Yonsei medical journal
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Yonsei medical journal · Jun 2021
Case ReportsFulminant Disseminating Fatal Granulomatous Amebic Encephalitis: The First Case Report in an Immunocompetent Patient in South Korea.
Central nervous system infections caused by free-living amoeba are very rare, but often fatal. The typical image findings of amebic meningoencephalitis are non-specific, showing ring-like enhancement. We report the first case of fulminant disseminating fatal granulomatous amebic encephalitis caused by Balamuthia mandrillaris in an immunocompetent patient in South Korea. ⋯ Magnetic resonance imaging revealed a rim-enhancing lesion with intralesional blooming dark signal intensity on susceptibility weighted imaging and low signal intensity on diffusion weighted images and on apparent diffusion coefficient maps. Differential diagnosis was started from a tumor or non-tumorous lesion, and diagnosis was difficult due to the rarity of the disease. Following the clinical and diagnostic courses of our case, we recommend inspecting image findings of granulomatous amebic encephalitis for early diagnosis.
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Yonsei medical journal · Jun 2021
Randomized Controlled TrialEffect of Equal Ratio Ventilation on Respiratory Mechanics and Oxygenation During Volume-Controlled Ventilation in Pediatric Patients.
Children have few small alveoli, which reduce lung compliance; in contrast, their cartilaginous rib cage makes their chest wall highly compliant. This combination promotes lung collapse. Prolonged inspiratory to expiratory (I:E) ratio ventilation is used to optimize gas exchange and respiratory mechanics in surgery. However, the optimal ratio is unclear in children. We hypothesized that, compared to a 1:2 I:E ratio, a 1:1 I:E ratio would improve dynamic compliance and oxygenation, and affect the peak airway pressure in pediatric patients undergoing surgery. ⋯ Compared to a 1:2 I:E ratio, a 1:1 I:E ratio improved dynamic compliance and lowered the peak airway pressure without complications in pediatric patients. Nevertheless, our results do not support its use solely for improving oxygenation.
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Yonsei medical journal · Jun 2021
Benzodiazepine Use and Long-Term Mortality in South Korean Adult Population: A Cohort Study.
Studies have reported mixed results on the association between benzodiazepine use and mortality. Here, we investigated whether benzodiazepine use is associated with a higher risk of 5-year all-cause mortality, and examined the association between benzodiazepine use and 5-year disease-specific mortality. ⋯ Benzodiazepine use was associated with increased 5-year all-cause mortality in the South Korean adult population. Further studies are needed to confirm these findings.
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Yonsei medical journal · Jun 2021
Venous Thromboembolism in a Single Korean Trauma Center: Incidence, Risk Factors, and Assessing the Validity of VTE Diagnostic Tools.
Trauma increases the risk of venous thromboembolism (VTE) in hospitalized patients. However, the risk and incidence of VTE in Korean trauma patients are limited. Therefore, we aimed to evaluate the incidence and identify potential predictors of VTE occurrence in Korean trauma patients. Moreover, we assessed the validity of the Greenfield risk assessment profile (RAP) and the trauma embolic scoring system (TESS) in these patients. ⋯ RAP and TESS, which are well-known diagnostic tools, demonstrated potentials in predicting the VTE occurrence in Korean trauma patients. Additionally, patients with pelvic-bone fractures and long-term ventilator treatment should be carefully examined for possible VTE.