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A Case of an Imported Dengue Hemorrhagic Fever with Spontaneous Bleeding: Case Report and Review of the Literature (자발성 출혈을 동반한 뎅기출혈열 1례)

  • Choi, Hyun Hyi;Park, Jeong A;Kim, Jun Soo;Hur, Yun Jung;Song, Min Seop;Hwang, Tae Gyu;Choi, Yong
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.207-211
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    • 2011
  • Dengue is an acute febrile viral disease which is found in tropical and sub-tropical regions around the world. Dengue fever has steadily increased in both incidence and distribution over the past 50 years. Even though Korea is not an endemic country for dengue fever, with the increasing numbers of overseas travelers in Korea, the numbers of imported dengue cases are steadily increasing. Here, we report a case of imported dengue hemorrhagic fever in a Korean child presenting with fever and epistaxis. Dengue fever should be considered if a patient who has a recent travel history to endemic areas showed classical symptoms.

The Analysis of Risk Factors of Treatment Failure in MDR-TB (다제내성 폐결핵 치료실패의 위험인자 분석)

  • Kim, Hyoung-Soo;Choi, Kwang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.686-692
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    • 2001
  • Background : Outbreaks of multidrug-resistant tuberculosis(MDR-TB) are caused by the low rate of treatment response due to limitation in number of available drugs and high rates of adverse drug side-effects. This study analysed the risk factors for MDR-TB patients, who did not respond to treatment, with an aim to improve the rate of treatment response. Methods : Retrospective study of 111 MDR-TB patients at National Mokpo Tuberculosis Hospital from Jan. 1996 to Dec. 1998 was made. The patients were separated into two groups ; group I comprised of patients who were treated successfully and group II comprised of those were not treated successfully. In order to analyze the risk factors for treatment failure, differences between the two groups were compared and the confidence limit regarding the results were tested using an independent t-test. chi-square test and a Fisher's exact test. Results : The treatment failure rate of MDR-TB patients was 32% (36 patients), and treatment success rate 68%(75 patients). This study found no significant difference between two groups in terms of age, sex, family history, extent of the disease on the chest X-ray, the number of sensitive drugs in the treatment regimen, and the number of sensitive bactericidal drugs in the treatment regimen (p>0.05). However, a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used showed a significant difference(p<0.05). Conclusion : The rate of treatment failure in MDR-TB was increased by a past history of pulmonary tuberculosis, cavitary lesions on the chest X-ray, the number of treatments, the number of resistant drugs and the number of drugs used. For improving the treatment response of MDR-TB, every effort should be made to reduce the drug resistance caused by failure of the first treatment.

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Clinical Characteristics of Diffuse Panbronchiolitis (미만성 범세기관지염의 임상상에 관한 연구)

  • Kim, Young-Whan;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.28-34
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    • 1992
  • Background: Diffuse panbronchiolitis (DPB) is a chronic obstructive pulmonary disease distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. It is prevalent in Japan, but is known to be rare outside of Japan. Only a few cases in Chinese, Italian, Noirth American and Korean have been reported. During recent two years we have found 16 cases of DPB in Seoul National University Hospital and analyzed the clinical characteristics. Method: We reviewed the patients' age, sex, duration of illness, smoking history, occupational history and past medical history. And we analyzed patients' symptoms, physical signs, laboratory findings and responses to treatment. Results: 1) Male: female ratio was 2.2:1, the ages ranged from 27 to 72 years old, and the duration of disease varied from 1 to 20 years. 2) Most of the patients were being treated as bronchiectasis, miliary tuberculosis, chronic bronchitis or bronchial asthma before they were diagnosed as DPB. 3) Only one patient was a smoker, and 25% of patients had the occupational history of exposure to particles or gas. And all patients had paranasal sinusitis. 4) High resolution computed tomography (HRCT) was very useful in diagnosing the disease in most of the patients. 5) PFT showed obstructive and restrictive abnormalities, and blood gas revealed hypoxemia in most of the patients. 6) Pseudomonas aeruginosa was isolated in the sputum of four patients (25%). 7) The titers of cold hemaglutinin, RA factor and CRP were elevated in most of the patients. 8) Most of the patients improved after treatment with erythromycin. Conclusion: DPB might not be a rare disease in Korea. So DPB should be suspected in a patient who has chronic cough, sputum, dyspnea and diffuse fine nodular chest X-ray abnormality. HRCT and open lung biopsy should be considered in a patient suspected of DPB.

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The Clinical Characteristics of Endobronchial Anthracofibrotic Pigmentation (기관지 탄분 섬유화증의 임상양상)

  • Lim, Dongmee;Son, Jiwoong;Choi, Eugene
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.337-341
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    • 2006
  • Objectives : Endobronchial anthracofibrotic pigmentation, which presents as dark black or brown pigmentation mucosal changes of multiple bronchi combined with bronchial fibrosis and obstruction, is not a rare finding when performing diagnostic bronchoscopy for Koreans. This study was performed to define the clinical characteristics and to determine the association of these finding with the Korean life style and such other diseases as coal workers, pneumoconiosis or tuberculosis in the patients with anthracofibrotic pigmentation. Methods : This retrospective analysis was conducted on 70 (5.2%) patients with endobronchial anthracofibrotic pigmentation, among a total of 1340 patients who underwent bronchoscopy. The distinctive clinical features, the personal life style, the past medical history, the histology and microbiology, the radiologic finding and the natures of the bronchoscopic lesions were analyzed. Results : This mean age of the patients with anthracofibrotic pigmentation was $60.6{\pm}9.2$ year old and the male to female ratio was 1:1.7. The common respiratory symptoms of these patients were coughing and sputum (81%, 57/70), and this was followed in order by dyspnea and hemoptysisir. The symptoms were not related with smoking and an occupational history such as being a coal worker and so on. Pneumonia was most common finding on the radiologic studies. On bronchoscopy, the right middle lobe bronchus was most commonly involved. The most common associated disease was tuberculosis, and 40 cases (57.1%) were diagnosed by AFB staining, TB PCR, bronchoscopic guided tissue biopsy and a past history of tuberculosis. Other diseases related with anthracotic pigmentation were hypertension, diabetes, COPD, lung cancer, pneumoconiosis and asthma. Conclusion : These results suggest that endobronchial anthracofibrotic pigmentation was mostly related with pulmonary tuberculosis rather than with coal- related disease. Endobronchial anthracofibrotic pigmentation was more prevalent in older age females in Korea.

Analysis of Acute Ischemic Stroke Patients about Awareness of Hypertension, Diabetes Mellitus and Hyperlipidemia: Three Oriental Medical Centers-Based Prospective Registration Study (급성기 뇌경색 환자들의 고혈압, 당뇨, 고지혈증 인지여부에 관한 분석 : 3개 한방병원기반 전향적 자료등록 연구)

  • Hong, Jin-Woo;Jung, Woo-Sang;Sun, Jong-Joo;Jung, Jae-Han;Moon, Sang-Kwan;Ko, Seong-Gyu;Chen, Chan-Yong;Han, Chang-Ho;Cho, Ki-Ho
    • The Journal of Internal Korean Medicine
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    • v.28 no.2
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    • pp.284-293
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    • 2007
  • Objectives : Hypertension(HTN), diabetes mellitus(DM) and hyperlipidemia(HL) are the most common risk factors of cerebro-vascular attack(CVA). To prevent CVA, early diagnosis (awareness before CVA) of HTN, DM and HL is essential, and for the effective early diagnosis we need to analyze the data of CVA patients concerned with HTN, DM and HL. In this study, we studied characteristics of patients early diagnosed before CVA. Methods : We analyzed the data of 363 patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Subjects' enrollment was done in the oriental medical hospitals of 3 universities located in the metropolitan region from October 2005 to October 2006. We analyzed all registered data about HTN. DM and HL, for example, how many patients were aware of their HTN, DM or HL before CVA, differences in characteristics of early diagnosed patients, effects of early diagnosis on CAV, etc. Results : Patients aware of their HTN. DM and HL before CVA have more past history and family history about HTN, DM or HL. Early diagnosis rate of HL is lower than HTN and DM, and early diagnosed HL patients were younger and deucated longer than patients who weren't aware of their HL before CVA. These results mean that publicity is the key to promoting early diagnosis rates of HTN, DM and HL. In DM and HL, early diagnosed patients had more SVO type cerebral infarction than patients who weren't aware of risk factors. We can thus see that early diagnosis even affects CVA types. Conclusion : This work helps us to understand the realities and importance of early diagnosis of HTN, DM and HL before CVA. There should be further research, which can contribute to much more improved early diagnosis rates of HTN, DM and HL.

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Clinical Analysis about Diagnosis and Treatment of 86 Hand Paresthesia Cases Using MPS Theory and Pharmacopuncture Therapy (손저림 증상을 호소하는 86명의 환자들에 대한 아시혈 진단법과 약침치료 효능에 관한 연구)

  • Oh, Sung-Won;Jeong, Jong-Jin;Kim, Soo-Yeon;Han, In-Sun;Kang, Hyun-Min;Kwon, Ki-Rok;Kim, Byoung-Woo
    • Journal of Pharmacopuncture
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    • v.10 no.3
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    • pp.121-126
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    • 2007
  • Objectives Hand paresthesia is common syndrome and the cause is more unknown than known reason. The Purpose of this study were investigated the effects of Myofacial Pain Syndrome theory to make diagnosis and treatment by Pharmacopuncture for the patients of hand paresthesia. Method This study was carried out to established the clinical criteria of hand parethesia. The patients who had past history of diabeics, neuropathy induced by alcohol or drug were excluded, and 86 patients who had hand paresthesia related with unknown-reason was selected by the interview process. And the effects of Pharmacopuncture theory were analyzed using VAS score before and after treatment. Results and conclusions 56.9% of unknown-reason patients are positive at diagnosis by MPS theory. While positive group decrease from $62.81{\pm}14.27$ to $25.28{\pm}15.97$, negative group decrease from $55.88{\pm}10.92$ to $48.28{\pm}14.01$ by VAS scores. Positive group was accordingly more effective than negative group. So diagnosis and treatment for hand numbness patients by MPS theory was useful in clinical.

Treatment of Scalp Arteriovenous Malformation

  • Jung, Sung-Hoon;Yim, Man-Bin;Lee, Chang-Young;Song, Dal-Won;Kim, Il-Man;Son, Eun-Ik
    • Journal of Korean Neurosurgical Society
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    • v.38 no.4
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    • pp.269-272
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    • 2005
  • Objective : The object of this study is to present the treatment experience of the 6cases of scalp arteriovenous malformations[AVMs] focus on treatment strategy. Methods : Six patients with scalp AVM were treated during past 12years. We analysis the clinical characteristics of the lesions, treatment methods and management outcomes. Results : The lesions were located on temporal in 2patients, parietal in 2patients, frontal and occipital area in each one. Four of six patients had a trauma history on scalp. The presenting symptoms were progressive enlarged pulsating mass with or without bruit. Four of the six lesions had the large fistula in the lesion. Two patients were treated with surgical resection alone, three patients with proximal feeding artery balloon[s] occlusion followed by surgical resection, and one patient with coil embolization through trans-venous route alone. We obtained good results in all patients. Conclusion : Most of scalp AVM can be completely cured by Judicious selection and a combination of treatment modalities, i.e., surgery only, or embolization only, or embolization plus surgical therapy. Although embolization became a primary therapy for this sort of scalp AVM recently, the selection of treatment modality should be chose based on the size, angioarchitecture, and clinical presentations of the lesion.

A Clinical Analysis of Ophthalmologic Disease (안과질환 외래환자에 관한 임상적 분석)

  • Shin, Sang-Ho;Kim, Ja-Hye;Kim, Min-Hee;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.3 s.31
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    • pp.171-179
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    • 2006
  • Objective : The purpose of this study is to investigate outpatients of ophthalmologic disease who had visited to Hospital of Oriental Medicine. Method : We analyzed statistics study in 590 patients, who had visited to the Dept. of dermatology, ophthalmology & otorhinolayngology Hospital of Oriental Medicine Dongeui University from January, 1998 to July , 2006. Result : The results were as follows. 1. Distributions of sex : male 45.42%, female 54.58%. 2. The age distributions of patients showed highest in 51-60 years, followed by 41-50 years, 61-70 years in order. 3. The yearly distributions of patients showed highest in 2004, followed by 2005, 2002 in order. The seasonal distributions of patients showed highest in summer, followed by spring, winter, autumn in order. The monthly distributions of patients showed highest in August, followed by June, March in order. 4. The frequency of chief complaint showed highest in visual disorder, followed by dry eye, blepharospasm, squint in arch order. Visual disorder and dry eye were the most common ophthalmologic disease, irrespective of age. 5. The Distribution of past history showed highest in ophthalmologic disease, followed by circulatory disease, digestive disease in order. The Distribution of ophthalmologic diseases showed highest in retinal disease, followed by lens-induced ocular disease, disease of the optic nerve in order. 6. The number of times in treatment : 1-20 times(84.07%), 21-40 times(7.97%). 7. In the treatment method, a major portion of treatment methods was acupuncture & herbal medicine treatment, followed by acupuncture, consulting, herbal medicine treatment in order.

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A Case of Intestinal Duplication Cyst Identified as Pathological Lead Point in a Child with Recurrent Intussusception (재발성 장중첩증 환아에서 병적 선두로 확인된 장중복 낭종 1예)

  • Lee, Kun-Song;Park, Ji-Yun;Oh, Jong-Seok;Seong, In-Chang;Han, Kang-Min;Lee, Young-Seok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.75-80
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    • 2010
  • Intestinal duplication cysts are characterized by the attachment to some part of the gastrointestinal tract with which a blood supply is shared, and have an epithelial lining resembling some part of the alimentary tract. A 15-month-old female was admitted to our hospital with cyclic irritability, vomiting, and blood-tinged stool. The results of an ultrasound showed an ileocolic intussusception and a 1.3 cm cystic mass had double-wall sign and a Y-configuration with an adjacent ileal loop. She had a past history of two ileocolic intussusceptions. The cystic mass was considered to be a pathologic lead point, so resection and end-to-end anastomosis was performed. The gross and histologic evaluation of the specimen demonstrated a $2.4{\times}2.4$ cm cystic mass containing yellow mucoid fluid and the cyst wall was lined with intestinal and gastric mucosa and enclosed by a layer of muscle, which was shared with the adjacent ileum.

Clinical Study on Intracytoplasmic Sperm Injection Using Epididymal and Testicular Sperm (부고환 및 고환 정자를 이용한 세포질내 정자주입술에 관한 임상 연구)

  • Lee, Young-Il;Jung, Byeong-Jun;Lee, Sang-Hoon;Kim, Young-Sun
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.3
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    • pp.447-456
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    • 1999
  • Objective: The purpose of this study was to evaluate outcome of intracytoplasmic sperm injection (ICSI) using epididymal and testicular sperm in patients with azoospermia. Methods: From March, 1993 to May, 1999, a retrospective clinical analysis was done of a total of 140 cycles in 112 patients who underwent ICSI. Subjects were divided into three groups: ejaculated-ICSI group included 42 cycles in 34 patients with ejaculated sperm who underwent ICSI due to severe oligospermia and past history of failed or poor fertilization in the previous in vitro fertilization and embryo tranfer (IVF-ET) cycles, microsurgical epididymal sperm aspiration and intracytoplasmic sperm injection (MESA-ICSI) group included 50 cycles in 42 patients with congenital absence of the vas deferens (CAVD) or unreconstructable obstructive azoospermia and testicular sperm extraction and intracytoplasmic sperm injection (TESE-ICSI) group included 48 cycles in 36 patients with no spermatozoa which can be retrieved from epididymis or non-obstructive azoospermia. Results: Normal two-pronuclear fertilization rates were similar in three groups: 64.4% for ejaculated-ICSI group, 59.4% for MESA-ICSI group and 60.4% for TESE-ICSI group. The pregnancy rates were 26.2%, 26.0% and 25.0% respectively. There were no significant differences in the fertilization, cleavage, and clinical pregnancy rates among ICSI cycles using ejaculated, epididymal and testicular sperm. Conclusion: Epididymal and testicular sperm obtained in azoospermic patients can fertilize oocyte successfully and may lead to be similar fertilization rates and clinical pregnancy rates to ejaculated sperm.

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