BACKGROUND: Although heart transplantation is the only therapeutic modality for patients with end-stage heart disease, immunosuppressive therapy to reduce organ rejection may increase the risk of infection in transplant patients. Little is known regarding infectious complications in heart transplant recipients in Korea. Thus, this study was performed to evaluate the clinical features and outcome of infectious complications in patients receiving heart transplantation. MATERIALS AND METHODS: A retrospective cohort study was performed by reviewing medical records of patients who underwent heart transplantation from December 1996 to October 2008 in Samsung Medical Center, Seoul, Korea. RESULTS: A total of 72 cardiac allograft recipients were included in the analysis. Median follow-up duration was 417 (range, 2-3995) days. During the follow-up period, 75 infectious complications occurred in 39 (54.2%) recipients, of which 31 cases (41.3%) were caused by bacteria, 28 (37.3%) by viruses, 10 (13.3%) by fungi, 4 (5.4%) by Pneumocystis jirovecii, and 2 (2.7%) by Mycobacterium tuberculosis. Median onset time of bacterial, viral and fungal infection were 153, 106 and 68 days, respectively. The most common site of infection was lung (n=26, 34.7%), followed by gastrointestinal tract (n=11, 14.7%) and oral cavity (n=9, 12%). All patients were sero-positive for cytomegalovirus (CMV)-specific IgG before transplantation and received preemptive therapy of CMV infection. After heart transplantation, 44 (63.8%) patients experienced CMV reactivation identified by CMV antigenemia and 9 (13%) patients had organ-specific CMV diseases. The overall mortality rate was 33.3% (24/72). Infectious complications were the most common cause of death (n=10, 41.7%). The operative risk factors for death were lung infection, fungal infection and bloodstream infection. CONCLUSIONS: In the current study, the lung was the most common site of infection and bacteria were the most frequent etiologic pathogens among heart transplant recipients. Infectious complications, especially fungal infections were the most common causes of death. Prevention strategies against fungal infections should be evaluated in the future studies.
Bacteria ; Cause of Death ; Cohort Studies ; Cytomegalovirus ; Follow-Up Studies ; Fungi ; Gastrointestinal Tract ; Heart ; Heart Diseases ; Heart Transplantation ; Humans ; Immunoglobulin G ; Korea ; Lung ; Medical Records ; Mouth ; Mycobacterium tuberculosis ; Pneumocystis jirovecii ; Rejection (Psychology) ; Retrospective Studies ; Risk Factors ; Transplantation, Homologous ; Transplants

The number of low vision patients and the demand for low vision rehabilitation are increasing as the life expectancy and visual impairment due to largely untreatable ocular conditions are.It is therefore, imperative to recognize the importance of low vision aids, which have recently been developed actively.To evaluate the efficacy of low vision aids for low vision rehabilitation, we reviewed the clinical records of 350 patients who had visited our low vision clinic more than twice and had been prescribed with low vision aids. According to the data analysed, optic nerve atrophy, macular degeneration and retinitis pigmentosa were the leading causes of visual impairment in those patients.The purposes to visit our low vision clinic were to read books, read letters on the black board, identify a person at a distance, etc.Hand-held magnifiers, aspheric doublet lens and telemicroscope with plus cap were commonly used for near vision, while Keplerian and Galilean telescope were popular aids for distant vision.Visual acuity after prescription was improved when it was compared with that before prescription.Majority of the patients benefited from attending low vision clinic.These results suggest that the optical low vision aids were required to rehabilitate the visually impaired patients.
Atrophy ; Humans ; Life Expectancy ; Macular Degeneration ; Optic Nerve ; Prescriptions ; Rehabilitation ; Retinitis Pigmentosa ; Telescopes ; Vision Disorders ; Vision, Low*

Traumatic aniridia is usually accompanied by severe anterior segment disruption including corneal laceration, cataract, and vitreous prolapse into the anterior chamber. We experienced a case of complete traumatic aniridia following corneal laceration without capsular rupture of lens, which has not been reported in Korea. A 28-year-old man had a corneal laceration of his right eye from a screw driver at work, which resulted in complete aniridia with only a remnant of ciliary process and UCVA was 0.08. Primary closure of corneal laceration was performed. During surgery, lens capsule was intact. Visual acuity was reduced 10 days after surgery as cataract developed. Although UCVA was 0.3 at 1 month postoperatively, he was symtomatic with glare due to aniridia.
Adult ; Aniridia* ; Anterior Chamber ; Cataract ; Glare ; Humans ; Korea ; Lacerations* ; Prolapse ; Rupture ; Visual Acuity

Ideal low vision devices used for reading should have a large clear field of view.To determine the usefulness of Aspheric Doublet Lens, we compared visual field, image clarity and reading speed of aids in 100 patients who were prescribed with Aspheric doublet lens, Telemicroscope with plus cap and Hand held magnifier.Aspheric doublet lens was prescribed most commonly.Used lens of optical aids was aspheric doublet lens, aplantic lens, biconvex lens and aspheric lens.Visual field and image clarity of Aspheric doublet lens were wider and clearer than those of other devices.Reading speed of each aid after prescription was improved significantly than before prescription (P=0.01).Reading speed of Aspheric doublet lens was more improved than that of other devices.Therefore Aspheric doublet lens might be useful as reading aids to low vision patients.
Hand ; Humans ; Prescriptions ; Vision, Low ; Visual Fields

We experienced a case of infective endocarditis, which unusual has symptoms and microcytic hypochromic anemia. Anemia associated with infective endocarditis is a common manifestation, but is generally normocytic nor-mochromic. However, microcytic hypochromic anemia is an uncommon manifestation of infective endo-carditis, and has only been noted in a few previous reports. We systematically evaluated anemia, and diagnosed fatal underlying diseases, such as infective endocarditis.
Anemia ; Anemia, Hypochromic* ; Endocarditis*

OBJECTIVE: The objective of this study was to examine the effect on development of mouse preimplantation embryos in culture media with different composition of energy sources in vitro culture. METHODS: Two hundred and seventy one two-cell embryos were cultured in four different culture system for 96 hours. Group I (n=61) was cultured in DMEM-G (DMEM with glutamine) only, groupII (n=64) was cultured in DMEM-GGP (DMEM with glutamine, glucose and pyruvate) only, group III (n=72) was cultured for 48 hours in DMEM-G and then transferred to DMEM-GGP and group IV (n=74) was cultured for 48 hours in DMEM-GGP and then transferred to DMEM-G. Development of embryos in each group was observed every 24 hours. RESULTS: After 24 hours, the rate of development > or = 3-cell was significantly higher in groupII (87.5%) and IV (86.5%) compared with group I (59.0%) and III (62.5%). After 48 hours, the rate of development into > or = morula stage was significantly higher in GroupII (79.7%) and IV (86.5%) compared with group I (34.4%) and III (37.5%). After 72 hours, the rate of development into blastocyst was significantly higher in group IV (74.3%) compared with group I (49.2%) and III (45.8%). After 96 hours, the rate of development into > or = expanded blastocyst was significantly higher in group IV (70.3%) compared with group I (32.8%),II (53.1%), and group III (40.3%). CONCLUSION: Mouse preimplantation embryos development was the most effective in culture system with DMEM-GGP for 48 hours and then transferred to DMEM-G.
Animals ; Blastocyst* ; Culture Media* ; Embryonic Structures ; Glucose ; Glutamine ; Mice* ; Morula ; Pyruvic Acid

Leclercia adecarboxylata and Escherichia hermannii are motile, gram-negative facultative anaerobic bacilli which have rarely been isolated from environmental and clinical specimens. Although several cases of L. adecarboxylata or E. hermannii infections have been reported, a confirmed case of Hickman catheter-associated bacteremia has, to our knowledge, never been reported. A 69-year old woman completed her fourth schedule of chemotherapy for the treatment of leiomyosarcoma and was discharged without complication. However, she suffered from fever and chills for three weeks soon after the completion of chemotherapy and visited the emergency department. A Hickman catheter was promptly removed and the catheter tip was submitted to semiquantitative culture, as well as three sets of blood cultures from three different peripheral veins. Mixed growth of L. adecarboxylata and E. hermannii was isolated from Hickman catheter tip culture and all three sets of blood cultures.
Aged ; Appointments and Schedules ; Bacteremia* ; Catheters ; Chills ; Drug Therapy ; Emergency Service, Hospital ; Enterobacteriaceae* ; Escherichia* ; Female ; Fever ; Humans ; Leiomyosarcoma ; Veins

We shoud give attention to Wernicke's encephalopathy as a cause of sudden coma & respiratory arrest in patients, who are not usually suspected to develop the disorder and empirical treatment with thiamine in cases of coma of unknown cause is recommended. Respiratory stimulants, doxapram & aminophylline have an effect in assisting ventilatory weaning in patient with central hypoventilation as a complication of acute Wernicke's encephalopathy No previous reports where doxapram had been used to assist weaning from mechanical ventilation in adults were noted. Nor has newly developed central hypoventilation been identified as an impediment to weaning in literature to date in Korea. We reported a rare case of Wernicke's encephalopathy caused by poor oral intake & inadequate nutritional suppliment after car accident, showing acute coma & respiratory arrest and treated adequately by thiamine replacement & mechanical ventilation with respiratory stimulant.
Adult ; Aminophylline ; Coma* ; Doxapram ; Humans ; Hypoventilation ; Korea ; Malnutrition* ; Respiration, Artificial ; Respiratory System Agents ; Thiamine ; Weaning ; Wernicke Encephalopathy*

OBJECTIVE: The study was designed to find out current state of conservative treatment modalities for cervical pregnancies in korean. METHOD: 64 cases of cervical pregnancies reported by the joining of The Korean Society of Obstetrics & Gynecology from 1960 to 2000 and the 10 cases at Chungnam National University Hospital were analyzed retrospectively. RESULTS: The average age of the 74 cases was 31.7+/-6.6 years, and the average gestational age at the time of diagnosis was 8.3+/-3.4 weeks. The average duration of hospitalization was 8.2+/-4.8 days. Most (67/74) of the patients had previously experienced delivery or abortion. Out of the 74 cases, 36 had total hysterectomy; 4 cases had curettage; 12 were used only methotrexate; 11 had combined curettage and methotrexate; 10 cases had Foley catheter ballooning after curettage. From the 1960's to the end of 1980's, 33 (84.6%) cases out of 39 were performed hysterectomy. Whereas mainly conservative methods, in particular methotrexate treatment, were performed in the 1990's. Among the conservative modalities, Foley catheter ballooning after curettage had the shortest length of hospitalization with 4.3 days. CONCLUSION: After comparing the conservative methods for treating cervical pregnancies, it was found that methotrexate treatment was performed the most; however, Foley catheter ballooning after curettage seems to be an excellent treatment option.
Catheters ; Chungcheongnam-do ; Curettage ; Diagnosis ; Gestational Age ; Gynecology ; Hospitalization ; Humans ; Hysterectomy ; Methotrexate ; Obstetrics ; Pregnancy* ; Retrospective Studies

Melioidosis is a life-threatening disease caused by Burkholderia pseudomallei , which is endemic in Southeast Asia and Northern Australia. It may manifest as a pulmonary lesion, osteomyelitis, septicemia, or abscesses of soft tissue or various organs. However, soft tissue abscess associated with bacteremia, especially those found in the head and neck, are rarely reported. We report a case of disseminated septicemia due to Burkholderia pseudomallei presenting as head and neck abscesses in a 55-year-old Korean man with a history of working in Malaysia. This is the first report of fatal melioidosis presenting as a complicated skin and soft tissue infection, in Korea.
Abscess ; Asia, Southeastern ; Australia ; Bacteremia ; Burkholderia pseudomallei ; Head ; Humans ; Korea ; Malaysia ; Melioidosis ; Middle Aged ; Neck ; Osteomyelitis ; Sepsis ; Skin ; Soft Tissue Infections