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신증후출혈열 환자에서 경구 Ribavirin 의 투여 효과
이승우(Seoung Woo Lee),민현조(Hyun Zo Min) 대한내과학회 1995 대한내과학회지 Vol.48 No.4
N/A (ribavirin group). The control group was 17 patients (15 in 1992, 2 in 1993) and the ribavirin group was 15 patients(all in 1993). No difference was noted between ribavirin and control group at baseline. Results: 1) There were no baseline prognostic factors for mortality in control group. No significant difference in mortality was seen between ribavirin and control group(0/15 vs. 2/17). 2) There were no baseline prognostic factors for hemorrhage in control group. Hemorrhagic complications were significantly decreased in ribavirin group (1/15 vs 7/17, p<0.05)and the ribavirin treatment correlated inversely with the development of hemorrhage(odds ratio 0.16, 95% confidence interval 0.02 to 1.19,p=0.02). By stepwise multiple logistc regression, the variable which better contributed to explain the development of hemorrhagic complications in our patients were ribavirin treatment. 3) No significant differences in duration of febrile, hypotensive and oliguric stage, and skipping of hypotensive and oliguric stage between two groups were seen. But duration of diuretic stage was significantly decreased in ribavirin group(4.7±4.2 vs. 11.4±7.6 days, p<0.05). 4) Mild anemia was observed in most patients and no difference in hematocrit was observed between two groups. Conclusion: Oral ribavirin therapy was effective in the reduction of hemorrhagic complications and duration of diuretic stage. But prospective, double-blind and placebo-controlled study with larger number of patients would be nececsary.
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뇌 전산화 단층촬영과 뇌 단일광자방출 전산화 단층촬영에서 다발성 저음영 또는 관류장애를 보인 열사병 2 예
이승우,민현조 대한내과학회 1994 대한내과학회지 Vol.47 No.2
Heat stroke is the life-threatening emergency recognized by three cardinal signs: severe central nervous disturbance; hyperpyrexia; and hot, dry skin, which is pink or ashen, depending on the circulatory state. It is subdivided into two forms, classic and exertional. Exertional heat stroke is a state of extreme hyperthermia that occurs when excess heat generated by muscular exercise exceeds the body's ability to dissipate it. It has been reported in military personnel, marathon runners, miners who perform strenous jobs in a hot environment, and among Muslim pilgrims in Mekkah, It is an important cause of death and morbidity in military activities such as long marches or field training exercise and annually several patients are admitted to our hospital. It commonly involves several organs including the brain, liver, kidney, heart, and the coagulation system. Immediate elimination of hyperpyrexia and support of vital organ systems are the two principal therapeutic objectives. Disturbances of the central nervous system are present in all cases as the brain is extremely sensitive to hyperthermia. Loss of consciousness often occurs with little waming. Coma, stupor, and combative delirium are often accompanied by plantar response, pupillary abnormalities, or generalized convulsions. The CNS manifestations are caused by the hyperthermia, hemorrhages, congestion, edema, and metabolic disturbances. There had been few reports on the brain CT and SPECT findings of seizure in heat stroke patients. We reported two cases of exertional heat stroke with central nervous system manifiestations, which were manifested by loss of consciousness and generalized convulsion associated with multifocal low density on computed tomography or multifocal perfusion defect on brain SPECT (single photon emission computed tomography).
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