No abstract available.
Aortic Rupture*

Endocarditis due to anaerobes is not a rare ocurrence. However, Clostridial endocarditis, most cases are caused by Clostridium perfringens, is an uncommon disease. Clostridium are gram positive spore forming obligate anaerobes that are found widely in soil, water, and foods. They naturally inhabit the respiratory, gastrointestinal, and female genital tract. We observed a case of Clostridium perfringens endocarditis in a 67 years old woman. Who experienced fever, chronic diarrhea and vegetation in the aortic valve.
Aged ; Aortic Valve ; Clostridium perfringens* ; Clostridium* ; Diarrhea ; Endocarditis* ; Female ; Fever ; Humans ; Soil ; Spores

PURPOSE: The option of selecting isotonic rather than hypotonic fluids for maintenance fluid in children has been advocated by some authors. Pneumonia and CNS infections are frequent clinical settings for acute hyponatremia because of nonosmotic anti-diuretic hormone stimuli in children. We conducted the present study to identify the incidence of hyponatremia in pneumonia and CNS infection of children and to determine the importance of maintenance intravenous fluid therapy regimen and other related factors. METHODS: The study included 1,992 patients admitted to the Department of Pediatrics at Pusan National University Children's Hospital between November 2008 and August 2011, who were diagnosed with pneumonia or CNS infections and checked for serum sodium concentration. Their clinical data including laboratory findings were reviewed retrospectively. RESULTS: During the study period, 218 patients were identified to have acute hyponatremia among 1,992 patients. The overall incidence of hyponatremia was 10.9%. The incidence of hyponatremia in encephalitis (37.3%) was highest and the incidence in bacterial meningitis (27.4%), viral meningitis (20.0%), bacterial pneumonia (11.1%), mycoplasma pneumonia (9.2%), and viral pneumonia (6.8%) were in descending order. The mean age was higher in hyponatremic patients than in isonatremic patients. The incidence of hyponatremia was higher in who had 0.18% NaCl in 5% dextrose (D5 0.18% NS) than 0.45% NaCl in 5% dextrose infusion (D5 1/2NS) (9.0% vs. 2.2%). SIADH was identified in 20.5% among hospital acquired hyponatremic patients after adequate evaluation for SIADH. CONCLUSION: We recommend D5 1/2NS rather than D5 0.18% NS as the maintenance fluid given to children with pneumonia or infectious CNS diseases.
Central Nervous System Diseases ; Child ; Encephalitis ; Fluid Therapy ; Glucose ; Humans ; Hyponatremia ; Inappropriate ADH Syndrome ; Incidence ; Meningitis ; Meningitis, Bacterial ; Meningitis, Viral ; Pediatrics ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Pneumonia, Viral ; Sodium

Since oxidative stresses are involved in gastroenteritis and diarrhea, we investigated antioxidative and antidiarrheal activities of persimmon flesh extract (PFE) and persimmon calyx extract (PCE) in vitro and in vivo, respectively. PCE significantly scavenged 1,1-diphenyl-2-picrylhydrazyl hydrate and 2,2'-azinobis (3-ethylbenzthiazoline-6-sulfonic acid) from 500 microg/mL, although PFE was ineffective. In addition, PFE and PCE exhibited strong nitric oxide-scavenging effects from 1 microg/mL, in which PCE was superior to ascorbic acid (50 microM). Furthermore, PFE and PCE significantly inhibited FeCl3-induced lipid peroxidation as well as Cu2+/H2O2-induced protein oxidation from 10 microg/mL. In vivo charcoal-propulsion assay, in contrast to a negligible effect of PFE, treatment with PCE (160-500 mg/kg) markedly inhibited intestinal motility. The results indicate that extracts of persimmon, especially PCE, possess antioxidative, antiinflammatory and antidiarrheal activities. Therefore, it is suggested that persimmon extracts could be used for the relief of gastroenteritis and diarrhea.
Ascorbic Acid ; Biphenyl Compounds ; Diarrhea ; Diospyros ; Gastroenteritis ; Gastrointestinal Motility ; Lipid Peroxidation ; Oxidative Stress ; Picrates

BACKGROUND: Uncomplicated myocardial infarction is often the harbinger of future cardiac events such as unstable angina, recurrent myocardial infarction or death. The prognostic utility of exercise test(pre-discharge low level exercise test) in patients recovering from acute myocardial infarction(AMI) has been documented by many studies. However there are few data of the safety and value of a symptom-limited exercise test early after AMI. We performed this study to assess the safety of test and the prevalence of abnormal response to symptom-limited exercise test and to determine the ability to predict future cardiac events. METHODS: The study group comprised 91 patients(male ; 73, Anterior infarction ; 43, Q-wave infarction ; 68, Thrombolysis ; 58, Age ; 57+/- years) with uncomplicated AMI. Symptom-limited exercise tests were performed before discharge(8.7+/-0.5 days after infarction) using modified Bruce protocol. Exercise test was considered positive if there was new > or =1mm horizontal or downsloping ST segment depression at 0.08sec after J point compared with baseline. The patients were followed for the development of new cardiac events. RESULTS: 1) The mean duration of exercise test was 14.2 min(range 4.3 - 21.5)and the mean workload(Metabolic Equivalents : METs) was 6.0 METs(range 2.1 - 17.0). There were no complications during exercise test and post-recovery phase. 2) There were positive test in 31 patients(34%), ST segment elevation in 10(11%), and inadequate blood pressure(BP) response in 10 patients(11%). 3) During the follow-up period(1-50 months, mean 12.5 months), 9 patients experienced post-myocardial infarction angina and revascularization therapy, respectively, and 1 patient had cardiac death and recurrent myocardial infarction, respectively. 4) The patients with cardiac events had a significantly higher degree in stenosis of infarct-related artery(90+/-3 vs 78+/-3, p<0.05) and lower systolic BP on peak exercise(136+/-7 vs 156+/-4, p<0.05). 5) The positive exercise test was associated with cardiac events in the follow-up period but ST-segment elevation, inadequate BP response, the use of thrombolytic agents, and non-Q wave infarction did not predict future cardiac events. CONCLUSIONS: The symptom-limited exercise tests early after acute myocardial infarction appear to be safe and will identify more patients with inducible myocardial ischemia relatively. The posive test can predict cardiac events and the prognosis of patients of this group can be improved with aggressive management and careful follow-up.
Angina, Unstable ; Constriction, Pathologic ; Death ; Depression ; Exercise Test* ; Fibrinolytic Agents ; Follow-Up Studies ; Humans ; Infarction ; Myocardial Infarction* ; Myocardial Ischemia ; Prevalence ; Prognosis