• Advances in pediatric surgery
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• 제6권1호
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• pp.10-18
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• 2000

Multisystem organ failure resulting from gram negative bacterial sepsis is associated with high morbidity and mortality in surgical neonates. There are differences in the clinical characteristics of organ failure in neonates and adults. The purpose of this study is to identify the differences and determine the order of organ failure between baby rats and adult rats after induction of gram negative sepsis. Fifty baby rats less than 30-day-old and another 50 adult rats more than 2-month-old were divided into control group (G1) and experimental group (G2). The G1 consisted of 10 baby- and 10 adult-rats, and the G2 consisted of 40 babies and 40 adults. E. coli ($10^8/mL$ per 100g of body weight) were injected into the peritoneal cavity in G2 and same amount of saline was injected in G 1. Blood samples were obtained before injection, 24 hour, 48 hour, 72 hour and after death. WEC, platelet, $PaO_2$, $PaCO_2$, total bilirubin, BUN, creatinine, albumin and abdominal wall thickness were measured to evaluate the sequence of organ failure. The mortality was 55.0 % in G2-babies and 32.5 % in G2-adults. In baby rats, microvascular, hematologic and renal failure appeared within 24 hours after injection and pulmonary failure followed. Pulmonary, renal and liver failure developed within 24-48 hours in adult rats; however, microvascular failure did not appear until they were moribund. Thrombocytopenia, hypoalbuminemia, increased BUN and generalized edema was the earlist sign of sepsis in baby rats.

• Journal of Korean Medical Science
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• 제33권50호
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• pp.326.1-326.10
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• 2018

Background: This retrospective study analyzed the causes of failure in the management process from the identification of brain-dead potential organ donors to actual donation in Korea over the past 5 years. Methods: Data of 8,120 potential brain deaths reported to the Korea Organ Donation Agency were used, including information received at the time of reporting, donation suitability evaluation performed by the coordinator after the report, and data obtained from interviews of hospital medical staff and the donor's family. Results: From January 2012 to December 2016, the total number of brain-dead potential organ donors in Korea was 8,120, of which 2,348 (28.9%) underwent organ procurement surgery with designated recipients. While the number of transplant donors has increased over time, the ratio of transplant donors to medically suitable brain-dead donors has decreased. The common causes of donation failure included donation refusal (27.6%), non-brain death (15.5%), and incompatible donation (11.6%); 104 potential donors (7.8%) were unable to donate their organs because they were not pronounced brain dead. Conclusion: The rate of successful organ donation may be increased by analyzing the major causes of failure in the brain-dead organ donation management process and engaging in various efforts to prevent such failures.

• Journal of Chest Surgery
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• 제23권2호
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• pp.275-284
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• 1990

A serious problem after cardiovascular surgery known as Multiple Organ Failure[MOF] whereby several vital organs successively demonstrate dysfunction in spite of intensive postoperative treatment has recently arisen. We have made a retrospective study of the clinical records of 137 patients who underwent cardiovascular surgery during past two years [1987-1988]. Fourteen patients [10%] developed multi-organ failure postoperatively with the results of seven death [50%]. In fatal group, preoperative poor cardiac function [Cardiac Index<2.0L/min/m2] was considered important prognostic factor and infection 5 disseminated intravascular coagulation complicating gastrointestinal bleeding were the leading cause of death. In conclusion, evaluation of multiple factors concerning multi-organ failure demonstrates preoperative poor functional preservation of vital organs is the main factor. So early diagnosis k management for each of the failing organs & prevention of infection are mandatory of the treatment of these critically ill patients.

• Parasites, Hosts and Diseases
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• 제54권1호
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• pp.21-29
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• 2016

The sodium hydrogen exchanger 1 (NHE1), which functions in maintaining the ratio of $Na^+$ and $H^+$ ions, is widely distributed in cell plasma membranes. It plays a prominent role in pH balancing, cell proliferation, differentiation, adhesion, and migration. However, its exact subcellular location and biological functions in Toxoplasma gondii are largely unclear. In this study, we cloned the C-terminal sequence of T. gondii NHE1 (TgNHE1) incorporating the C-terminal peptide of NHE1 (C-NHE1) into the pGEX4T-1 expression plasmid. The peptide sequence was predicted to have good antigenicity based on the information obtained from an immune epitope database. After induction of heterologous gene expression with isopropyl-b-D-thiogalactoside, the recombinant C-NHE1 protein successfully expressed in a soluble form was purified by glutathione sepharose beads as an immunogen for production of a rabbit polyclonal antiserum. The specificity of this antiserum was confirmed by western blotting and immunofluorescence. The antiserum could reduce T. gondii invasion into host cells, indicated by the decreased TgNHE1 expression in T. gondii parasites that were pre-incubated with antiserum in the process of cell entry. Furthermore, the antiserum reduced the virulence of T. gondii parasites to host cells in vitro, possibly by blocking the release of $Ca^{2+}$. In this regard, this antiserum has potential to be a valuable tool for further studies of TgNHE1.

• Tuberculosis and Respiratory Diseases
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• 제45권4호
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• pp.888-895
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• 1998

Malaria is one of the most common infectious diseases in the world. Plasmodium falciparum, accounting for nearly all malaria mortality, kills an estimated 1 to 2 million persons yearly and has several features that make it deadlist of malarias. While cerebral malaria is the most common presentation of severe disease, acute lung injury associated with malaria is uncommon but serious and fatal complication. We report two cases of severe malaria with ARDS and multi-organ failure. All two patients traveled to foreign countries, Kenya, Papua New Guinea where choroquine-resistant malaria is distributed. The first case, which developed cerebral malaria, hypoglycemia, multi-organ failure, and ARDS, treated with quinine and mechanical ventilator, but expired due to oxygenation failure. Autopsy showed acute necrotizing infiltration, diffuse eosinophilic fibrinoid deposits along the alveolar space, and alveolar macrophage with malaria pigment The second case also developed multi-organ failure, followed by ARDS, and was treated with quinine, exchange transfusion, plasmapheresis, and mechanical ventilator. He recovered with residual restrictive lung change after treatment.

• Journal of Chest Surgery
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• 제25권4호
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• pp.424-428
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• 1992

Post-AMI VSD is an infrequent but often catastrophic complication of acute myocardial infarction In general, the mortality is associated with end organ failure due to low output syndrome. Therefore, a stable hemodynamic is necessary to prevent the end organ failure. If a supportive therapy does not accomplish it, surgical intervention should be considered. Recently, we have experinced a case of post-AMI VSD with cardiogenic shock. Early recognition and surgical repair of post-AMI VSD gave us a good result. Postoperative result was satisfactory and recovery was uneventful. We believe that early surgical repair can be lifesaving in the case of post-AMI VSD with cardiogenic shock.

• Tuberculosis and Respiratory Diseases
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• 제57권4호
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• pp.329-335
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• 2004

연구 배경 : 중환자의 예후를 예측할 수 있는 지표로 현재까지 APACHE II, III 점수체계와 SAPS 등이 임상에 응용되고 있다. 1996년 유럽에서 SOFA 점수체계가 제안되었고 1998년 다기관 전향적 연구를 통하여 장기부전을 평가하고 경과를 감시하는 간편하고 효과적인 점수체계임을 입증하였다. 이 연구는 춘천성심병원에서 내과계 중환자만을 대상으로 SOFA 점수체계의 유용성을 조사하였다. 방 법 : 2000년 5월 1일부터 6월 30일까지 춘천성심병원 내과계 중환자실에 입원한 154명을 대상으로 하였고, 이중 타과환자, 타병원으로 전원된 경우, ECG 관찰만을 위하여 입원한 경우, 처치 후 관찰을 위해 48시간 이내만 체류한 환자를 제외한 105명을 연구에 포함시켰으며, 91명에서 평가가 가능하였다. SOFA 점수와 APACHE III 점수는 입원 시부터 매일 24시간 간격으로 중환자실에서 퇴실할 때까지 하였다. 결 과 : 1) 사망률은 20%였고 중환자실 체류기간의 중앙값은 3일이었다. 2) 사망군과 생존군 간의 24시간 내 SOFA 점수는 각각 $8.17{\pm}4.05$, $3.85{\pm}3.24$로 유의한 차이가 있었다. 3) 장기부전이 없는 경우의 사망률은 6.5%, 5개의 다발성 장기부전이 있는 경우 사망률은 100%였다. 4) 48시간 이상 체류했던 74명을 분석한 결과 사망군에서는 최대 SOFA 점수가 81%에서 증가하였고 생존군에서는 21%에서 증가하여 유의한 차이를 보였다. 5) 24시간 내 SOFA 점수와 APACHE III 점수와의 관련성을 평가한 결과 r=0.85 (p<0.01)로 유의한 상관관계가 있었다. 결 론 : SOFA 점수체계는 다발성 장기부전이 있는 환자에서 장기부전을 평가하고 예후를 예측하며 임상경과를 관찰하는데 이용할 수 있는 간편하고 임상적 효용성이 있는 지표로서 임상적으로 많은 도움이 될 것으로 생각한다.

• 대한임상독성학회지
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• 제5권2호
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• pp.119-122
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• 2007

Paraquat poisoning is a fatal type of herbicide intoxication. It is characterized by multi-organ failure and pulmonary fibrosis with respiratory failure. Intravenous and intramuscular injection of paraquat is rarely described. However, We encountered two fatal cases of acute poisoning caused by paraquat injection. Two patients were admitted to our emergency unit after intravenous and intramuscular injection of 23.8% paraquat (about 476 mg of paraquat). A 37-year-old man diluted 2 ml of 23.8% paraquat solution with 1 ml of normal saline and injected it both intravenously into his left antecubital fossa and intramuscularly into his abdomen in a suicide attempt. He died 5 days later from respiratory failure and acute renal failure. A 92-year-old man was injected intravenously into his right antecubital fossa by his grandson with 2 ml of 23.8% paraquat solution diluted with 1 ml of normal saline. He died 2 days later from early circulatory collapse and multi-organ failure (metabolic acidosis, acute renal failure, coagulopathy). Intravenous and intramuscular injection with a small quantity of paraquat resulted in fatal toxicity in our patients.

• Journal of Yeungnam Medical Science
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• 제6권1호
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• pp.1-7
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• 1989

• 대한임상독성학회지
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• 제10권2호
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• pp.118-121
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• 2012

Chromic acid is a strong metal acid and acute poisoning is very rare. However, chromic acid causes serious complications, such as skin injuries, as well as renal and hepatic failure. We report on a case of a 47-year-old male who accidentally had chromic acid spilled over his nose and face. For the first few days, he was treated with ascorbic acid and massive hydration. However, after three days, his condition began to worsen. He was treated with hemodialysis for anuria and acute renal failure, and antibiotics for pneumonia. On day 10 of hospitalization, he expired of multi-organ failure. We suggest firm control and close supervision of chromic acid in the work place, and, considering severe complications of chromic acid, we propose a nearly and aggressive treatment.