Eikenella corrodens is a slow growing, facultatively anaerobic gram-negative rod that is part of the normal flora of the oral cavity and upper respiratory tracts. In most patients with E. corrodens infections, host defenses are compromised due to surgery, or chronic debilitating illness such as malignancies, or immunosuppressive therapy. This organism causes abscesses and infections that are at times fatal. We experienced a case of E. corrodens isolated from liver abscess in an immunocompetent patient. A 50-year-old man who is a dentist, was hospitalized because of fever and myalgia of 10 days' duration. Abdominal ultrasonography showed non-septated, 3.8x4.6 cm sized abscess in the segment 6/7 of the liver. E. corrodens was isolated from aspiration of liver abscess. This organism was presumably acquired from his patient's oral cavity during dental procedure. We hope that increased awareness to E. corrodens will raise the index of suspicion, and contribute to optimal management of these infections, minimizing the significant morbidity associated with this organism.
Abscess ; Bites, Human* ; Dentists ; Eikenella corrodens* ; Eikenella* ; Fever ; Hope ; Humans ; Humans* ; Liver Abscess* ; Liver* ; Middle Aged ; Mouth ; Myalgia ; Respiratory System ; Ultrasonography

The Mycobacterium avium complex (MAC) comprises slow-growing mycobacteria that is ubiquitous in the environment and capable of infecting diverse species with consequences ranging from asymptomatic infection to clinically significant and even fatal disease. Especially, basal pleural disease is infrequently found in immunocompetent person. We report a very rare case of M. avium pleuritis with massive pleural effusion without any predisposing conditions. A previously healthy 36-year-old man was admitted to our hospital because of generalized malaise, low-grade fever, and right pleuritic chest pain of 5 days' duration. Chest X-ray showed mottled infiltration in the right upper lung zone with minimal right pleural effusion which was exudate with lymphocyte-dominance. The pleural effusion progressively increased without responding to anti-tuberculosis treatment. Afterwards M. avium was identified from the pleural effusion using PCR-Restriction Fragment Length Polymorphism Assay(PCR-RFLP). The treatment regimen was changed to rifampine, ethambutol, clarithromycin and streptomycin afterwhich the patient recovered.
Adult ; Asymptomatic Infections ; Chest Pain ; Clarithromycin ; Ethambutol ; Exudates and Transudates ; Fever ; Humans ; Lung ; Lung Diseases* ; Mycobacterium avium Complex ; Mycobacterium avium* ; Mycobacterium* ; Pleural Diseases ; Pleural Effusion* ; Pleurisy ; Rifampin ; Streptomycin ; Thorax

The Mycobacterium avium complex (MAC) comprises slow-growing mycobacteria that is ubiquitous in the environment and capable of infecting diverse species with consequences ranging from asymptomatic infection to clinically significant and even fatal disease. Especially, basal pleural disease is infrequently found in immunocompetent person. We report a very rare case of M. avium pleuritis with massive pleural effusion without any predisposing conditions. A previously healthy 36-year-old man was admitted to our hospital because of generalized malaise, low-grade fever, and right pleuritic chest pain of 5 days' duration. Chest X-ray showed mottled infiltration in the right upper lung zone with minimal right pleural effusion which was exudate with lymphocyte-dominance. The pleural effusion progressively increased without responding to anti-tuberculosis treatment. Afterwards M. avium was identified from the pleural effusion using PCR-Restriction Fragment Length Polymorphism Assay(PCR-RFLP). The treatment regimen was changed to rifampine, ethambutol, clarithromycin and streptomycin afterwhich the patient recovered.
Adult ; Asymptomatic Infections ; Chest Pain ; Clarithromycin ; Ethambutol ; Exudates and Transudates ; Fever ; Humans ; Lung ; Lung Diseases* ; Mycobacterium avium Complex ; Mycobacterium avium* ; Mycobacterium* ; Pleural Diseases ; Pleural Effusion* ; Pleurisy ; Rifampin ; Streptomycin ; Thorax

Eikenella corrodens is a slow growing, facultatively anaerobic gram-negative rod that is part of the normal flora of the oral cavity and upper respiratory tracts. In most patients with E. corrodens infections, host defenses are compromised due to surgery, or chronic debilitating illness such as malignancies, or immunosuppressive therapy. This organism causes abscesses and infections that are at times fatal. We experienced a case of E. corrodens isolated from liver abscess in an immunocompetent patient. A 50-year-old man who is a dentist, was hospitalized because of fever and myalgia of 10 days' duration. Abdominal ultrasonography showed non-septated, 3.8x4.6 cm sized abscess in the segment 6/7 of the liver. E. corrodens was isolated from aspiration of liver abscess. This organism was presumably acquired from his patient's oral cavity during dental procedure. We hope that increased awareness to E. corrodens will raise the index of suspicion, and contribute to optimal management of these infections, minimizing the significant morbidity associated with this organism.
Abscess ; Bites, Human* ; Dentists ; Eikenella corrodens* ; Eikenella* ; Fever ; Hope ; Humans ; Humans* ; Liver Abscess* ; Liver* ; Middle Aged ; Mouth ; Myalgia ; Respiratory System ; Ultrasonography

PURPOSE: Congenital chloride diarrhea(CLD) is an autosomal recessive disease characterized by life-long watery diarrhea of prenatal onset with high fecal Cl concentration. Recent studies have revealed that the protein product of the down-regulated in adenoma(DRA) gene is an intestinal anion transporter molecule and causes CLD when mutatec4: We investigated the clinical characteristics of CLD in Korean infants in order to increase awareness of this disease, which might be simply overlooked as chronic diarrhea. METHODS: Medical records of 5 infants admitted to the pediatric departments of Eulji Medical Center and Seoul National 1Jniversity Children's Hospital from April 1988 to January 1998 with the diagnosis of CLD were retrospectively reviewed. The criteria for inclusion in the study were based on a typical clinical picture and high fecal Cl RESULTS: There were 4 boys and 1 girl, 2 of them were siblings with no consanguinity in their parents. Their ages ranged from birth to l4 months. The mean gestational age was 36 weeks and the mean birth weight was 2.99kg. In all patients abdominal distension, jaundice and watery diarrhea with a history of maternal polyhydramnios were found, lack of meconium passage was also documented and fecal Cl levels were greater than 90mmol/L. Three patients who were diagnosed beyond neonatal period had retarded growth and delayed development and presented hypochloremic hypokalernic dehydration. Two of thern were in a state of metabolic alkalosis. CONCLUSION: CLD should be considered in infants presenting with intractable watery diarrhea, abdominal distension, prematurity and history of polyhydramnios. Full replacement of the fecal losses of electrolytes ancl water can correct hypoelectrolyternic dehydration and will abolish[all the secondary] disorders. In this study we can be aware that with early detection and appropriate therapy infants with CLI) will achieve adequate growth and development.
Alkalosis ; Birth Weight ; Consanguinity ; Dehydration ; Diagnosis ; Diarrhea* ; Electrolytes ; Failure to Thrive ; Female ; Gestational Age ; Growth and Development ; Humans ; Infant* ; Jaundice ; Meconium ; Medical Records ; Parents ; Parturition ; Polyhydramnios ; Retrospective Studies ; Seoul ; Siblings ; Water

BACKGROUND: Esophageal injury requires early and proper management. We want to determine the results of various esophageal injuries. MATERIAL AND METHOD: We respectively analyzed 22 patients who were managed for esophageal injury between 1999 and 2009. Based on the medical records, we reviewed the causes of injury, the diagnoses, the treatment methods, the complications and the prognosis. RESULT: The main causes of esophageal injury were a foreign body in 9 cases (41%) and vomiting in 5 cases (23%). We treated the patients with esophageal primary repair in 12 cases (55%), abscess drainage in 4 cases (18%) and conservative management in 6 cases (27%). There was esophageal leakage in 7 cases (32%) and death occurred in 3 cases (14%). CONCLUSION: For minor esophageal injury, conservative management was sometimes possible to treat the esophagus, yet aggressive and urgent surgical treatment should be applied for cases of major esophageal injury, including mediastinal abscess.
Abscess ; Drainage ; Esophageal Perforation ; Esophagus ; Foreign Bodies ; Humans ; Medical Records ; Vomiting

Genotyping of Toxoplasma gondii has been performed in 23 PCR positive blood samples from stray cats in Korea. We used 2 separate PCR-restriction fragment length polymorphism (RFLP) patterns of SAG2 gene, amplifying the 5'and 3'ends of the locus. The results revealed that all samples belonged to the type I clonal lineage. Although T. gondii organisms were not isolated from the samples, the results of the present study represent that stray cats with T. gondii infection should be seriously concerned in our environment. Adequate and continuous control programs of stray cats are needed to reduce the risk of transmission of T. gondii as a zoonotic infection threatening the public health.
Animals ; Antigens, Protozoan/genetics ; Blood/*parasitology ; Cat Diseases/*parasitology ; Cats ; Cluster Analysis ; DNA Fingerprinting/methods ; DNA, Protozoan/genetics/isolation & purification ; Genotype ; Korea ; Polymerase Chain Reaction/methods ; Polymorphism, Restriction Fragment Length ; Protozoan Proteins/genetics ; Toxoplasma/*classification/*genetics/isolation & purification ; Toxoplasmosis, Animal/*parasitology

Living related liver transplantation(LRLT) is theoretically the best treatment option for end stage liver disease and nonresectable hepatocellular carcinomas. Anastomosed hepatic artery is at high risk in thrombosis after LRLT, which directly related to the patient's life. Usually, recipient hepatic artery is so friable and intimal separation and blood clot between intima and media were noted frequently. From December 2001 to June 2003, consecutive 30 hepatic arteries were harvested from 45 LRLTs patients with end stage liver disease. All hepatic artery were anastomosed with #9-0 nylon by plastic surgeon. All hepatic arteries were patent intraoperatively and postoperatively. In the histopathologic study of hepatic artery, some had intimal thickening, myxoid change and intimal hyperplasia in 14 out of 30 cases. Since pathologic changes may develop as a result of transarterial chemoembolization(TACE) and others causes, we postulated that the prevalence of hepatic arterial thrombosis, a catastrophic graft-threatening complication of LRLT, might be increased in this subset of LRLT patients who received TACE. But, in our study, patients who underwent hepatic arterial chemoembolization statistically do not show an increased risk of developing hepatic arterial thrombosis or other hepatic arterial complications after LRLT. And pathologic changes are statistically not correlate with the TACE.
Carcinoma, Hepatocellular ; End Stage Liver Disease ; Hepatic Artery* ; Humans ; Hyperplasia ; Liver Transplantation* ; Liver* ; Nylons ; Prevalence ; Thrombosis

The conventional surgery method of thrombectomy of venous thrombi from the deep veins of the lower extremity was the use of Forgarty balloon catheter. The catheter is inconvenient due to the presence of the balloon and prohibiting venous valves within the venous trees. With the use of a stone-forceps(Fig. 1), thrombi within iliofemoral vein could be easily removed without the obstacle of the valves because the instrument keeps valves open. This instrument is also useful in monitoring the back-flow from the iliac vein. Thrombi within the veins below the level of inguinal incision are removed successfully only by effective manual compression of the calf and thigh muscles. I recommend operating on the iliac vein first rather than the lower venous tree.
Catheters ; Iliac Vein ; Lower Extremity* ; Muscles ; Thigh ; Thrombectomy ; Veins* ; Venous Thrombosis ; Venous Valves

PURPOSE: Regarding recombinant human growth hormone (rhGH) use in the pediatric population, no long-term follow-up data are available for Korean patients. To fill in the gap of knowledge, a registry study (LG Growth Study) was initiated to assess the safety and effectiveness of four types of rhGH products in real-life settings. METHODS: A total of 4,000 children will be registered and prospectively followed up at 6-month intervals until 2 years after epiphyseal closure to collect data on treatment and adverse events, with primary interest in malignancies and growth outcomes. RESULTS: As of 22 March 2017, approximately 50% (2,024) of the target number of patients have been included in the analysis set: growth hormone deficiency, 1,297 (64.1%); idiopathic short stature, 315 (15.6%); small for gestational age, 206 (10.2%); Turner syndrome, 197 (9.7%); and chronic renal failure, 9 (0.4%). At baseline, median age (years) was 8 (interquartile range [IQR], 5–11); 52% (1,048) were boys; and the majority were at Tanner stage I (83% based on breast/external genitalia, 97% on pubic hair). Median height standard deviation score was -2.26 (IQR, -2.69 to -2.0), and median bone age delay (years) was -1.46 (IQR, -2.26 to -0.78). CONCLUSIONS: This registry study will provide the opportunity to assess the risk of malignancies as well as the general safety data in Korean pediatric patients receiving rhGH. In addition, the long-term effectiveness of rhGH and comparative data between different disease entities will provide practical insight on the standard rhGH treatment.
Child* ; Cohort Studies* ; Follow-Up Studies ; Genitalia ; Gestational Age ; Growth Hormone ; Human Growth Hormone* ; Humans* ; Kidney Failure, Chronic ; Prospective Studies ; Turner Syndrome