Diagnostic evaluation comprises acylcarnitine analysis, genetic analysis, and VLCAD activity assay. In the acylcarnitine analysis, the key metabolites are C14:1, C14:2, C14, and C12:1. A C14:1 level >1 mmol/L strongly suggests VLCADD. Various treatment recommendations are available for this condition. Dietary management includes decreasing fat content, increasing medium-chain triglyceride levels, and decreasing fasting periods. Supplementation with L-carnitine is controversial. Triheptanoin (a seven-carbon fatty acid triglyceride) treatment demonstrates improvement of cardiac functions. Bezafibrate may improve the quality of life of patients with VLCAD.

The potential of Panax notoginseng against COVID-19 infection

  • Yeye Hu ;Ziliang He ;Wei Zhang ;Zhiqiang Niu ;Yanting Wang;Ji Zhang ;Ting Shen;Hong Cheng;Weicheng Hu
    • Journal of Ginseng Research
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    • v.47 no.5
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    • pp.622-626
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    • 2023
  • The COVID-19 pandemic has changed the world and has presented the scientific community with unprecedented challenges. Infection is associated with overproduction of proinflammatory cytokines secondary to hyperactivation of the innate immune response, inducing a cytokine storm and triggering multiorgan failure and significant morbidity/mortality. No specific treatment is yet available. For thousands of years, Panax notoginseng has been used to treat various infectious diseases. Experimental evidence of P. notoginseng utility in terms of alleviating the cytokine storm, especially the cascade, and improving post-COVID-19 symptoms, suggests that P. notoginseng may serve as a valuable adjunct treatment for COVID-19 infection.

Bamboo Culm Extract Attenuates Early Development of Systemic Inflammation in Pristane-Primed Lupus Mice

  • Chae, Byeong-Suk
    • Natural Product Sciences
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    • v.16 no.4
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    • pp.271-279
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    • 2010
  • Systemic lupus erythematosus (SLE) is characterized by systemic inflammation through production of inflammatory mediators and signaling abnormalities between T- and B- cells, leading to autoantibody production and multiorgan injuries. This study was investigated whether bamboo culm extract (BC) attenuates development of lupus systemic inflammation in the early stage in pristane-induced lupus mice. The pristane-induced lupus mice were administrated with BC 0.5 ml/kg or PBS and healthy mice with PBS orally once a day for 14 days. Our results showed that BC remarkably attenuated levels of serum TNF-$\alpha$, IL-6, IL-10, IFN-$\gamma$, $PGE_2$, and VEGF, production of macrophages IL-6 and $PGE_2$ and expression of macrophages IL-6 and COX-2 mRNA in the presence or absence of LPS in pristane-induced lupus mice. Also, BC remarkably reduced expression of CD40L on the splenic T cells and CD80 on the splenic B cells and upregulated the reduced apoptosis of splenic T cells and CD4+ T cells in pristane-induced lupus mice. Therefore, these findings suggest that BC may attenuate early development of lupus systemic inflammation via downregulation of inflammatory mediators and amelioration of abnormal signaling between T cells and B cells.

Surgical Treatment of Acute Necrotizing Klebsiella Pneumonia -Two cases report- (급성 괴사성 클렙시엘라 폐렴의 외과적 치료 -2례 보고-)

  • 류경민;김삼현;박성식;류재욱;최창휴;박재석;서필원
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.484-488
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    • 1999
  • Massive lung gangrene is a rare but very rapidly progressing fatal complication of lobar pneumonia. Etiologic agents are Klebsiella pneumoniae, Pneumococcus and Aspergillus, etc. Chest X-ray shows firm consolidation of the involved pulmonary lobe and bulging fissure due to the volume expansion of involved lung. CT-scan shows extensive lung parenchymal destructions with multiple small cavitary lesions. Recommended treatment is the early surgical intervention combined with antibiotics. Without surgical intervention, lung gangrene is known to progress toward sepsis, multiorgan failure, and high mortality. We report two cases of rapidly progressing massive lung gangrene by Klebsiella pneumonia treated by the resectional surgery.

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