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Cardiac Transplantation; 1 Case Report (심장이식 1례보고)

  • 송명근
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.224-227
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    • 1993
  • We experienced one case of orthotopic cardiac transplantation in a patient with end stage dilated cardiomyopathy. This 50 year-old female recipient was suffered from NYHA functional class IV cardiac failure and dependent upon intravenous inotropic support for 2 months [recipient category 1]. Her preoperative condition was grave with left ventricular ejection fraction of 20% and estimated systolic pulmonary arterial pressure [from Doppler study] was 50mmHg. The brain-dead donor was 31 year-old male with head trauma. The body sizes [weight, height] of the donor/recipient were 70 Kg, 165 cm / 43 Kg, 160 cm and appropriately overmatched. Preoperatively, identical ABO/Rh blood group [A+] and nonreacting HLA crossmatching were confirmed. On November 11 1992 cardiac transplantation was performed without complication. Multiple organ procurement team and heart transplantation team were organized the operation schedule appropriately to minimize the ischemic time. The pump time was 126 minutes and aortic crossclamping time of recipient heart was 73 minutes and, as a result, total ischemic time of the transplanted heart was 75 minutes. Postoperatively, the vital signs were stable with minimal inotropic support. The immunosuppressive therapy was commenced from preoperatively and cyclosporine, azathioprine, and corticosteroid were used as a combination therapy as scheduled and monitored with blood drug concentration, WBC count, renal function and most importantly regular endomyocardial biopsy.Now, 5 months after transplantation, the patient is in NYHA functional class II with minimal cardiac drug support.

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A case of fatal malabsorption syndrome caused by strongyloidiasis complicated with isosporiasis and human cytomegalovirus infection (분선충, Isospora 및 인형세포거대바이러스에 감염된 흡수불량 증후군 1례)

  • 윤동헌;양승지
    • Parasites, Hosts and Diseases
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    • v.30 no.1
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    • pp.53-58
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    • 1992
  • This 54-year-old Korean coal miner soBered from continuous watery diarrhea and weight loss after corticosteroid treatment(${\beta}-methasone$, 4 mg daily for 1 week) due to hip-bone fracture in January 1991. Except for the short therapy f steroid, no other histories were contributory. The malabsorption syndrome was aggravated while the case was treated under the impression of amebiasis or intestinal tuberculosis. AIDS antibody test by EIA was negative and quantitative analysis of serum immunoglobulins was in normal ranges. Nine months after the onset of symptoms, the case was diagnosed as malabsorption syndrome caused by complected and aggravated infection by Strengyleides stercoralis, Isospora and cytomegalovirus in the small intestine, which were proved by stool examination and duodenal biopsy. His clinical course became worse even after high-dosaged and prolonged albendazole treatment for strongyloidiasis with supportive quid therapy. The patient was discharged in hopeless status in November, 1991 and died after one week at home.

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Comparing the Therapeutic Effects of Aloe vera and Olive Oil Combination Cream versus Topical Betamethasone for Atopic Dermatitis: A Randomized Double-blind Clinical Trial

  • Panahi, Yunes;Rastgar, Nassim;Zamani, Ali;Sahebkar, Amirhossein
    • Journal of Pharmacopuncture
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    • v.23 no.3
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    • pp.173-178
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    • 2020
  • Objectives: Atopic dermatitis (AD) is a prevalent and chronic, pruritic inflammatory skin condition that can influence all age groups. AD is associated with a poor health-related quality of life. This randomized clinical trial was performed to compare the effectiveness of Olivederma (combination of aloe vera and virgin olive oil) or betamethasone regarding disease severity, quality of life, serum IgE and eosinophil count. Methods: Thirty-six AD patients were randomly allocated to topical Olivederma or betamethasone, and were followed for 6 weeks. Results: Total SCORAD severity scores showed significant decrease in both groups, while it was more prominent in Olivederma group (64.5% improvement in Olivederma vs. 13.5% improvement in Betamethasone, p-value < 0.001). Quality of life (DLQI questionnaire) of AD patients was significantly improved after 6 weeks treatment with Betamethasone (22.3%, p < 0.001) and Olivederma (60.7%, p-value < 0.001). Olivederma group showed a significantly lower DLQI score in comparison with Betamethasone treated patients after 6 weeks of therapy (p < 0.001). Improvements in eosinophil count and serum IgE was observed. Conclusion: In summary, this study shows that Olivederma is superior to topical Betamethasone after 6 weeks of therapy with regard to disease severity, quality of life and eosinophil count.

Atypical Hemolytic Uremic Syndrome in a 13-year-old Lao Girl: A Case Report

  • Kedsatha, Philavanh;Cheong, Hae Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.23 no.1
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    • pp.43-47
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    • 2019
  • Atypical hemolytic uremic syndrome (aHUS), a rare form of thrombotic microangiopathy, is distinguished from the typical form by the absence of a preceding verotoxin-producing Escherichia coli infection. Notably, aHUS occurs in association with genetic or acquired disorders causing dysregulation of the alternative complement pathway. Patients with aHUS may show the presence of anti-complement factor H (CFH) autoantibodies. This acquired form of aHUS (antiCFH-aHUS) primarily affects children aged 9-13 years. We report a case of a 13-year-old Lao girl with clinical features of aHUS (most likely anti-CFH-aHUS). The initial presentation of the patient met the classical clinical triad of thrombotic microangiopathy (microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury) without preceding diarrheal illness. Low serum levels of complement 3 and normal levels of complement 4 indicated abnormal activation of the alternative complement pathway. Plasma infusion and high-dose corticosteroid therapy resulted in improvement of the renal function and hematological profile, although the patient subsequently died of infectious complications. This is the first case report that describes aHUS (possibly anti-CFH-aHUS) in Laos.

A Case of Pyoderma Gangrenosum in Rheumotoid Arthritis Patient (류마티스 관절염 환자에서 발생한 괴저성 농피증 1예)

  • Ryu, Dong-Hwan;Kwon, Chang-Mo;Lee, Jung-Hun;Hong, Young-Hun;Lee, Choong-Ki
    • Journal of Yeungnam Medical Science
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    • v.20 no.1
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    • pp.79-84
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    • 2003
  • Pyoderma gangrenosum is uncommon neutrophilic dermatosis characterized by richness of the mature neutrophilic polynuclear dermal infiltrate. Pyoderma gangrenosum is associated with variable diseases, most commonly inflammatory bowel disease, hematological diseases, malignancies, but it is reported rarely in rheumatoid arthritis. We report a case of pyoderma gangrenosum in rheumoid arthritis patient. A 50-year-old woman admitted to our hospital due to painful pretibial ulcerative skin lesions. She had been treated as rheumatoid arthritis for 8 years. At admission, body temperature was $36.5^{\circ}C$ and other vital sign was unremarkable. Physical examination revealed right pretibial ulceration, multiple pustules on left pretibial area and both palms. Laboratory studies revealed WBC count 7,600/uL (neutrophils 60.3%, eosinophil 3.2%), hemoglobin 11.4 g/dL, platelet count 319,000/uL, ESR 65 mm/hour. Other lab findings were also unremarkable. Skin biopsy was done, which showed dense dermal infiltrate of neutrophils and wound culture were negative. By 8 weeks after systemic high dose corticosteroid (1 mg/kg/day), cyclosporine A (5 mg/kg/day), sulfasalazine 2 g therapy, symptoms and skin ulceration were being improved. Without skin relapse, she is followed up our hospital with low dose corticosteroid and sulfasalazine.

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A Case of Myasthenia Gravis Combined with Mediastinal Leiomyosarcoma and Stevens-Johnson Syndrome (종격 평활근육종 및 Stevens-Johnson증후군과 동반된 중증 근무력증 1예)

  • Lee, Dong-Kuck;Kweon, Young-Mi
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.43-47
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    • 2004
  • We report a case of 36-year-old woman with myasthenia gravis (MG) combined with mediastinal leiomyosarcoma (LMS) and Stevens-Johnson syndrome (SJS). She was admitted to ICU with the symptoms of acute onset headache, diplopia, ptosis, dysphagia, general weakness, and respiratory difficulty for several days. Physical examination revealed tachypnea, decreased breath sounds and dullness to percussion in right lower chest. Neurologic examination showed ptosis, diplopia, decreased gag reflexes, and generalized proximal weakness. Laboratory studies revealed increased serum acetylcholine receptor antibodies and positive Tensilon test. Chest CT showed a huge mass in the right middle mediastium but no evidence of thymic enlargement. Mediastinal LMS was diagnosed by ultrasound-guided needle biopsy. The myasthenic symptoms were fluctuated in spite og intravenous immunoglobulin, plasmapheresis, and corticosteroid. During therapy, SJS developed. She died 4 months after the onset of the myasthenic symptoms despite the chemotherapy for LMS.

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A Case of Intraorbital Pseudotumor - Case Report - (안와내 가성종양 1예 - 증 례 보 고 -)

  • Chang, In Bok;Cho, Byung Moon;Hwang, Hyung-Sik;Park, Se-Hyuck;Shin, Dong-Ik;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.1
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    • pp.85-88
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    • 2001
  • Intraorbital pseudotumors are inflammatory lesions of the orbit of unknown etiology, which initially mimic an orbital neoplasm. The authors report a case of intraorbital pseudotumor presenting with painful exophthalmos. A 45-year-old male patient had a two-week history of acute progressive exophthalmos and diplopia. Right orbit was explored through transcranial route and the mass was biopsied, which revealed dense inflammatory cells and fibrosis. He subsequently underwent corticosteroid therapy and symptoms improved gradually. The literatures were reviewed.

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Two Cases of Cerebral Aspergillosis Following Cranial Operation - Case Report - (개두술후 발생한 뇌 아스퍼질루스증 2예)

  • Kim, Jung Dug;Kim, Eui Jung;Park, Sang June;Cho, Chang Weon;Youn, Sung Moon
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1094-1097
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    • 2000
  • Aspergillosis is an opportunistic infection associated with diabetes, alcoholism, use of corticosteroid and transplantation procedure. Aspergillosis of central nervous system is a rare disease and known to show an aggressive course with high mortality. We managed two cases of cerebral aspergillosis, following cranial operation, with combination therapy of surgery and antifungal agents. One patient recorvered but the other patient died. The clinical course of these two patients is presented with review of pertinent literature.

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A Case of Intractable Hiccups Associated with High Dose Intravenous Methylprednisolone in a Patient with Third Nerve Palsy (동안신경마비 환자에서 고용량 메칠프레드니솔론 정주 후 발생한 난치성 딸꾹질 1예)

  • Na, Sang-Jun;Yum, Kyu Sun;Lee, Kee Ook
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.79-82
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    • 2008
  • The etiology of intractable hiccups is most commonly idiopathic. However, they are occasionally associated with some underlying disorders including gastro-esophageal reflux disease. There are a few previous reports describing the association of intractable hiccups with high dose corticosteroid. We experienced an unusual case of intractable hiccups following a high dose intravenous methylprednisolone therapy in a patient with right third nerve palsy. Since methylprednisolone is commonly used in various neurological problems, physicians should be aware of its possible side effect including intractable hiccups.

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Chronic Inflammatory Demyelinating Polyneuropathy Presenting as Features of Guillain-Barre Syndrome (길랑-바레 증후군의 양상으로 나타난 만성염증수초탈락여러신경병증)

  • Kang, Sung-Jin;Kim, Jong Kuk;Lee, Ji-Hyun;Kim, Sang-Woo
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.70-73
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    • 2008
  • By definition, the time to reach nadir in Guillain-Barre syndrome (GBS) is within four weeks. This is in contrast to the chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which progress for at least two months. However, CIDP can take a relapsing and remitting form and could mimic treatment related fluctuations of GBS (GBS-TRFs) especially during the early phase of disease. We report a patient with CIDP who initially presented with a rapidly progressive limb weakness mimicking GBS, but finally showed good recovery after long term corticosteroid therapy.

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