• 제목/요약/키워드: recurrent acute

검색결과 188건 처리시간 0.031초

한양방 병행치료를 시행한 양측성 중복 요관 환자의 재발성 신우신염 치험 1례 (A Case Report of Recurrent Pyelonephritis in a Patient with a Bilateral Bifid Ureter Treated with Korean-Western Cooperative Treatment)

  • 노지원;정수민;이민승;전민수;안영민;안세영;이병철
    • 대한한방내과학회지
    • /
    • 제41권6호
    • /
    • pp.1172-1179
    • /
    • 2020
  • Introduction: In this case report, we addressed the effects of a Korean medicine treatment on recurrent pyelonephritis in a female patient with a duplicated collecting system. Case report: A 22-year-old female with acute pyelonephritis was treated with Korean medicine, including herbal medication, Insampaedok-san plus Oryeong-san, and with antibiotic therapy. We evaluated the improvements in her symptoms by measuring C-reactive protein, WBC count, body temperature, and a numeric rating scale for nausea. The symptoms of fever and nausea improved after two days of hospitalization. From the 4th day of taking the herbal medicine, the antibiotic IV infusion was changed to oral agents. Conclusions: This clinical case study suggests that modified Insampaedok-san might have shortened the duration of intravenous antibiotic infusion and hospitalization for recurrent pyelonephritis in a female patient with a bifid ureter.

급성 범자율신경장해성신경병증 (Acute Pandysautonomic Neuropathy) 2개증례 (Acute Pandysautonomic Neuropathy 2 Cases)

  • 전종은;이용석;남현우;박성호
    • Annals of Clinical Neurophysiology
    • /
    • 제3권1호
    • /
    • pp.43-46
    • /
    • 2001
  • Acute pandysautonomic neuropathy(APN) is an uncommon clinical entitiy involving vasomotor, sudomotor, pupilomotor, secretomotor and other autonomic systems. Both sympathetic or parasympathetic fibers are involved with relative preservation of somatic sensory and motor function. Although APN shares several clinical features with GBS, it is not clear whether APN is a subvariety of GBS. We report two young patients with APN. Patient 1 was a 18-year-old girl with recurrent fainting spells. Patient 2 was a 23-year-old man sufferring from unexplained nausea and vomiting. Both had a history of previous upper respiratory infection. They presented with gastroparesis, anhydrosis and orthostatic hypotension. Mild numbness and tingling sense was present, but motor power was intact. Neurologic examination showed bilateral tonic pupil, decreased pain and vibration sense, and absent tendon reflexes. Nerve conduction study indicated diffuse sensorimotor polyneuropathy. Nerve biopsy in patient 2 revealed axonal degeneration. After conservative management, gastrointestinal symptoms were improved in patient 2, however, patient 1 suffered from the symptoms lasting more than several months. These cases suggest that post-infectious dysautonomic symptoms in young patient may indicate the diagnosis of APN. Although the natural course is generally benign, accurate diagnosis and proper management may be mandatory for the better clinical outcome.

  • PDF

가뭄뇨로 인한 급성 신우신염 1례 (Infrequent Voiding Induced Acute Pyelonephritis in a Thirteen-Year Old Girl)

  • 안혜영;배기수;이진용;김병길;이재승
    • Childhood Kidney Diseases
    • /
    • 제5권1호
    • /
    • pp.69-72
    • /
    • 2001
  • 대부분의 정상 소아는 하루에 수7회 정도씩 배뇨를 한다. 일부 소아에서는 하루에 2회 이하로 배뇨를 하는데, 이 경우를 infrequent voiding이라 지칭한다. 이들의 경우 대개 장기간 수의적으로 소변을 참아오는 경우가 대부분이다. 이러한 비정상적인 배뇨습관으로 인하여 종종 방광 용적이 증가되며, 잔뇨량이 늘어나고 배뇨의 욕구가 감소됨으로써 만성적인 방광확장과 함께 재발성 요로감염 및 신손상까지 초래될 수 있다. 본 보고자들은 13세의 여아에서 하루 2차례 이하로 매우 드물게 배뇨를 하는(가뭄뇨) 습관으로 인하여 요로감염과 신손상이 초래된 증례를 경험하였기에 문헌고찰과 함께 보고하고자 한다.

  • PDF

Endoscopic Ultrasonography in Pediatric Patients with Pancreatobiliary Disease: Single-Center Trial

  • Demirbas, Fatma;Kaymazli, Mustafa;Caltepe, Gonul;Abbasguliyev, Hasan;Kalayci, Ayhan Gazi;Bektas, Ahmet
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제24권2호
    • /
    • pp.164-172
    • /
    • 2021
  • Purpose: The use of Endoscopic ultrasonography (EUS) in pediatric patients is not as common as in adults. The aim of this study is to evaluate the role of EUS in the diagnosis of pancreatobiliary disease in childhood. Methods: Between December 2016 and January 2018, the findings of patients who underwent EUS were evaluated retrospectively. Results: Of the 41 patients included in the study 25 were girls (61.0%), mean age was 12.2±4.2 years. EUS was performed for biliary colic in 21 (51.2%), for recurrent pancreatitis in 12 (29.2%), for cholecystitis/cholangitis in 5 (12.2%), and for acute pancreatitis in 3 (7.4%) patients. EUS had a significant clinical effect in the decision of treatment and follow-up of 6/21 biliary colic cases, in diagnosis and follow-up of 6/12 recurrent pancreatitis cases, in decision-making and monitoring of invasive procedures (ERCP/surgery) of 3/5 acute cholecystitis/cholangitis and 2/3 of acute pancreatitis cases as well as in follow-up of the other cases. The effectiveness of EUS in determining direct treatment and invasive intervention was 43.9%. None of the patients had complications related to the EUS procedure. Conclusion: Although current guidelines show that EUS can be used in pediatric patients, this is limited to a few published studies. In this study, it is shown that EUS is a safe method for the diagnosis, follow-up and treatment of common pancreatobiliary pathologies in childhood.

Epidemiology and Characteristics of Recurrent Stroke : The Occurrence Type of Restroke is Similar as Previous Stroke

  • Ok, Young-Cheol;Park, Seung-Kyu;Cho, Kyu-Yong;Lim, Jun-Seob;Lee, Rae-Seop
    • Journal of Korean Neurosurgical Society
    • /
    • 제41권4호
    • /
    • pp.224-229
    • /
    • 2007
  • Objective : Despite improvement of therapeutic regimen, incidence of stroke increases and it remains a leading cause of death. Our study aims at offering variable data on recurrent strokes. Methods : There were 59 patients who admitted from Jan. 2002 to Dec. 2004 due to recurrent strokes. A retrospective longitudinal cohort study was done. Results : Four-hundred-seventy five patients, diagnosed with acute stroke, experienced 491 strokes in 3 years, and there were 75 recurrent strokes [15.3%] in 59 patients. These 59 patients were included in the study. First hemorrhagic cases [H] were 19 [32%], and the first infarction cases [I] were 40 [68%]. Subsequent strokes after first stroke were as follows : $H{\to}H$ 14 [23.7%] cases, $H{\to}I$ 5 [8.5%], $I{\to}H$ 8 [13.6%], $I{\to}I$ 32 (54.2%]. A Cox regression analyses showed that the first type of stroke was a significant factor to the second stroke as follows : if one has had a hemorrhagic stroke, the possibility of second hemorrhagic attack ($H{\to}H$ attack) increase 3.2 times than ischemic type and in ischemic stroke [$I{\to}I$ attack] 3.6 times increased incidence of second ischemic attack. Conclusion : The recurrence rate of stroke was 12.4% [59 of 475 patients]. If the first stroke is hemorrhage or infarction, the next stroke would have high potentiality of hemorrhage, or infarction. The possibility of same type in second stroke Increase over 3 times. In $H{\to}H$ group, the time interval between first and second stroke was shorter and the age of onset was earlier than in $I{\to}I$ group. Moreover, the infarction was more frequent than hemorrhage in multiple strokes. There was a correlation in lacunar type infarction between first and second attack.

Long-term outcomes after salvage radiotherapy for postoperative locoregionally recurrent non-small-cell lung cancer

  • Kim, Eunji;Song, Changhoon;Kim, Mi Young;Kim, Jae-Sung
    • Radiation Oncology Journal
    • /
    • 제35권1호
    • /
    • pp.55-64
    • /
    • 2017
  • Purpose: The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Materials and Methods: Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Results: Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Conclusion: Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.

Predictors of renal scars in infants with recurrent febrile urinary tract infection: a retrospective, single-center study

  • Han, Jae Ha;Rhie, Seonkyeong;Lee, Jun Ho
    • Childhood Kidney Diseases
    • /
    • 제26권1호
    • /
    • pp.52-57
    • /
    • 2022
  • Purpose: To determine predictive factors for detecting renal parenchymal damages (RPDs) in infants with recurrent febrile urinary tract infection (fUTI). Methods: From January 2015 to December 2021, 102 infants with recurrent fUTI and who underwent 99mTc-dimercaptosuccinic acid (DMSA) renal scan in our hospital were included in this study. Controls included infants with normal DMSA results performed 3 months apart from the 2nd episode of fUTI. DMSA-positive group included infants with positive DMSA results performed 3 months apart from the 2nd episode of fUTI or at the 3rd episode of fUTI. The recurrence rate, causative bacteria, renal size discrepancy of both kidneys, and laboratory findings including C-reactive protein (CRP) and spot urine sodium-to-potassium ratio (uNa/K) were compared between both groups. Results: Only 3.8% of 79 infants with a 2nd episode of fUTI showed positive DMSA results. fUTI recurred more frequently within 12 months of follow-up in the DMSA-positive group than in the control group (69% vs. 13%, P<0.001). CRP values were significantly higher in the DMSA-positive group than in the control group (7.3 mg/dL vs. 3.7 mg/dL, P<0.001). Spot uNa/K were significantly lower in the DMSA-positive group than in the control group (0.6 vs. 1.1, P<0.001). Conclusions: Congenital renal scar and RPDs on the DMSA scan were more frequently found in infants with recurrent fUTI than those in the control group. High CRP values and low spot uNa/K in acute infections were helpful in predicting the presence of RPD in infants with recurrent fUTI.

두풍(頭風)과 편두통(Migraine)에 대(對)한 동서의학적(東西醫學的) 문헌고찰(文獻考察) (The biblographical study on $T{\acute{o}}u\;f{\bar{e}}ng$ and Migraine -(Comparative study between Oriental and Western Medicine)-)

  • 오소조;정지천;이원철
    • 대한한방내과학회지
    • /
    • 제14권1호
    • /
    • pp.129-138
    • /
    • 1993
  • This report on the $T{\acute{o}}u\;f{\bar{e}}ng$ and Migraine comes to conclude, through the study of the Oriental- Western medical references, as follow; 1. First, $T{\acute{o}}u\;f{\bar{e}}ng$ and Migraine had some concurrencies that both the two symptoms have appeared severe and recurrent headache and more often to the female. 2 Many of them e.g. Sensory disturbance, Vertigo, Nausea, Vomiting, Tinnitus etc. in the prodrome and main symptom of $T{\acute{o}}u\;f{\bar{e}}ng$ and Migraine were identical, especially the symptom of the $f{\bar{e}}ng\;t{\acute{a}}n\;t{\acute{o}}u\;t{\grave{o}}ng$ was similar to the prodrome of the Migraine. We could find out the semilarity of the symptoms through that Migraine is proximately set in unilateral, and $Pi{\bar{a}}nT{\acute{o}}u\;f{\bar{e}}ng$ is so called alias $B{\grave{a}}n\;bi{\bar{a}}n\;t{\acute{o}}u\;t{\grave{o}}ng$. 3. The pathogeny of $T{\acute{o}}u\;f{\bar{e}}ng$ include the case of ‘$f{\bar{e}}ng\;xi{\acute{e}}\;r{\grave{u}}\;n{\bar{a}}o$’, the patient feeling weak condition, $T{\acute{a}}n,\;T{\acute{a}}nshi,\;T{\acute{a}}nhu{\breve{o}},\;Y{\grave{u}}q{\grave{i}}$, etc. and, ‘$t{\acute{a}}n\;zhu{\grave{o}}\;sh{\grave{a}}ng\;y{\acute{a}}o$’, ‘$G{\bar{a}}n\;y{\acute{a}}ng\;hu{\grave{a}}\;f{\bar{e}}ng$’. There were variable that $F{\bar{e}}ng,\;Xu{\grave{e}},\;F{\bar{e}}ngr{\grave{a}},\;F{\bar{e}}ngx{\bar{u}},\;Xu{\grave{e}}x{\bar{u}},\;Hu{\check{o}}$ in the left, and $t{\acute{a}}n,\;R{\grave{e}},\;t{\acute{a}}nr{\grave{e}},\;Qir{\acute{a}}$ in the right partial pathogeny. It was referred $Sh{\grave{a}}o\;y{\acute{a}}ng\;j{\bar{i}}ng$, $Ju{\acute{e}}\;y{\bar{i}}n\;j{\bar{i}}ng$, $Y{\acute{a}}ng\;m{\acute{i}}ng\;j{\bar{i}}ng$, $T{\grave{a}}i\;y{\acute{a}}ng\;j{\bar{i}}ng$ in connection with the Meridian system. And otherwise the primary cause of Migraine is still unknown to us. Heredity is probably important, but the mode of transmission is uncertain. Recently, the important assumption is the vasomotor change caused by vasoconstrictors like that norepinephrine, epinephrine, and serotonin etc.

  • PDF

Modified Puestow Procedure for Chronic Pancreatitis in a Child Due to Annular Pancreas and Duodenal Duplication: A Case Report

  • Alatas, Fatima Safira;Masumoto, Kouji;Matsuura, Toshiharu;Pudjiadi, Antonius Hocky;Taguchi, Tomoaki
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제23권3호
    • /
    • pp.304-309
    • /
    • 2020
  • An 18-year-old woman with annular pancreas and duodenal duplication presented with recurrent acute pancreatitis and underwent a resection of duodenal duplication. However, the patient experienced recurrent abdominal pain after resection. Abdominal computed tomography and magnetic resonance imaging showed a dilatation of the peripheral pancreatic duct and stenosis and malformation of both the Wirsung's and Santorini's duct due to multiple stones. The modified puestow procedure was performed. The main pancreatic ducts in the body and tail were opened, and the intrapancreatic common bile duct was preserved. A Roux-en-Y pancreatico-jejunostomy was performed for reconstructing the pancreaticobiliary system after removing the ductal protein plug. The patient experienced no abdominal pain, no significant elevation of the serum amylase and lipase levels, and no stone formation during the 2 years of follow-up. This procedure is considered to be beneficial for pediatric patients with chronic pancreatitis due to annular pancreas and duodenal duplication.

Recurrent Prosthetic Mitral Valve Dehiscence due to Infective Endocarditis: Discussion of Possible Causes

  • Ercan, Suleyman;Altunbas, Gokhan;Deniz, Hayati;Gokaslan, Gokhan;Bosnak, Vuslat;Kaplan, Mehmet;Davutoglu, Vedat
    • Journal of Chest Surgery
    • /
    • 제46권4호
    • /
    • pp.285-288
    • /
    • 2013
  • Prosthetic valves are being widely used in the treatment of heart valve disease. Prosthetic valve endocarditis (PVE) is one of the most catastrophic complications seen in these patients. In particular, prosthetic valve dehiscence can lead to acute decompensation, pulmonary edema, and cardiogenic shock. Here, we discuss the medical management of late PVE in a patient with a prior history of late and redo early PVE and recurrent dehiscence. According to the present case, we can summarize the learning points as follows. A prior history of infective endocarditis increases the risk of relapse or recurrence, and these patients should be evaluated very cautiously to prevent late complications. Adequate debridement of infected material is of paramount importance to prevent relapse. A history of dehiscence is associated with increased risk of relapse and recurrent dehiscence.