• Title/Summary/Keyword: Fluid therapy

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Neonatal invasive Streptococcus gallolyticus subsp. pasteurianus infection with delayed central nervous system complications

  • Park, Jung-Weon;Eun, So-Hee;Kim, Eui-Chong;Seong, Moon-Woo;Kim, Yun-Kyung
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.33-36
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    • 2015
  • Group D streptococci are known to cause newborn septicemia and meningitis, but the Streptococcus bovis group strains rarely cause serious neonatal infections in Korea. Central nervous system (CNS) complications of neonatal S. bovis group infection have rarely been reported. In adults, S. bovis group strains cause bacteremia and endocarditis, and are associated with gastrointestinal malignancy. However, only a few studies have reported meningitis and septicemia in infants. Here, we describe a case of bacteremia and meningitis due to Streptococcus gallolyticus subsp. pasteurianus with a delayed CNS complication in an infant. A 28-day-old male infant was admitted to the hospital with a 1-day history of fever. Cultures of blood, cerebrospinal fluid, and urine showed the presence of S. bovis group strain-S. gallolyticus subsp. pasteurianus. He was discharged after 21 days of intravenous ampicillin and cefotaxime administration. Two weeks later, he was readmitted with a fever and short episodes of tonic-clonic movements. Brain magnetic resonance imaging showed marked bilateral frontal subdural effusion. He was discharged after 31 days of antibiotic therapy, and no neurological sequelae were observed at the 9-month follow-up. In conclusion, we present a rare case of neonatal S. gallolyticus subsp. pasteurianus infection causing urinary tract infection, septicemia, meningitis, and delayed CNS complications. This case emphasizes the need for physicians to be aware of S. bovis infection in infants.

Reconstruction of the Cone-shaped Defect in the Temporal Area with Rectus Abdominis Free Flap (유리 복직근 피판을 이용한 측두부 원추형 결손의 재건)

  • Kim, Woo Ram;Chang, Hak;Park, Sang Hoon;Koh, Kyung Suck
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.183-188
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    • 2005
  • Defect on the temporal area caused by, surgical ablation of a tumor or an infection should be reconstructed immediately to prevent potentially life-threatening complications such as meningitis and cerebrospinal fluid leakage. The defect on the temporal area usually presents as a typical 'cone-shape'. Successful reconstruction requires sufficient volume of well-vascularized soft tissue to cover the exposed bone and dura. From 1994 through 2003, the authors applied rectus abdominis free flap for the reconstruction of the temporal defect from 1994 through 2003. There were 10 patients with a mean age of 52.1 years. Of these 10 patients, external auditory canal cancer was present in four patients, temporal bone cancer in two, parotid gland cancer in one and three patients were reconstructed after debridement of infection(destructive chronic otitis media). All the free flaps survived, and flap-related complications did not occur. Compared to a local flap, the rectus abdominis free flap can provide sufficient volume of well-vascularized tissue to cover the large defect and can be well-tolerated during an adjuvant radiation therapy. The long and flat muscle can be easily molded to fit in to the 'cone-shape' temporal defect without dead space. It is also preferred because of the low donor site morbidity, a large skin island and an excellent vascular pedicle. Two-team approach without position change is possible. In conclusion, the authors think that rectus abdominis free flap should be considered as one of the most useful method for the reconstruction of a cone-shaped temporal defect.

Acute Suppurative Pericarditis Caused by Liver Abscess -1 case report- (간농양에 속발한 급성화농성 심 낭염 -1례 보고-)

  • 홍장수;노윤우
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.785-788
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    • 1996
  • Pericardial abscess due to liver abscess is a very rare disease, the result of which is usually fatal when untreated. But a combination of antibiotics therapy and pericardial drainage has broug t good result. A 32-year-old man was admitted to the emergency room because of fever and chilling sensation. Chest X-ray showed cardiomegaly and a mass lesion In the left lobe of liver on ultrasonography. The echocardiography revealed impending cardiac tamponade. Pus drainage of the liver abscess through per- foration of right diaphram and pericardiotomy were performed. The pericardium was thickened and 600 ml of purulent fluid and necrotic debris were drained. Fibrin clots were firmly attached to the undelying myocradium. Histological examination of the pericardium showed acute inflammation with microabsscess and Escherichia soli was cultured from pericardial pus. He was discharged after 4 weeks on antibiotics, but Doppler echocardiograpy revealed a slightly thickened pericardium with a mild constrictive physiology.

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A case report of chronic granulomatous disease presenting with aspergillus pneumonia in a 2-month old girl

  • Lee, Eun;Oh, Seak-Hee;Kwon, Ji-Won;Kim, Byoung-Ju;Yu, Jin-Ho;Park, Chan-Jeoung;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.722-726
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    • 2010
  • Chronic granulomatous disease (CGD) is an uncommon inherited disorder caused by mutations in any of the genes encoding subunits of the superoxide-generating phagocyte NADPH oxidase system, which is essential for killing catalase producing bacteria and fungi, such as $Aspergillus$ species, $Staphylococcus$ $aureus$, $Serratia$ $marcescens$, $Nocardia$ species and $Burkholderia$ $cepacia$. In case of a history of recurrent or persistent infections, immune deficiency should be investigated. Particularly, in the case of uncommon infections such as aspergillosis in early life, CGD should be considered. We describe here a case of CGD that presented with invasive pulmonary aspergillosis in a 2-month-old girl. We confirmed pulmonary aspergillosis noninvasively through a positive result from the culture of bronchial alveolar lavage fluid, positive serological test for $Aspergillus$ antigen and radiology results. She was successfully treated with Amphotericin B and recombinant IFN-${\gamma}$ initially. Six weeks later after discharge, she was readmitted for pneumonia. Since there were infiltrates on the right lower lung, which were considered as residual lesions, voriconazole therapy was initiated. She showed a favorable response to the treatment and follow-up CT showed regression of the pulmonary infiltrates.

A Case of Pleural Endometriosis Presented as Right Sided Hemothorax in a Patient Who Underwent Kidney Transplantation (신장이식 후 우측 혈흉으로 발현한 흉막자궁내막증 1예)

  • Shin, Eun-Hye;Shin, Bo-Mi;Ha, Yeon-Jung;Jang, Il-Young;Jung, Ji-Won;Cho, Hyung-Jin;Park, Su-Kil
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.145-148
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    • 2013
  • Thoracic endometriosis is an uncommon disease that has four main forms: catamenial pneumothorax, hemothorax, hemoptysis, and pulmonary nodules. Since the growth of endometrial tissue depends on the presence of estrogen, thoracic endometriosis usually occurs in menstruating women between 25 and 35 years of age. Menstrual disturbances are common in women with chronic kidney disease (CKD). However, they could be reversed after kidney transplantation. Therefore, previously asymptomatic endometriosis may become symptomatic after kidney transplantation. A 49-year-old woman with CKD underwent kidney transplantation. A month later, she experienced dyspnea, and hemothorax in her right hemithorax. However, there was no evidence of infectious diseases and malignancy in thoracentesis, pleural biopsy, and computed chest tomography (CT). The serum and pleural fluid levels of his carbohydrate antigen 125 were elevated. Hemothorax secondary to pleural endometriosis was suspected. We tried hormonal therapy, and the hemothorax disappeared. At the sixth-month follow-up, there was no recurrence of hemothorax.

Atypical presentation of Kawasaki disease resembling a retropharyngeal abscess (인두후부의 농양과 유사하게 표현된 비전형적인 가와사끼병)

  • Kim, Eu Jin;Lim, Young Su;Yoon, Ji Eun;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.251-255
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    • 2009
  • Kawasaki disease is an acute systemic inflammatory disorder, the etiology of which has not yet been established. The clinical manifestations are non-specific and are common to many pediatric infectious and immunologic diseases. In 2 cases presenting fever, cervical lymphadenopathy, and retropharyngeal abscess-like lesions on the neck shown in a computerized tomography (CT) scan, the diagnosis of Kawasaki disease was delayed. The patients were not responsive to antibiotic therapy, and fluid collection was not found during retropharyngeal aspiration. They showed typical Kawasaki manifestations over time and atrioventricular valve regurgitation in the echocardiogram. A diagnosis of Kawasaki disease should be considered in similar cases of fever and cervical lymphadenopathy. A CT scan that shows a retropharyngeal abscess-like lesion on the neck can be a false positive finding, and other laboratory exams, including echocardiography, should be performed as early as possible to avoid unnecessary medical and surgical procedures.

Acute Gastric Dilatation in Rhesus (Macaca mulatta) and Cynomolgus (Macaca fascicularis) Monkeys (Rhesus 및 Cynomolgus 원숭이에서 급성위확장 증례)

  • Lee, Jae-Il;Kang, Byeong-Cheol
    • Journal of Veterinary Clinics
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    • v.25 no.4
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    • pp.314-316
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    • 2008
  • Acute gastric dilatation (AGD), one of the common causes of emergency occurs in macaca monkeys that are accommodated as laboratory-housed nonhuman primates. This report introduces some cases of occurrence in raising primates. The primates revealed an acute gastric dilatation, including the histories that were trained by monkey chair, anesthetized for the study or intact case. The clinical signs were comatose condition with sever abdominal distension, dehydration, cyanosis and apnea. One case died by deterioration of systemic body condition and performed necropsy. The other cases recovered from the AGD by the emergency treatment using the gastric tube and fluid therapy. Necropsy revealed the huge stomach filled with water, gas and ingesta. This report suggests that etiologic factors of AGD may include non-specific factors like these cases, with special emphasis on the incidence and management of AGD in nonhuman primates.

A Literature Study of Senile Constipation (노인(老人) 변비(便秘)에 대(對)한 문헌적(文獻的) 고찰(考察))

  • Jeong, Chang-Hwan;Shin, Hyeon-Chul;Jeong, Ji-Cheon
    • The Journal of Internal Korean Medicine
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    • v.16 no.1
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    • pp.40-61
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    • 1995
  • This study was performed to investigate concept, systoms, causes of disease, pathogenic mechanisms, therapies and precriptions about senile constipation through the successive medical literature, recent chinese medical literature and chinese medical joumals. Senile constipation seems to be applicable to dryness syndrom and constipation of insufficiency type, have something to do with kidney(the most), lung, spleen and large intestine. The most principal cause of disease is yin-fluid, the rest deficiency of qi, insufficiency of yang, stagnation of qi and retention of fever etc. There are enriching the blood and moistening dryness in principal therapy, the rest are invigorating qi and loosing the bowel, warming and invigorating the spleen and kidney, regulating the flow of qi and promoting the stagnancy of qi and expelling the pathogenic heat etc. In prescriptions there are Yunjangtang, Jengaektang, Hwanggitang, Jechunjeon, Yukmatang and Majainhwan as the causes of disease, meanwhile are Yungjang-tang, Jechunjeon and Majainhwan in the vulgaris prescriptions. And in medical herbs there are nourishing yin medicines as Rhizoma rehmanniac, Radix ophiopogonis and Radix scrophulariae etc., invigorating qi medicines as Radix astragali, Radix codonopsitis and Radix polygoni multiflori etc, invigorating yang medicines as Caulis cistanchis and Semen psoraleae etc., promoting qi circulating medicines as Radix saussurea, Lignum aquilariae and Radix linderae etc., and reducing fever and therapeutic method to keep the adverse qi flowing downward medicines as Semen cannabis, Rhizoma rhei, Fructus immaturus ponciri, and Cortex magnoliae etc.. Meantime Rhizoma rehmanniae, Radix ophiopogonis, Caulis cistanchis, Radix angelicae gigantis, Semen cannabis, Semen biotae, Semen pruni japonicae and Semen persicae in principal herb-medicines. In clinical reports the process of disease was between 10 to 20 years, the evacuation cycle between 4 to 7 days, generally possessed chronic diseases as hypertension, diabetes, arteriosclerosis and cerebro- vascular disorders etc. and the efficiency rate was more than 90%. The senile constipation is occured in succession or promoted by chronic diseases as obesity, hypertension, diabetes, arteriosclerosis. hrperlipemia, cerebro- vascular disorders etc., so diet-regulating, adequate exercise, proper evacuation-habit and psychologic rest etc. are important more than medicine-treatments.

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The Study on Aging Process Research (노화(老化)의 연구동향(硏究動向)에 관한 고찰(考察))

  • Lee, Hong-Min;Seo, Jung-Chul;Kim, Yong-Suk
    • Journal of Acupuncture Research
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    • v.18 no.1
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    • pp.146-156
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    • 2001
  • Objectrve : To research the trends of the study related to aging process, and to establish the direction of the study on aging process. Method : We reviewed the journal and essay about the aging process which are published as well in Korea as in foreign country. Results : 1. The study on the Oriental Medicine field can be classfied with the fourth. first, the study of single herb medication's effect on the aging process. second, the study of multiple herb medication's effect on the aging process. third, the study of herb-acupuncture solution's effect on the aging process. fourth, journal review. We find the fact that the study on the Oriental Medicine is concerned with pathology of deficiency syndrome of the kidneys, retention of phlegm and fluid, blood stasis. 2. On the Western Medicine field, mechanism and pathology of aging pracess primarily has been studied. The mechanism of aging process is classified with 'Wear and tear theory' and 'Genome-based theory'. Among the mechanism of aging process, 'Free radical theory' is the most important. Additionally 'Senescence-Accelerated Mouse' has been studied. 3. We review the journal published in foreign country and its subject was the following: first, moxibustion combined with acu-area skin allograft therapy for the aging was effective, second, the traditional chinese medicine bu-zhong-yi-qi-tang in mice have anti-aging effect. third, the overview Preventive geriatrics of Traditional chinese medicine. 4. We researched anti-aging effect study in the journal of the Korean Acupuncture and Moxibustion, and we found a few journal of Herb-acupuncture solution's anti-aging effect. Hereafter, it is necessory that we will study about relationship between acupuncture-moxibustion therpy and anti-aging effect using Senescence-Accelerated Mouse.

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Locally delivered antioxidant gel as an adjunct to nonsurgical therapy improves measures of oxidative stress and periodontal disease

  • Chandra, Rampalli Viswa;Srinivas, Gorremuchu;Reddy, Aileni Amarender;Reddy, Bavigadda Harish;Reddy, Chakravarthy;Nagarajan, Sripriya;Naveen, Anumala
    • Journal of Periodontal and Implant Science
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    • v.43 no.3
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    • pp.121-129
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    • 2013
  • Purpose: The present study has two aims; firstly, it attempts to verify the presence of oxidative stress by estimating the reactive oxygen species (ROS) levels in periodontal pockets ${\geq}5$ mm as compared to controls. The second aim is to evaluate the effect of lycopene as a locally delivered antioxidant gel on periodontal health and on the gingival crevicular fluid (GCF) levels of 8-hydroxydeoxyguanosine (8-OHdG), a marker of oxidative injury. Methods: Thirty-one subjects participated in this study. In the pretreatment phase, the ROS levels in pockets ${\geq}5$ mm were measured by flow cytometry. Three sites in each subject were randomly assigned into each of the following experimental groups: sham group, only scaling and root planing (SRP) was done; placebo group, local delivery of placebo gel after SRP; and lycopene group, local delivery of lycopene gel after SRP. Clinical parameters included recording site-specific measures of GCF 8-OHdG, plaque, gingivitis, probing depth, and clinical attachment level. Results: The gel, when delivered to the sites with oxidative stress, was effective in increasing clinical attachment and in reducing gingival inflammation, probing depth, and 8-OHdG levels as compared to the placebo and sham sites. Conclusions: From this trial conducted over a period of 6 months, it was found that locally delivered lycopene seems to be effective in reducing the measures of oxidative stress and periodontal disease.