• 제목/요약/키워드: Massive infection

검색결과 102건 처리시간 0.029초

한국산 잡견에서의 실험적 심장 이식술 (II) (Experimental cardiac transplantation in the mongrel dogs (II))

  • 이정렬
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.844-853
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    • 1990
  • We have performed 27 cases of orthotopic homologous cardiac transplantation using Korean mongrel dogs and one case of sham operation for the evaluation of harmful effect of cardiopulmonary bypass itself on the dog from April, 1989 to June, 1990. Our previous reports have already demonstrated basal hemodynamic and hematologic data on the canine homologous heart transplantation and the fundamental principles of transplantation of the heart. The mean body weight of recipients was 13.2$\pm$1.2kg with a rage of 11 ~ 15kg, and the hemodynamic and hematologic pictures were almost same as the result of previous reports from our hospital, except marked decrease in postoperative platelet count[from 3.18 $\pm$0.80x106/mm3 to 1.41$\pm$0 37x 106/mm3]. Mean survival time was 24.82$\pm$49.40 hours with the longest survival of 264 hours. Donor cardiectomy included coronary vasodilatation with diltiazem, potassium arrest, and the rapid cooling of the heart suspending in the specially designed ice-bath. Median sternotomy provided excellent exposure of the surgical field. 6 \ulcorner0 prolene suture was used for the anastomosis of both atrial cuffs and the great arteries, and we found the fact that stenosis, bleeding, thrombus formation around the anastomotic site could be decreased with the use of everted horizontal mattress suture techniques. Immunosuppression was done with a combination of lower dose Cyclosporin-A, Azathioprine, methyl-prednisolone, but our cases still showed too short survival to worry about graft rejection. Still poor was our quality control of experimental animal, we had much difficulties in postmortem evaluation of the dogs. Low cardiac output due to biventricular failure, intractable supraventricular or ventricular tachyarrhythmia, postoperative massive bleeding, sepsis were most frequent findings that could be thought as a cause of death. A few cases showed subendocardial patch hemorrhage in both ventricular cavity or atrial septum at autopsy, suggesting acute subendocardial infarction. Although our team overcome most of the technical problems of orthotopic heart transplantation, we should pile up further knowledges about donor heart preservation, quality control of animal, infection, rejection, the effect of the cardiopulmonary bypass to improve the results.

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경안면 괴사성 근막염;증례보고 (CERVICOFACIAL NECROTIZING FASCIITIS;CASE REPORT)

  • 박관수;정기훈;김효언;정정권;윤규호;전인성
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권1호
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    • pp.77-81
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    • 2001
  • 경안명 괴사성 근막염은 높은 사망률을 가진 치명적인 질환이나 혈류가 풍부한 두경부에서는 거의 발생하지 않고 피부에 괴사를 보이지 않는 경우도 많아 두경부에 발생한 감염증의 진단시에 그 가능성을 고려하지 않는 오류를 범하기 쉽다. 따라서, 일단 발생한 경우 오진 또는 뒤늦은 진단으로 환자의 생명을 위협하게 될 수 있다. 이의 진단에는 임상적 검사상 촉진시 느껴지는 염발음이 가장 중요하고 이환 부위의 종창, 악취, 지저분하고 창백하며 붉은 빛을 띠는 피부 표면의 모습, 절개 시 회색빛의 구정물과 같은 삼출물 등이 참고자료가 될 수 있으며, 컴퓨터 단층사진의 촬영을 통해 피하조직의 공기 방울이나 공기 주머니를 확인하고 hemolytic Streptococci등의 균배양 결과를 종합적으로 판단함으로써 더욱 정확한 진단이 가능해지고, 치료방법으로는 빠르고 광범위한 외과적 처치와 대량의 항생제 투여가 가장 중요하고 고압산소요법 등 기타 보조적 처치법을 적절히 시행한다면 좋은 결과를 얻을 수 있을 것으로 사료되었다.

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호산구 증가증을 동반한 거대세포바이러스 감염 소아 Menetrier병 1례 (Cytomegalovirus-induced Childhood Menetrier's Disease with Peripheral Eosinophilia)

  • 최원정;이보영;이희정;오훈규;황진복
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제7권1호
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    • pp.87-91
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    • 2004
  • 저자들은 복통과 구토에 동반된 전신 부종을 주소로 내원하여 저알부민혈증과 말초혈액 호산구증가증의 임상 소견으로 단백 소실성 위장증을 동반한 호산구성 위장관염으로 의심되었으나, 내시경검사 소견, 조직 소견, 방사선 소견과 저절로 좋아지는 일과성 임상 경과 등을 종합하여 말초혈액의 호산구 증가증과 조직 내에서 호산구의 심한 침윤을 보인 CMV 감염 소아 Menetrier병 1례를 보고하고자 한다. CMV 감염과 관련된 소아 Menetrier병의 특징적인 임상 증상과 소견을 염두에 두어야 하며, 향후 CMV 감염과 말초 혈액 호산구증가증과 조직내 호산구 침윤의 관련성에 대하여 임상적 해석이 필요하리라 판단된다.

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Discovering Novel Genes of poultry in Genomic Era

  • S.K. Kang;Lee, B.C.;J.M. Lim;J.Y. Han;W.S. Hwang
    • 한국가금학회지
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    • 제28권2호
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    • pp.143-153
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    • 2001
  • Using bioinformatic tools for searching the massive genome databases, it is possible to Identify new genes in few minutes for initial discoveries based on evolutionary conservation, domain homology, and tissue expression patterns, followed by further verification and characterization using the bench-top works. The development of high-density two-dimensional arrays has allowed the analysis of the expression of thousands of genes simultaneously in the humans, mice, rats, yeast, and bacteria to elucidate the genes and pathways involved in physiological processes. In addition, rapid and automated protein identification is being achieved by searching protein and nucleotide sequence databases directly with data generated from mass spectrometry. Recently, analysis at the bio-chemical level such as biochemical screening and metabolic profiling (Biochemical genomics) has been introduced as an additional approach for categorical assignment of gene function. To make advantage of recent achievements in computational approaches for facilitated gene discoveries in the avian model, chicken expression sequence tags (ESTs) have been reported and deposited in the international databases. By searching EST databases, a chicken heparanase gene was identified and functionally confirmed by subsequent experiments. Using combination of sub-tractive hybridization assay and Genbank database searches, a chicken heme -binding protein family (cSOUL/HBP) was isolated in the retina and pineal gland of domestic chicken and verified by Northern blot analysis. Microarrays have identified several host genes whose expression levels are elevated following infection of chicken embryo fibroblasts (CEF) with Marek's disease virus (MDV). The ongoing process of chicken genome projects and new discoveries and breakthroughs in genomics and proteomics will no doubt reveal new and exciting information and advances in the avian research.

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Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome

  • Song, Seung Min;Cho, Min Sung;Oh, Seak Hee;Kim, Kyung Mo;Park, Young Seo;Kim, Dae Yeon;Lee, Sung Gyu
    • Clinical and Experimental Pediatrics
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    • 제56권5호
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    • pp.224-226
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    • 2013
  • Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resistant Staphylococcus aureus, who presented with non-specific symptoms, which progressed to acute liver failure, displaying the hallmarks of DRESS syndrome. With the presence of aggravated hepatic encephalopathy and azotemia, the patient was refractory to medical treatments, she received a living-donor liver transplantation, and a cure was achieved without any sign of recurrence. Vancomycin can be a cause of DRESS syndrome. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal disease.

우측 폐동맥 형성부전증 -수술치험 1례- (Right Pulmonary Artery Agenesis -A Case Report-)

  • 신동근;김민호;김공수
    • Journal of Chest Surgery
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    • 제30권1호
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    • pp.108-111
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    • 1997
  • 독립적으로 발생하는 일측 폐동맥의 선천성 형성부전증은 매우 드문 기형이며 대부분 활로씨 4징과 같은 심장기형과 동반하여 발생한다. 동반된 선천성 심기형이라 폐감염이 없는 경우 대부분의 환자에서 증상이 없기 때문에 일차적 인 진단은 흉부방사선 촬영상에서 특징적인 양상을 보이는 것으로써 이루어진다 흉부 단순 촬영상 심장과 종격동이 병변측으로 전위되고, 병변측 폐동맥 음영이 보이지 않으며 흉곽의 크기가 정상측에 비하여 작고 횡격막이 거상된 양상을 보인다. 최근 저자들은 다량의 객혈을 주소로 내원한 48세 남자환자에서 우측폐동맥 형성부전증을 폐관류 스캔과 전산화 감골처리 폐동맥 조영술로 진단하고 우중·하엽절제술을 통하여 치료하였기에 문헌고찰과 함께 보고하는 바이다.

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Clinical Outcomes of Diffuse Axonal Injury According to Radiological Grade

  • Lee, Hak-Jae;Sun, Hyun-Woo;Lee, Jae-Seok;Choi, Nak-Joon;Jung, Yoon-Joong;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • 제31권2호
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    • pp.51-57
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    • 2018
  • Purpose: Patients with diffuse axonal injury experience various disabilities and have a high cost of treatment. Recent researches have revealed the underlying mechanism and pathogenesis of diffuse axonal injury. This study aimed to investigate the correlation between the radiological grading of diffuse axonal injury and the clinical outcomes of patients. Methods: From January 2011 to December 2016, among 294 patients with traumatic brain injury, 44 patients underwent magnetic resonance imaging (MRI). A total of 18 patients were enrolled in this study except for other cerebral injuries, such as cerebral hemorrhage or hypoxic brain damage. Demographic data, clinical data, and radiological findings were retrospectively reviewed. The grading of diffuse axonal injury was analyzed based on patient's MRI findings. Results: For the most severe diffuse axonal injury patients, prolonged intensive care unit (ICU) stay (p=0.035), hospital stay (p=0.012), and prolonged mechanical ventilation (p=0.030) were observed. However, there was no significant difference in healthcare-associated infection rates between MRI grading (p=0.123). Massive transfusion, initial hemoglobin and lactate levels, and MRI gradings were found to be highly significant in predicting the duration of unconsciousness. Conclusions: This study showed that patients with high grade diffuse axonal injury have prolonged ICU stays and significantly longer hospital stays. Deteriorated mental patients with high energy injuries should be evaluated to identify diffuse axonal injuries by using an appropriate imaging tool, such as MRI. It will be important to predict the duration of consciousness recovery using MRI scans.

Detection of Xanthomonas axonopodis pv. citri on Citrus Fruits Using Enzyme-Linked Immunosorbent Assay

  • Jin, Kyoung-Sik;Kang, Ik-Beom;Ko, Kyoung-Il;Lee, Eun-Seob;Heo, Jong-Young;Kang, Young-Kil;Kim, Byung-Ki
    • The Plant Pathology Journal
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    • 제17권1호
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    • pp.62-66
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    • 2001
  • Detection of Xanthomonas axonopodis pv. citri (Xac) on citrus fruits for exporting is usually made by bacteriophage test (BPT) to demonstrate the pathogen-free status. BPT has rather time-consuming and complicate procedures for dealing with massive samples to be inspected. In this study, enzyme-linked immunosorbent assay (ELISA) was applied to detect Xac on fruits, and compared with BPT. In ELISA, positive reactions occurred in the bacterial densities of $3\times10^5$ cells/ml or more. To detect the bacterial infection on citrus fruits with a density of lower than $3\times10^5$ cells/ml, the bacterial suspensions were mixed with fruit rinse water and incubated in broth medium. Ordinary peptone sucrose broth (PSB) was not a proper medium for increasing Xac density specifically enough to be detect by ELISA. On the other hand, modified PSB (MPSP) amended with Fe-EDTA (0.25 g/$\ell$) and 2.5% potato-dextrose broth sufficed to differentiate uninfected and infected citrus fruits by ELISA after 24 h incubation of the fruit rinse water. Using various citrus samples from infected and uninfected fields, efficiencies in detecting Xac on fruits were compared between ELISA and BPT. For infected fruits samples, ELISA detected Xac by 100%, while BPT by about 44%, indicating that the detection efficiency was improved by 23.5% by ELISA, compared to BPT. In addition, ELISA has simpler procedures for testing and is less time-consuming than BPT, suggesting that ELISA may be accurate and simple method to detect Xac on citrus fruits.

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Impact of inland waters on highly pathogenic avian influenza outbreaks in neighboring poultry farms in South Korea

  • Ahmad, Saleem;Koh, Kyeyoung;Yoo, Daesung;Suh, Gukhyun;Lee, Jaeil;Lee, Chang-Min
    • Journal of Veterinary Science
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    • 제23권3호
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    • pp.36.1-36.14
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    • 2022
  • Background: Since 2003, the H5 highly pathogenic avian influenza (HPAI) subtype has caused massive economic losses in the poultry industry in South Korea. The role of inland water bodies in avian influenza (AI) outbreaks has not been investigated. Identifying water bodies that facilitate risk pathways leading to the incursion of the HPAI virus (HPAIV) into poultry farms is essential for implementing specific precautionary measures to prevent viral transmission. Objectives: This matched case-control study (1:4) examined whether inland waters were associated with a higher risk of AI outbreaks in the neighboring poultry farms. Methods: Rivers, irrigation canals, lakes, and ponds were considered inland water bodies. The cases and controls were chosen based on the matching criteria. The nearest possible farms located within a radius of 3 km of the case farms were chosen as the control farms. The poultry farms were selected randomly, and two HPAI epidemics (H5N8 [2014-2016] and H5N6 [2016-2017]) were studied. Conditional logistic regression analysis was applied. Results: Statistical analysis revealed that inland waters near poultry farms were significant risk factors for AI outbreaks. The study speculated that freely wandering wild waterfowl and small animals contaminate areas surrounding poultry farms. Conclusions: Pet birds and animals raised alongside poultry birds on farm premises may wander easily to nearby waters, potentially increasing the risk of AI infection in poultry farms. Mechanical transmission of the AI virus occurs when poultry farm workers or visitors come into contact with infected water bodies or their surroundings. To prevent AI outbreaks in the future, poultry farms should adopt strict precautions to avoid contact with nearby water bodies and their surroundings.