• Title/Summary/Keyword: systemic risk

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Corticosteroid-induced Avascular Necrosis of Talus after Cardiac Transplantation (심장이식 후 부신피질호르몬 투여로 인한 거골의 무혈성 괴사 - 1예 보고 -)

  • Park, Hong-Gi;Eom, Gi-Serk
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.2
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    • pp.83-86
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    • 2000
  • A vascular necrosis of the talus has frequently been reported following trauma because talus has no muscle insertions, sixty percent of the surface of the talus is covered by hyaline cartilage, takes only a small area for entrance of a blood supply. Osteonecrosis is also associated with a variety of nontraumatic disorders. There are many indications for steroid usage, patient with rheumatoid arthritis, systemic lupus erythematosus, chronic obstructive pulmonary disease, and status- post renal or cardiac transplantation may be on long- term steroid usage, osteonecrosis may develop. A vascular necrosis of the talus secondary to chronic steroid usage is an unusual case. Delay in detection of osteonecrosis may lead to fragmentation and collapse of the talar body. When pain on range of motion is present and conservative treatment have been exhausted, surgical treatment is indicated, that is, fusion of the ankle joint. However it is important that conservative treatment may prevent its various sequelae with early diagnosis because steroid - treated patients have a more operative risk and increased risk for postoperative infection. We report a rare case of corticosteroid induced avascular necrosis of talus after cardiac transplantation.

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TREATMENT OF LYMPHANGIOMA BY SURGICAL EXCISION AND SCLEROTHERAPY WITH OK-432 : A CASE REPORT (외과적 절제술과 OK-432 경화요법을 병용한 임파관종의 치료: 증례보고)

  • Cho, Ju-Yeon;Cha, Du-Won;Baek, Sang-Heum;Lee, Ju-Duck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.3
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    • pp.267-271
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    • 2006
  • Lymphangiomas are benign tumors of the lymphatic system characterized by congenital lymphatic malformation such as anastomosis or obstruction of the lymphatic channels. They are most frequently diagnosed in children younger than 2 years, and the lymphangiomas in head and neck represent about 50-75% of all lymphangiomas. Spontaneous regression is rare, and rapid enlargement occurs secondary to infection or trauma. Enlargement may cause serious sequence such as airway obstruction, feeding difficulties, and cosmetic problems. Treatments previously used for lymphangiomas include surgical excision and intralesional injection of sclerosing agents. Problems associated with surgical excision include the risk of scarring, damage to surrounding vital structure and the high risk of incomplete excision. The sclerosing agents previously used have numerous local and systemic side effects as their problems. We present a case of lymphangioma occured in tongue that was treated by surgical excision and sclerotherapy with OK-432.

A Systemic Review of Korean Medical Treatment Combined with Continuous Passive Motion Therapy on the Knee Joint Postoperative Rehabilitation (슬관절 수술 후 재활에 대한 Continuous Passive Motion 치료와 한의 병행치료의 체계적 문헌 고찰)

  • Ha, Hyun Ju;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.3
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    • pp.33-45
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    • 2017
  • Objectives The objective of this study is to report the evidence that continuous passive motion (CPM) therapy combined with Korean Medicine is effective for knee injuries. Methods We searched 2 Korean medical electronic databases, and 2 Chinese electronic databases to find randomized controlled clinical trials (RCTs) that treat knee injuries with Korean Medicine combined with CPM therapy. We selected studies by screening. We extracted data from selected RCTs, and analyzed RCTs by using Cochrane's Risk of bias criteria. Results 386 studies are searched, and 7 RCTs are selected. According to the study, several kinds of Korean Medicine such as hydrotherapy, decoction, acupuncture, moxibustion, and manual therapy are used with CPM therapy for the knee joint postoperative rehabilitation. We found the encouraging evidence that Korean Medicine and CPM combined therapy is more effective than single CPM therapy by alleviating pain, increasing range of motion, and improving knee function, etc. However, the risk of bias in most RCTs was judged to be uncertain. Conclusions Combination of Korean Medicine and CPM therapy can compensate the defect of single CPM therapy, and promotes the recovery of knee joint function.

Development of Verification System and Selection Process for Track Structure (궤도구조 성능검증체계 및 선정프로세스 구축)

  • Lee, Ho-Ryong;Jang, Seung-Yup;Kim, Yeon-Guk;Yun, Sung-Soon
    • Proceedings of the KSR Conference
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    • 2010.06a
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    • pp.292-298
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    • 2010
  • Recently, with the beginning of the commercial operation of high-speed railway, there have been a number of changes in track structure fields. Also, it is expected that the development and introduction of new technology will be increased afterwards. However, it accompanies a lot of risk to install new track structures of which performance and safety are not verified on permanent ways with high traffic density. Therefore, to minimize the risk and enhance the adoption of new technology, it is required to develop a systemic verification system for track structure. To do this, in this paper, main contents of a draft of guidelines for track structure verification, and main issues in debate such as criteria and method for verification, test conditions and test periods are discussed. Also, a process to choose a most appropriate one for a specific project out of proven track structures by the above verification system, the selection process by the technical investigation committee and the VE process to analyze the economical and maintenance aspects based on LCC concept in Korea Rail Network Authority is introduced.

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A basic study on control factor for the marine casualties of fishing vessel in Korea (우리나라 어선 해양사고 제어 요소에 관한 기초 연구)

  • Kim, Wook-Sung;Lee, Ju-Hee;Kim, Seok-Jae;Kim, Hyung-Suk;Lee, Yoo-Won
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.49 no.1
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    • pp.40-50
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    • 2013
  • This study is aimed to find a control factor for the marine casualty of fishing vessel by using the risk quantitative method of marine casualty, and sequentially timed event analysis for the reason finding. The result is that collision, sinking, and capsizing took high risk need to be strongly controlled. And the accident reason and control factors distinguished are as follows. The 82.2% of collided fishing vessels have negligence of look out as a immediate cause, while it was judged that underlying causes were the characteristics of vessels and fishing method, lack of suitable complement, fatigue, the prejudice or ignorance on steering and sailing rules. So the control factors are; firstly needs educational control measures and in terms of systemic control approach expand the range of the certificate of competency more smaller tonnage.

Effect of Rivaroxaban on Fibrinolytic Therapy in Massive Pulmonary Embolism: Two Cases

  • Kim, Hye-Jin;Koo, So-My;Ham, Nam-Suk;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yang-Ki
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.3
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    • pp.127-130
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    • 2014
  • The risk of dying from a pulmonary embolism (PE) is estimated to be about 30% if inotropic support is required and no cardiopulmonary arrest occurs. Fibrinolysis in massive PE is regarded as a life-saving intervention, unless there is a high risk of bleeding following the use of the fibrinolytic therapy. Rivaroxaban is an oral factor Xa inhibitor, however its anticoagulation effects before or after administration of fibrinolytics in massive PE are still unknown. Two patents were admitted: 61-year-old woman with repeated syncope, and a 73-year-old woman was admitted with dyspnea and poor oral intake. Systemic arterial hypotension with radiologic confirmation led to a diagnosis of massive PE in both patients. Rivaroxaban was administered before in one, and after firbrinolytic therapy in the other. One showed similar efficacy of rivaroxaban with currently used anticoagulants after successful fibrinolysis, and the other one without antecedent administration of the fibrinolytic agent showed unfavorable efficacy of rivaroxaban.

Cardiometabolic Effects of Obstructive Sleep Apnea and Treatment Effects of Oral Appliance: An Updated Review for Dentists

  • Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.43 no.3
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    • pp.61-69
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    • 2018
  • Obstructive sleep apnea (OSA) is a relatively common, but greatly underdiagnosed sleep-related breathing disorder, characterized by recurrent collapse of the upper airway during sleep. OSA has been associated with a variety of cardiometabolic disease, such as hypertension, coronary artery disease, cardiac arrhythmia, cerebrovascular disease and metabolic dysfunction. Neurocognitive impairment, including excessive daytime sleepiness, increased risk of motor vehicle accidents, is also related to OSA. Sleep fragmentation and related arousals during sleep lead to intermittent hypoxia, sympathetic activation, oxidative stress, systemic inflammation and metabolic dysregulation which provide biological plausibility to this pathologic mechanism. Extensive studies demonstrated that OSA is a modifiable risk factor for the above mentioned diseases and oral appliances (OAs), although continuous positive air pressure (CPAP) is a first-line therapy of OSA, are not inferior to CPAP at least in mild OSA, and may be an alternative to CPAP in CPAP-intolerant subjects with OSA. The goal of this article is to provide a current knowledge of pathologic link between OSA and cardiovascular disease, focusing on intermittent hypoxia, sympathetic activation, oxidative stress and metabolic dysregulation. Then, previous epidemiologic studies will be reviewed to understand the causal relationship between OSA and cardiovascular disease. Finally, the effects of OAs will be updated via recent metaanalyses compared to CPAP.

Ginseng alleviates microbial infections of the respiratory tract: a review

  • Iqbal, Hamid;Rhee, Dong-kwon
    • Journal of Ginseng Research
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    • v.44 no.2
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    • pp.194-204
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    • 2020
  • The detrimental impact of air pollution as a result of frequent exposure to fine particles posed a global public health risk mainly to the pulmonary disorders in pediatric and geriatric population. Here, we reviewed the current literature regarding the role of ginseng and/or its components as antimicrobials, especially against pathogens that cause respiratory infections in animal and in vitro models. Some of the possible mechanisms for ginseng-mediated viral inhibition suggested are improvements in systemic and mucosa-specific antibody responses, serum hemagglutinin inhibition, lymphocyte proliferation, cell survival rate, and viral clearance in the lungs. In addition, ginseng reduces the expression levels of proinflammatory cytokines (IFN-γ, TNF-α, IL-2, IL-4, IL-5, IL-6, IL-8) and chemokines produced by airway epithelial cells and macrophages, thus preventing weight loss. In case of bacterial infections, ginseng acts by alleviating inflammatory cytokine production, increasing survival rates, and activating phagocytes and natural killer cells. In addition, ginseng inhibits biofilm formation and induces the dispersion and dissolution of mature biofilms. Most clinical trials revealed that ginseng, at various dosages, is a safe and effective method of seasonal prophylaxis, relieving the symptoms and reducing the risk and duration of colds and flu. Taken together, these findings support the efficacy of ginseng as a therapeutic and prophylactic agent for respiratory infections.

Delayed-type retrobulbar hematoma caused by low temperature after reconstruction of inferior blow-out fracture

  • Lee, Da Woon;Kim, Tae Hyung;Choi, Hwan Jun;Wee, Syeo Young
    • Archives of Craniofacial Surgery
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    • v.22 no.2
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    • pp.110-114
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    • 2021
  • Retrobulbar hemorrhage is a disastrous condition that can lead to permanent blindness. As such, rapid diagnosis and treatment are critical. Here, we report a patient who presented with retrobulbar hemorrhage following an orbital floor fracture. Restoration of inferior orbital wall with porous polyethylene implant was underwent. Four days after the orbital floor reconstruction, the patient smoked a cigarette outdoors in -3℃ weather. Cold temperature and smoking caused an increase in his systemic blood pressure. The elevated blood pressure increased intraorbital pressure to the extent of causing central retinal artery occlusion and exacerbated oozing. During exploratory surgery, 3 mL of hematoma and diffuse oozing without arterial bleeding were observed. Prompt diagnosis and treatment prevented vision impairment. Few studies have reported on the risk factors for retrobulbar hemorrhage. This case showed that daily activities, such as exposure to cold weather or tobacco smoking, could be risk factors for retrobulbar hemorrhage.

Studies on the role of the system administrator according to the changing IT environment (IT환경변화에 따른 시스템 관리자의 역할에 관한 연구)

  • Choi, Dae-young;Kim, Myung-su;Seo, Won-woo;Kim, Jong-bae
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2014.10a
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    • pp.264-266
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    • 2014
  • The current is quickly changed to a simple structure in the existing system architecture is complex and diverse structures. Especially due to the new cyber threat is growing more and more system risks. And many kinds of system monitoring and analysis tools are released in order to minimize the risk, but there is a limit to such a system depends on the Partially automated tools. Therefore, to present the role of a system administrator for effectively managing the system for the new changing environment out of the frame of the old system in order to minimize the systemic risk management system in this study.

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