Ischemic colitis primarily affects the elderly with underlying disease, but it rarely occurs in young adults with risk factors, such as coagulopathy or vascular disorder. Moreover, it is extremely rare in the very young without risk factors. This paper presents a patient with ischemic colitis associated with heat stroke and rhabdomyolysis after intense exercise under high-temperature conditions. A 20-year-old man presented with mental deterioration after a vigorous soccer game for more than 30 minutes in sweltering weather. He also presented with hematochezia with abdominal pain. The laboratory tests revealed the following: AST 515 U/L, ALT 269 U/L, creatine kinase 23,181 U/L, BUN 29.1 mg/dL, creatinine 1.55 mg/dL, and red blood cell >50/high-power field in urine analysis. Sigmoidoscopy showed ischemic changes at the rectum and rectosigmoid junction. A diagnosis of ischemic colitis and rhabdomyolysis was made, and the patient recovered after conservative and fluid therapy. This case showed that a diagnosis of ischemic colitis should be considered in patients who present with abdominal pain and bloody diarrhea after intense exercise, and appropriate treatment should be initiated immediately.
Abdominal Pain ; Aged ; Colitis, Ischemic ; Creatine Kinase ; Creatinine ; Diagnosis ; Diarrhea ; Erythrocytes ; Fluid Therapy ; Gastrointestinal Hemorrhage ; Heat Stroke ; Hot Temperature ; Humans ; Rectum ; Rhabdomyolysis ; Risk Factors ; Sigmoidoscopy ; Soccer ; Weather ; Young Adult

Ischemic colitis primarily affects the elderly with underlying disease, but it rarely occurs in young adults with risk factors, such as coagulopathy or vascular disorder. Moreover, it is extremely rare in the very young without risk factors. This paper presents a patient with ischemic colitis associated with heat stroke and rhabdomyolysis after intense exercise under high-temperature conditions. A 20-year-old man presented with mental deterioration after a vigorous soccer game for more than 30 minutes in sweltering weather. He also presented with hematochezia with abdominal pain. The laboratory tests revealed the following: AST 515 U/L, ALT 269 U/L, creatine kinase 23,181 U/L, BUN 29.1 mg/dL, creatinine 1.55 mg/dL, and red blood cell >50/high-power field in urine analysis. Sigmoidoscopy showed ischemic changes at the rectum and rectosigmoid junction. A diagnosis of ischemic colitis and rhabdomyolysis was made, and the patient recovered after conservative and fluid therapy. This case showed that a diagnosis of ischemic colitis should be considered in patients who present with abdominal pain and bloody diarrhea after intense exercise, and appropriate treatment should be initiated immediately.
Abdominal Pain ; Aged ; Colitis, Ischemic ; Creatine Kinase ; Creatinine ; Diagnosis ; Diarrhea ; Erythrocytes ; Fluid Therapy ; Gastrointestinal Hemorrhage ; Heat Stroke ; Hot Temperature ; Humans ; Rectum ; Rhabdomyolysis ; Risk Factors ; Sigmoidoscopy ; Soccer ; Weather ; Young Adult

BACKGROUND: Acute liver failure (ALF) is a rapidly progressing and fatal disease for which liver transplantation (LT) is the only treatment. Posttransplant mechanical ventilation tends to be more prolonged in patients with ALF than in other LT patients. The present study examined the clinical effects of prolonged posttransplant mechanical ventilation (PMV), and identified risk factors for PMV following LT for ALF. METHODS: We reviewed data of patients undergoing LT for ALF between January 2005 and June 2011. After grouping patients according to administration of PMV (> or = 24 h), donor and recipient perioperative variables were compared between the groups with and without PMV. Potentially significant factors (P < 0.1) from the univariate intergroup comparison were entered into a multivariate logistic regression to establish a predictive model for PMV. RESULTS: Twenty-four (25.3%) of 95 patients with ALF who received PMV had a higher mortality rate (29.2% vs 11.3%, P = 0.038) and longer intensive care unit stay (12.9 +/- 10.4 vs 7.1 +/- 2.7 days, P = 0.012) than patients without PMV. The intergroup comparisons revealed worse preoperative hepatic conditions, more supportive therapy, and more intraoperative fluctuations in vital signs and less urine output in the with- compared with the without-PMV group. The multivariate analysis revealed that preoperative hepatic encephalopathy (> or = grade III), intraoperative blood pressure fluctuation, and oliguria (< 0.5 ml/kg/h) were independent risk factors for PMV. CONCLUSIONS: PMV was associated with deleterious outcomes. Besides care for known risk factors including hepatic encephalopathy, meticulous attention to managing intraoperative hemodynamic circulatory status is required to avoid PMV and improve the posttransplant prognosis in ALF patients.
Blood Pressure ; Hemodynamics ; Hepatic Encephalopathy ; Humans ; Intensive Care Units ; Liver ; Liver Failure, Acute ; Liver Transplantation ; Logistic Models ; Multivariate Analysis ; Oliguria ; Prognosis ; Respiration, Artificial ; Risk Factors ; Tissue Donors ; Vital Signs

PURPOSE: This study was performed in order to evaluate the association of media exposure with language developmental delay. METHODS: The sample consisted of 40 patients with language developmental delay who visited the pediatric clinic of Dongtan Sacred Heart Hospital from January 2013 to July 2014. The 66 patients, who visited our clinic without language developmental delay, were included in the control group. The data were collected by using self-report questionnaires (media exposure time, contents, background media or foreground media, age of first exposure, and media exposure with or without parents), and analyzed through a t-test, Chi-square test, bivariate logistic regression model by using the SPSS-Version 21.0. RESULTS: The mean age of the language delay group was 33.6±10 months, while the male-to-female ratio was 2.6:1 in this study. In regard to media exposure time, 63% of the language delay patients were exposed to media for more than 2 hours a day, as compared to 16% of the control group (P<0.001). Among the language delay group, 90% of the patients were under 24 months old at the time of exposure to media, as compared to 58% of the control group (P<0.001). In addition, 79% of the language delay group watched media without anyone, as compared to 41% of the control group (P=0.001). CONCLUSION: Risk factors of language developmental delay were exposure to media more than 2 hours a day and toddlers under 24 months old at the time of exposure, as compared to the control group. In conclusion, longer exposure and earlier exposure to media would be risk factors in language developmental delay, and watching media alone may negatively influence the language development.
Heart ; Humans ; Language Development Disorders ; Language Development* ; Logistic Models ; Risk Factors

PURPOSE: This study was performed in order to evaluate the association of media exposure with language developmental delay. METHODS: The sample consisted of 40 patients with language developmental delay who visited the pediatric clinic of Dongtan Sacred Heart Hospital from January 2013 to July 2014. The 66 patients, who visited our clinic without language developmental delay, were included in the control group. The data were collected by using self-report questionnaires (media exposure time, contents, background media or foreground media, age of first exposure, and media exposure with or without parents), and analyzed through a t-test, Chi-square test, bivariate logistic regression model by using the SPSS-Version 21.0. RESULTS: The mean age of the language delay group was 33.6±10 months, while the male-to-female ratio was 2.6:1 in this study. In regard to media exposure time, 63% of the language delay patients were exposed to media for more than 2 hours a day, as compared to 16% of the control group (P<0.001). Among the language delay group, 90% of the patients were under 24 months old at the time of exposure to media, as compared to 58% of the control group (P<0.001). In addition, 79% of the language delay group watched media without anyone, as compared to 41% of the control group (P=0.001). CONCLUSION: Risk factors of language developmental delay were exposure to media more than 2 hours a day and toddlers under 24 months old at the time of exposure, as compared to the control group. In conclusion, longer exposure and earlier exposure to media would be risk factors in language developmental delay, and watching media alone may negatively influence the language development.
Heart ; Humans ; Language Development Disorders ; Language Development* ; Logistic Models ; Risk Factors