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화농성 간농양과 대량 용혈성 빈혈로 나타난 Clostridium perfringens에 의한 중증 패혈쇼크 1예
강선명 ( Sun-myoung Kang ),윤정아 ( Jung A Yoon ),김시찬 ( Si Chan Kim ),소설 ( Seol So ),이훈희 ( Hoon Hee Lee ),조석정 ( Seok Jung Jo ),허진원 ( Jin-won Huh ) 대한내과학회 2016 대한내과학회지 Vol.91 No.1
임상적으로 간농양의 원인균은 폐렴간균과 같은 그람음성간균에 의한 것이 대부분으로 건강한 사람에서 클로스트리듐퍼프린젠스에 의한 간농양 및 패혈증은 매우 드물다. 하지만 클로스트리듐퍼프린젠스에 의한 패혈증은 매우 중독한 경과를 보이며, 드물지만 특징적인 합병증인 대량 혈관내 용혈이 동반된 경우 사망률은 70%에서 100%에 이른다. 이에주의 깊은 병력 청취 및 특징적인 임상 관찰을 통해 클로스트리듐퍼프린젠스 감염을 조기 진단하는 것이 가장 중요하며 이후 신속한 경험적 항생제 투약 및 원인 조직의 수술적제거가 사망률을 낮추는데 필수적이다. A 65-year-old female visited the emergency room for severe back pain radiating to the neck. Aortic dissection computed tomography revealed a ruptured liver abscess and large pneumoperitoneum. Although emergent percutaneous drainage of the liver abscess and aggressive resuscitation were performed, massive hemolytic anemia and disseminated intravascular hemolysis developed and she subsequently died, 11 hours after her visit to the emergency room. Clostridium perfringens was identified in a blood culture obtained at the emergency room. We report this case because refractory septic shock due to a liver abscess and massive intravascular hemolytic anemia caused by Clostridium perfringens in a healthy female is rare. (Korean J Med 2016;91:57-61)
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李善明,姜順熙 漢陽大學校 韓國生活科學硏究所 1986 韓國 生活 科學 硏究 Vol.- No.4
For the purpose of establishing the stand size and studying the basic somatotype of pregnant women's garments, I measured pregnant women's physical variation each month by Martin anthropometer. 390 pregnant women, between age from eighteen to fortyfour, living in Seoul and Kyung-ki Province, were selected as subject by cluster sampling method. The month of pregnancy were calculated to be distributed equally each month by completed week on the basis of the last menstrual period. 55 measurement items involving body weight and seven additional items were used. The obtained from this analysis were as follows: (1) Physical variation of pregnant women from month to month: The result of measurement: measured values of 55 items studied appear at Table 5. a) In the items of height; frontal waist height and omphalion height increased, but others remained with no change. b; In the items of breadth, depth and length; bust breadth, waist breadth, nipples breadth, chest length increased, all the items of depth increased as well. c) The items which showed a remarkable and significant increase were bust girth, waist girth, abdominal girth, hip girth, neck base girth, and maximum thigh girth. d) In the items of length: total crotch length, FNP to middle hip line (=abdominal), waist to hip increased, however, FNP to frontal waist line decreased. e) The transition by monthly variation increased slowly from the third to the fifth month of pregnancy and from the fifth to the eighth month increased and rolled largely while the ninth fixed or rather decreased. f) The value of cross-index; the items of bust and hip moved narrowly but the items of waist, omphalion and middle hip (=abdominal) moved largely. From the measurement, these changes seemed due to the following three factors. i) by growth of fetus ii) augmentation of corpulency iii) change in posture of pregnant women themselves (2) Comparison with other reports: As for monthly variation in pregnancy, the conclusion was the same in the items which showed meaningful physical changes, however, the measurement value used in this report predominated over other reports. (3) The comparison between the third month of pregnant women and non-pregnant by age: In general, the items representing the size of body were shown to be increased according to increase of age. But non-pregnancy was nothing to do with pregnancy in physical variation. (4) The comparison between the primiparae and the multiparae: except for the women in the fifth month of pregnancy, all the values of multiparae were greater than those of primiparae. (5) The establishment of standard parts by way of analizing the factors, I conclude that following items should be considered when we are to design for garments and trousers of pregnant women. a) One-piece garments designed for pregnant women: Stature, bust girth, omphalion girth and length of FNP-middle hip. b) Trousers designed for pregnant women: Back waist height, waist girth, hip girth and total crotch length or waist to hip length. In particular, as for designes by individual preferences, I specify following items as specific unique factors. Tibiale height, crotch height, posterior waist length, total posterior arm length, posterior shoulder width, across back width neck-base girth, upper arm girth, tight girth, middle hip girth, FNP-hip line and SNP-bust point. (6) As for comparison with ages, changes occured only on bust breadth between the third month of pregnant women and nonpregnant. I came to a conclusion that the changes occur from the bust breadth part, therefore, non-pregnancy is nothing to do with pregnancy in physical variation. As a conclusion, when we design for garments of pregnant women, it is desirable to make patterns after considering the monthly variation of body which were caused by pregnancy and make gradings of standard part by means of establishing items for measurement. However, as it seems difficult to make the size for garments of pregnant women according to the monthly variation of body caused by, pregnancy, it is better to plan for making garments in advance by expecting the variation of body at the fifth month, eighth month and tenth of pregnancy. Moreover, it is wise way, even look further for the future changes of season, to plan suitable size for eadh seasons.
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