• Title/Summary/Keyword: effusion

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Pulmonary Hypertension in a Dog after Embolic Coil Placement for Interventional Occlusion of Patent Ductus Arteriosus (동맥관 개존증 개에서 색전 코일의 중재적 시술 후 발생한 폐성 고혈압)

  • Lee, Bareun;Kim, Jiyoun;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.507-510
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    • 2014
  • An 8 month-old female Pomeranian dog was presented with major complaints of heart murmur and cardiomegaly. Diagnostic study found the left-to-right patent ductus arteriosus (PDA) with moderate heart failure (ISACHC II). The PDA occlusion was successfully accomplished using a $5mm{\times}3loops$ embolic coil through right femoral artery. Two months later, the dog came back to clinic with marked hypotension, severe diarrhea and pleural effusion. Diagnostic study found severe pulmonary hypertension and tricuspid regurgitation. The clinical condition was controlled by the administration of sildenafil (3 mg/kg, PO, TID). However, the dog was expired by dislodged embolic coil and inconsistent medication by the owner. Postmortem study found the pulmonary hypertension was occurred by the abnormally dislodged embolic coil. Although the embolic coil is widely used for PDA occlusion in toy dogs with PDA, the more careful evaluation for the size and shape of PDA is necessary to minimize the risk of dislodgement of pre-placed coil.

Ultrasonographic Findings of Pneumatosis Intestinalis in a Dog (개에서 장 기종의 초음파적 특징 1례)

  • Song, Yu-Mi;Lee, Jeong-Yang;Lee, Jung-Woo;Jeung, Woo-Chang;Lee, Young-Won;Choi, Ho-Jung
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.138-141
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    • 2013
  • A 4-month-old, intact male mongrel dog was presented with trauma (hit by car), astasia, stupor and abdominal pain. Radiographic findings were peritoneal effusion, intestinal dilation, right iliac fracture, and microcardia. Abdominal ultrasonography revealed severely, dilated small intestine containing anechoic fluid in lumen and intramural gas within the wall. The sonographic finding suggested pnematosis intestinalis (PI), and vascular compromise of bowel loop by trauma was strongly suspected. After the dog was dead, postmortem examination revealed discolored and necrotized small intestine strangulated by sublumbar muscle. The detection of echogenic gas bubbles in the wall of bowel using ultrasound may be helpful in detecting PI.

Study on Diseases Scope of Prescriptions Related with the Palpitation in "Shanghanlun" ("상한론"에 나타난 계(悸)와 관련된 처방들의 현대 질환 범위 고찰)

  • Park, Mi Sun;Kim, Yeong Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.1
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    • pp.1-10
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    • 2015
  • This article is a study on palpitation of which disease cause, disease mechanism and formulas were analyzed with reference to annotations on "Shanghanlun" and "Jinkuiyaolue". And the scope of modern diseases related with palpitation was drawn by research on clinical papers. The source books are "Zhujieshanghanlun" and "Jinkuiyaoluefanglun" and the clinical papers are searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). 13 clauses in "Shanghanlun" and 9 clauses in "Jinkuiyaolue" and 12 formulas are related with palpitation. Disease mechanisms of palpitation were classified as yang deficiency, yin deficiency, qi deficiency, blood deficiency, retained fluid, cold, etc and these days, qi stagnation, phlegm turbidity, blood stasis and fire heat are also considered as disease mechanisms. Modern diseases related with palpitation are arrhythmia(extrasystole, atrial fibrillation, bradycardia, tachycardia, sick sinus syndrome, atrioventricular block), vascular diseases(arterial occlusion, phlebothrombosis, Buerger's disease, coronary artery disease, vasculitis), blood pressure disorder(hypertension, hypotension) and heart diseases such as heart failure, angina pectoris, myocardial infarction, myocarditis, cardiomyopathy, pericardial effusion. And diseases related with psychological change(cardiac neurosis, anxiety neurosis, neurosis, depression, hyperthyroidism, hypothyroidism), pyrexia, anemia, drug intoxication, etc are also related with palpitation. Zhen Wu Tang showing an efficacy in dilating blood vessels and strengthening cardiac function, Wuling Powder with diuretic effect and Fried Glycyrrhizae Decoction acting on the ${\beta}$ receptor are applied to heart failure in different ways. Fried Glycyrrhizae Decoction(308 cases), Zhen Wu Tang(154), Wuling Powder(54), Xiao Chaihu Tang(34), Sini San(20) are reported to have been clinically applied to cardiovascular diseases and Zhen Wu Tang and Wuling Powder mainly applied to heart failure, Fried Glycyrrhizae Decoction, Lizhong Wan, Sini San and Zhen Wu Tang chiefly applied to arrhythmia related diseases. This study focuses on the general research and consideration on clinical applications and is a preliminary study to understand relations between Korean Medicine's symptoms and categories of modern diseases.

Balloon-Occluded Retrograde Transvenous Obliteration versus Transjugular Intrahepatic Portosystemic Shunt for the Management of Gastric Variceal Bleeding

  • Gimm, Geunwu;Chang, Young;Kim, Hyo-Cheol;Shin, Aesun;Cho, Eun Ju;Lee, Jeong-Hoon;Yu, Su Jong;Yoon, Jung-Hwan;Kim, Yoon Jun
    • Gut and Liver
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    • v.12 no.6
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    • pp.704-713
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    • 2018
  • Background/Aims: Gastric varices (GVs) are a major cause of upper gastrointestinal bleeding in patients with liver cirrhosis. The current treatments of choice are balloon-occluded retrograde transvenous obliteration (BRTO) and the placement of a transjugular intrahepatic portosystemic shunt (TIPS). We aimed to compare the efficacy and outcomes of these two methods for the management of GV bleeding. Methods: This retrospective study included consecutive patients who received BRTO (n=157) or TIPS (n=19) to control GV bleeding from January 2005 to December 2014 at a single tertiary hospital in Korea. The overall survival (OS), immediate bleeding control rate, rebleeding rate and complication rate were compared between patients in the BRTO and TIPS groups. Results: Patients in the BRTO group showed higher immediate bleeding control rates (p=0.059, odds ratio [OR]=4.72) and lower cumulative rebleeding rates (logrank p=0.060) than those in the TIPS group, although the difference failed to reach statistical significance. There were no significant differences in the rates of complications, including pleural effusion, aggravation of esophageal varices, portal hypertensive gastropathy, and portosystemic encephalopathy, although the rate of the progression of ascites was significantly higher in the BRTO group (p=0.02, OR=7.93). After adjusting for several confounding factors using a multivariate Cox analysis, the BRTO group had a significantly longer OS (adjusted hazard ratio [aHR]=0.44, p=0.01) and a longer rebleeding-free survival (aHR=0.34, p=0.001) than the TIPS group. Conclusions: BRTO provides better bleeding control, rebleeding-free survival, and OS than TIPS for patients with GV bleeding.

Mycoplasma pneumoniae pneumonia in children: Clinical characteristics and risk factors of refractory pneumonia by age (소아 마이코플라스마 폐렴: 나이에 따른 임상적 특징과 불응성폐렴의 위험 요인)

  • Kim, Hyung Young;Park, Hee Ju
    • Allergy, Asthma & Respiratory Disease
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    • v.6 no.6
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    • pp.295-302
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    • 2018
  • Purpose: It is thought that Mycoplasma pneumoniae infection is more prevalent and causes more severe pneumonia in school-age children and young adults than in preschool children; however, recent studies suggest that the infection may be underdiagnosed and more severe in preschool children. This study investigated the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) and the risk factors of refractory MPP (RMPP) by age. Methods: We retrospectively reviewed the medical records of 353 children admitted due to MPP from January 2015 to December 2016. Demographics, clinical information, laboratory data and radiological findings were collected from all patients in this study. The patients were divided into 2 groups by the age of 6 years. Also, both preschool (< 6 years old) and school-age (${\geq}6$ years old) children were divided into RMPP and non-RMPP patients. Results: Total febrile days, febrile days before admission and the duration of macrolide antibiotic therapy were significantly longer in school-age children than in preschool children. School-age children had significantly greater risk of lobar consolidation (P=0.036), pleural effusion (P=0.001) and extrapulmonary complications (P=0.019). Necrotizing pneumonia and bronchiolitis obliterans tended to occur more frequently in preschool children than in school-age children. In both preschool and school-age children, lactate dehydrogenase (LDH) levels were significantly higher in RMPP patients than in non-RMPP patients. In preschool children, LDH > 722 IU/L (odds ratio [OR], 3.02; 95% confidence interval [CI], 1.44-6.50) and ferritin > 177 ng/mL (OR, 5.38; 95% CI, 1.61-19.49) were significant risk factors for RMPP, while LDH > 645 IU/L (OR, 4.12; 95% CI, 1.64-10.97) and ferritin > 166 ng/mL (OR, 5.51; 95% CI, 1.59-22.32) were so in school-age children. Conclusion: Clinical features of MPP were significantly different between preschool and school-age children. LDH and ferritin may be significant factors of RMPP in preschool and school-age children.

A TiO2-Coated Reflective Layer Enhances the Sensitivity of a CsI:Tl Scintillator for X-ray Imaging Sensors

  • Kim, Youngju;Kim, Byoungwook;Kwon, Youngman;Kim, Jongyul;Kim, MyungSoo;Cho, Gyuseong;Jun, Hong Young;Thap, Tharoeun;Lee, Jinseok;Yoon, Kwon-Ha
    • Journal of the Optical Society of Korea
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    • v.18 no.3
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    • pp.256-260
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    • 2014
  • Columnar-structured cesium iodide (CsI) scintillators doped with thallium (Tl) are frequently used as x-ray converters in medical and industrial imaging. In this study we investigated the imaging characteristics of CsI:Tl films with various reflective layers-aluminum (Al), chromium (Cr), and titanium dioxide ($TiO_2$) powder-coated on glass substrates. We used two effusion-cell sources in a thermal evaporator system to fabricate CsI:Tl films on substrates. The scintillators were observed via scanning electron microscopy (SEM), and scintillation characteristics were evaluated on the basis of the emission spectrum, light output, light response to x-ray dose, modulation transfer function (MTF), and x-ray images. Compared to control films without a reflective layer, CsI:Tl films with reflective layers showed better sensitivity and light collection efficiency, and the film with a $TiO_2$ reflective layer showed the best properties.

A Child of Severe Mycoplasma pneumoniae pneumonia with Multiple Organ Failure Treated with ECMO and CRRT

  • Hwang, Woojin;Lee, Yoonjin;Lee, Eunjee;Lee, Jiwon M.;Kil, Hong Ryang;Yu, Jae Hyeon;Chung, Eun Hee
    • Pediatric Infection and Vaccine
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    • v.26 no.1
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    • pp.71-79
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    • 2019
  • Mycoplasma pneumoniae (MP) is the most common causative agent of community-acquired pneumonia in school-aged children. An 8-year-old boy who had been diagnosed with autism looked severely ill when he presented to our hospital due to dyspnea and lethargy. He had fever and cough 7 days prior to hospitalization. He had signs and symptoms of severe respiratory distress. The percutaneous oxygen saturation was 88% at high oxygen supply. Chest radiography showed diffusely increased opacity with moderate pleural effusion. He was intubated immediately and admitted to the intensive care unit. Under the clinical impression of mycoplasmal pneumonia, intravenous clarithromycin was started. Laboratory findings showed leukocytosis, hepatitis, decreased renal function, and presence of serum MP immunoglobulin (Ig) M (+) IgG (+) and sputum MP polymerase chain reaction (+). On hospital day 2, the patient developed multiple organ failure with acute respiratory distress syndrome (ARDS). Veno-venous extracorporeal membrane oxygenation (ECMO) was performed with continuous renal replacement therapy (CRRT) and was weaned successfully. This is the first reported case of an ARDS due to MP infection complicated by multiple organ failure that was successfully treated with ECMO and CRRT in South Korea.

A Deep Learning Model for Judging Presence or Absence of Lesions in the Chest X-ray Images (흉부 디지털 영상의 병변 유무 판단을 위한 딥러닝 모델)

  • Lee, Jong-Keun;Kim, Seon-Jin;Kwak, Nae-Joung;Kim, Dong-Woo;Ahn, Jae-Hyeong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.24 no.2
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    • pp.212-218
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    • 2020
  • There are dozens of different types of lesions that can be diagnosed through chest X-ray images, including Atelectasis, Cardiomegaly, Mass, Pneumothorax, and Effusion. Computed tomography(CT) test is generally necessary to determine the exact diagnosis and location and size of thoracic lesions, however computed tomography has disadvantages such as expensive cost and a lot of radiation exposure. Therefore, in this paper, we propose a deep learning algorithm for judging the presence or absence of lesions in chest X-ray images as the primary screening tool for the diagnosis of thoracic lesions. The proposed algorithm was designed by comparing various configuration methods to optimize the judgment of presence of lesions from chest X-ray. As a result, the evaluation rate of lesion presence of the proposed algorithm is about 1% better than the existing algorithm.

Characteristics of Atopic Dermatitis Patients Based on Personal Health Records (PHR) according to Age and Sasang Constitution (연령과 사상체질에 따른 개인건강기록(PHR)에 기반한 아토피피부염 환자의 특성)

  • Oh, Jin-Ah;Sung, Hyun-Kyung;Go, Ho-Yeon;Shin, Mi-Ran
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.1
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    • pp.63-75
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    • 2021
  • Objectives The purpose of this study is to identify the characteristics of atopic dermatitis patients based on the personal health records (PHR) according to age and Sasang Constitution, and to find basic data for daily life management using the personal health record. Methods We analyzed the characteristics of atopic dermatitis patients based on PHR (symptoms, emotional state, SCORAD Index, five viscera weakness questionnaire, etc.), and Sasang Constitution collected for 6 weeks in 34 patients (or guardians). Results Each item of the SCORAD Index score in children and adolescents showed that children and adolescents have significantly higher edema than adults. However, repeated measurement of the SCORAD Index showed a significant positive improvement over time regardless of age and constitution. In terms of the symptoms of atopic dermatitis, there was a significant correlation between age and swelling, quality of life and effusion, pruritus (itch) and sleep disturbance in relation to the general characteristics of the subject. In the five visceral weakness scores, adults had significantly higher spleen weakness, liver weakness, kidney weakness scores than in children and adolescents. All results showed a high tendency to have a high lung weakness score, which was more pronounced in children and adolescents. Conclusion This study is meaningful to confirm the correlation between SCORAD Index items related to the symptoms of atopic dermatitis, and to identify trends for specific items by ages and Sasang Constitution.

Bilateral Lipoma Arborescens of the Knee in an Adolescent Patient (청소년에서 양측 슬관절에 발생한 수지상 지방종)

  • Kim, Hee-June;Kim, Jeong-Woo;Lee, Hyun-Joo;Kyung, Hee-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.354-358
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    • 2020
  • Lipoma arborescens (LA) is a rare lesion that causes joint effusion and pain. LA usually presents as a unilateral knee lesion, and bilateral lesions are extremely rare. LA among adolescent patients is also extremely rare with the disorder having a much higher incidence among adults. This paper reports a 14-year-old boy who was treated for bilateral knee LA. X-rays revealed the characteristic features of LA in both knees, and arthroscopic synovectomy was performed to resect the lesions. Postoperative recovery progressed smoothly, and the patient was eventually relieved of pain and swelling. LA should be considered when adolescent patients present with bilateral pain and swelling, even though this condition is rare in this age group. Furthermore, surgical synovectomy for a complete resection is an appropriate treatment option.