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Clinical features and prognostic factors in drowning children: a regional experience
손경래,황수경,최희정 대한소아청소년과학회 2016 Clinical and Experimental Pediatrics (CEP) Vol.59 No.5
Purpose: This study aimed to evaluate the clinical features of children who have survived a water submersion incident, and to identify risk factors for prognosis. Methods: We retrospectively reviewed the medical records of patients who experienced submersion between January 2005 and December 2014. The patients were classified into 2 groups, according to complications, and prognostic factors were evaluated. Results: During the study period, 29 children experienced submersion (20 boys and 9 girls; mean age, 83.8±46.4 months). Submersion occurred most commonly in the summer, with the peak incidence in August. The most frequent Szpilman clinical score was grade 5 (13 patients; 44.8%), followed by grade 6 (7 patients; 24.1%), and grades 1 or 2 (3 patients; 10.3%). Five children (17.2%) in the poor prognosis group died or had hypoxic ischemic encephalopathy, and the overall mortality rate was 6.9%. Poor prognosis after submersion was associated with lower consciousness levels (P=0.003), higher Szpilman scores (P=0.007), greater need for intubation and mechanical ventilator support (P=0.001), and longer duration of oxygen therapy (P=0.015). Poor prognosis was also associated with lower bicarbonate levels (P=0.038), as well as higher sodium, aspartate transaminase (AST), and alanine transaminase (ALT) levels (P=0.034, P=0.006, and P=0.005, respectively). Szpilman clinical scores were positively correlated with consciousness levels (r=0.489, P=0.002) and serum liver enzyme levels (AST and ALT; r=0.521, P=0.004). Conclusion: We characterized the prognostic factors associated with submersion outcomes, using the Szpilman clinical score, which is comparable to consciousness level for predicting mortality.
肝藤疾患患者의 血淸 및 肝生檢 組織內 Glucose-6-phosphatase 活性値에 關한 硏究
孫慶來,高侊道 우석대학교 의과대학 1970 우석의대잡지 Vol.7 No.1
Clinically there are numerous liver function test evidently showing the disturbance of liver function. But the most important thing is to react sensitively to the minor pathologic changes of the liver. In this sense, the determination of enzyme, ie, alkaline phosphatase, choline esterase, transaminase etc. plays an important roles at present. In such enzyme study, glucose-6-phosphatase determination is one of the method relatively well showing the functional disturbance of the liver. Originally, it is said that the glucose-6-phosphatase (G-6-P) participated in forming glucose from glucose-6-phosphate, and this enzyme is mose important in the carbohydrate metabolism. In this report, the G-6-P activity, of the serum and the biopsied liver tissue from several liver disease, was determined and the clinical value was observed. The results were as follows; The G-6-P activity, in 10 cases of control subjects, 53 cases in the serum and 41 cases in the liver tissue on various liver disease, were determined. Remarkable increase of G-6-P activity were observed in acute hepatitis, and when the clinical pictre recovered with treatment the activity became normal limit mostly It seemed to have clinica diagnostic value. But no remarkable increase were observed in chronic hepatitis, liver cirrhosis and primary hepatoma and it seemed to be less clinical value because of little fluctuation after treatment.