Cardiac rupture following blunt thoracic trauma is rarely encountered, since it commonly causes death at the scene. With advances in critical care, blunt cardiac rupture has been successfully treated with well-organized team approach including an emergency physician, anesthesiologist, and cardiac surgeon. We encountered a patient with blunt cardiac rupture of the junction of the superior vena cava and right atrium that extended 7 cm to the right ventricular junction. The patient was successfully resuscitated after a closed thoracostomy and pericardiocentesis with fluid loading. Cardiac injury was repaired via mid-sternotomy without cardiopulmonary bypass. The patient recovered without complications and was discharged on the 7th day after surgery.
Cardiopulmonary Bypass ; Critical Care ; Emergencies ; Heart Atria* ; Heart Injuries ; Heart Rupture* ; Humans ; Pericardiocentesis ; Thoracostomy ; Vena Cava, Superior*

No abstract available.
Malaria*

Ceftizoxime sodium is a new synthetic β-lactam antibiotic combining potent antibacterial activity with high stability to a wide range of bacterial β-lactamase. This experiment was achieved to evaluate the antibacterial activities of ceftizoxime sodium against. Gram negative enteric bacteria isolated from in outpatient visiting Yeungnam university hospital and to study the emergence of drug induced bacterial variants which resist to ceftizoxime in vitro. The antibacterial activity of the ceftizoxime was compared with that of antibiotics and its effect on population of normal intestinal flora in mice was observed. The results are summarized as follows: 1. Highly effective antibacterial activity of ceftizoxime against Gram negative enteric bacilli was demonstrated and this antibacterial activity was superior to that of ampicillin. 2. Several test strains shows multiple antibiotic resistance. Among 15 strains of Escherichia coli, 1 strain was resistant to ampicillin, cefadroxil, gentamicin, tetracycline, and 2 strains were resistant to ampicillin, cefadroxil, tetracycline, five strains of Escherichia coli and Enterobacter cloacae was resistant to ampicillin, tetracycline and Shigella dysenteriae was resistant to ampicillin, gentamicin, tetracycline. 3. The frequency of in vitro emergence of resistant variants among ceftizoxime sensitive bacteria in the presence of increasing concentrations of the compound was found to be low. 4. Plasmid was isolated in 6 of 9 strains (6 strains of Escherichia coli, Shigella dysenteriae, Enterobacter cloacae and Salmonella typhi). That showed different antibiotic resistance. They were 5 strains of Escherichia coli and 1 strain of Shigella dysenteriae. However, plasmid could not be considered as a hallmark for antibiotic resistance by this Further studies with curing experiment are to be accomplished for this purpose. 5. Changes in the bacterial count of normal intestinal flora following 25 mg/kg/day administration of ceftizoxime over 5 consecutive days were not significant. In conclusion, ceftizoxime appeared to be a drug of choice in the treatment of Gram negative enteric bacilli infection.
Ampicillin ; Animals ; Anti-Bacterial Agents ; Bacteria ; Bacterial Load ; Cefadroxil ; Ceftizoxime* ; Drug Resistance, Microbial ; Enterobacter cloacae ; Enterobacteriaceae* ; Escherichia coli ; Gastrointestinal Microbiome ; Gentamicins ; Humans ; In Vitro Techniques* ; Mice ; Outpatients ; Plasmids ; Salmonella ; Shigella dysenteriae ; Tetracycline

Trachobronchial aspiration of foreign bodies is one cause of fatal acciderts in children. Serious complications and death of these children is avoided by early diagnocsis and early removal of foreign bodies. The purpose of this report is to analyze the alteration of anesthetic method for removal of tracheobronchial foreign bodies in 54 children(62 anesthesia) experienced in St. Mary's hospital, Catholic Medical College, seoul, Korea, From Jan. 1, 1963 to Sep. 30, 1980. The removal of tracheobronchail foreign bodies for all cases was done under general anesthesia. Results were as follows: 1) Most tracheobronchial foreign bodies appeared in the 1~3 year old group (24 cases among 54 children). 2) The kinds of foreign bodies were foods and metals. Most were peanuts and beans, which were not visible on chest X-ray films. These foreign bodies can cause atelectasis and emphysema in 24 hours, which was evidenced by chest X-ray. 3) During bronchoscopy, the chest was compressed manually after mask ventilation. Recently 1005 oxygen was inhaled through a thin plastic catheter lodged side the bronchescope. intravenous ketamine with 100% oxygen through thin catheter allowed safe anesthesia for bronchoscopic procedure. 4) Anesthetic time required for bronchoscopic procedure was 31~60 minutes on the average. 5) Pulse rate was increased in 39 cases during bronchoscopic procedure.
Anesthesia* ; Anesthesia, General ; Arachis ; Bronchoscopy ; Catheters ; Child* ; Emphysema ; Fabaceae ; Foreign Bodies ; Heart Rate ; Humans ; Ketamine ; Korea ; Masks ; Metals ; Oxygen ; Plastics ; Pulmonary Atelectasis ; Seoul ; Thorax ; Ventilation ; X-Ray Film

We found an error in this article. The author's affiliation.

BACKGROUND: Totally implantable access port (TIAP) provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. METHODS: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92) and subclavian approach (Group 2, n = 79) between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. RESULTS: Median follow-up for TIAP was 278 days (range, 1-1868). Twenty four complications were occurred (14.0%), including pneumothorax (n = 1, 0.6%), migration/malposition (n = 4, 2.3%), pinch-off syndrome (n = 4, 2.3%), malfunction (n = 2, 1.1%), infection (n = 8, 4.7%), and venous thrombosis (n = 5, 2.9%). The overall incidence was 8.7% and 20.3% in each group (p = 0.030). Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033). The mechanical complication free probability is significantly higher in group 1 (p = 0.040). CONCLUSIONS: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.
Catheterization ; Catheters ; Follow-Up Studies ; Humans ; Incidence ; Jugular Veins ; Medical Records ; Motor Activity ; Pneumothorax ; Retrospective Studies ; Subclavian Vein ; Vascular Access Devices ; Vena Cava, Superior ; Venous Thrombosis

There was an episode of complete recovery of congenital muscular torticollis presenting an ipsilateral neck mass due to the right sternocleidomastoid muscle (SCM) with other symptoms such as contralateral rotation of the head and restricted motion following initial physiotherapy for 6 months in a male infant. Physical examination and neck ultrasonography in the neonate clinic at 6 months revealed that his neck mass had disappeared, so therapy was discontinued. After 12 months of the episode, there was a reoccurrence of congenital muscular torticollis with the only symptom of ipsilateral neck mass and subsequently recovered without restricted motion. After 26 months of the reoccurrence, with no treatment except for 2 months of the second physiotherapy which was proven to be ineffective, spontaneous resolution of the right neck mass was demonstrated on serial ultrasound. Recovery of relapse SCM hypertrophy is extremely rare; therefore, we report the case. We suggest that the case may help clinicians diagnose and treating patients with the recovery of relapse SCM hypertrophy without complications.

There was an episode of complete recovery of congenital muscular torticollis presenting an ipsilateral neck mass due to the right sternocleidomastoid muscle (SCM) with other symptoms such as contralateral rotation of the head and restricted motion following initial physiotherapy for 6 months in a male infant. Physical examination and neck ultrasonography in the neonate clinic at 6 months revealed that his neck mass had disappeared, so therapy was discontinued. After 12 months of the episode, there was a reoccurrence of congenital muscular torticollis with the only symptom of ipsilateral neck mass and subsequently recovered without restricted motion. After 26 months of the reoccurrence, with no treatment except for 2 months of the second physiotherapy which was proven to be ineffective, spontaneous resolution of the right neck mass was demonstrated on serial ultrasound. Recovery of relapse SCM hypertrophy is extremely rare; therefore, we report the case. We suggest that the case may help clinicians diagnose and treating patients with the recovery of relapse SCM hypertrophy without complications.

An unconscious 5-year-old girl was admitted to the Intensive Care Unit. She was neglected by her parents; she suffered from inadequate nutritional, medical and emotional care. The girl appeared to be emotionally detached, dehydrated and malnourished; she had edematous extremities, moderately bruised skin and brittle coarse hair. Laboratory testing showed electrolyte imbalance, anemia, pneumonia, copper deficiency, and liver dysfunction in addition to severe protein-energy malnutrition (PEM). Medical intervention was followed by improvement of most of the symptoms. During the rehabilitation phase, the patient showed a voracious appetite and gained weight too fast. The liver became enlarged and the patient developed a mild fever due to excessive nutrition. The microcytic anemia with severe PEM did not responded to iron supplementation possibly due to the copper deficiency. Addition of copper without zinc and iron helped to improve the anemia. The patient was discharged to a childcare center where she received cognitive and psychosocial therapy.
Anemia* ; Appetite ; Child ; Child Abuse* ; Child* ; Child, Preschool ; Copper* ; Extremities ; Female ; Fever ; Hair ; Humans ; Intensive Care Units ; Iron ; Liver ; Liver Diseases ; Malnutrition ; Parents ; Pneumonia ; Protein-Energy Malnutrition ; Rehabilitation ; Skin ; Zinc