• Title/Summary/Keyword: Organ failure

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Study on the Organ Transplantation in the Oriental Medicine (장기이식에 관한 한의학적 개념 연구)

  • Kim, Kyoung-Shin;Lee, Soo-Jin;Kim, Byoung-Soo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.4
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    • pp.571-579
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    • 2010
  • The advancement of medical technology has made it possible to treat various incurable diseases. Especially organ transplantation can give another life to the patients who have organ failure and could not find any other ways to treat their diseases. According to the development of medical technology and immunosuppressive drugs, the rate and extent of organ transplantation is increasing these days. New medical technologies like organ transplantation brought on critical issues and these have changed the way of thinking and morals that has been the fundamental rules in our society. Bioethics is already an important field of medicine and oriental medicine should investigate the problem caused by the development of medical technology and life science and should form a view of life in oriental medicine. Oriental medicine is East Asian traditional medicine based on "Huangdi-Neijing", constructed by the system of Jangfu and meridian. The traditional therapies of oriental medicine have completed a scientific system on the point of view that looks on human and nature equally. This process continued to form a new medical theory as the environment was changed and the new diseases were appeared since "Huangdi-Neijing" and "Shoganron" showed a new scope to investigate human and diseases. Therefore, it is important to develop the point of view of oriental medicine as the medical situation was changed. Oriental medicine has a holistic view that considers human as a little cosmos resonated by a big cosmos and regards the possibility to recover and to regulate the energy in our body. This theory is a basic idea of oriental philosophy. Oriental medicine focuses on the balance of yin and yang of the body and tries to harmonize the imbalance of yin and yang caused by the life style and environment. This can solve many problems that cannot be settled by modern medicine and this can accomplish the new paradigm of oriental medicine that is needed these days.

Veiled Paraquat Poisoning - A Focus on Clinical Characteristics (베일에 가린 파라쿼트 중독 - 임상적 특징을 중심으로)

  • Song, Ye-Wan;Choi, Sang-Cheon;You, Young-Yeol;Shin, Yeoun-Ho;Park, Eun-Jung;Ahn, Jung-Hwan;Min, Young-Gi;Jung, Yoon-Seok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.1
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    • pp.14-19
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    • 2011
  • Purpose: Most paraquat poisonings are easily diagnosed by history taking on physical examination, however, some are failed to be diagnosed initially if the poisoning was veiled. The purpose of this study was to explore the clinical characteristics of veiled paraquat poisoning. Methods: We retrospectively reviewed the medical records of patients whose discharge diagnosis was paraquat poisoning in one university teaching hospital between 1 Jan, 2001 and 31 Dec, 2010. Veiled paraquat poisoning was determined when there was a positive urine paraquat kit in patients who did not mention paraquat poisoning in an initial physical examination or had unknown cause of pulmonary fibrosis, acute renal failure, or multi-organ failure. Results: Of the 117 patients with paraquat poisoning during the study period, 6 patients (5.1%) had veiled paraquat poisoning. The clinical characteristics were 1) proteinuria - 6 (100%), 2) increased creatinine - 4 (66.7%), 3) green skin stains - 2 (33.3%), 4) mucosal ulcer - 3 (50%). Blood chemistry results were variable. Conclusion: We should suspect veiled paraquat poisoning for patients who have proteinuria, increased creatinine, green skin stain, mucosal ulcer and vomiting, or if they have rapidly progressing acute renal failure or multi-organ failure with unknown cause, even if patients didn't mention about paraquat poisoning upon the initial physical examination. In cases with the above clinical conditions, a thorough repeated physical examination including history taking and use of urine paraquat kits should be performed.

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A Case of 'ALUM' Intoxication Leading to ARDS (급성 호흡 곤란 증후군을 유발한 백반 중독 중독 1예)

  • Kim, Won-Jang;Park, Youn-Hee;Kim, Eun-Kyung;Lim, Chae-Man;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.234-237
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    • 2002
  • A 77-year-old female was admitted 3 hours after intentionally ingesting 5g of aluminum ammonium sulfate ('Alum') powder dissolved in water. Gastric lavage with normal saline, activated charcoal chelation, and supportive therapies were performed. She showed a high anion gap metabolic acidosis, which rapidly progressed to multiple organ failure including ARDS. The patient subsequently progressed to a refractory shock which eventually led to death.

A Model Curriculum Development for Clinical Nurse Specialist Training Program in Organ Transplant (장기이식 전문간호사를 위한 교육과정 연구)

  • Kim, Jung-Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.6 no.2
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    • pp.171-185
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    • 2000
  • The twenty-first century may be said to be entering into a specialized qualification age to meet the needs of new technical innovations such as environmental changes, demographical changes, changes in the constitution of diseases, changes in the needs of the national health, reforms of information and knowledge, etc., which requires the provision of competitive services that can fulfill the high level needs of consumers. In consequence, it is needed to apply a practical nursing model that can serve as a guide for healthy society and to secure the sphere that can affect nursing policy-making by keeping pace with the changing environment. Furthermore, it is also urgent to expand more the activity sphere of nurse specialists with authority and autonomy, establish their legal foundation, establish a qualification accreditation system for nurse specialists, and develop educational programs. In Korea, the law relative to organ transplant past the national assembly on February 9, 2000, legally acknowledged brain death, which indicated to us the emergence of an age of organ transplant. Therefore, it necessitates to find out those of brain death from whom organ transplant is feasible in clinical practices, with their families' consent link to those terminal organ failure patients who are in need of an organ, and mediate both parties so that smooth transplant can be accomplished. A series of these complicated procedures require systematically trained specialists with high level techniques of organic management. With this in mind, this study was conducted on 69 clinical nurse specialists for organ transplant, accredited by the hospital, who are in active service in clinical practices. The resultant findings were revealed, as follows: 1. The qualifications of clinical nurse specialists for organ transplant should be accredited by Ministry of Health and Welfare or Korea Nurses Association. 2. The validity of qualifications should be for three years, and their renewal should be based on marks of a supplemental training or an education course for more than 12 hours a year. 3. The qualification of the clinical nurse specialist necessitates theoretical lectures and practices on those nurses who have had clinical experience in the pertinent field. 4. The course of training is required to be one year in the length of training and take more than 20 credits (320 hours) and 5 credits (240 hours).

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Hepatocyte Growth Factor and Met: Molecular Dialogue for Tissue Organization and Repair

  • Matsumoto, Kunio;Nakamura, Toshikazu
    • Animal cells and systems
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    • v.2 no.1
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    • pp.1-8
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    • 1998
  • Hepatocyte growth factor (HGF), originally discovered and cloned as a powerful mitogen for hepatocytes, is a four kringle-containing growth factor which specifically binds to membrane-spanning tyrosine kinase, c-Met/HGF receptor. HGF has mitogenic, motogenic (enhancement of cell movement), morphogenic (e.g., induction of branching tubulogenesis), and anti-apoptotic activities for a wide variety of cells. During embryogenesis, HGF supports organogenesis and morphogenesis of various tissues, including liver, kidney, lung, gut, mammary gland, and tooth. In adult tissues HGF elicits an organotrophic function which supports regeneration of organs such as liver, kidney, lung, and vascular tissues. HGF is also a novel member of neurotrophic factor in nervous systems. Together with the preferential expression of HGF in mesenchymal or stromal cells, and c-Met/HGF receptor In epithelial or endothelial cells, the HGF-Met coupling seems to orchestrate dynamic morphogenic processes through epithelial-mesenchymal (or-stromal) interactions for organogenesis and organ regeneration. HGF or HGF gene may well become unique therapeutic tools for treatment of patients with various organ failure, through its actions to reconstruct organized tissue architectures. This review focuses on recently characterized biological and physiological functions integrated by HGF-Met coupling during organogenesis and organ regeneration.

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The Clinical Manifestations of Patients with Severe Alcoholic Ketoacidosis Treated at a Medical Intensive Care Unit (한 내과계 중환자실에서 치료하였던 중증 알코올성 케톤산증 환자들의 임상적 특성)

  • Lee, Kwang Ha;Lee, Sae Hwan;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Koh, Yoonsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Hong, Sang Bum
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.548-553
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    • 2006
  • Background : Alcoholic ketoacidosis(AKA) is a metabolic disturbance that is caused by prolonged and excessive alcohol consumption. Though the prognosis is reportedly good, its outcome is unclear in some cases that are combined with multi-organ failure. There are few reports of an analysis of cases admitted to an intensive care unit(ICU) Method: Cases of AKA admitted to the ICU over the last 5 years were retrospectively analyzed. Severe AKA was characterized by multi-organ failure that required treatment in an ICU Results : All patients were males with a history of excessive alcohol consumption. Five of them (50%) mainly complained of gastrointestinal symptoms (nausea, vomiting, diarrhea), showing metabolic acidosis with an increased asmolar and anion gap. Rhabdomyolysis with acute renal failure was the most common combined organ failure. Mechanical ventilation was performed in 80%. Six patients died and 4 patients survived. In the surviving patients, the arterial blood gas analysis(ABGA) was normalized within 12 hours after admission. Conclusion : In severe AKA patients, rhabdomyolysis with acute renal failure was the most common complication. The mortality rate was high and death from shock occurred within 3 days.

Technical Aspects of Combined Heart-Lung Transplantation

  • Ju, Min Ho;Je, Hyung Gon
    • Journal of Chest Surgery
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    • v.55 no.4
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    • pp.319-324
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    • 2022
  • Although organ transplants have become quite common, combined heart-lung transplantation (CHLTx) is unfamiliar at most institutions. While the remarkable rate of development in treatment options, such as drugs and mechanical circulatory support, have reduced the need for CHLTx, it remains the sole treatment option for a subset of patients with end-stage cardiopulmonary failure. For many cardiothoracic surgeons, CHLTx is not technically new or difficult, but it does pose challenges due to its low frequency and relative complexity. Thus, this review aims to describe the CHLTx technique in technical detail using the existing literature.

A case of Diagnosing Paraquat Intoxication on Transferred Patient with Acute Renal Failure (원인 불명의 급성 신부전으로 발현된 급성 파라콰트중독 1례)

  • Gil Hyo Wook;Yang Jong Oh;Lee Eun Young;Hong Sae Yong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.1
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    • pp.45-48
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    • 2004
  • Paraquat, a widely used herbicide, is extremely toxic, causing multiple organ failure in human. Many treatment modality has been used, but now paraquat is very fatal drug. Elimination rate of plasma paraquat seems to be a factor for the survival rate. So early diagnosis and early treatment are very important. Plasma paraquat concentration could be measured by radioimmunoassay. But it is impossible that the test was done at Emergency room and the result was checked immediately. There was relation between plasma paraquat concentrations and urine paraquat concentration. Because of its simplicity and low cost, urine paraquat concentration test is complementary to the plasma concentration measurement. If the patient has psychotic problem or unconscious mental state, and is observed unexplained dyspnea and oral ulcer, urine paraquat test is very important to rule out acute paraquat intoxication. We experienced a patient who was presented as unexplained acute renal failure initially and was diagnosed as paraquat intoxication later.

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Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Outcomes Among Patients with Trauma in the Emergency Department: A Comparison with the Modified Early Warning Score, Revised Trauma Score, and Injury Severity Score

  • Kang, Min Woo;Ko, Seo Young;Song, Sung Wook;Kim, Woo Jeong;Kang, Young Joon;Kang, Kyeong Won;Park, Hyun Soo;Park, Chang Bae;Kang, Jeong Ho;Bu, Ji Hwan;Lee, Sung Kgun
    • Journal of Trauma and Injury
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    • v.34 no.1
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    • pp.3-12
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    • 2021
  • Purpose: To evaluate the severity of trauma, many scoring systems and predictive models have been presented. The quick Sequential Organ Failure Assessment (qSOFA) is a simple scoring system based on vital signs, and we expect it to be easier to apply to trauma patients than other trauma assessment tools. Methods: This study was a cross-sectional study of trauma patients who visited the emergency department of Jeju National University Hospital. We excluded patients under the age of 18 years and unknown outcomes. We calculated the qSOFA, the Modified Early Warning Score (mEWS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) based on patients' initial vital signs and assessments performed in the emergency department (ED). The primary outcome was mortality within 14 days of trauma. We analyzed qSOFA scores using multivariate logistic regression analysis and compared the predictive accuracy of these scoring systems using the area under the receiver operating characteristic curve (AUROC). Results: In total, 27,764 patients were analyzed. In the multivariate logistic regression analysis of the qSOFA, the adjusted odds ratios with 95% confidence interval (CI) for mortality relative to a qSOFA score of 0 were 27.82 (13.63-56.79) for a qSOFA score of 1, 373.31 (183.47-759.57) for a qSOFA score of 2, and 494.07 (143.75-1698.15) for a qSOFA score of 3. In the receiver operating characteristic (ROC) curve analysis for the qSOFA, mEWS, ISS, and RTS in predicting the outcomes, for mortality, the AUROC for the qSOFA (AUROC [95% CI]; 0.912 [0.871-0.952]) was significantly greater than those for the ISS (0.700 [0.608-0.793]) and RTS (0.160 [0.108-0.211]). Conclusions: The qSOFA was useful for predicting the prognosis of trauma patients evaluated in the ED.

Clinical Practice of Blood Transfusion in Orthotopic Organ Transplantation: A Single Institution Experience

  • Tsai, Huang-Wen;Hsieh, Fu-Chien;Chang, Chih-Chun;Su, Ming-Jang;Chu, Fang-Yeh;Chen, Kuo-Hsin;Jeng, Kuo-Shyang;Chen, Yun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.8009-8013
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    • 2015
  • Background: Orthotopic organ transplantation, a treatment option for irreversible organ dysfunction according to organ failure, severe damaged organ or malignancy in situ, was usually accompanied with massive blood loss thus transfusion was required. We aimed to evaluate the adverse impact of blood transfusion on solid organ transplantation. Materials and Methods: From January, 2009 to December, 2014, patients who received orthotopic organ transplantation at Far Eastern Memorial Hospital medical center were enrolled. Clinical data regarding anemia status and red blood cell (RBC) transfusion before, during and after operation, as well as patient outcomes were collected for further univariate analysis. Results: A total of 105 patients who underwent orthotopic transplantation, including liver, kidney and small intestine were registered. The mean hemoglobin (Hb) level upon admission and before operation were $11.6{\pm}1.8g/dL$ and $11.7{\pm}1.7g/dL$, respectively; and the nadir Hb level post operation and the final Hb level before discharge were $8.3{\pm}1.6g/dL$ and $10.2{\pm}1.6g/dL$, respectively. The median units (interquartile range) of RBC transfusion in pre-operative, peri-operative and post-operative periods were 0 (0-0), 2 (0-12), and 2 (0-6) units, respectively. Furthermore, the median (interquartile range) length of hospital stay (LHS) from admission to discharge and from operation to discharge were 28 (17-44) and 24 (16-37) days, respectively. Both peri-operative and post-operative RBC transfusion were associated with longer LHS from admission to discharge and from operation to discharge. Furthermore, it increased the risk of post-operative septicemia. While peri-operative RBC transfusion elevated the risk of acute graft rejection in patients who received orthotopic transplantation. Conclusions: Worse outcome could be anticipated in those who had received massive RBC transfusion in transplantation operation. Hence, peri-operative RBC transfusion should be avoided as much as possible.