Acute renal failure is a serious complication after open heart surgery which involve total body perfusion but the reported incidence of the complication has varied widely. We have experienced a case of acute renal failure with hemoglobinuria following an open heart surgery for correction of ventricular septal depect, which was comfirmed by cardiac catheterization. Kidney biopsy shows a typical change of acute tubular necrosis. A brief review of literature was also presented.
Acute Kidney Injury* ; Biopsy ; Cardiac Catheterization ; Cardiac Catheters ; Heart* ; Hemoglobinuria* ; Incidence ; Kidney ; Necrosis ; Perfusion ; Thoracic Surgery*

Since the first report on infective endocarditis by Rokitansky in 1985, this subject has been extensively dealt with in the world literature. Nowadays by use of echocardiography, there has been a high discovery rate of vegetation, and thus made it a valuable tool in diagnosis, treatment, and the evaluation of the patient. However in Korea, there have been only a few case reports and even fewer studies on infective endocarditis. This study is a clinical analysis of 87 infective endocarditis cases, which were admitted and treated at the department of Pediatrics and Internal medicine, diagnosed as infective endocarditis, during the period from january 1975 through February 1984. 1) The mean age was 24.8 years and male to female ratio was 1.49:1. 2) Annual incidence showed no increment during the period and it was 1:2500. 3) Underlying heart diseases consisted of rheumatic heart disease(52.3%), congenital heart disease(39.7%), no underlying heart disease(8%), previous infective endocarditis(4.6%), and prosthetic valve endocarditis(3.4%). 4) Frequent clinical manifestations on admission were high fever, heart murmur, congestive heart failure and frequent laboratory findings were positive blood culture results, anemia, positive C-reactive protein, and hematuria. 5) Blood culture was positive in 75.9% and the most common infecting organism was alpha-streptococcus, which represented 42.4% of total positive cases. S. aureus and S. epidermidis were next common and these three organisms consisted of 71.2% Culture positivity was not significantly related to the type and incidence of complications. 6) Antibiotics sensitivity of the major isolated organisms were performed. Alpha-streptococcus was sensitive to almost all antibiotics except Tetracycline. Group D-streptococcus was sensitive to Chloramphenicol and Cephalosporin. S. aureus and S. epidermidis showed same results, which showd sensitivity to Chloramphenicol, Cephalosporin and Methicillin and resistence to penicillin. 7) Echocardiography was performed in 55 cases and showed vegetation in 58.2%. Complications related to the echocardiographic identification of the vegetations showed difference only in the mortality rate, which was greater by 3 times in the positive cases than in the negative. 8) Peripheral embolizations occurred in 29.9% of cases, and by far the mostcommon site was the brain, where 63% of the embolism was localized. 9) Sufficient duration of hospitalization(4-6 weeks) and judicious antibiotics administration was done in 43.7%. The initial response to therapy was noted in 48.5% of total febrile cases. 10) The mortality rate of the cases was 13.8% of the patients died. However, as many patients were discharged against advice because of socio-economic factors, precise therapeutic results of these cases could not be obtained.
Anemia ; Anti-Bacterial Agents ; Brain ; C-Reactive Protein ; Chloramphenicol ; Diagnosis ; Echocardiography ; Embolism ; Endocarditis* ; Female ; Fever ; Heart ; Heart Diseases ; Heart Failure ; Heart Murmurs ; Hematuria ; Humans ; Incidence ; Internal Medicine ; Korea ; Male ; Methicillin ; Mortality ; Pediatrics ; Penicillins ; Tetracycline

BACKGROUND: Since 2005, the commercial patch test panel, the TRUE-test, has been available. However, there have been no reports regarding the results of the TRUE-test compared with previously used Korean Standard Series in Korea. OBJECTIVE: This study aimed to evaluate the prevalence of the contact allergy, causative allergens, and source of allergens in patients who were diagnosed with allergic contact dermatitis, and to compare the findings with previously used Korean Standard Series. METHODS: We reviewed the results of the TRUE-test from 2005~2010 in Wonju Christian Hospital. We patch-tested 843 patients who were diagnosed with allergic contact dermatitis. The patch test reading was performed on day 2 and days 3 or 4, according to the patients' needs. Epidemiologic findings of patients and the results of the patch tests were analyzed. RESULTS: A total of 843 patch-tested cases were compiled and analyzed. Of 843 patch-tested patients (male, 309; female, 534), 65.8% had at least 1 positive reaction and 30.2% at least 2 positive reactions. The highest age distribution was the 5th decade in females. The face, with the exception of the eyelids, ears, and lips, was the most frequently affected site (comprising 50.3%). The highest sensitization rates were found with nickel (29.1%), thiomersal (10.9%), and cobalt dichloride (9.7%). The lowest positivity included caine mix (0.7%), mercaptobenzothiazole (1.2%), and quinolone mix (1.2%). Metal allergens displayed higher positive rates than any other standard allergens. The overall prevalence was similar with a recent report in Korea. CONCLUSION: There was no significant difference in the overall prevalence of the most sensitized allergen compared with the reports about previously used Korean standard series.
Age Distribution ; Allergens ; Cobalt ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Ear ; Eyelids ; Female ; Humans ; Hypersensitivity ; Lip ; Nickel ; Patch Tests ; Prevalence ; Thimerosal

BACKGROUND/AIMS: Although trials have suggested an association between osteoporosis and cardiovascular disease (CVD), the relationship between fracture risk and cardiovascular disease is not well defined. Here, we examined whether subjects with a higher risk of fracture also share an increased likelihood of developing CVD. METHODS: This study included 477 subjects; patients with a history of diabetes, chronic hepatopathy, nephritic syndrome, or any cardiovascular diseases were excluded. We used dual energy X-ray absorptiometry to assess the bone mineral density (BMD) of the lumbar spine and femur, and calculated fracture risk based on the Fracture Risk Assessment (FRAX) score. The Framingham risk score (FRS) was used to estimate cardiovascular risk. RESULTS: Of the 477 subjects, 222 had osteopenia and 150 had osteoporosis; the remaining 105 had a normal BMD. In men, no significant differences were observed in systolic blood pressure (SBP), diastolic blood pressure, low-density lipoprotein, high-density lipoprotein (HDL), and triglyceride (TG) between groups. Men with osteoporosis were generally older, and had significantly higher total cholesterol (TC). In women, age and FRS were significantly higher in the osteoporosis group. In the multivariate analysis, age, SBP, TC, HDL, TG, and FRAX were all significantly associated with FRS. CONCLUSIONS: These data suggest that patients with a higher risk of fracture are also at greater risk of developing CVD, indicating a possible mechanistic link between CVD and osteoporosis.
Absorptiometry, Photon ; Blood Pressure ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Cholesterol ; Female ; Femur ; Humans ; Lipoproteins ; Male ; Multivariate Analysis ; Osteoporosis ; Risk Assessment* ; Spine ; Triglycerides

Renal tubular acidosis (RTA) refers to a group of disorders involving transport defects in bicarbonate reabsorption or hydrogen excretion. Features like metabolic acidosis with a normal anion gap, neurological symptoms, and electrolyte imbalances indicate RTA. Kidney transplantation, cirrhosis, sickle cell anemia, medications, and autoimmune diseases, particularly Sjogren's syndrome and rheumatoid arthritis, are related to RTA. We encountered a rare case of a patient with systemic lupus erythematosus accompanied by RTA secondary to tacrolimus administration, who had muscle weakness and paralysis. Her symptoms improved after discontinuing tacrolimus and correcting the acidosis and potassium levels. Here, we report on this case and review the relevant literature.
Acid-Base Equilibrium ; Acidosis ; Acidosis, Renal Tubular* ; Anemia, Sickle Cell ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Fibrosis ; Humans ; Hydrogen ; Kidney Transplantation ; Lupus Erythematosus, Systemic* ; Muscle Weakness ; Paralysis ; Potassium ; Sjogren's Syndrome ; Tacrolimus*

Viperin is an IFN-stimulated gene (ISG)-encoded protein that was identified in human primary macrophages treated with IFN-γ and in human primary fibroblasts infected with cytomegalovirus (CMV). This protein plays multiple roles in various cell types. It inhibits viral replication, mediates signaling pathways, and regulates cellular metabolism. Recent studies have shown that viperin inhibits IFN expression in macrophages, while it enhances TLR7 and TLR9-mediated IFN production in plasmacytoid dendritic cells, suggesting that viperin can play different roles in activation of the same pathway in different cell types. Viperin also controls induction of ISGs in macrophages. However, the effect of viperin on induction of ISGs in cell types other than macrophages is unknown. Here, we show that viperin differentially induces ISGs in 2 distinct cell types, macrophages and fibroblasts isolated from wild type and viperin knockout mice. Unlike in bone marrow-derived macrophages (BMDMs), viperin downregulates the expression levels of ISGs such as bone marrow stromal cell antigen-2, Isg15, Isg54, myxovirus resistance dynamin like GTPase 2, and guanylate binding protein 2 in murine embryonic fibroblasts (MEFs) treated with type I or II IFN. However, viperin upregulates expression of these ISGs in both BMDMs and MEFs stimulated with polyinosinic-polycytidylic acid or CpG DNA and infected with murine CMV. The efficiency of viral entry is inversely proportional to the expression levels of ISGs in both cell types. The data indicate that viperin differentially regulates induction of ISGs in a cell type-dependent manner, which might provide different innate immune responses in distinct cell types against infections.
Animals ; Carrier Proteins ; Cytomegalovirus ; Dendritic Cells ; DNA ; Dynamins ; Fibroblasts ; GTP Phosphohydrolases ; Humans ; Immunity, Innate ; Interferons ; Macrophages ; Mesenchymal Stromal Cells ; Metabolism ; Mice ; Mice, Knockout ; Orthomyxoviridae ; Poly I-C

BACKGROUND: Topical steroid treatment induces diverse local Wand systemic adverse effects. Several approaches have been tried to reduce the steroid-induced adverse effects. Simultaneous application of physiological lipid mixture is also suggested. OBJECTIVE: Novel vehicles for topical glucocorticoids formulation were evaluated for the efficacy of reducing side-effects and the drug delivery properties of desonide, a low potency topical steroid. METHODS: Transcutaneous permeation and skin residual amount of desonide were measured using Franz diffusion cells. The in vivo anti-inflammatory activity was evaluated using murine model. RESULTS: Topical steroids formulation containing desonide, in either cream or lotion form, were prepared using multi-lamellar emulsion (MLE), and conventional desonide formulations were employed for comparison. MLE formulations did not affect the anti-inflammatory activity of the desonide in phobol ester-induced skin inflammation model, compared with conventional formulations. While the penetrated amounts of desonide were similar for all the tested formulations at 24 hours after application, the increased lag time was observed for the MLE formulations. Interestingly, residual amount of desonide in epidermis was significantly higher in lotion type MLE formulation. Steroid-induced adverse effects, including permeability barrier function impairment, were partially prevented by MLE formulation. CONCLUSION: Topical desonide formulation using MLE as a vehicle showed a better drug delivery with increased epidermal retention. MLE also partially prevented the steroid-induced side effects, such as skin barrier impairment.
Desonide ; Diffusion ; Epidermis ; Glucocorticoids ; Inflammation ; Permeability ; Retention (Psychology) ; Skin ; Steroids

A 64-year-old man was admitted for gross hematuria. Preoperative study revealed right renal cell carcinoma with inferior vena cava(IVC) tumor thrombus. Right radical nephrectomy was performed, and deep hypothermic circulatory arrest(DHCA) with retrograde cerebral perfusion(RCP) was used for extraction of tumor thrombus in the IVC. The thrombus originated from the right kidney, which extended the orifice of the gonadal vein in the left renal vein laterally, the hepatic vein superiorly, and 3 cm below the right renal vein inferiorly. The thrombus was removed completely without caval wall injury under DHCA with RCP, and the postoperative course was uneventful. He received immunotherapy with interferon, and followed up without any surgical problem.
Carcinoma, Renal Cell* ; Circulatory Arrest, Deep Hypothermia Induced* ; Gonads ; Hematuria ; Hepatic Veins ; Humans ; Immunotherapy ; Interferons ; Kidney ; Middle Aged ; Nephrectomy ; Renal Veins ; Thrombosis ; Veins ; Vena Cava, Inferior