1.Management of Cardiac Arrest following Anaphylactic Reaction to Cisatracurium Using Extracorporeal Membrane Oxygenation.
Dae Sung MA ; Tae Hyun KIM ; Min Ae KEUM ; Dong Kwan KIM ; Suk Kyung HONG
Korean Journal of Critical Care Medicine 2015;30(1):42-45
Anaphylactic reaction during the perioperative period typically exhibits rapid onset, varying clinical manifestations, and an expected mortality rate of 1.5-9%. Neuromuscular blocking agents are the leading cause of perioperative anaphylaxis. Here, we report a severe case of anaphylaxis that developed in a 66-year-old man due to cisatracurium administration. And he was successfully managed by extracorporeal membrane oxygenation. Cardiopulmonary resuscitation was performed by extracorporeal membrane oxygenation, and the patient was successfully weaned off 24 hours later.
Aged
;
Anaphylaxis*
;
Cardiopulmonary Resuscitation
;
Extracorporeal Membrane Oxygenation*
;
Heart Arrest*
;
Humans
;
Mortality
;
Neuromuscular Blocking Agents
;
Perioperative Period
2.Clinical Study on Adult Onset Still's Disease: Analysis in 15 Cases.
Ae Ra HONG ; Chang Ho SONG ; Ji Soo LEE ; Kyung Ae MA ; Chong Seog PARK ; Chan Hee LEE ; Soo Kon LEE
The Journal of the Korean Rheumatism Association 1997;4(1):60-69
OBJECTIVE: To understand the clinical manifestations and disease course of adult onset Still' s disease (AOSD). METHODS: 15 patients of AOSD diagnosed at Severance hospital, Yonsei University College of Medicine were retrospectively analysed in the period of September 1988 to September 1995. RESULTS: There were 3 men and 12 women (male to female ratio of 1:4). Age of disease onset ranged from 17-55 years, and over 86% of the patients were younger than age 40 at disease onset. The prevalence of clinical features were as follows fever (100%), arthritis (93%), skin rash (93%), sore throat (60%), abnormal liver function (73%), lymphadenopathy (47%), splenomegaly (47%), hepatomegaly (20%), serositis (13%). Fever was the most common initial symptom. Common labaratory features were leukocytosis with neutrophilia (87%), anemia' Hgb <10 g/dL (67%), increased serum ferritin (83%), ESR (87%) and CRP (93%). Serum ferritin was markedly raised at disease onset and correlated with disease activity. In 2 patients, the disease was controlled with NSAID alone, but most of the patients required steroid to control the disease activity. In 6 patients, MTX was added for steroid sparing effect and for steroid resistant arthritis. Most of AOSD patients had intermittent and chronic disease course. Root joint arthritis and polyarthritis were factors associated with chronicity. CONCLUSION: The clinical features of AOSD in our study generally resemble previous reports. Serum ferritin was a useful marker of disease activity. Most patients of AOSD had intermittent and chronic disease course. Root joint athritis and polyarticular pattern at disease onset were factors associated with chronicity.
Adult*
;
Arthritis
;
Chronic Disease
;
Exanthema
;
Female
;
Ferritins
;
Fever
;
Hepatomegaly
;
Humans
;
Joints
;
Leukocytosis
;
Liver
;
Lymphatic Diseases
;
Male
;
Pharyngitis
;
Prevalence
;
Retrospective Studies
;
Serositis
;
Splenomegaly
;
Still's Disease, Adult-Onset*
3.Increase Circulationf CD5+ B Cell in Human SLE : No Correlation with the Level of Autoantibodies.
Jeong Soo PARK ; Soo Youn BAEK ; Gyu Tae SHIN ; Do Hun KIM ; Dong Ho NAHM ; Kyung Ae MA ; Jung Koo YOUN ; Young Ju JANG
Korean Journal of Immunology 2000;22(1):23-30
No abstract available.
Autoantibodies*
;
Humans*
4.Urinary Transforming Growth Factor-beta1 is a Robust Predictor of Kidney Disease Progression.
Ji Eun PARK ; Seung Jung KIM ; Hyunee YIM ; Seungsoo SHEEN ; Kyung Ae MA ; Heungsoo KIM ; Gyu Tae SHIN
Korean Journal of Nephrology 2005;24(5):755-762
BACKGROUND: TGF-beta1 is the main fibrogenic cytokine associated with human glomerulonephritis. TGF-beta1 levels were found to be significantly increased in the urine of patients with IgA nephropathy. However, urinary TGF-beta1 excretion has so far not been evaluated with respect to the risk of kidney disease progression. METHODS: In the current study, urine samples were taken for TGF-beta1 protein analysis from 37 patients diagnosed with IgA nephropathy on the day of renal biopsy, and patients were followed until either the date of serum creatinine doubling or until the end of the follow-up period. RESULTS: The median follow-up was 3.6 years (range, 0.4-6.2 years). Urinary TGF-beta1/creatinine ratios (TGF-beta1/Cr, pg/mg) were significantly higher in IgA nephropathy patients than in normal controls (10.7+/-1.92 versus 2.38+/-0.52). The area under the receiver-operating-characteristics curve was 0.78 (P<0.05, 95% confidence interval 0.61-0.90), indicating that urinary TGF-beta1/Cr is an excellent predictor of kidney disease progression. Univariate Cox regression analysis showed that urinary TGF-beta1/Cr was the most powerful predictor of serum creatinine doubling (p=0.0026, relative risk 1.09, 95% confidence interval 1.03-1.15). Furthermore, multivariate Cox regression analysis adjusted for other confounders revealed that urinary TGF-beta1/Cr was the only significant predictor of serum creatinine doubling. In contrast, serum TGF-beta1 levels were not found to be a risk factor of kidney disease progression. CONCLUSION: Our findings provide new evidence of a robust association between urinary TGF-beta1 and kidney disease progression in patients with IgA nephropathy.
Biopsy
;
Creatinine
;
Follow-Up Studies
;
Glomerulonephritis
;
Glomerulonephritis, IGA
;
Humans
;
Kidney Diseases*
;
Kidney*
;
Risk Factors
;
Transforming Growth Factor beta1
5.Management of Cardiac Arrest following Anaphylactic Reaction to Cisatracurium Using Extracorporeal Membrane Oxygenation
Dae Sung MA ; Tae Hyun KIM ; Min Ae KEUM ; Dong Kwan KIM ; Suk Kyung HONG
The Korean Journal of Critical Care Medicine 2015;30(1):42-45
Anaphylactic reaction during the perioperative period typically exhibits rapid onset, varying clinical manifestations, and an expected mortality rate of 1.5-9%. Neuromuscular blocking agents are the leading cause of perioperative anaphylaxis. Here, we report a severe case of anaphylaxis that developed in a 66-year-old man due to cisatracurium administration. And he was successfully managed by extracorporeal membrane oxygenation. Cardiopulmonary resuscitation was performed by extracorporeal membrane oxygenation, and the patient was successfully weaned off 24 hours later.
Aged
;
Anaphylaxis
;
Cardiopulmonary Resuscitation
;
Extracorporeal Membrane Oxygenation
;
Heart Arrest
;
Humans
;
Mortality
;
Neuromuscular Blocking Agents
;
Perioperative Period
6.A Case of Crescentic Glomerulonephritis Associated with Bacterial Endocarditis.
Jin Ho LEE ; Kyung Ae MA ; Hong Soo KIM ; Kyu Tae SHIN ; Myung Sung KIM ; Yu Jin SUH ; Soo Jin LEE ; Seung Jung KIM ; Do Heon KIM ; Joon Han SHIN ; Hyun Ey LEE
Korean Journal of Nephrology 1999;18(5):820-824
A 25-year-old male presented with mitral insufficiency, perimembranous type of ventricular septal defect, pulmonary edema and renal insufficiency. The initial serum creatinine level was 16.2mg/dl. Blood cultures were positive for Streptococcus viridans and appropriate antibiotic therapy was initiated. Renal biopsy revealed diffuse proliferative glomerulonephritis with crescents involving all of the glomeruli. Even after adequate duration of treatment with antibiotics, surgical therapy, and high dose steroid therapy, renal function did not recover and the patient ended up with continuous ambulatory peritoneal dialysis. We present a case of crescentic glomerulonephritis associated with bacterial endocarditis with a review of the literature.
Adult
;
Anti-Bacterial Agents
;
Biopsy
;
Creatinine
;
Endocarditis, Bacterial*
;
Glomerulonephritis*
;
Heart Septal Defects, Ventricular
;
Humans
;
Male
;
Mitral Valve Insufficiency
;
Peritoneal Dialysis, Continuous Ambulatory
;
Pulmonary Edema
;
Renal Insufficiency
;
Viridans Streptococci