Burns, Inhalation ; Humans ; Respiratory System ; injuries

In recent years, improved antibiotic care and physiologic fluid replacement in cases involving burn wounds have led to a decrease in the rate of fatalaties caused by wound sepsis and shock. There has, however, been an upsurge and relative increase in the frequency (15 -25%) and mortality rate (50 -89 %) of pulmonary complications. Since pulmonary lesions may result from direct injury to the respiratory tract caused by smoke inhalation, from circulatory, metabolic or infectious complications in cases involving cutaneous burns, or may develop during the therapeutic management of these lesions, a wide spectrum of pulmonary abnormalities can occur during the post-burn period. There is considerable overlap between their radiographic appearances, which are often nonspecific. Since the successful management of these patients is based on the early recognition and vig-orous treatment of lesions, familiarity with all facets of these complications, based on a pathophysiology of the injury and on the knowledge of the clinical setting, enables radiologists to make more specific diagnoses.
Burns* ; Diagnosis ; Humans ; Inhalation ; Mortality ; Recognition (Psychology) ; Respiratory System ; Sepsis ; Shock ; Smoke ; Wounds and Injuries

Major pathogenic Gramnegative organisms such as P. aeruginosa, Serratia species, E. coli, Enterobacter species which are isolated from the specimens in large medical centers are greatly resistant to the commonly used antibiotics. Gramnegative bacilli, which had been isolated in Yeungnam Uni rersity Hospital during the period from December 1992 to April 1993 and turned out to be resistant to the primary antibiotics susceptibility test for chloramphenicoi, ampicillin, eephaiothin,- geniamicitt, tetracyclin, amikin and tobramycin, were subjected to the secondary antibiotics susceptibility test for aztreonam, ceftazidime, ciprofloxacine, cefotaxime, cefamandole, piperacillin, ticarcillin and sulfamethoxazole trimethopime. Out of 315 tested organisms, 167 organisms (53%) were resistant to all secondary antibiotics in vitro. Antimicrobial activity of ceftazidime (37.1%), aztreonam (11. %), ciprofloxacine (7.9%) against Gram negative bacilli were slightly more active than other antibiotics tested, while cefamandole was not active to all the Gramnegative bacilli tested. According to the specimens, E. coli was the most frequently resistant organisms to the primary antibiotics from urine, A. baumanii, from respiratory system and wounds, and P. aeruginosa from various specimens. In summary, Gram negative bacilli resistant to the primarily applied antibiotics also were resistant to the secondary antibiotics. Rearrangement of the antibiotics disks for the antibiotic susceptibility test should be considered.
Amikacin ; Ampicillin ; Anti-Bacterial Agents* ; Aztreonam ; Cefamandole ; Cefotaxime ; Ceftazidime ; Ciprofloxacin ; Enterobacter ; Piperacillin ; Respiratory System ; Serratia ; Sulfamethoxazole ; Ticarcillin ; Tobramycin ; Wounds and Injuries

PURPOSE: The purpose of this study was to identify international students' use of university health centers by individual characteristics and seasons. METHODS: This was a retrospective descriptive study using data obtained from the electronic record system of one university health center. The study participants were international undergraduate students who registered for any of two semesters between March 1, 2014 and February 28, 2015 and visited the university health center during their registration period. RESULTS: The most common reasons for visits were problems of head, eye, nose and throat systems, followed by respiratory system. Their visits mostly occurred in the fall and spring. The most frequently used services were distribution of oral medication followed by wound treatment. The number of visits per individual was statistically different by gender (u=-3.307, p=.001), but not by their major (chi2=.543, p=0.762) or nationality (chi2=5.518, p=.271). CONCLUSION: Further study is necessary to better define health needs and related factors for this unique population. The electronic record system provides great opportunities in development and application of need based health services for international students and for research in this area.
Ethnic Groups ; Head ; Health Services ; Humans ; Nose ; Pharynx ; Respiratory System ; Retrospective Studies ; Seasons ; Student Health Services ; Wounds and Injuries

BACKGROUND: Prevotella species is one of the major microoranism responsible for invasive anaerobic bacterial infection. This study was performed to investigate the clinical characteristics and outcome of invasive Prevotella infection in a University affiliated, tertiary care Hospital. METHODS: We obtained the information from the computerized data base of the clinical microbiology laboratory from January 1997 to December 2000, and identified patients whose sterile clinical specimen culture had yielded Prevotella species. We then reviewed the patients' medical records, and studied demographic, clinical, and microbiologic data. RESULTS: The total of 34 patients with invasive Prevotella infection were enrolled for the analysis. Seventeen strains were isolated from blood, 13 from the pleural fluid, 5 from the ascites, and 1 from both the ascites and blood. Half of the cases of Prevotella infection were mixed-infection and 22 cases (64.7%) were of community origin. Twenty-six patients (76%) were men and the mean age was 59 years. Most common underlying disease was malignant neoplasms (19/34, 55.9%). A portal of entry could be determined in 29 patients (85.3%) with the most common being the respiratory tract (12/34, 35.3%), followed by the gastrointestinal tract (6/34, 14.4%), and the wound site (6/34, 14.4%). Surgical procedure was necessary for 21 cases (63.5%). One-month mortality was 32.3%. The mortality was significantly associated with the underlying chronic renal failure (p=0.028) and ICU care (p=0.002). Surgical therapy had a protective effect (54% vs 14%, p=0.022) CONCLUSION: Invasive Prevotella Infections were more prevalent among old age patients with underlying malignancy than younger people and frequently necessitated surgical procedure. Early surgical treatment would decrease mortality.
Aged ; Ascites ; Bacterial Infections ; Gastrointestinal Tract ; Humans ; Kidney Failure, Chronic ; Male ; Medical Records ; Mortality ; Prevotella* ; Respiratory System ; Tertiary Healthcare ; Wounds and Injuries

OBJECTIVE: Stenotrophomonas maltophilia has been emerging as an important nosocomial pathogen in recent years in patients with impaired host- defense mechanism or who has been exposed to large amount of inocula. This organism is usually resistant to multiple (commonly used) antimicrobial agents, particularly to those of the beta-lactam class. To evaluate the clinical feature of Stenotrophomonas maltophilia infection and in vitro anti- microbial susceptibility, we performed a retrospective study. METHODS: We analyzed the result of in vitro antimicrobial susceptibility test for 200 isolates of S. maltophilia and the annual isolation rate during the period between January 1990 and December 1994 in our institution, and performed a retrospective study for the available records of 165 cases among them. The data were obtained with only the first isolation of the organism for each patients. RESULTS: Total of 165 initial isolates, the isolates were from wounds in 50(30.3%), urine in 47(28.5%), the respiratory tract in 37(22.4%), blood in 9(5.5%), bile in 6(3.6%), and miscellaneous sources in 16(9.7%). The 84.2% of isolates were hospital-acquired isolate and 58.3% of these patients had received antecedent antibiotic therapy: polymicrobial growth was demonstrated in 61.9% of the cases. In vitro antimicrobial susceptibiiity test, ofloxacin was active against the isolates in 89.2%, moxalactam in 85.9%, ciprofloxacin in 83.9%, TMP-SMX(trimethoprim-sulfamethoxazole) in 64.2%, As expected, S. maltophilia isolates were, in general, not susceptible to cephalosporins, penicillins. The annual isolation rate at Kyung Hee University hospital was not increased significantly from 1990 to 1994, 19.53 per 10,000 patients dismissals in 1990, 13.56 in 1994. The major underlying diseases of patients were malignancy(17.6%), cerebrovascular disorder(17%), diabetic mellitus(13.3%). Mortality rate is 10.3%. CONCLUSION: S. maltophilia has been emerging as an important nosocomial pathogen in immunocompromised patients, especially those receiving broad-spectrum antimicrobial therapy. And this organism is resistant to multiple antimicrobial agents, particularly to those of the beta-lactam class. When antimicrobial treatment is necessary, the clinician should be guided by results of in vitro susceptibility testing because of the notable in vitro resistance of S. maltophilia to commonly used antibiotics. And when S. maltophilia has been recovered from a patient, wound and contact isolation is warranted.
Anti-Bacterial Agents ; Anti-Infective Agents ; Bile ; Cephalosporins ; Ciprofloxacin ; Humans ; Immunocompromised Host ; Mortality ; Moxalactam ; Ofloxacin ; Penicillins ; Respiratory System ; Retrospective Studies ; Stenotrophomonas maltophilia ; Stenotrophomonas* ; Wounds and Injuries

Acute organophosphate intoxication is important because of its high morbidity and mortality. The mortality is still high despite the use of atropine as specific antidotal therapy and oximes for reactivation of acetylcholinesterase. Inhibition of acetylcholinesterase by organophosphate can cause acute parasympathetic system dysfunction, muscle weakness, seizure, coma, and respiratory failure. Acute alteration in conscious state or a coma, which may occur following organophosphate intoxication, is an indication of severe intoxication and poorer prognosis. This acute decline in conscious state often reverses when the cholinergic crisis settles; however, it may be prolonged in some patients. We report on a case of a 60-year-old male who showed prolonged decline in conscious state due to of Central Nervous System (CNS) toxicity after a suicide attempt with organophosphate.
Acetylcholinesterase ; Atropine ; Brain Injuries ; Central Nervous System ; Coma ; Humans ; Male ; Middle Aged ; Muscle Weakness ; Organophosphate Poisoning ; Oximes ; Prognosis ; Respiratory Insufficiency ; Seizures ; Suicide

Electrical monitoring of the nervous system offers the potential for the detection of injury, intraoperatively. The relationship of MEP(Motor Evoked Potential) and SEO(Sensory Evoked Potential) taken in 30 rats before and after spinal cord injury is reported. MEP was obtained from distal portion to the site of spinal cord injury by electrical stimulation of the cerebral motor cortex after insertion of a ball electrode in the cerebral motor cortex. SEP was collected at the cerebral somatosensory cortex during the sciatic nerve stimulation. Experimental animals were divided into a 20 gcm spinal cord-trauma group and a 50 gcm spinal cord-trauma group. Changes of cardiopulmonary function after cerebral motor cortex stimulation and pre-and post-injury MEP and SEP were obtained at constant time interval. The results were follows : 1) Significant changes in blood pressure, pulse rate, and respiratory rate were noted to be elevated after stimulation of cerebral motor cortex and these were returned to normal in 10 minutes after stimulation. 2) MEP in control group showed that the latency was 8.6+/-1.54 msec and the amplitude was 20.60+/-3.2 microV. In MEP of 20 gcm spinal cord trauma group, the latency was increased to 30% (11.26+/-2.76 msec) compared to control group at 10 minutes after the injury and the amplitude was decreased to 29% (14.60+/-1.99 microV). The latency was slowly decreased with the passage of time, to 21% increase. (10.42+/-1.84 msec) at 1 hour after injury but the amplitude was not changes. In 50 gcm spinal cord-trauma group the latency was decreased to 75% (4.9+/-1.52 microV) compared to control group. With the passage of time. no change was revealed in latency but amplitude was decreased. The amplitude was decreased to 80% (4.00+/-1.49 microV) compared to control group. Change of MEP was marked in 50 gcm spinal cord-trauma group. With the passage of time MEP was slightly improved in 20 gcm spinal cord-trauma group but deteriorated in 50 gcm spinal cord-trauma group. 3) The latency of SEP in control group was 12.22+/-0.7 msec and the amplitude of those was 20.00+/-2.21 microV. No significant statistical change was recorded in the SEP of each spinal cord-trauma group compared to control group. MEP might be more important indicator than SEP in estimation and evaluation of the functional change of spinal cord injury.
Animals ; Blood Pressure ; Electric Stimulation ; Electrodes ; Evoked Potentials* ; Heart Rate ; Motor Cortex ; Nervous System ; Rats* ; Respiratory Rate ; Sciatic Nerve ; Somatosensory Cortex ; Spinal Cord Injuries ; Spinal Cord*

Enterobacter cloacae, a gram negative bacillus is an increasingly frequent cause of nosocomial pediatric infection. It can cause infection of postsurgical wounds, meningitis, and infection of the gastrointestinal, urinary, and respiratory tracts. Newborn infants often are colonized by Enterobacter species in the gastrointestina tract or respiratory tract soon after birth, and a acquisition of hospital strains in immunocompromised newborn infants is common. Neonatal pneumonia has been associated with many infectious agents. Pneumatocele, a cyst-like lesion that develops within the lung parenchyma, is an unusual complication of pneumonia in the neonate, especially in the preterm neonate. Pneumatocele has been reported to occur with Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, and Pseudomonas aeruginosa infections. We describe 2 cases of premature neonates with pneumonia and subsequent pneumatocele formation caused by Enterobacter cloacae.
Bacillus ; Colon ; Enterobacter cloacae* ; Enterobacter* ; Escherichia coli ; Humans ; Infant, Newborn* ; Klebsiella pneumoniae ; Lung ; Meningitis ; Parturition ; Pneumonia ; Pseudomonas aeruginosa ; Respiratory System ; Staphylococcus aureus ; Streptococcus pneumoniae ; Wounds and Injuries

PURPOSE: This study aimed to describe the pattern of injuries and illnesses among Korean athletes during the Almaty Winter Universiade 2017. METHODS: All medical staffs of Korean team recorded the daily occurrence of injuries and illnesses sustained during the Almaty Winter Universiade Games by using a standardized online form via kociss.com. The design of this study was a prospective study. RESULTS: In total, 98 athletes (68 men and 30 women) in 11 sports events from Korean Sport Olympic Committee participated in this study. Korean medical staffs reported 40 injuries (40.8%) and 26 illnesses (26.5%), equaling incidences of 6.3 injuries and 4.1 illnesses per 100 athletes. Men suffered more injury and illness than women (44.1% vs. 33.3%). The rate of Injury and illness in training was higher than the competition (13.3 vs. 2.0 athlete exposures). The risk of an athlete being injured was the highest in freestyle skiing, followed by snowboard and speed skating. Overall, the main common type and location of injury was the joint or ligaments sprain (13.3%) and knee (7.1%). The rate of main illness was 17.3% of the respiratory system with the main symptom of pain and the main cause of environment (22.4%). CONCLUSION: Injuries and illnesses occurred 40.8% and 26.5% during this winter game, and were higher during training than a competition. Based on the epidemiologic data of this study, it could provide the source for the injury prevention and improving the performance of the athlete and further develop scientific injury and illness surveillance systems.
Athletes* ; Athletic Injuries ; Epidemiology ; Female ; Humans ; Incidence ; Joints ; Knee ; Ligaments ; Male ; Medical Staff ; Prospective Studies ; Respiratory System ; Skating ; Skiing ; Sports ; Sprains and Strains