• Title/Summary/Keyword: recurrent acute

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Chronic intermittent form of isovaleric aciduria in a 2-year-old boy

  • Cho, Jin Min;Lee, Beom Hee;Kim, Gu-Hwan;Kim, Yoo-Mi;Choi, Jin-Ho;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.56 no.8
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    • pp.351-354
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    • 2013
  • Isovaleric aciduria (IVA) is caused by an autosomal recessive deficiency of isovaleryl-CoA dehydrogenase (IVD). IVA presents either in the neonatal period as an acute episode of fulminant metabolic acidosis, which may lead to coma or death, or later as a "chronic intermittent form" that is associated with developmental delays, with or without recurrent acidotic episodes during periods of stress, such as infections. Here, we report the case of a 2-year old boy with IVA who presented with the chronic intermittent form. He was admitted to Asan Medical Center Children's Hospital with recurrent vomiting. Metabolic acidosis, hyperammonemia, elevated serum lactate and isovalerylcarnitine levels, and markedly increased urine isovalerylglycine concentration were noted. Sequence analysis of the IVD gene in the patient revealed the novel compound mutations-a missense mutation, c.986T>C (p.Met329Thr) and a frameshift mutation, c.1083del (p.Ile361fs$^*11$). Following stabilization during the acute phase, the patient has remained in a stable condition on a low-leucine diet.

An 8-month-old Male Infant with High Grade Vesicoureteral Reflux who Developed Incomplete Kawasaki disease after Recurrent Pyelonephritis (급성 신우신염이 재발한 후 불완전 가와사끼병이 발생한 고도의 방광요관역류가 있는 8개월 남아)

  • Jung, Su Jin;Park, Sung Eun;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.42-46
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    • 2014
  • Kawasaki disease (KD) is a systemic vasculitis that can affect many organ systems. Renal manifestations include pyuria, hematuria, proteinuria, tubulointerstitial nephritis, acute renal failure, hemolytic uremic syndrome, or renal scarring. Although its precise pathogenesis remains unknown, it is considered an autoimmune disease. In the literature, it has been reported that KD may develop in conjunction with urinary tract infections. However, many of these previous studies did not use imaging methods such as renal sonograms, dimercaptosuccinic acid renal scans, and voiding urethrocystograms. We report a case of an 8-month old male infant with high grade vesicoureteral reflux, who developed incomplete KD after recurrent pyelonephritis. Acute pyelonephritis can be an early manifestation of KD. Such cases require the evaluation of urinary tract anomalies according to the guidelines for the management of urinary tract infections.

Analysis of sports injuries among Korean national players during official training (국가대표 선수들의 훈련 기간 동안 발생한 스포츠 손상 분석)

  • Kim, Eun Kuk;Kim, Tae Gyu
    • Journal of the Korean Data and Information Science Society
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    • v.25 no.3
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    • pp.555-565
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    • 2014
  • The purpose of this study was to analyze sports injuries which occurred in Korea National Team during official training period. All sports injuries are recorded on injury report form by physicians, medical staffs and athletic trainer, and only acute and recurred injuries were analyzed. Total 3,421 injuries were reported, and 1,560 injuries were newly incurred and 1,861 injuries were recurrent with previous history. The frequency of new injuries in male and female athletes was highest in boxing (n=130, 14.5%) and hockey (n=75, 11.3%) respectively. The frequency of recurred injuries in male and female athletes was highest in wrestling (n=147, 14.8%) and fencing (n=103, 11.9%) respectively. Our data provides incidence rates, characteristics of acute and recurrent sports injuries during official training period and thus these results could provide relevant information for the sports injury prevention at Korea National Team player.

A Case of Acute Respiratory Distress Syndrome(ARDS) after Talc Pleurodesis (Talc를 이용한 늑막유착술 후 발생한 급성 호흡곤란증후군 1례)

  • Kim, Ki-Up;Cha, Kun-Young;Han, Sang-Hoon;Yun, Yeo-Il;Park, Sung-Woo;Kim, Do-Jin;Na, Mun-Jun;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.265-269
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    • 2001
  • Presently talc is one of the agents most commonly used for producing a pleurodesis in patients with either a recurrent pleural effusion or a spontaneous pneumothorax. Talc can be instilled into the pleural space either as an aerosol (insufflation) or as a suspension (slurry) in saline. They are quite effective in producing a pleurodesis. However, they rarely have acute serious adverse effects including acute respiratory distress syndrome, and recently a discussion for using pleurodesis has been reported. We experienced a case of acute respiratory distressed syndrome after talc pleurodesis. A 64 year old man, who was diagnosed lung cancer with a malignant pleural effusion at the same side, was treated by pleurodesis using talc to control the effusion. After 3 days, he suffered fever, chill and breathlessness. The chest P A and CT revealed a bilateral infiltration in both lungs and the blood gas analysis confirmed hypoxemia, which required mechanical ventilation.

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Treatment for Patients with Acute Ischemic Stroke Presenting beyond Six Hours of Ischemic Symptom Onset : Effectiveness of Intravenous Direct Thrombin Inhibitor, Argatroban

  • Park, Jung-Soo;Park, Seung-Soo;Koh, Eun-Jeong;Eun, Jong-Pil;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.258-264
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    • 2010
  • Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

Re-irradiation of unresectable recurrent head and neck cancer: using Helical Tomotherapy as image-guided intensity-modulated radiotherapy

  • Jeong, Songmi;Yoo, Eun Jung;Kim, Ji Yoon;Han, Chi Wha;Kim, Ki Jun;Kay, Chul Seung
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.206-215
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    • 2013
  • Purpose: Re-irradiation (re-RT) is considered a treatment option for inoperable locoregionally recurrent head and neck cancer (HNC) after prior radiotherapy. We evaluated the efficacy and safety of re-RT using Helical Tomotherapy as image-guided intensity-modulated radiotherapy in recurrent HNC. Materials and Methods: Patients diagnosed with recurrent HNC and received re-RT were retrospectively reviewed. Primary endpoint was overall survival (OS) and secondary endpoints were locoregional control and toxicities. Results: The median follow-up period of total 9 patients was 18.7 months (range, 4.1 to 76 months) and that of 3 alive patients was 49 months (range, 47 to 76 months). Median dose of first radiotherapy and re-RT was 64.8 and 47.5 $Gy_{10}$. Median cumulative dose of the two courses of radiotherapy was 116.3 $Gy_{10}$ (range, 91.8 to 128.9 $Gy_{10}$) while the median interval between the two courses of radiation was 25 months (range, 4 to 137 months). The response rate after re-RT of the evaluated 8 patients was 75% (complete response, 4; partial response, 2). Median locoregional relapse-free survival after re-RT was 11.9 months (range, 3.4 to 75.1 months) and 5 patients eventually presented with treatment failure (in-field failure, 2; in- and out-field failure, 2; out-field failure, 1). Median OS of the 8 patients was 20.3 months (range, 4.1 to 75.1 months). One- and two-year OS rates were 62.5% and 50%, respectively. Grade 3 leucopenia developed in one patient as acute toxicity, and grade 2 osteonecrosis and trismus as chronic toxicity in another patient. Conclusion: Re-RT using Helical Tomotherapy for previously irradiated patients with unresectable locoregionally recurrent HNC may be a feasible treatment option with long-term survival and acceptable toxicities.

Intestinal obstruction caused by a duplication cyst of the cecum in a neonate (신생아에서 맹장의 장 중복낭종에 의해 발생한 장 폐쇄 1예)

  • Keum, Seung-woon;Hwang, Min-Woo;Na, Jong-In;Yu, Seung-taek;Kang, Dong-Baek;Oh, Yeon-Kyun
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.261-264
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    • 2009
  • Duplication cysts are rare congenital malformations, that may be detected anywhere along the alimentary tract, and they may communicate with the intestinal tract. Cystic duplication of the cecum is especially rare. About 80% of these cases are detected in the first 2 years of life as a result of an acute intestinal obstruction, which manifests as vomiting, recurrent abdominal pain, recurrent gastrointestinal bleeding and constipation. We report a case of intestinal obstruction secondary to a duplication cyst of the cecum in a neonate. The patient underwent surgery and was diagnosed subsequently, and is presently healthy.

Elevated Serum Ferritin Levels in Patients with Hematologic Malignancies

  • Zhang, Xue-Zhong;Su, Ai-Ling;Hu, Ming-Qiu;Zhang, Xiu-Qun;Xu, Yan-Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6099-6101
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    • 2014
  • Purpose: To retrospectively analyze variability and clinical significance of serum ferritin levels in Chinese patients with hematologic malignancies. Materials and Methods: Serum ferritin were measured by radioimmunoassay, using a kit produced by the Beijing Institute of Atomic Energy. Patients with hematologic malignancies, and treated in the Department of Hematology in Nanjing First Hospital and fulfilled study criteria were recruited. Results: Of 473 patients with hematologic malignancies, 262 patients were diagnosed with acute leukemia, 131 with lymphoma and 80 with multiple myeloma. Serum ferritin levels of newly diagnosed and recurrent patients were significantly higher than those entering complete remission stage or in the control group (p<0.001). Conclusions: Serum ferritin lever in patients with hematologic malignancies at early stage and recurrent stage are significantly increased, so that detection and surveillance of changes of serum ferritin could be helpful in assessing conditions and prognosis of this patient cohort.

A Case of Intestinal Malrotation with Midgut Volvulus Presenting with Intermittent Vomiting and Abdominal Pain (간헐성 복통과 구토를 주소로 하는 중장염전이 동반된 장 이상회전 1례)

  • Kim, Jong-Shik;Chung, Ju-Young;Park, Dong-Churl;Kim, Sang-Woo;Kim, Hong-Joo;Kim, Young-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.79-82
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    • 2002
  • Intestinal malrotation is a developmental anomaly resulting from embryologic failure of fixation and rotation of the gut and predisposed to midgut volvulus and small bowel obstruction. Acute midgut volvulus is most often encountered in the newborn period. But older children and adults may have a history of intermittent episodes of partial volvulus presenting with recurrent colicky abdominal pain accompanying bilious vomiting. We experienced a case of intestinal malrotation complicated by midgut volvulus presented with recurrent vomiting and abdominal pain in a 6-year-old boy.

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Herbal Medicines for the Treatment of Otitis Media in Children : A Literature Review of Randomised Controlled Trials (소아청소년기 중이염의 천연물 의약품 치료 : 무작위 대조군 연구에 대한 문헌 고찰)

  • Da Hee Hong;Min Hee Kim
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.37 no.1
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    • pp.42-56
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    • 2024
  • Objectives : The purpose of this literature review is to analyze herbal medicine's efficacy in pediatric otitis media. Methods : Six databases(Pubmed, CNKI, RISS, KISS, KCI, OASIS) were used to search randomized controlled trials related to pediatric otitis media until October 2023. Total nine studies written in Korean, English, Chinese, and German were selected and analyzed. Results : Recurrent otitis media was treated with Kami-hyunggyeyungyo-tang, Echinacea purpurea, and Sipjeondaebo-tang. For acute otitis media, Otovowen and Sopunghaedok capsule were administered, while Oryung-san, Chongyi-tang, and Changyija-san were used for otitis media with effusion. Glycyrrhizae Radix(甘草) and Cnidii Rhizome(川芎) were the most frequently used. Objective measures showed superior effects in the herbal medicine group for otoscopic examination, impedance test, audiometry, and fever. Sipjeondaebo-tang exhibited significant efficacy in recurrent otitis media treatment, possibly related to warming-interior medicine(溫裏藥) or blood-invigorating medicine(血分藥). Conclusion : Analyzing studies revealed herbal medicine's superiority for pediatric otitis media over conventional approaches.