• Title/Summary/Keyword: Persistent Infection

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Surgical Treatment of Empyema using Intrathoracic Transposition of Extrathoracic Skeletal Muscles (흉곽내로 전위시킨 골격근을 이용한 농흉의 외과적 치료)

  • Kim, Gi-Bong;Park, Jong-Ho
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.630-636
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    • 1992
  • From August 1990 through December 1991, 14 patients[all males] underwent int-rathoracic muscle transposition of extrathoracic skeletal muscles to treat empyemas, 6 patients had tuberculous empyemas, 4 had chronic empyemas of unknown etiology, 3 had pos-tpneumonectomy empyemas, and 1 had postlobectomy empyema. 9 patients had associated bronchopleural fistulas, Their ages ranged from 22 to 67 years, with mean age of 45.1$\pm$17. 6[$\pm$S.D] years. The serratus anterior was transposed in 13 patients, the latissimus dorsi in 12. In 11 patients, both the serratus anterior and the latissimus dorsi were transposed. The omental flap also transposed in 3 patients. To reduce the dead space in the thoracic cavity, thr-oacoplasty was also carried out in 10 patients. The number of the partially resected ribs was 3.0$\pm$0.8[$\pm$S.D.]. All operations were single stage procedures, and all wounds were closed primarily, with no permanent tubes or chest wall openings. There was no hospital mortality, and so no subsequent operation has been required. Follow-up of the patients ranged from 5 to 16 months with a mean of 9.2$\pm$3.1[$\pm$S.D] months, All the patints had no further signs or symptoms of the original infection after discharge. We conclude that intrathoracic transposition of extrathoracic skeletal muscle is an excellent method of treatment for persistent, life-threatening intrathoracic infections.

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Candida Parapsilosis Spondylodiscitis after Lumbar Discectomy

  • Cho, Kyun-Gil;Lee, Sun-Ho;Kim, Eun-Sang;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.295-297
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    • 2010
  • Candida is a relatively rare cause of spinal infections that commonly affects immunocompromised patients. A 70-year-old woman, who underwent a lumbar discectomy on L5-S1 two months earlier, was admitted to our department complaining of persistent back and leg pain. Magnetic resonance imaging showed irregular enhancing mass lesion in L5-S1 intervertebral space, suggest of pyogenic discitis with epidural abscess. The surgery was performed via retroperitoneal approach and the infected material at L5-S1 intervertebral space was removed. The histological examination of the specimen revealed chronic inflammation involving the bone and soft tissue, and a culture of the excised material was positive for Candida parapsilosis. The patient received intravenous fluconazole for 4 weeks after surgery and oral fluconazole 400 mg/day for 3 months after surgery. The patient made a full recovery with no symptoms 6 months after surgery. We present a rare case of spondylodiscitis after a lumbar discectomy due to Candida parapsilosis and discuss treatment option with a review of the literatures.

Two Cases of Intravenous Immun Globulin Non-responded Kawasaki Disease (정맥용 면역 글로불린 무반응성 가와사끼병 2례)

  • Kim, Hyeon-Bu;Cho, Byung-Soo;CHa, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.5 no.1
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    • pp.147-151
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    • 1998
  • On the treatment of Kawasaki disease, approximately 10% of children treated with IVIG have persistent or recrudescent fever despite IVIG treatment. We had experienced two children with Kawasaki disease who did not respond after multiple dosages of IVIG. They were treated within the first 10 days of onset of fever and were given oral aspirin (100mg/kg/day) and IVIG(2gm/kg) in a single infusion for 8 to 10 hours. The first child had not resolution of symptoms after three intravenous doses of IVIG(total 4gm/kg). And then treated with high dose methylprednisolone(30mg/kg) for 2 to 3 hours intravenously without symptoms improvement. On fifth hospital days, he was retreated with IVIG (2gm/kg) again with ultimate resolution of symptoms. The second child had resolution of symptoms after three intravenous doses of IVIG(total 4gm/kg). No adverse events were associated with the administration of IVIG or steroid. We reported two cases of IVIG non-responded Kawasaki disease with a brief review of the related literatures.

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Management of Post-lobectomy Bronchopleural-cutaneous Fistula With a Rectus Abdominis Free Flap (폐절제술 후 발생한 기관지늑막 피부루에서 유리 복직근피판을 이용한 치료)

  • Heo, Chan Yeong;Min, Kyung Hee;Eun, Seok Chan;Baek, Rong Min;Cheon, Sang Hoon
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.795-798
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    • 2009
  • Purpose: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural - cutaneous fistula developed after undergoing lobectomy for lung cancer. Methods: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleural - cutaneous fistula. Results: The patient has remained healed for 14 months without any postoperative complications and recurrent infection or fistula. Conclusion: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.

A Case of Intralobar Pulmonary Sequestration (내엽형 폐격리증 1예)

  • Seo, Hae-Sook;Park, Mun-Hwan;Rhee, Myung-Seon;Rhu, Nam-Soo;Cho, Dong-Ill;Hur, Yong
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.736-741
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    • 1993
  • Pulmonary sequestration is the part of a spectrum of bronchopulmonary foregut anomalies in which a portion of lung parenchyma does not communicate with the tracheobronchial tree and usually receives its arterial supply from a systemic vessel. The sequestrated portion of the lung is susceptible to infection. The patient with this entity will have a paucity of symptoms and will present himself for treatment because of a persistent pneumonia. The associated aberrant systemic artery makes the preoperative diagnosis of the lesion imperative because of the life-threatening technical hazards posed by this artery. We experienced a case of intralobar pulmonary sequestration. Initially, the diagnosis of sequestration was unsuspected and open thoracotomy was done for management of homogenous cystic mass on left lower lobe, but one anomalous systemic artery from thoracic descending aorta to sequestrated lung was incidentally revealed. Then we underwent lower lobectomy and ligation of anomalous artery.

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Network Defense Mechanism Based on Isolated Networks (격리 네트워크를 활용한 네트워크 방어 기법)

  • Jung, Yongbum;Park, Minho
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.41 no.9
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    • pp.1103-1107
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    • 2016
  • Network assets have been protected from malware infection by checking the integrity of mobile devices through network access control systems, vaccines, or mobile device management. However, most of existing systems apply a uniform security policy to all users, and allow even infected mobile devices to log into the network inside for completion of the integrity checking, which makes it possible that the infected devices behave maliciously inside the network. Therefore, this paper proposes a network defense mechanism based on isolated networks. In the proposed mechanism, every mobile device go through the integrity check system implemented in an isolated network, and can get the network access only if it has been validated successfully.

Esophageal Stricture Secondary to Candidiasis in a Child with Glycogen Storage Disease 1b

  • Lee, Kyung Jae;Choi, Shin Jie;Kim, Woo Sun;Park, Sung-Sup;Moon, Jin Soo;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.1
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    • pp.71-75
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    • 2016
  • Esophageal candidiasis is commonly seen in immunocompromised patients; however, candida esophagitis induced stricture is a very rare complication. We report the first case of esophageal stricture secondary to candidiasis in a glycogen storage disease (GSD) 1b child. The patient was diagnosed with GSD type 1b by liver biopsy. No mutation was found in the G6PC gene, but SLC37A4 gene sequencing revealed a compound heterozygous mutation (p.R28H and p.W107X, which was a novel mutation). The patient's absolute neutrophil count was continuously under $1,000/{\mu}L$ when he was over 6 years of age. He was admitted frequently for recurrent fever and infection, and frequently received intravenous antibiotics, antifungal agents. He complained of persistent dysphagia beginning at age 7 years. Esophageal stricture and multiple whitish patches were observed by endoscopy and endoscopic biopsy revealed numerous fungal hyphae consistent with candida esophagitis. He received esophageal balloon dilatation four times, and his symptoms improved.

A Case of Complete Treatment of Multiple Intracranial Tuberculoma (범발성 두개내 결핵종 완치 1례)

  • La, Eun Young;Lee, Chang Yoo
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.117-121
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    • 2002
  • Although the incidence of intracranial tuberculosis in children have been decreased with development of antituberculous therapy, mortality rate is still high as formerly if the diagnosis and treatment was not performed early. Authors report a case of a 5-month old male with multiple intracranial tuberculoma who have been accompanied by miliary tuberculosis and tuberculous meningitis. He was hospitalized at the pediatric department of Wonkwang University Hospital with mild fever and persistent cough. The brain MRI was performed and showed that there were multiple intracranial micronodular densities, perinodular edema and diffuse leptomeningeal enhancement which were disappeared completely after antituberculosis chemotherapy for 12 months and he had completely recovered without sequale.

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Overview of the Formation, Components, Color, and Abnormal Findings of Urine (소변의 생성, 구성성분, 색깔, 그리고 이상소견)

  • Park, Se Jin;Shin, Jae Il
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.29-34
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    • 2013
  • Urine production is vital for the removal of certain waste products produced by metabolism in the body and for the maintenance of homeostasis in the body. The kidneys produce urine by the following three precisely regulated processes: filtration, reabsorption, and secretion. Urine is composed of water, certain electrolytes, and various waste products that are filtered out of the blood through the glomeruli. The physical features of urine are evaluated carefully to detect any abnormal findings that may indicate underlying diseases in the genitourinary system. A change in urine color may indicate an underlying pathological condition, although many of the causes of abnormal urine color are benign effects of medications and foods. A characteristic and specific odor may be the result of a metabolic disease rather than a concentrated specimen or a simple urinary tract infection. Although transient changes in urine output and nocturia are usually benign conditions, persistent abnormal findings require further workup, with a thorough medical history taking. This article presents many of the conditions that physicians may encounter and will help them in the diagnosis and in establishing a treatment plan.

A long-term subacute sclerosing panencephalitis survivor treated with intraventricular interferon-alpha for 13 years

  • Kwak, Minsun;Yeh, Hye-Ryun;Yum, Mi-Sun;Kim, Hyun-Jin;You, Su Jeong;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.62 no.3
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    • pp.108-112
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    • 2019
  • Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal central nervous system disorder resulting from persistent measles virus infection. Long-term data are scarce, with a maximum follow-up period of 10 years. Interferon-alpha ($IFN-{\alpha}$) is a protein that exerts its antiviral activity via enhancement of cellular immune response and is reported to be an effective drug for the treatment of SSPE. However, there is currently no consensus regarding the optimal duration of $IFN-{\alpha}$ therapy. Here, we present a case report of a patient with SSPE treated with long-term intraventricular $IFN-{\alpha}$ therapy, which facilitated clinical improvement and neurological stabilization without causing serious adverse effects. To the best of our knowledge, this is one of the longest follow-up studies investigating a patient with SSPE receiving intraventricular $IFN-{\alpha}$ treatment. Further studies are necessary to validate the benefits and safety of long-term intraventricular $IFN-{\alpha}$ treatment in patients with SSPE.