• 제목/요약/키워드: Organ failure

검색결과 269건 처리시간 0.022초

Etiologies, Prognostic Factors, and Outcomes of Pediatric Acute Liver Failure in Thailand

  • Getsuwan, Songpon;Lertudomphonwanit, Chatmanee;Tanpowpong, Pornthep;Thirapattaraphan, Chollasak;Tim-Aroon, Thipwimol;Wattanasirichaigoon, Duangrurdee;Treepongkaruna, Suporn
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권6호
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    • pp.539-547
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    • 2020
  • Purpose: Pediatric acute liver failure (PALF) is a serious condition; however, data on PALF in developing countries are sparse, particularly concerning molecular diagnosis and liver transplantation (LT). This study aimed to determine the causes, outcomes, and prognostic factors of PALF. Methods: We retrospectively reviewed the medical records of children (age <15 years) with PALF diagnosed using the American Association for the Study of Liver Diseases criteria at our center from 2011 to 2016. The collected data included laboratory results, complications, outcomes, and potential factors associated with death and LT. Results: We included a total of 27 patients, with a median age of 2 years (interquartile range, 3 months to 4 years). Viral infection was the most common etiology (n=8, 30%), predominantly dengue infection (n=4). A total of 16 patients (59%) died and 11 patients survived (3 patients with LT). The prognostic factors associated with death or LT requirement were grade IV hepatic encephalopathy (p<0.01), hypotension (p=0.02), gastrointestinal bleeding (p=0.03), increased intracranial pressure (p=0.04), and higher peak serum lactate level (p=0.01). Peak serum lactate ≥6 mmoL/L had a sensitivity of 79% and a specificity of 88% for predicting mortality or the necessity of LT. Conclusion: Viral infection was the most common cause of PALF. The mortality rate remained high, and a considerable number of patients required LT. In addition to several clinical factors, peak serum lactate could be a potential marker for predicting poor outcomes in PALF.

성장 장애를 보인 영아에서 발현된 주폐포자충 폐렴 1례 (A Case of Pneumocystis carinii Pneumonia in an Infant with Failure to Thrive)

  • 공선희;이호준;김수연;김학성;이동우;김재윤
    • Pediatric Infection and Vaccine
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    • 제12권1호
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    • pp.95-99
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    • 2005
  • 주폐포자충 폐렴은 면역 기능이 억제된 환자군에서 발병률이 높은 감염성 질환으로 특히, 후천성 면역 결핍증이나 백혈병 등의 혈액 종양 환자군, 심한 영양 결핍 환자군, 장기 이식 환자군, 고용량의 부신 피질 호르몬 사용 환자군 등이 고위험군으로 알려져 있으며, 일차성 면역 결핍증에 이환된 환아에서 주폐포자충 폐렴의 증례가 보고되어 있다. 저자들은 상기 위험군에는 속하지 않으나, 10여일 정도의 수유부진 후 빈호흡을 보인 영아에서 흉부 방사선 소견상, 폐양측에 간질성 침윤이 관찰되었고 기관지내 삽관으로 흡인한 객담의 Gomori-methenamine silver 염색 검사상 주폐포자충이 검출되어 주폐포자충 폐렴으로 확진 후 TMP-SMX 14일 투여로 호전을 보인 예를 경험하여 보고하는 바이다.

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폐에 발생한 뮤코르진균증의 외과적 치료 - 1예 보고- (Surgical Treatment of Pulmonary Mucormycosis -1 case report -)

  • 이응배;한원경;김신우
    • Journal of Chest Surgery
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    • 제38권9호
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    • pp.656-659
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    • 2005
  • 뮤코르진균증은 비교적 드문 질환으로 면역이 저하된 환자에게 있어서 치명적인 기회감염을 일으킨다. 감염은 주로 혈액암, 만성 신부전, 당뇨 환자나 장기이식을 받은 환자에게 일어난다. 저자들은 조절되지 않은 당뇨를 동반한 신장이식을 받은 환자에서 발생한 폐뮤코르진균증을 암포테리신과 함께 수술적 절제를 통해 성공적으로 치료하였다.

Hepatic Vascular Stress Gene Expression in the Liver Response to Trauma

  • Lee, Sun-Mee
    • Biomolecules & Therapeutics
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    • 제12권2호
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    • pp.62-67
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    • 2004
  • Trauma remains one of the important sources leading to systemic inflammatory response anti sub-sequent multiple organ failure. Although hepatic microvascular dysfunction occurs during trauma, the mechanism responsible remains unclear. The aim of this study was to investigate the effect of trauma on hepatic vascular stress gene expression. Femur fracture (EFx) was induced by torsion to the femur at midshaft. Liver samples were taken for RT-PCR analysis of mRNA for gtenes of interest: endothelin-1 (ET-1), its receptors $ET_A$ and $ET_B$, nitric oxide synthases (iNOS and eNOS), cyclooxygenase-2 (COX-2), heme oxygenase-1 (HO-1), and tumor necrosis tactor-${\alpha}$ (TNF-${\alpha}$). The expression of ET-1 mRNA was significantly increased by FFx. Expression of mRNA in FFx group showed no change in $ET_A$, $ET_B$, iNOS and HO-1 and showed a slight increase of 2.2-fold and 2.7-fold for eNOS tll1d COX-2, respectively. The level of TNF-${\alpha}$ mRNA significantly increased in FFx group. In conclusion, mild trauma alone causes little change in expression of vasoactive mediators.

Colon Interposition in Children after Failed Tracheoesophageal Fistula Repair

  • Park, Samina;Kang, Chang-Hyun;Kim, Hye-Seon;Park, In-Kyu;Kim, Young-Tae;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • 제44권6호
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    • pp.452-454
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    • 2011
  • The most common surgical procedure used to manage tracheoesophageal fistula is the primary anastomosis of the esophagus. However, in the case of failed anastomosis, replacing the esophagus with another organ is necessary. We performed two procedures of colon interposition after failure of tracheoesophageal fistula repair. In those cases, stomach replacement was not possible because of a failed Ivor Lewis operation in one case and duodenal atresia in the other.

The Potential of Renal Progenitor Cells in Kidney Diseases: Preclinical Findings

  • Jo, Jeong Hyun;Kim, Ki Hoon;Kim, Tae Min
    • 한국동물생명공학회지
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    • 제34권2호
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    • pp.70-74
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    • 2019
  • The kidney is a highly complex organ, and acute or chronic renal diseases can occur with various complications such as diabetes and hypertension. So far, no target specific treatment is available in acute or chronic renal failure, necessitating the development of alternative therapeutic strategy. Recent experimental findings suggest that the renal function and structure can be restored after being treated with various sources of stem/progenitor cells. In this review, we discuss up-to-date findings of the potential of renal progenitor/stem cells in alleviating renal injuries with a focus on preclinical studies. We also review cellular mechanisms underlying the therapeutic function of these cells.

Update of Sepsis: Recent Evidences about Early Goal Directed Therapy

  • Cho, Woo Hyun
    • Tuberculosis and Respiratory Diseases
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    • 제78권3호
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    • pp.156-160
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    • 2015
  • Severe sepsis and septic shock is a life-threatening disease. It is combined with multi-organ failure. In the past decade, early goal directed therapy has been proposed as an effective treatment strategy for better outcome. Recent epidemiologic studies showed that the outcome of sepsis has been improved with the introduction of early goal directed therapy. However, it is unclear which elements of early goal directed therapy contributed to the better outcome. Recent prospective and randomized trials suggested that some elements of early goal directed therapy did not have any effect on the outcome benefit. In this paper, recent articles about early goal directed therapy will be reviewed and the effectiveness of individual elements of early goal directed therapy will be discussed.

Septicemia Caused by Leuconostoc lactis with Intrinsic Resistance to Vancomycin in a Patient with Biliary Stent

  • Shin, Kyeong Seob;Han, Kyudong;Hong, Seung Bok
    • 대한의생명과학회지
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    • 제19권3호
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    • pp.280-283
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    • 2013
  • Leuconostoc spp. is intrinsically resistant against vancomycin and rarely causes the infection in immunocompromised patients. In this report, we describe a fatal case of Leuconostoc lactis bacteremia in a patient with biliary tract stent insertion to resolve the biliary tract obstruction by multiple pseudocysts in the pancreatic head region. Leuconostic lactis isolated from the blood of the patients was confirmed by 16S rRNA sequencing and this isolate was susceptible against most antibiotics, including levofloxacin, penicillin, erythromycin and cefotaxime except vancomycin. The septic shock and multi-organ failure was abruptly progressed due to delayed use of adequate antibiotic. Using vancomycin as the empirical antibiotics in a bacteremic patient by Gram positive cocci, the treatment failures by the isolates with intrinsic resistance against vancomycin have to be considered. In addition, the prompt and accurate identification of Leuconostoc spp. are very important to select the adequate antibiotics.

VDT 업무(業務)로 발생된 경견완장해(頸肩腕障害) 환자(患者)에 대한 임상연구(臨床硏究) (Clinical study on shoulder-arm syndrome Patients caused by VDT work)

  • 신홍중;최승훈
    • 혜화의학회지
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    • 제13권1호
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    • pp.295-302
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    • 2004
  • Nowadays VDT(Visual Display Termimal) syndrome-especially causes disorder of skeletalmuscular structure, ophthalmic organ, neuropsychiatic parts, etc.-are so common and many people are suffering from it. The purpose of this study is to investigate the clinical result of patients diagnosed as shoulder-arm syndrome by VDT work. This study carried out on 50 patients who have been treated at Cheonan Oriental hospital(Daejon University), February 2nd, 2003 to May 31th, 2004. The patients were classified into age, sex, the period between onset and visit, symptom, clinical diagnosis and so on. And the methods of treatment were acupuncture, herbal medication, oriental physical therapy, Chuna, etc. About treatment results, Exellant were 12(24.00%), Improve were 25(50.00%), Mild improve were 11(22.00%), Failure were 2(4.00%)

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외상성 횡격막 손상에 대한 임상적 고찰 (Clinical Evaluation of Traumatic Diaphragmatic Injuries)

  • 서성구;권오춘;이길노
    • Journal of Chest Surgery
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    • 제27권12호
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    • pp.1023-1026
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    • 1994
  • We reviewed 10 cases of traumatic diaphragmatic injuries at Soonchunhyang University Gumi Hospital from January 1990 through April 1993. seven patients were male and three patients were female. The age distribution was ranged from 25 to 79 years, predominant 4th decades occurred in male. The traumatic diaphragmatic injuries were due to blunt trauma in 9 cases (traffic accident 7 and crash injury 2) and penetrating wound in 1 case (stab wound). The common symptom were dyspnea (60%), chest pain and abdominal pain in order frequency. In the blunt trauma and crash injury, te rupture site was all located in the left(9 cases). In the penetrating wound, the rupture site was located in the right(1 case). The surgical repair of 10 cases were performed with transthoracic approach in 9 cases and thoracoabodominal approach in 1 case. The postoperative mortality was 10% (1/10). The cause of death was multiple organ failure with pulmonary edema.

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