Prosthetic Valve Endocarditis caused by HACEK Organisms: a Case Report and Systematic Review of the Literature / 감염과화학요법

HACEK is a rare cause of prosthetic valve endocarditis (PVE). We describe 42-year-old male patient who presented with Aggregatibacter aphrophilus PVE and cerebral infarct. A. aphrophilus was isolated from his blood cultures as the sole pathogen, which was confirmed by subsequent 16S rRNA sequencing. He was treated with valve replacement surgery and an 8 week course of pathogen-directed antibiotic therapy and followed for 20 months without recurrence.

Comparison of End-of-Life Care Intensity between Cancer and Non-cancer Patients: a Single Center Experience / 한국호스피스완화의료학회지

PURPOSE: The aging of society has rapidly progressed, especially in Korea. Therefore, the necessity of research on end-of-life (EOL) care in elderly patients has increased. However, there are few studies on EOL care intensity for non-cancer patients. This study was designed to compare the EOL care intensity between cancer and non-cancer patients. METHODS: We retrospectively analyzed the EOL care intensity based on medical records of decedents of Kyung Hee University Medical Center, a tertiary referral hospital from December 2014 through March 2015. And we compared EOL care intensity between cancer patients and non-cancer patients using statistical analysis of the frequency of invasive procedures and logistic regression analysis for factors that affect the EOL care intensity. RESULTS: Statistical analysis showed invasive procedures, such as intensive care unit admission, endotracheal intubation followed by mechanical ventilation and emergency dialysis, were performed more frequently in non-cancer patients than cancer patients (29.3% vs. 72.4%, P<0.001). And age (P=0.038) and morbidity of cancer (P<0.001) influenced the invasive procedural decision when analyzed by logistic regression analysis. CONCLUSION: The EOL care was more intensive in non-cancer patients, and age and morbidity of cancer were major factors for the treatment intensity.

Clinical Features in 147 Patients with Systemic Contact Dermatitisdue to the Ingestion of Chicken Boiled with Japanease Lacquer Tree / 대한피부과학회지

BACKGROUND: Systemic contact dermatitis (SCD) due to the ingestion of Japanese lacquer tree (Rhus verniciflua) is pretty common in Korea, and it is on a trend of increment. It is thought that the increase in ingestion of chickens boiled with the lacquer tree has been caused by the regard of the lacquer tree as a health food or herbal medicine for gastrointestinal disease. OBJECTIVE: To review the clinical findings and laboratory findings, and to make people aware of the harmful effects of the lacquer tree. METHODS: We retrospectively reviewed the medical records of 147 patients who had SCD due to chicken boiled with lacquer tree, 98 patients in Wonkwang University Hospital over the last 20 years (1998`2007) and 49 patients in Areumdaun Dermatology Clinic over the past 5 months (August~December, 2007). RESULTS: The sex ratio of patients (male to female) was 1.3:1 and the average age was 44.0 years old (range: 11~76). They ate chicken boiled with lacquer tree as a health food (42.9%) and for the treatment of gastrointestinal disease (22.4%). The mean incubation period was 47.7 hours (range: 30 min~16 days). The first symptoms they had were erythematous maculopapules (42.9%), itching without rash (33.7%), and edematous change (16.3%). The skin lesions developed as maculopapules (50.6%), erythroderma (40.9%), and erythema multiforme-like lesion (8.4%), vesicles, wheals, purpura, and pustules. On laboratory findings, some people had leukocytosis (61.2%), increment of Ig E (26.4%), abnormalities of liver function test (ALT: 16.3%, AST: 4.1%). Sixty percent of patients had a history of contact dermititous contracted via chicken boiled with rhus lacquer ingestion (36.7%) or contact with the lacquer tree. Clinical symptoms were developed by 29.5% who ate chicken boiled with lacquer. Mainly they had been treated with corticosteroids, antihistamines. The mean period needed for treatment was 8+/-2.4 days. CONCLUSION: Systemic contact dermatitis due to ingestion of the lacquer tree was developed in either sensitized or non-sensitized persons. It is suggested that SCD is caused by the highly allergic and toxic effects of lacquer. Physicians need to make people aware of the harmful effects of the lacquer tree and educate people not to ingest it.

A Case of Acute Fatty Metamorphosis / 대한산부인과학회잡지

Acute fatty metamorphosis is a rare but potentially fatal complication of the third trimester of pregnancy. In 20~40% of cases, acute fatty metamorphosis is associated with preeclampsia and may be difficult to distinguish from preeclamptic liver involvement. Recent reports suggest that the mortality has decreased to 25% fo both mother and fetus, due to largely to early delivery and to the recognition of a higher proportion of mild and nonfatal cases. We experienced one case of acute fatty liver metamorphosis that caused fulminant hepatitis and complete resolution, so we report the case and review of literature briefly.

A Clinical Study on the Effect and Toxicity of rhGM-CSF / 대한부인종양콜포스코피학회잡지

Dosage reinforcement of chemotherapeutic agent is thought to be a solution in treating many malignancies, including ovarian cancer and cervical cancer. The remission rate after administration of chemotherapeutic agents has a positive correlation with dosage and in cases where limitations were put on dosage, improved survival rate was achieved with dose-intensive therapy facilitated by autologous bone marrow transplantation(BMT) or the use of cytokines such as G-CSF. Our objectives are to evaluate therapeutic efficacy and toxicity of GM-CSF and to elucidate the effect of premedication which was administered to minimize the toxicity of the GM-CSF. Total number of patients entered into this study was fifty two and they are consisted of thirty seven patients of the uterine cervix, fourteen patients of ovarian cancer and one endometrial cancer patient. The increase in neutrophil count and WBC count was found to be statistically valid, but the changes in the number of platelets, hemoglobin, neutrophil and monocytes were not shown to be meaningful when statistics are brought in. Administration of GM-CSF resulted in mild toxicities such as myalgia, fever, skin reaction and neuropathy. But, one patient had grade 3 myalgia. Premedication brought about meaningful reductions in the toxicities of GM-CSF and can be used safely to reduce the toxicities.