• 한국임상수의학회지
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• 제35권6호
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• pp.269-272
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• 2018

A 4-year-old, 6.1 kg intact female dachshund was referred to the Animal Medical Center with acute right hind limb lameness. Radiographs revealed fractures of iliac body and tibia in the right limb. In addition, the dog exhibited tricuspid valve regurgitation and moderate heartworm infection in the right ventricle and main pulmonary artery on echocardiogram. To obtain stable anesthetic conditions for operation, an adult heartworm removal procedure was previously followed by repair of the complex fractures. All surgical procedures were done without complication and with stable patient conditions. At a one month postoperative follow-up, the dog was doing well with normal ambulation and no tricuspid valve regurgitation as well.

• Parasites, Hosts and Diseases
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• 제52권5호
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• pp.521-525
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• 2014

Human infections with Lophomonas blattarum are rare. However, the majority of the infections occurred in China, 94.4% (136 cases) of all cases in the world. This infection is difficult to differentiate from other pulmonary infections with similar symptoms. Here we reported a case of L. blattarum infection confirmed by bronchoalveolar lavage fluid smear on the microscopic observations. The patient was a 21-year-old female college student. The previous case which occurred in Chongqing was 20 years ago. We briefly reviewed on this infection reported in the world during the recent 20 years. The epidemiological characteristics, possible diagnostic basis, and treatment of this disease is discussed in order to provide a better understanding of recognition, diagnosis, and treatment of L. blattarum infection.

• Journal of Medicine and Life Science
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• 제19권1호
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• pp.26-29
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• 2022

Cryptococcus neoformans infection usually occurs in patients with advanced human immunodeficiency virus (HIV) infection or with a CD4 T lymphocyte count of <100 cells/µL. Pulmonary and central nervous system infections are the most frequently encountered forms of cryptococcosis; however, colonic cryptococcosis is uncommon. We describe the case of a 41-year-old antiretroviral-naïve man with HIV infection diagnosed eight years prior and intermittent diarrhea for 4 months who presented to the emergency department with a 1-day history of low-grade fever and confusion. Brain magnetic resonance imaging and cerebrospinal fluid analysis revealed normal results; however, he was diagnosed with Pneumocystis jirovecii pneumonia based on chest computed tomography and bronchoalveolar lavage analysis. Trimethoprim-sulfamethoxazole administration was initiated followed by antiretroviral treatment. Although his condition gradually improved, he developed fever and abdominal discomfort, and the diarrhea worsened. Endoscopy revealed a small ulcer in the distal transverse colon. Histopathological examination of a colon tissue sample revealed cryptococcal infection. He improved substantially during liposomal amphotericin B and fluconazole treatment. We encountered a rare case of colonic cryptococcosis that caused chronic diarrhea in a patient with advanced HIV infection. Colonic cryptococcosis should be considered when patients with acquired immune deficiency syndrome present with gastrointestinal symptoms.

• Tuberculosis and Respiratory Diseases
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• 제73권4호
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• pp.219-223
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• 2012

Background: We investigated the prevalence of latent tuberculosis infection (LTBI) among medical students in South Korea. Methods: Students from one medical school, who were in second- or third-year classes before clerkship course, were enrolled for three consecutive years in the study. A standard questionnaire was given to each participant, and tuberculin skin test (TST), QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay, and chest radiography were performed. Results: A total of 153 participants were enrolled in the study. The mean age of the subjects was $21.9{\pm}0.9$ years, 105 (68.6%) were male, and 132 (86.3%) had been vaccinated with Bacille Calmette-Gu$\acute{e}$rin (BCG). Four students (2.6%) had a history of contact with tuberculosis (TB) patients during medical practice. No abnormal chest radiograph findings were found for any of the subjects. Of the 153 subjects, 23 (15.0%) tested positive for the TST, and 8 (5.2%) tested positive for the QFT-GIT. The agreement between the two tests was determined to be 0.34 using kappa coefficients. Of the four students who had a history of contact with TB patients, only one subject tested positive for both tests, and the other three students tested negative for both tests. Conclusion: A low prevalence of LTBI was found among medical students before clerkship course in South Korea.

• Journal of Chest Surgery
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• 제40권11호
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• pp.782-785
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• 2007

Lemierre 증후군은 구인두 감염증에 의해 유발되며 이차적으로 내경정맥의 패혈성 혈전정맥염이 발생하고 원격전이성 감염증이 흔하다. Fusobacterium necrophorum이 가장 흔한 원인 균주이고, 항균제의 출현 이전에는 사망률이 매우 높은 흔한 질환이었다. 항균제의 출현과 구인두 감염증에 대한 광범위한 항균제의 사용으로 발병이 매우 드물어, 이제는 잊혀져 가는 질환이 되었으나, 여전히 높은 사망률을 보이고 있다. 합병증과 사망률을 줄이기 위해서 빠른 진단과 적절한 항생제 치료가 필수적이다. 패혈성 폐색전증을 동반한 Lemierre 증후군 1예를 보고한다.

• Journal of Chest Surgery
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• 제32권6호
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• pp.573-578
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• 1999

배경: 식도절제술후 식도대용장기로 위장이 가장 흔히 사용되어지는데 위장은 다른 장기에 비해 다루기가 비교적 간편하며 합병증이 적게 발생된다고 한다. 위장을 이용한 식도재건술에서 발생한 합병증을 분석 조사하였다. 대상 및 방법: 연세의대 영동세브란스병원 흉부외과에서는 1990년부터 1998년까지 식도질환으로 식도절제술후 식도위 문합술을 시행 받은 환자를 대상으로 하였다. 결과: 술후 합병증이 70.5%이었고 수술 사망률이 6.8%이었다, 가장 흔히 발생되었된 합병증은 문합부협착이 13.6%, 폐렴 11.4%, 창상 감염이 9.1% 이었다. 술후 사망원인은 전부가 폐합병증과 패혈증이였다. 결론: 문합부 누출 및 협착 등의 기술적인 문제는 많은 발전을 보였으나 술후 충분한 영양공급, 폐감염 방지 , 적극적인 물리치료 등이 폐합병증 및 사망률을 감소시키는데 중요하다.

• Tuberculosis and Respiratory Diseases
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• 제70권3호
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• pp.191-198
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• 2011

Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU), with an incidence ranging from 8% to 38%. Patients who acquire VAP have higher mortality rates and longer ICU and hospital stays. Because there are other potential causes of fever, leukocytosis, and pulmonary infiltrates, clinical diagnosis of VAP is overly sensitive. The only alternative approach to the clinical diagnosis of VAP is the Clinical Pulmonary Infection Score (CPIS). Employing quantitative cultures of respiratory secretions in the diagnosis of VAP leads to less antibiotic use and probably to lower mortality. With respect to microbiologic diagnosis, however, it is not clear that the use of invasive sampling using bronchoscopy is associated with better outcomes. Delayed administration of antibiotic therapy is associated with an increased mortality, and inadequate antibiotic therapy is also associated with higher mortality. Therefore, prompt initiation of adequate antibiotic therapy is a cornerstone of the treatment of VAP. The initial antibiotic therapy should be based on the most common organisms in each hospital and the most likely pathogens for that specific patient. When final cultures and susceptibilities are available, de-escalation to less broad spectrum antibiotics should be done. Since clinical improvement usually takes 2 to 3 days, clinical responses to the initial empirical therapy should be evaluated by day 3. A short course of antibiotic therapy appears to be equivalent to a traditional course of more than 14 days, except when treating non-fermenting gram-negative organisms. If patients receive initially adequate antibiotic therapy, efforts should be made to shorten the duration of therapy to as short as 7 days, provided that the etiologic pathogen is not a non-fermenting gram-negative organism.

• 대한의생명과학회지
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• 제20권3호
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• pp.162-167
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• 2014

Tuberculosis (TB) is one of the major global health problems and it has been estimated that in 5~10% of Mycobacterium tuberculosis (MTB)-infected individuals, the infection progresses to an active disease. Numerous cytokines and chemokines regulate immunological responses at cellular level including stimulation and recruitment of wide range of cells in immunity and inflammation. In the present study, the mRNA expression levels of eight host immune markers containing of IFN-${\gamma}$, TNF-${\alpha}$, IL-2R, IL-4, IL-10, CXCL9, CXCL10, and CXCL11 in whole blood cells from active pulmonary TB patients were measured after T-cell mitogen (PHA) and MTB specific antigens (ESAT-6, CFP-10, and TB7.7). Among the TH1-type factors, IFN-${\gamma}$ mRNA expression was peaked at 4 h, TNF-${\alpha}$ and IL-2R mRNA expression was significantly high at the late time points (24 h) in active TB patients, TH2-type cytokine (IL4 and IL10) mRNA expression levels in both active TB and healthy controls samples did not changed significantly, and the mRNA expression of the three IFN-${\gamma}$-induced chemokines (CXCL9, CXCL10, and CXCL11) were peaked at the late time points (24 h) in active TB patients after MTB specific antigen stimulation. In conclusion, the mRNA expression patterns of the TB-related immune markers in response to the T-cell mitogen (PHA) differed from those in response to MTB specific antigens and these findings may helpful for understanding the relationship between MTB infection and host immune markers in a transcripts level.

• Tuberculosis and Respiratory Diseases
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• 제81권1호
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• pp.6-12
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• 2018

The role of the treatment for latent tuberculosis infection (LTBI) has been underscored in the intermediate tuberculosis (TB) burden countries like South Korea. LTBI treatment is recommended only for patients at risk for progression to active TB-those with frequent exposure to active TB cases, and those with clinical risk factors (e.g., immunocompromised patients). Recently revised National Institute for Health and Care Excellence (NICE) guideline recommended that close contacts of individuals with active pulmonary or laryngeal TB, aged between 18 and 65 years, should undergo LTBI treatment. Various regimens for LTBI treatment were recommended in NICE, World Health Organization (WHO), and Centers for Disease Control and Prevention guidelines, and superiority of one recommended regimen over another was not yet established. Traditional 6 to 9 months of isoniazid (6H or 9H) regimen has an advantage of the most abundant evidence for clinical efficacy-60%-90% of estimated protective effect. However, 6H or 9H regimen is related with hepatotoxicity and low compliance. Four months of rifampin regimen is characterized by less hepatotoxicity and better compliance than 9H, but has few evidence of clinical efficacy. Three months of isoniazid plus rifampin was proved equivalence with 6H or 9H regimen in terms of efficacy and safety, which was recommended in NICE and WHO guidelines. The clinical efficacy of isoniazid plus rifapentine once-weekly regimen for 3 months was demonstrated recently, which is not yet introduced into South Korea.

• Tuberculosis and Respiratory Diseases
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• 제74권6호
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• pp.269-273
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• 2013

Mucormycosis is a rare fungal disease that holds a fatal opportunistic fungal infection in diabetes mellitus, hematological malignancy, and immunocompromised host. Isolated pulmonary mucormycosis is extremely rare. Optimal therapy is a combined medical-surgical approach and a management of the patient's underlying disease. Herein, we report a case-study of isolated pulmonary mucormycosis which was being presented as multiple lung nodules in a patient with no underlying risk factors. Considering that the patient had poor pulmonary functions, we treated him with only antifungal agent rather than a combined medical-surgical approach. After treatment with antifungal agent for six months, the nodules of pulmonary mucormycosis were improved with the prominent reductions of size on the computed tomography.