• 한국동물위생학회지
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• 제39권2호
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• pp.131-136
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• 2016

Clostridium novyi (C. novyi) is a gram positive, non-capsulated, motile, obligatory anaerobe that produces endospores. Both C. novyi type A and B produce a bacteriophage encoded lethal alpha toxin which belongs to a family of large clostridial cytotoxins. These large clostridial cytotoxins of C. novyi bind to the uncharacterized receptors on host vascular endothelial cells, which leads to the loss of integrity of the vascular endothelium with subsequent edema, refractory hypotension, organ failure, and sudden death. A total of 13 sudden death cases were submitted to Chonbuk National University-Veterinary Diagnostic Center between June and October, 2015. The samples, mainly liver, were collected in sterile vials after necropsy and processed within 12~24 hours for diagnosis, isolation and identification of C. novyi. All of the 4 gram positive samples showed amplification by PCR. Out of 4 positive samples, 3 were detected to be C. novyi type B and 1 was detected as C. novyi type A. Based on the 16S rDNA sequence analysis, 1 case (150564) showed 99% similarity with C. novyi type A while other 3 cases (150388, 150557 and 150775) presented 99% similarity with C. novyi type B. Based on the results, C. novyi was found to be prevalent in Korean pig farms and causes sudden death to finishing pigs or sows during summer season. Thus, C. novyi should be considered for differential diagnosis on sudden death cases during the summer season.

• 대한신경과학회지
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• 제36권4호
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• pp.310-313
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• 2018

The causes of sudden death after medullary infarction involve arrhythmia, central respiratory failure, and dysautonomia. Sudden cardiac arrest in a medullary infarction is uncommon. Most of these cases experienced sudden cardiopulmonary arrest within 2 weeks from stroke onset as the extent of lesion increased. Here, we report two cases of medullary infarction presenting as sudden cardiac arrest. These cases indicate that medullary infarction could be one of the causes of sudden cardiac arrest.

• Clinical and Experimental Pediatrics
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• 제45권9호
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• pp.1065-1074
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• 2002

목 적 : 영아 돌연사에 있어서 그 역학적 특성을 알아보고 사인을 밝히는데 병력에 대한 자세한 검토, 사망 당시 상황에 대한 조사, 그리고 부검 및 대사 이상 검사 등 사후 검사의 중요성에 대하여 알아보고자 하였다. 방 법 : 1987년 2월부터 2001년 12월까지 14년 8개월간 갑작스런 사망으로 응급실을 방문한 1세 미만의 영아 34례를 대상으로 하여 이들의 임상기록을 후향적으로 조사하여 이들의 역학적 특성을 조사하였다. 과거 병력에 대한 검토, 사망 당시 상황에 대한 조사 및 부검을 실시한 13례의 기록과 2000년 이후 시행한 혈액, 소변, 담즙 및 간조직에서의 사후 아실카르니틴 및 유기산 분석 검사를 통하여 사망의 원인을 분석하였다. 결 과 : 1) 성별 및 연령별 분포 : 총 34례 중 남아 18명(52.9%), 여아 16명(47.1%)으로 남아에서 많이 발생하였고 연령별 분포는 생후 6개월 이하가 31례 (88.2%)로 가장 많은 분포를 차지하였다. 2) 사망시각은 오전 6-12시에 18례(52.9%)로 가장 많은 분포를 보였다. 3) 계절적 분포는 겨울에 가장 많이 사망하였고 13례(38.2%)였다. 4) 사망 발견시 수면 자세를 알 수 있었던 15례 중 복와위가 9례, 앙와위는 6례였다. 5) 병력과 사망 당시 상황으로도 죽음의 원인을 설명할 수 없는 경우가 23례였고 이중 부검을 실시한 13례 중 특이한 병리 소견을 발견할 수 없어 SIDS로 진단을 내린 경우가 7례였고 6례는 부검을 통하여 사망의 원인을 밝힐 수 있었다. 부검을 통해 밝혀진 사인으로는 심내막 섬유 탄성증 1례, 췌도 세포증 1례, 간의 지방 변화로 지방산 대사 이상을 의심할 수 있었던 2례, 경막하 및 경막외 출혈 1례, 기관지폐렴이 1례였다. 선천성 대사 이상 질환은 부검상 총 3례에서 의심되었으나 당시에는 대사 이상 검사가 시행되지 못하였고 2000년부터 시행한 대사 이상 검사에서는 모두 정상 소견이었다. 결 론 : 자세한 병력과 사망 상황에 대한 조사와 함께 부검은 사망의 원인을 밝히고 영아 돌연사 증후군을 진단하는데 필수적이라고 할 수 있으며 앞으로 우리나라에서도 부검의 중요성을 인지하고 이를 적극적으로 시행하여야겠고 지방산 대사 이상을 포함하는 대사 이상 검사도 아울러 적극적으로 시행하여야 할 것이다.

• 한국동물위생학회지
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• 제22권4호
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• pp.325-347
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• 1999

This study was conducted to investigate the epidemiological, clinicopathological, microbiological, pathological observations and other tests from sudden death in feedlot cattle at the region of Sarari in Korea during the period from 1994 to 1999. Massive or sporadic occurrence of sudden death has been observed in 101 heads of 47 farmhouse. There were 20.8% in spring, 29.7% in summer, 16.8% in autumn, 32.7% in winter, and 62.3% in reproductive, 27.7% in growing, 5.0% in beef cattle, 5.0% in calf in prevalence of sudden death in cattle. Enterotoxemia(88.0%), pneumonia(3.5%), intestinal diarrhea(3.5%), liver abscess(1.5%) and indigestion(1.5%) were detected from 67 heads of sudden death cattle. In clinical observations, cattle were generally died of sudden recumbency with convulsions followed anorexia, depression, ataxia, muscular tremor, tachycardia and dyspnea without any premonitory symptoms. Epidemiological surveys showed no evidence that other factors such as pesticide, insecticide, fertilizer, chemical drug3 and those of others caused sudden death. Macroscopically, there were coagulation disorders of blood, congestion, edema and haemorrhage of lung, congestion and haemorrhages, watery and blood-tinged contents of small intestine. Histopathologically, we observed pulmonary congestion and haemorrhage, necrotic intestinal mucosa accompanied with haemorrhage and congestion, and also increased globule leukocytes between bronchial epithelia with mild pneumonia. Clinicopathologically, only elevation of blood glucose and aspartate aminotransferase(AST) was detected. Magnesium and calcium deficiency were not detected, but parasites were detected highly in normal and dead cattles. Microbiologically, Clostridium(Cl) pefringens were detected from small intestinal contents of 94% (63/67) of sudden death cattle and 51%(51/101) of slaughter cattle, and the population were $10^{6-8}$/cfu/$m\ell$ after 16~32 hours. Consequently, it was proved that the cause of death in cattle was enterotoxemia. Pathogenic test of mouse and goat inoculated with Cl perfringens type A toxin has been demonstrated as similar observation to natural cases. In antimicrobial susceptibility test, ampicillin, bacitracin, polymycin, cephalothin, penicillin, choramphenicol, erythromycin, tetracycline were highly susceptible, and amikacin, gentamicin, kanamycin, neomycin, streptomycin, sulfamethoxine, sulfamethazine were resistant. Cl perfringens were resisted for 4 hours in 3% formalin, 20 minutes in 4% phenol, 20 minutes in 0.5% mercuric chloride and 40 minutes in 0.1% sodium hydroxide, respectively. The useful method to prevent from occurrance of enterotoxemia in feedlot cattle was a dietary administration of antibiotics and miyari acid.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.121-126
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• 2018

Coronary spasm generally occurs in patients with minimal atherosclerotic plaque lesion, and it has a rather favorable prognosis. However, in some cases, coronary spasm may induce myocardial infarction and even sudden cardiac death (SCD). Here, we report a case in which multi-vessel intractable coronary vasospasm suddenly occurred in a diffuse atherosclerotic lesion after percutaneous coronary intervention (PCI) in a patient with aborted SCD. We identified the characteristics of the spasm portion in intravascular ultrasound (IVUS) images and conducted percutaneous cardiopulmonary bypass support-PCI with stenting as treatment. Intima and media thickening and a large attenuated plaque burden with rupture were identified in IVUS images at the obstructive spasm portion.

• 한국임상수의학회지
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• 제38권5호
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• pp.254-259
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• 2021

Two cases of sudden death without clinical signs in a four-month-old female Hanwoo (Bos taurus coreanae) and sixteen-month-old female Holstein (Bos taurus taurus) were investigated. Severe pneumonia and septicemia were found on postmortem examination. Petechial and ecchymotic hemorrhages were present in the subcutaneous tissues of the neck region. The lungs remained expanded without collapsing, and the mediastinal lymph nodes were enlarged. A significant number of hemorrhagic bubbles were present in the tracheal lumen. On histopathology, the alveolar blood vessels were moderately congested, and inflammatory cells and multinucleated syncytial cells were found in the alveolar space. The pathogen isolated from the lesion was identified as Bibersteinia trehalosi using MALDI-TOF and 16S rRNA gene and sodA gene sequence analyses. To the best of our knowledge, this is the first report of B. trehalosi infection in cattle in Korea.

• Molecules and Cells
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• 제37권3호
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• pp.241-247
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• 2014

Sudden cardiac death (SCD), which is primarily caused by lethal heart disorders resulting in structural and arrhythmogenic abnormalities, is one of the prevalent modes of death in most developed countries. Myocardial ischemia, mainly due to coronary artery disease, is the most common type of heart disease leading to SCD. However, postmortem diagnosis of SCD is frequently complicated by obscure histological evidence. Here, we show that certain mRNA species, namely those encoding hemoglobin A1/2 and B (Hba1/2 and Hbb, respectively) as well as pyruvate dehydrogenase kinase 4 (Pdk4), exhibit distinct postmortem expression patterns in the left ventricular free wall of SCD subjects when compared with their expression patterns in the corresponding tissues from control subjects with non-cardiac causes of death. Hba1/2 and Hbb mRNA expression levels were higher in ischemic SCD cases with acute myocardial infarction or ischemic heart disease without recent infarction, and even in cardiac death subjects without apparent pathological signs of heart injuries, than control subjects. By contrast, Pdk4 mRNA was expressed at lower levels in SCD subjects. In conclusion, we found that altered myocardial Hba1/2, Hbb, and Pdk4 mRNA expression patterns can be employed as molecular signatures of fatal cardiac dysfunction to forensically implicate SCD as the primary cause of death.

• 한국동물위생학회지
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• 제23권4호
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• pp.309-312
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• 2000

Pathological findings of natural cases of rabbit hemorrhagic disease was investigated. Clinically inappentence, increase in body temperature, depression, bloody foam from nostrils, and sudden death were recognized. Characteristic anatomical findings were hemorrhages in the lungs, liver, kidneys, and heart. Intestinal catarrh and retention of turbid urine in urinary bladder were also often observed. Severe .necrosis of hepatic cells, massive hemorrhages in many organs and membranous glomerulonephritis with hyaline droplet formation were characteristic changes under the microscopy. Perivascular cuffing of brain and catarrhal enteritis were also seen in many cases.

• Journal of Chest Surgery
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• 제28권4호
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• pp.355-359
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• 1995

A clinical analysis was performed on 48 cases with mitral stenosis who received open mitral commissurotomy from December 1983 to June 1991 at the Department of Thoracic & Cardiovascular Surgery, Chungnam National University Hospital. Fifteen patients were men and 33 were women. the mean age was 35.6 years with the range of 16 to 61 years. The distribution of preoperative NYHA Functional Classes was as follows; class II, 25 patients; class III, 20 patients; class IV, 3 patients. Three patients had cerebral emboli preoperatively, all of whom were in atrial fibrillation. The preoperative electrocardiographic studies revealed that 32 patients had sinus rhythms and 16 had atrial fibrillations. Twenty-six patients had open mitral commissurotomy alone and 22 patients had additional cardiac procedures. Intraoperatively, there were 6 cases of left atrial thrombosis. There was no perioperative death but early postoperative complications were found in 3 cases. The patients were followed up from 2 to 99 months[mean 33.7 months . There was one case of late unexplained sudden death. There was a case of late postoperative cerebral infarction, 5 cases of mitral restenosis and 3 cases of congestive heart failure and/or arrhythmia. Mitral valve replacements were required in 3 patients.But, it is evident that open mitral commissurotomy has many advantages beyond mitral valve replacement concerning the results of the mitral valve replacement underwent during the same period at the Department of Thoracic & Cardiovascular Surgery, Chungnam National University Hospital.

• Journal of Chest Surgery
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• 제25권1호
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• pp.49-56
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• 1992

Total 20 cases of reoperation for mitral vavular disease, which had been performed during the period from May 1983 till October 1991, were reviewed. This study contained 1 case of previous balloon valvuloplasty and 1 case of death with bleeding from right ventricle during sternal reenrty. The average time intervals between reoperation and previous operation was 19 years in closed mitral commissurotomy[n=4], 7 years and 2 months in mitral valve replacement[n=10], 1 year and 8 months in mitral valvuloplasty[n=4], 3 years and 10 months in open mitral commissurotomy [n=2]. The cause of reoperation in closed mitral commissurotomy was progression of the disease, and residual stenosis with progression was the cause in open mitral commissurotomy cases. Technical failure might be the cause in the cases of valvuloplasty. In prosthetic valve replacement group the causes of reoperation were primary failure. Also two cases of suggested valve thrombosis and one case of failure of tricuspid annuloplasty was noted in prosthetic valve replacement group. The used valves for reoperation were Ionescue-Shiley in 3 cases, Bjork-Shiley in 6 cases, St. Jude Medical in 2 cases and CarboMedics in 8 cases. The mortality rate was 20%[n=4] and the causes of death were low output syndrome in 1 case, multiple organ failure in 2 cases and bleeding in 1 case during sternal reentry. During follow up 1 case of sudden death was observed.