• Journal of Veterinary Clinics
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• v.41 no.3
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• pp.195-199
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• 2024

A free-range wild raccoon dog (Nyctereutes procyonoides) was rescued with cachexia. Physical examination revealed generalized hyperkeratosis and alopecia typical of scabies as well as hypothermia (35.6℃). The patient was obtunded and severely dehydrated (10%). Hematological parameters included a low packed cell volume (PCV; 15%) and hemoglobin concentration, leukocytosis, and hypoglycemia. A blood smear revealed different subtypes of hypochromic leptocytes, indicating a regenerative response against severe anemia. This case was initially tentatively diagnosed as a severe anemia due to chronic external bleeding presumed to be caused by scabies-induced skin injuries. Darbepoetin alpha (DPO), iron dextran, and fluralaner were administered at the initial presentation, and supportive care including oxygen supplementation, warming, and nutritional support was provided. However, on day 5, the PCV dropped to 5.9% presumably caused by rapid rehydration due to drinking water ad libitum. DPO was boosted on days 5 and 6 along with daily iron dextran. On day 21, the PCV had recovered to 19.8%, and a blood smear evaluation showed a strong regenerative response. This case shows that even if severe anemia occurs in a raccoon dog, it can be managed with an appropriate response. In particular, since the rehydration rate due to food intake is faster than the hematopoietic response rate of raccoon dogs, the PCV may decrease rapidly in the early stage of treatment; therefore, diagnostic examination and additional medical management for hematopoiesis are necessary.

• The korean journal of orthodontics
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• v.52 no.5
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• pp.362-371
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• 2022

Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option, considering the risks of surgery. A 19.5-yearold man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered because of his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for orthognathic surgery did not recommend surgery under general anesthesia because of risk factors associated with the patient's aplastic anemia, including bleeding and infections. Thus, a camouflage treatment to promote backward rotation of the mandible via orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of nonsurgical orthodontic treatment, normal occlusion was achieved, and the facial profile was dramatically improved. This case report describes the dentoskeletal and soft-tissue effects of mandibular rotation and its long-term stability.

• Parasites, Hosts and Diseases
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• v.52 no.6
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• pp.667-672
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• 2014

While imported falciparum malaria has been increasingly reported in recent years in Korea, clinicians have difficulties in making a clinical diagnosis as well as in having accessibility to effective anti-malarial agents. Here we describe an unusual case of imported falciparum malaria with severe hemolytic anemia lasting over 2 weeks, clinically mimicking a coinfection with babesiosis. A 48-year old Korean man was diagnosed with severe falciparum malaria in France after traveling to the Republic of Benin, West Africa. He received a 1-day course of intravenous artesunate and a 7-day course of Malarone (atovaquone/proguanil) with supportive hemodialysis. Coming back to Korea 5 days after discharge, he was readmitted due to recurrent fever, and further treated with Malarone for 3 days. Both the peripheral blood smears and PCR test were positive for Plasmodium falciparum. However, he had prolonged severe hemolytic anemia (Hb 5.6 g/dl). Therefore, 10 days after the hospitalization, Babesia was considered to be potentially coinfected. A 7-day course of Malarone and azithromycin was empirically started. He became afebrile within 3 days of this babesiosis treatment, and hemolytic anemia profiles began to improve at the completion of the treatment. He has remained stable since his discharge. Unexpectedly, the PCR assays failed to detect DNA of Babesia spp. from blood. In addition, during the retrospective review of the case, the artesunate-induced delayed hemolytic anemia was considered as an alternative cause of the unexplained hemolytic anemia.

• The Journal of Internal Korean Medicine
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• v.30 no.1
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• pp.228-232
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• 2009

Objective : To expend the oriental medicine-based strategies or therapeutics for anemia, including iron deficiency anemia. Methods : A 23 year-old man suffering from severe and chronic iron deficiency anemia was believed to have disorder of iron absorption. He had neither specific medical cause nor positive response to western treatments. Blood and biochemical parameters such as levels of hemoglobin, ferritin, transferrin and serum iron were serially chased during treatments. Result : Bojungicki-tang was given to the patient based on diagnosis as a deficiency of spleen qi. The hemoglobin level was normalized along with administration of Bojungicki-tang. Also, the distortions of biochemical indicators (ferritin, transferrin and serum iron) reached a normal range within three months. Conclusion : Bojungicki-tang could be a curing remedy for iron deficiency anemia caused by problems in iron absorption if symptom-differentiation has deficiency of spleen qi.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1250-1253
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• 1992

A patient with intravascular hemolysis due to residual shunt and right ventricular outflow track obstruction after total correction of TOF was presented. The patient was 29 years old female. She underwented VSD closure with dacron patch, infundibulectomy, pulmonic valvotomy and direct closure of PFO. 8 months after the operation, severe intravascular hemolysis and hemolytic anemia appeared. Conservative therapies were not effective, her general condition and laboratory finding got worse gradually. She underwent reoperation, the shunt was closed and right ventricular outflow tract obstruction was corrected by pulmonary valvotomy, infudibulectomy and transannular patch. After operation, hemolysis disappeared dramatically. Severe hemolysis may induce renal failure and necessitate transfusion frequently. If hemolytic anemia is not corrected by conservative treatment, early reoperation is required.

• Korean Journal of Veterinary Research
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• v.46 no.1
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• pp.77-81
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• 2006

A 1-year and 6-month-old, intact male, Shih-tzu dog was referred to the Konkuk University Veterinary Teaching Hospital, due to ascite, melena, severe anemia, and polyuria/polydipsia. Complete blood count showed moderate leukocytosis, lymphocytosis, monocytosis, and microcytic hypochromic nonregenerative anemia. On serum biochemistry profiles, hypoalbuminemia and hypoproteinemia were observed, and proteinuria was detected on urinalysis. Pleural effusion and mild ascites were noted in radiological findings, and bilateral nephromegaly was noted on ultrasonography. Babesia gibsoni was detected by PCR. Babesiosis and glomerular disease was treated at a time with prednisolone and buparvaquone. This therapeutic regime was very efficacious and clinical sings were rapidly improved. Proteinuria and severe anemia were disappeared following therapy.

• Clinical and Experimental Pediatrics
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• v.57 no.8
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• pp.337-344
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• 2014

Inherited bone marrow failure syndrome (IBMFS) encompasses a heterogeneous and complex group of genetic disorders characterized by physical malformations, insufficient blood cell production, and increased risk of malignancies. They often have substantial phenotype overlap, and therefore, genotyping is often a critical means of establishing a diagnosis. Current advances in the field of IBMFSs have identified multiple genes associated with IBMFSs and their pathways: genes involved in ribosome biogenesis, such as those associated with Diamond-Blackfan anemia and Shwachman-Diamond syndrome; genes involved in telomere maintenance, such as dyskeratosis congenita genes; genes encoding neutrophil elastase or neutrophil adhesion and mobility associated with severe congenital neutropenia; and genes involved in DNA recombination repair, such as those associated with Fanconi anemia. Early and adequate genetic diagnosis is required for proper management and follow-up in clinical practice. Recent advances using new molecular technologies, including next generation sequencing (NGS), have helped identify new candidate genes associated with the development of bone marrow failure. Targeted NGS using panels of large numbers of genes is rapidly gaining potential for use as a cost-effective diagnostic tool for the identification of mutations in newly diagnosed patients. In this review, we have described recent insights into IBMFS and how they are advancing our understanding of the disease's pathophysiology; we have also discussed the possible implications they will have in clinical practice for Korean patients.

• Korean Journal of Poultry Science
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• v.18 no.3
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• pp.141-150
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• 1991

A local isolate of chicken anemia agent (CAA), isolate 89-69. was tested for pathogenicity for chickens. When chickens from a specific pathogen free (SPF) flock were inoculated intramuscularly with the isolate at one day old, all the chickens showed severe anemia at 14 to 18 days post inoculation(DPI) and returned to normal at 25DPI, Some of the inoculated chickens (27∼33％) died between 13 to 17 DPI's with lesions of severe aplasia of bone marrow and thymic atrophy. In chickens kept in contact with inoculated chickens, some of the chickens had anemia at 25 and 28 DPI's. Virus could be reisolated from inoculated as well as in contact chickens till 21 DPI. Antibodies to CAA could be detected in all inoculated and in contact chickens when tested at 42 DPI by the indirect fluorescent antibody method. When chickens from a different SPF flock were inoculated at one day old, degrees of anemia, both in frequency of incidence and severity, were low These chickens were proved partly to have antibodies to CAA when tested for hatchmates. In a survey for antibodies to CAA in field chicken flocks, one out of 7 flocks(14％) aged 3 to 10weeks was antibody positive whereas 19 out of 20 flocks(95％) over 20 weeks of age were positive. Altogether 29 out of 39 flocks (74％) were antibody positive.

• Clinical and Experimental Pediatrics
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• v.53 no.5
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• pp.661-665
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• 2010

Anemia caused by vitamin B12 deficiency resulting from inadequate dietary intake is rare in children in the modern era because of improvements in nutritional status. However, such anemia can be caused by decreased ingestion or impaired absorption and/or utilization of vitamin B12. We report the case of an 18-year-old man with short stature, prepubertal sexual maturation, exertional dyspnea, and severe anemia with a hemoglobin level of 3.3 g/dL. He had a history of small bowel resection from 50 cm below the Treitz ligament to 5 cm above the ileocecal valve necessitated by midgut volvulus in the neonatal period. Laboratory tests showed deficiencies of both vitamin B12 and iron. A bone marrow examination revealed dyserythropoiesis and low levels of hemosiderin particles, and a cytogenetic study disclosed a normal karyotype. After treatment with parenteral vitamin B12 and elemental iron, both anemia and growth showed gradual improvement. This is a rare case that presented with short stature and delayed puberty caused by nutritional deficiency anemia in Korea.

• Journal of Oral Medicine and Pain
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• v.44 no.1
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• pp.40-44
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• 2019

Third molar extraction, one of the important surgical treatments commonly practiced in dentistry, presents various symptoms after surgery ranging from temporary or mild symptoms to permanent or severe complications. However, oral burning pain, dysesthesia, parageusia, dry mouth, headache and pain in multiple teeth are not the common symptoms that patients often complain after dental extraction. Here, the authors report two cases who presented acute neuropathic symptoms mentioned above in the orofacial regions following third molar extraction. At the initial examination, the healing of the tooth sockets of two patients was normal. One patient was diagnosed as megaloblastic anemia associated with Vitamin $B_{12}$ deficiency and was referred to the Department of Hematology for assessing the underlying etiology of anemia. The laboratory test for the other patient revealed microcytic anemia related to iron deficiency. The patient with iron deficiency anemia was successfully treated with iron supplement. These two cases suggest that anemia, as an underlying systemic disease, may be a rare etiology explaining acute onset of peripheral neuropathy in the orofacial regions after third molar extraction and should be considered in the assessment of patients who report neuropathic symptoms after dental extraction.