• Title/Summary/Keyword: progressive patient

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Successful Treatment with Rituximab and Immunoadsorption for an Auto-Antibody Induced Bile Salt Export Pump Deficiency in a Liver Transplanted Patient

  • Quintero, Jesus;Juamperez, Javier;Gonzales, Emmanuel;Julio, Ecaterina;Mercadal-Hally, Maria;Collado-Hilly, Mauricette;Marin-Sanchez, Ana;Charco, Ramon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.2
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    • pp.174-179
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    • 2020
  • We present an 8 years old girl who was diagnosed at 6 months of age of Progressive Familial Intrahepatic Cholestasis type 2. Although liver transplantation (LT) was classically considered curative for these patients, cholestasis recurrence with normal gamma-glutamyl transpeptidase (GGT), mediated by anti-bile salt export pump (BSEP) antibodies after LT (auto-antibody Induced BSEP Deficiency, AIBD) has been recently reported. Our patient underwent LT at 14 months. During her evolution, patient presented three episodes of acute rejection. Seven years after the LT, the patient presented pruritus with cholestasis and elevation of liver enzymes with persistent normal GGT. Liver biopsy showed intrahepatic cholestasis and giant-cell transformation with very low BSEP activity. Auto-antibodies against BSEP were detected therefore an AIBD was diagnosed. She was treated with Rituximab and immunoadsorption with resolution of the AIBD. As a complication of the treatment she developed a pneumocystis infection successfully treated with corticoids, cotrimoxazol and anidulafungin.

One Case Report of Chronic Motor Tic Disorder Patient with Extreme Headache and Insomnia. (극심한 두통과 불면을 호소하는 만성 운동 틱 장애 환자1례 보고)

  • Kim, Ja-Young;Kang, Hyun-Sun;Lee, Jin-Hwan;Sung, Woo-Yong;Jeong, Da-Un
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.3
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    • pp.219-229
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    • 2008
  • Tics are sudden, painless, nonrhythmic behaviors that are either motor or vocal. As to DSM- VI diagnostic criteria, chronic tic disorder is either single or multiple motor or phonic tics, but not both, which are present for more than a year. In this case, a male patient was diagnosed tics disorder at 8 years old. He has suffered for 15 years and his symptom was simple motor tics of neck, both arms and both legs, not vocal tics. So we diagnosed him as the chronic tic disorder. The severity score headache was assessed using the Visual Analog Scales. The severity score tics was assessed at baseline using the Yale Global Tic Severity Scale (YGTSS) and we compared score of before with after treatment. We treated him with oriental medication( herbal medicine, acupuncture, cry cupping) and progressive muscle relaxation. After this treatment, chronic insomnia and extreme headache were disappeard and the symptoms of tics were mildly decreased.

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A Case Report of Patient Parkinson's Disease Treated with Oxygen Therapy (산소치료를 비롯한 한방치료를 통하여 호전된 파킨슨병 치험1례)

  • Chu, Ching-Nai;Kim, Hyo-Ju;Kim, Ju-Won;Shin, Hynn-Kwon;Cha, Hye-Jin;Lee, Ji-Won;Park, Se-Jin;Chang, Jun-Ho
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.3
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    • pp.261-275
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    • 2007
  • Parkinson's Disease is a well known degenerative disease which result's in the depletion of dopamin-producing neurons in the pars compacta of the substantia nigra. This is a chronic, progressive disorder characterized by progressive muscular rigidity, pill-rolling tremor, flexed posture, shuffling gate and akinesia. This study was designed to evaluate the effects of an oxygen therapy with various scales on symptoms of Parkinson's disease. We treated his disease with Oxygen treatment , including herbal medicine acupuncture, and trigger point therapy, and we evaluated the clinical progress of the patient using UPDRS and H- Y stage. After treatment for about 1-month, the chief complaints and tremor symptoms were improved. This study suggests that oxygen therapy is significantly effective in the treatment of Parkinson's disease.

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Dental Treatment of a Patient with Pelizaeus-Merzbacher Disease under Outpatient General Anesthesia -A Case Report- (Pelizaeus-Merzbacher 병 환자의 외래전신마취 하 치과치료 -증례보고-)

  • Kim, Tae-Kyung;Shin, Cha-Uk;Kim, Hyun-Jeong;Yum, Kwang-Won;Seo, Kwang-Suk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.1
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    • pp.18-21
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    • 2007
  • Pelizaeus-Merzbacher disease (PMD) can be defined as an X-linked recessive leukodystrophy that is caused by a mutation in the proteolipid protein gene on chromosome Xq22. PMD is one of a group of progressive, degenerative disorders of the cerebral white matter known as the leukodystrophies. Due to the progressive nature of the disorders and their devastating effects on the central nervous system, these children frequently require anesthesia during imaging procedures such as MRI or during various surgical procedures. Anesthetic concerns in theses cases include high prevalence of seizure disorders, gastroesophageal reflux with the risk of aspiration, airway complications related to poor pharyngeal muscle control and copious oral secretions, and mental retardation. We report a successful anesthetic management in a patient with PMD for dental procedures.

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p53 Expression in a Malignant Mesothelioma Patient during Seven-Year Follow-up

  • Koo, So-My;Uh, Soo-Taek;Kim, Dong Won;Kim, Ki-Up;Kim, Yang-Ki
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.6
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    • pp.284-288
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    • 2014
  • Malignant mesothelioma (MM) is the aggressive tumor of serosal surfaces. There are crude pathogenetic results regarding the biology of MM. Coordinated upregulations of p53 gene expression are shown in malignancies. We believed that there are changes in the p53 expression with transformation from reactive hyperplasia to MM. A 65-year-old male was admitted the hospital because of left pleuritic chest pains in 2004. Chest computed tomography (CT) results showed left pleural effusions with loculation and pleural thickening. Pathologic findings revealed reactive mesothelial hyperplasia. In 2008, the patient again felt left pleuritic chest pains. Chest CT showed progressive thickening of the left pleura. Pathologic diagnosis was atypical mesothelial hyperplasia. In 2011, chest CT showed progressive thickening of his left pleura. He was diagnosed with well-differentiated papillary mesothelioma. Serial change was analyzed by immunohistochemical staining for p53 of pleural tissues. There were no remarkable changes in p53 expressions during the transformation to MM.

Obstructive Fibrinous Tracheal Pseudomenbrane Mimicking Tracheal Stents

  • Kim, Ju-Sang;Yu, Ji-Hyun;Kim, Yu-Seung;Kim, Il;Ahn, Joong-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.1
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    • pp.59-61
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    • 2011
  • Obstructive Fibrinous Tracheal Pseudomenbrane (OFTP) is a rarely known but potentially fatal complication of endotracheal intubation. Sudden respiratory failure shortly after extubation is not infrequent in the ICU. However, these cases are commonly diagnosed as laryngospasm, retention of secretion or laryngeal edema. A 68-year-old woman presented with a 6-day history of progressive dyspnea. She had undergone invasive ventilator care for 24 hours. The patient was discharged from the hospital with improvement after having an extubation. However, after 3 days she revisited the emergency department with progressive dyspnea. The patient was diagnosed with OFTP from the results of chest CT and bronchoscopy. This is the first case studied in detail using CT images, pulmonary function test, and bronchoscopy.

Rapidly Progressive Small Bowel Necrosis in a Previously Healthy Child without Proven Mechanical Obstruction

  • Kim, Hyun Hee;Kang, Hyungoo;Park, Chul Hee;Kwon, Yu Jin;Jung, Euna;Lim, Misun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.3
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    • pp.291-297
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    • 2019
  • Bowel ischemia is a life-threatening surgical emergency. We report a case of rapidly progressive bowel necrosis in a previously healthy child without proven mechanical small bowel obstruction. The definite diagnosis was established at the time of an exploratory operation. Of note, imaging studies and even a laparotomy did not reveal any evidence of acute appendicitis or mechanical obstruction such as intussusception or Meckel's diverticulum. During hospitalization, since we could not rule out surgical abdomen after inconclusive image findings, we closely followed the patient and repeated physical examinations carefully. Eventually surgical exploration was performed based on changes in clinical condition, which proved to be the right decision for the patient. We propose that in children with suspected strangulation of small bowel obstruction, especially when imaging findings do not provide a conclusive diagnosis, the timely exploratory surgical approach ought to be chosen based on carefully observed clinical findings and other evaluations.

Scientific-mind and Logical Thought Ability as an Dental Technician (치과기공사로서 갖추어야 할 과학적이고 논리적인 사고능력)

  • Lee, Sang-Jin
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.8 no.1
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    • pp.84-89
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    • 1999
  • These days, Dental Technic has been contributed to make more delicating Dental Prosthesis Restoration for patient and dentist. Diagnostic wax-up and making Temporary Crown are emphasized as an important part of Dental Technic. Choosing suitable Material and working with various new Equipments like Microscope improve accuracy. Repeated practice by setting up an organized system gives better result. Also, Esthetic Prosthesis requires patient's appearance and personality as well as patient' age, sex, and shade so on. Moreover, the problem which occurs by the patient's oral condition ha to be discussed before taking final impression. At a time like this, Scientific-mind and Logical thought Ability should be considered the important issue for more progressive Dental Technic.

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