Multiple organ dysfunction syndrome(MODS) emerged as a new syndrome about 30 years ago as a result of the ability to keep patients alive with advanced medical technology. Despite intensive investigation, it remains the main cause of deaths in the intensive care unit today. MODS was presumed to be caused by various pathophysiologic conditions. The epidemiology and pathophysiology include infectious mode 1 and 2, 1-hit and 2-hit models, dysfunctional inflammatory response, impaired oxygen consumption, xanthine oxidase-dependent reactive oxygen metabolites, neutrophil chemotaxis, polymorphonuclear neutrophil adherence, gut hypothesis, and immunosuppression from blood transfusion. Unfortunately, once MODS develops, our current understanding of the inflammatory response is inadequate to manage the condition. Our only recourse is to control the source of inflammation, support the failing organs, provide nutritional support, and prevent further iatrogenic injury.
Blood Transfusion ; Cause of Death ; Chemotaxis ; Epidemiology ; Humans ; Immunosuppression ; Inflammation ; Intensive Care Units ; Multiple Organ Failure* ; Neutrophils ; Nutritional Support ; Oxygen ; Oxygen Consumption ; Xanthine

Psychosomatic medicine is a part of medicine which is to find the effect of psychological, behavioural, and medical factors on the human body and disease. In the early 20th century, the idea of psychogenesis had been developed and resulted in the concept of psychosomatic disease which was believed to be caused by psychological factors. However a multifactorial model of illness developed and it allowed illness to be viewed as a result of biopsychosocial interactions. The following have been highlighted by consultation-liaison psychiatry. Psychosomatic medicine has addressed stress and psychiatric factors which affect the etiology, course, and treatment of medical disorders. Moreover it contributes the growth of other related disciplines such as psychoneuroendocrinology, psychoimmunology, behavioral medicine, health psychology and quality of life research. Nowadays, psychosomatic field becomes enlarged because medical and surgical departments have been developed rapidly, and research methods and tools have brought forth rapid progress and advance in medical science. Therefore the author reviews the past and present psychosomatic researches and suggests the future of psychosomatic research in Korea.
Behavioral Medicine ; Human Body ; Korea ; Psychoneuroimmunology ; Psychosomatic Medicine ; Quality of Life

No abstract available.
Capnography* ; Humans

No abstract available.
Empyema*

No abstract available.
Lymphoma, B-Cell, Marginal Zone*

No abstract available.
Child* ; Humans ; Lung Diseases, Interstitial*

In suicidal hanging, a death often occurs within minutes. f rescued, most victims later succumb to the respiratory failure secondary to pulmonary edema, bronchopneumonia, delayed airway obstruction, and acute respiratory distress syndrome(ARDS). Out of these, non-cardiogenic pulmonary edema is likely due to neurogenic factors or negative intrathoracic pressure. A 36-year-old female was brought to the Department of Emergency Medicine after the suicidal hanging attempt. She was unconscious but responsive to painful stimuli. A laryngeal stridor was present. The lung sound of the patient's was dear. Fourteen hours after admission, a chest X-ray showed bilateral diffuse interstitial infiltrates in both lung fields, which was compatible with ARDS. The patient was intubated and placed on a volume respirator with PEEP. She improved over the next 48 hours and a repeat chest X-ray aim showed marked clearing of the infiltrates. We report on the pathophysiologic results of this pulmonary complication and the implication of this finding, regarding the treatment of the patient.
Adult ; Airway Obstruction ; Bronchopneumonia ; Emergency Medicine ; Female ; Humans ; Lung ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Respiratory Sounds ; Thorax ; Ventilators, Mechanical

NK/T cell lymphoma is a distinct clinicopathologic entity which is more prevalent in Asia than in America and Europe and is highly associated with Epstein-Barr virus (EBV) infection. Although the clinicopathologic features of the tumor have been clearly defined, genetic changes and roles of virus associated with the development and progression of tumor have not been well studied. In this study, we carried out polymerase chain reaction (PCR) for EBNA-3B, EBNA-3C, and LMP-1 30 bp deletion to investigate EBV subtype and variants in tumor tissue and performed comparative genomic hybridization (CGH) to screen chromosomal imbalances using frozen tissues from 7 patients with nasal-type NK/T cell lymphoma and 1 patient with blastic NK cell lymphoma. Of 6 cases infected with EBV, there were EBV type 1 in six, LMP-1 30 bp deletion variant in four, and LMP-1 40 bp deletion variant in one. Frequent chromosomal imbalances included deletions at 1p31-pter (4), 12q23-q24 (3), and 17p (4), and gains at 2q (5), 10q (3), and 13q34-qter (4). Blastic NK cell lymphoma displayed deletions of 9q, 7q, and 6q, similar to that of nasal-type NK/T-cell lymphoma. With these results, we assumed that candidate genes in these imbalanced chromosomal loci would provide the clue for further molecular studies to identify putative tumor suppressor genes or proto-oncogenes associated with pathogenesis of this neoplasm.
Americas ; Asia ; Comparative Genomic Hybridization* ; Europe ; Genes, Tumor Suppressor ; Genotype* ; Herpesvirus 4, Human* ; Humans ; Killer Cells, Natural ; Lymphoma* ; Polymerase Chain Reaction ; Proto-Oncogenes

Pacemaker-mediated tachycardia(PMT) is a circus movement tachycardia that can occur in patients with dual chamber pacemaker with atrial sensing(VDD or DDD), when a ventricular depolarization, either spontaneous or paced, causes retrograde activation of the atrium. Recently, a number of pacemaker manufactures have incorporated in their devices a variety of relatively complex algorithms to prevent PMT. Despite these measures, PMT may still occur because of inappropriate programming or unpredictable variations of ventriculoatrial conduction. We report one case of PMT in a 78-year-old male who received DDD type pacemaker due to sick sinus syndrome. In this case, PMT was disappeared after reprogramming parameters of pacemaker and the application of PMT protection algorithm.
Aged ; Dichlorodiphenyldichloroethane ; Humans ; Male ; Sick Sinus Syndrome ; Tachycardia*

To determine the prevalence of Epstein-Barr virus infection in lymphoid neoplasms of various histology and location, the paraffin tissues of 74 non-Hodgkin's lymphomas and 13 Hodgkin's diseases were studied by EBER and BHLF RNA in situ hybridization as well as immunostaining using LMP-1, EBNA-2, and ZEBRA. As a control, non-neoplastic lymphoid tissues from the nasal cavity(10), lymph node(38) and Waldeyer's ring(12) were investigated. In non-neoplastic control, EBV genome was detected in none of 10 nasal mucosa, 6 of 38 lymph node, and 1 of 12 Waldeyer's ring. EBV-positive non-neoplastic lymphocytes expressed CD45RO in 2 cases and CD20 in 4 cases. Non-Hodgkin's lymphoma was positive for EBV in 37.8% of the cases in which T-cell lymphoma showed higher rate(56%) than B-cell lymphoma(15%), especially in nasal lymphoma(80%) and angiocentric lymphoma(63.6%). Hodgkin's disease was EBV positive in 38.4% of the cases. EBV genome in tumor tissue existed in latent form as well as in lytic form. LMP-1 was positive in 80% of Hodgkin's disease and 39% of non-Hodgkin's lymphoma in which EBV genome was detected. EBNA-2 was expressed in 3 cases of non-Hodgkin's lymphoma. On the basis of protein expression, most lymphomas belonged to type II latency. These results support that EBV is associated with pathogenesis of malignant lymphoma although its mechanism still awaits to be clarified.