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

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

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*

No abstract available.
Mesenteric Artery, Superior* ; Superior Mesenteric Artery Syndrome*

No abstract available.

Blunt chest trauma to the heart may produce instantaneous death or, more frequently, congestive heart failure due to myocardial injury or disruption of intracardiac structures. Cardiac injury following by blunt chest trauma is often unsuspected and can range from cardiac contusion to chamber rupture, or to valvular dysfunction. The rate of occurrence of acute traumatic valvular insufficiency is extremely rare. Especially, the tricuspid valve is very rarely injured. Although clinical diagnosis of acute traumatic valvular insufficiency can be difficult to make for trauma patients with multiple injuries, echocardiography can establish diagnosis quickly and accurately. This report describes a patient who developed tricuspid regurgitation and acute heart failure following by an MCV.
Contusions ; Diagnosis ; Echocardiography ; Heart ; Heart Failure ; Humans ; Multiple Trauma ; Rupture ; Thorax* ; Tricuspid Valve ; Tricuspid Valve Insufficiency*

No abstract available.
Endorphins* ; Pain, Postoperative* ; Plasma*

No abstract available.
Biliary Tract* ; Lymphatic Diseases*

No abstract available.

No abstract available.
Histamine* ; Peptic Ulcer*