OBJECTIVETo study the treatment and the treatment outcome in infants with congenital heart disease complicated by severe pneumonia and heart failure.

METHODSThe clinical data of 24 infants with congenital heart disease (left to right shunt) complicated by severe pneumonia and heart failure between January 2007 and December 2007 were retrospectively reviewed.

RESULTSTwenty-two infants recovered and 2 died. Severe pneumonia and heart failure were refractory even after 1-2 months medical treatment in 6 infants at ages of <6 months. They then underwent an open heart surgery under the mechanical ventilation and tracheal intubations and were successfully cured. The other 18 infants underwent a selective heart surgery after pneumonia and heart failure had been improved. Sixteen infants were successfully cured and 2 died of postoperative low cardiac output syndrome and diffuse intravascular clotting.

CONCLUSIONSThe heart surgery should be performed early when the medical treatment does not work in infants with congenital heart disease complicated by severe pneumonia and heart failure. This may improve their outcome.

Bronchopneumonia ; therapy ; Female ; Heart Defects, Congenital ; complications ; surgery ; Humans ; Infant ; Infant, Newborn ; Male

A clinical observation was made on 11 cases of kidney transplantation donors performed in the Department of Urology, School of Medicine, Kyung Hee University during the period from August, 1978 to October, 1979. The following results were obtained: 1) The age was ranged from 24 to 72 years old and most favorable age was in 50 to 59 years old The average was 51.7 years old. 2) The sex ratio, male to female, was 4:7. 3) Relation between donor and recipient: Related living donor: 10 cases, Unrelated living donor: 1 4) Among total 11 operated patients, thoracoabdominal incision performed on 10 cases and anterior subcostal incision was done only 1 case. 5) Postoperative renal function was estimated through the serum B.U.N and creatinine level at within postoperative 24 hours and it was almost normal range 6) Average operation time was 255 minutes. 7) The postoperative complications were would infection (2 cases), urinary tract infection(1 case), pneumothorax (1 case) and bronchopneumonia (1 case).
Aged ; Bronchopneumonia ; Creatinine ; Female ; Humans ; Kidney Transplantation ; Kidney* ; Living Donors ; Male ; Middle Aged ; Pneumothorax ; Postoperative Complications ; Reference Values ; Sex Ratio ; Tissue Donors* ; Urinary Tract ; Urology

BACKGROUND: Benign esophageal diseases are less common indications for an esophagectomy. The indications for an esophagectomy have not been clearly defined for benign esophageal diseases. The purpose of this study was to defermine whether an esophagectomy should be performed for benign esophageal disease and the indications for an esophagectomy. METHODS: The postoperative morbidity and mortality were examined in 11 patients who had received esophagectomy and esophageal reconstruction for benign esophageal diseases between 1981 and 1996 in this hospital. The indications were identified. RESULTS: The indications included corrosive stricture (6 cases), recurrent achalasia (2 cases), accidental esophageal perforation (1 case), a esophageal diverticulum with stricture (1 case) and suspicion of malignancy (1 case). All of the patients with recurrent achalasia had undergone at least one prior esophageal operation, and all of the patients with stricture had had at least one esophageal dilation previouly. There was no postoperative mortality after the esohagectomies. Postoperative complications developed in 7 patients. Early complications were anastomotic leakage (3 cases), bronchopneumonia (1 case) and DIC & ARDS (1 case). Later complications were intestinal obstruction (1 case), anastomotic bleeding (1 case) and anastomotic stenosis (4 cases) which needed one or two dilation procedures to improve the symptoms. CONCLUSION: Although an esophagectomy for benign esophageal diseases resulted in high morbidity, there were no mortalities. Thus, an esophagectomy should be considered for benign conditions of the esophagus because of corrosive cancer and the end-stage of motility disorders.
Anastomotic Leak ; Bronchopneumonia ; Constriction, Pathologic ; Dacarbazine ; Diverticulum, Esophageal ; Esophageal Achalasia ; Esophageal Diseases* ; Esophageal Perforation ; Esophagectomy* ; Esophagus ; Hemorrhage ; Humans ; Intestinal Obstruction ; Mortality ; Postoperative Complications

BACKGROUND: Community-acquired pneumonia (CAP) is a common respiratory disorder in children, which necessitates hospitalization. Bacterial pneumonia, especially lobar pneumonia and parapneumonic effusions, is associated with considerably severe clinical course and extensive alveolar infiltrates. Serum procalcitonin (PCT) level has been used to distinguish bacterial from viral infections, but its usefulness is disputed. The diagnostic accuracy and usefulness of PCT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count were determined by comparing their values in the patients with CAP with those in healthy controls. METHODS: The serum PCT levels, as well as CRP level, ESR, and WBC counts, were measured in 76 hospitalized patients with CAP (lobar pneumonia, 16; bronchopneumonia, 60) and 18 healthy controls. Serum PCT level was measured using VIDAS(R) BRAHMS PCT (Biomerieux, France), and ROC curve analysis was performed to evaluate its diagnostic accuracy. RESULTS: Serum PCT levels were higher in the patients with CAP than in healthy controls, especially in the patients with lobar pneumonia than in those with bronchopneumonia. Serum CRP level was also significantly elevated in the patients with CAP, especially in those with lobar pneumonia. The diagnostic accuracy of serum PCT level for the diagnosis of lobar pneumonia was better than those of serum CRP level and ESR. The serum PCT level was significantly correlated with the CRP level, ESR, and WBC count. CONCLUSIONS: Serum PCT level was a better marker than CRP level or ESR for the diagnosis of lobar pneumonia in children with CAP.
Adolescent ; Biological Markers/blood ; Blood Sedimentation ; Bronchopneumonia/complications ; C-Reactive Protein/analysis ; Calcitonin/*blood ; Child ; Child, Preschool ; Community-Acquired Infections/complications/*diagnosis ; Female ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Male ; Pneumonia/complications/*diagnosis ; Protein Precursors/*blood ; ROC Curve

Animals ; Antiparasitic Agents ; therapeutic use ; Bronchopneumonia ; drug therapy ; parasitology ; Child ; China ; Combined Modality Therapy ; Diagnosis, Differential ; Humans ; Male ; Myiasis ; complications ; diagnosis ; parasitology ; therapy ; Skin Diseases, Parasitic ; drug therapy ; parasitology ; surgery ; Treatment Outcome