• Title/Summary/Keyword: 감염성 심내막염

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Restoration of Blood Pressure after Administering Methylene Blue for Vasoplegic Syndrome, which Developed after Open Heart Surgery for Septic Infective Endocarditis -A case report - (폐혈성 감염성 심내막염으로 개심술 후 발생한 Vasoplegic Syndrome에서 메틸렌 블루의 투여 후 혈압회복 - 1예 보고 -)

  • Lee, Sak;Bae, Mi-Kyung;Yi, Gi-Jong;Youn, Young-Nam;Song, Suk-Won;Kim, Do-Kyun
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.305-308
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    • 2007
  • Vasoplegic syndrome occurs in $8{\sim}10%$ of patients following cardiac surgery, and this happens in part because of inducing the inflammatory response. Nitric oxide and guanylate cyclase play an important role in this response, and this is associated with increased morbidity and mortality. For our case, we administered methylene blue (MB), an inhibitor of guanylate cyclase, early after performing cardiopulmonary bypass in a patient with vasoplegic syndrome. The patient recovered immediately after MB administration and maintained an optimal blood pressure without the aid help of any vasopressors.

Implantation of a permanent pacemaker through the coronary sinus in a patient who underwent mechanical valve replacement for infective endocarditis with a complete atrioventricular block (완전방실차단을 동반한 감염성 심내막염 환자에서 판막치환술 후 관정맥동을 통해 좌심실을 조율하는 심박조율기 시술)

  • Jo, Kwan Hoon;Kim, Inho;Ann, Soe Hee;Oh, Yong Seog
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.113-116
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    • 2014
  • A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.

Complete genome sequence of Eikenella corrodens KCOM 3110 isolated from human subgingival dental plaque of periodontitis lesion (사람 치주염 병소의 치은연하치면세균막에서 분리된 Eikenella corrodens KCOM 3110의 유전체 염기서열 완전 해독)

  • Lim, Yun Kyong;Park, Soon-Nang;Shin, Ja Young;Roh, Hanseong;Ji, Suk;Kook, Joong-Ki
    • Korean Journal of Microbiology
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    • v.55 no.2
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    • pp.154-156
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    • 2019
  • Eikenella corrodens is Gram-negative, facultatively anaerobic, and rod-shaped bacterium. It is a part of the normal human mucosal flora that can cause several systemic diseases such as endocarditis, liver abscess, and intracranial bacterial infection. E. corrodens KCOM 3110 (= JS217) was isolated from human subgingival dental plaque of periodontitis lesion. Here, we present the complete genome sequence of E. corrodens KCOM 3110.

Safety of the genus Enterococcus and the development of food fermentation starters in Korea: Current status and future steps (Enterococcus 속 박테리아의 안전성과 식품발효용 종균 개발의 방향성)

  • Lee, Jong-Hoon
    • Korean Journal of Food Science and Technology
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    • v.52 no.1
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    • pp.11-18
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    • 2020
  • Bacteria of the genus Enterococcus are of importance in food fermentations as well as their use as probiotics in humans and livestock. However, they are also important nosocomial pathogens that cause infections. Some strains are resistant to multiple antibiotics and possess virulence factors. The role of Enterococcus species in disease has raised issues on their safety for use in foods or as probiotics. First, this review summarized the positive and negative traits of Enterococcus spp. to illustrate the controversial nature of this bacterial genus and discussed the current genomic approaches can eliminate pathogenic strains. Then, this review examined the current status of starter development for traditional food fermentations and the regulation on the approval of novel food microorganisms in Korea to point out problems in the regulation. Based on the conclusions from the studies on Enterococcus spp., we suggested the direction of safety assessment of novel food microorganisms in Korea.

Ten Years Experiences of ATS Mechanical Valve (ATS 기계 판막의 10년 임상경험)

  • Yi, Gi-Jong;Bae, Mi-Kyung;Lim, Sang-Hyun;Yoo, Kyung-Jong;Chang, Byung-Chul;Hong, You-Sun
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.891-899
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    • 2006
  • Background: This study is to evaluate the safety of ATS valve by examining the clinical results of ten-years experience. Material and Method: From July 1995 to March 2005, we reviewed 305 patients with ATS valve implantation. Mean age was $49.8{\pm}11.7$ years and 140(45.6%) males were included. Etiologies were rheumatic diseases in 207 cases(67.4%), degenerative changes in 57 cases(18.6%), valve dysfunction in 23 cases(7.5%) and infective endocarditis in 14 cases(4.6%). AVR was performed in 72 patients(23.5%), MVR in 156 patients (50.8%), DVR(AVR+MVR) in 63 patients(20.5%) and TVR in 16 patients(5.2%). Result: There were 9 operative mortalities(2.9%). Follow up period was $56.5{\pm}34.0(0{\sim}115)$ months and 96.4% patients were followed up with 9 late deaths. Five and ten years survival rates were $94.9{\pm}1.3%,\;91.2{\pm}2.3%$ using Kaplan-Meier's methods. Valve related event free survival rates in 5 and 10 years were $90.8{\pm}2.0%$ and $86.9{\pm}3.2%$. There were 16 anticoagulation-related hemorrhages, 6 thromboembolisms, 3 prosthetic valve endocarditis and 1 paravalvular leakage. NYHA class improved after operation(p<0.05). Postoperative echocardiography showed significant decrease in LA size, LVEDD and IVESD(p<0.01). Patients with 19 and 21 mm valve showed significantly higher transvalvular pressure gradient in aortic position(p<0.001, p<0.001). Conclusion: ATS valve showed good hemodynamic results with few valve related complications and thus can be used with acceptable risk.

Clinical Aspects of Pulmonary Radioactivity Observed in Radiocolloid Liver Scintigraphy (간 스캔에서 관찰되는 폐 방사능에 관한 임상적 고찰)

  • So, Young;Lee, Kang-Wook;Lee, Heon-Young;Lee, Won-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.3
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    • pp.185-194
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    • 2002
  • Purpose: We studied clinical aspects and courses of patients with pulmonary radioactivity on liver scintigraphy and speculated the mechanism of pulmonary uptake of radiocolloids. Materials and Methods: Forty-nine patients with pulmonary radioactivity were classified into 5 disease groups-liver disease, infection, cancer, ischemic necrosis of liver, etc.- and their presence or absence of chronic liver disease (CLD), Child-Pugh class, serum levels of AST and ALT, results of follow-up liver scintigraphy and clinical course were checked. Results: Of total 49 patients 25 had CLD; there were 23 liver disease patients, 16 infection patients, 7 advanced cancer patients, 2 ischemic necrosis of liver patients, and 1 hemolytic anemia patient. Reversible rise of serum levels of AST and ALT was observed in all patients with liver disease and ischemic necrosis of liver; on one-way ANOVA, these rise were statistically significant (p<0.01). Serum level of ALT of liver disease group patients without CLD was significantly higher than that of infection group patients without CLD (p<0.05). Among 17 patients who underwent follow-up liver scintigraphy, 13 showed no pulmonary radioactivity. Total 12 patients died during follow-up and most of them were terminal cancer patients or CLD patients of Child-Pugh class C. Conclusion: Pulmonary radioactivity of radiocolloid liver scintigraphy could be attributed to the mobilization of reticuloendothelial system (RES) cells by the activation of RES cells in severe infection and terminal cancer, and also by the extensive liver destruction in liver diseases.

Recurrent Paravalvular Leakage after Mitral Valve Replacement with Annular Reconstruction for Paravalvular Leakage Due to a Paravalvular Abscess - A case report - (판막주위농양에 의해 발생된 판막주위누출 환자에서 승모판막 치환술과 승모판륜 재건술을 함께 시행한 후 재발된 판막주위누출 - 1예 보고 -)

  • Park, Chan-Beom;Kim, Yong-Han;Kweon, Jong-Bum;Park, Kuhn;Chung, Mee-Young;Jin, Ung;Roh, Tae-Ho;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.268-272
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    • 2008
  • Paravalvular abscess is defined as infective necrosis of the mitral annulus and surrounding tissue that requires debridement of the necrotic tissue and patch reconstruction before valve implantation. Paravalvular abscess is associated with high operative mortality, postoperative complications, and recurrence. We report here a case of a 59-year old woman that had undergone mitral valvular replacement with a mechanical valve 13 years ago. The patient was determined to have paravalvular leakage due to paravalvular abscess as seen during follow-up. The patient underwent repeat mitral valvular replacement with annular reconstruction. However, the patient with mitral annular reconstruction and valvular replacement on the fifteenth postoperative day due to recurrence of paravalvular leakage. The patient is now receiving follow-up eight months after surgery.

Cooking Characteristics of Coated Rice with Water Homogenate of Citrus Fruits Peel (감귤과피 물 균질액으로 가공한 유색미의 취반 특성)

  • 서성수;김미향;노홍균;김순동
    • Journal of the East Asian Society of Dietary Life
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    • v.12 no.4
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    • pp.318-325
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    • 2002
  • Cooking characteristics of coated rice with water homogenate of citrus fruit peels (1% for rice) were investigated. The color of the coated rice both before and after cooking was dark yellow. The total content of carotenoids, hesperidin and naringin were 10.74, 2173.12 and 1468.40 mg% for citrus fruit peels, 0.46, 108.65 and 73.35 % for its water homogenate, 0.12, 21.73 and 14.62 mg% for coated rin, and 0.05, 8.67 and 5.87 mg% fur cooked coated rice, respectively. Citrus fruits peel contained 94.22 mg% of asparagine, 24.88 mg% of methionine, 19.64 mg% of alanine, and 15.37 mg% of ${\gamma}$-aminoisobutyric acid as the majority free amino acids, accounting for 70% of the total free amino acids present. Total free amino acid content of the cooked coated rice increased by 15% compared to those of cooked uncoated rice. The majority of minerals in the citrus fruit peels were K and Ca, accounting for 56% of total minerals present. The mineral content of cooked coated rice was generally higher than that of the cooked uncoated rice. The cooked coated rice showed comparable hardness, gumminess and brittleness, but higher cohesiveness and springiness than the cooked uncoated rice. There were no differences in sweet and bitter taste between the cooked uncoated and coated rice. However, the cooked coated rice showed higher sensory scores fur color acceptability, savory taste and overall acceptability than the cooked uncoated rice.

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Risk factors associated with complicated methicillin-resistant Staphylococcus aureus bacteremia in neonates (신생아의 MRSA 균혈증에서 합병증 발생과 연관된 위험인자)

  • Lee, Young Jin;Kim, Hyen Jin;Byun, Shin Yun;Park, Su Eun;Park, Hee Ju
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.173-177
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    • 2010
  • Purpose : Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen that causes nosocomial infection in NICU. It contributes to neonatal morbidity and mortality with variable complications. This study was conducted to identify the risk factors associated with complicated MRSA bacteremia in neonates. Methods : We reviewed the medical records of 44 neonates with positive blood culture for MRSA who were admitted to the NICU of Pusan National University Hospital from January 2002 to December 2007. We compared various factors of the complicated and uncomplicated MRSA bacteremia cases. Results : Of the 44 neonates, 31 were male and 13, female. The mean gestational age and birth weight were $33.2{\pm}4.9$ weeks and $1,859.9{\pm}962.2g$, respectively. Twenty-one of infants were treated with a mechanical ventilator during a mean of $8.8{\pm}13.8$ days. There were 13 cases of complicated and 31 cases of uncomplicated MRSA bacteremia. Between the 2 groups, we compared the following variables: gestational age, birth weight, ventilator use, umbilical catheter use and central catheter insertion, $O_2$ inhalation, first oral feeding day after birth, underlying disease, transfusion, and initial vancomycin use. The underlying disease and transfusion were the risk factors related to complicated MRSA bacteremia. Conclusion : Complicated MRSA bacteremia is related to underlying disease and transfusion. Since this was a retrospective study with a small sample size, it offered limited capacity to compare complicated and uncomplicated MRSA bacteremia. A prospective study with a larger population is needed to determine the exact characteristics of MRSA bacteremia in NICU.

Reoperation for Dysfunction of Cardiac Valve Prosthesis (인공 심장판막 기능부전 환자에서의 심장판막 재치환술)

  • 윤정섭;김치경;조규도;이성호;곽문섭;김세화
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.242-246
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    • 1998
  • From January 1988 to December 1995, 27 patients, 11 men and 16 women, underwent surgical intervention at our institution for prosthetic valve dysfunctions. The mean age was 43.5$\pm$12.2 years. Seventeen(63.0%) patients had the mitral valve replacement, 8(29.6%) the aortic valve, 1(3.7%) the aortic composite graft, and 1(3.7%) the tricuspid valve. Mean follow-up period was 49.5$\pm$30.9 months. In 12 bioprostheses, mean interval between the previous valve replacement and the reoperation was 104.9$\pm$34.9 months. The causes of redo surgery were structural deterioration of the prosthetic valve (12/12, 100%), paravalvular leak (2/12, 16.7%), and prosthetic valve endocarditis(1/12, 8.3%). In 15 mechanical prostheses, the mean interval was 55.2$\pm$43.7 months. The causes of redo surgery were pannus formation (8/15, 53.3%), paravalvular leak(4/15, 26.7%), and valve thrombosis(3/15, 20.0%). Posto- perative complications occurred in 7 patients (25.9%). There was no intraoperative death. But one patient, who received mechanical aortic valve replacement died on the 3rd postoperative day due to low cardiac output and multiorgan failure.

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