Pub Date : 2022-01-31DOI: 10.30579/mbse.2022.5.1.32
E. Jang, Seung Myung Park, Seongheon Lee, Joungmin Kim
Endotracheal intubation of patients with abnormal upper airway structures is rare. In these pa tients, endotracheal intubation may be difficult and sometimes emergent surgical airway security may be required, so a thorough airway evaluation, intubation plan, and implementation should be performed. We report a case of successful endotracheal intubation using bougie in the patient with unilateral vocal cord and narrow glottis who underwent thyroid cartilage fracture 10 years ago.
{"title":"Facilitation of endotracheal intubation using a bougie in a patient with unilateral vocal cord due to a traumatic thyroid cartilage fracture","authors":"E. Jang, Seung Myung Park, Seongheon Lee, Joungmin Kim","doi":"10.30579/mbse.2022.5.1.32","DOIUrl":"https://doi.org/10.30579/mbse.2022.5.1.32","url":null,"abstract":"Endotracheal intubation of patients with abnormal upper airway structures is rare. In these pa tients, endotracheal intubation may be difficult and sometimes emergent surgical airway security may be required, so a thorough airway evaluation, intubation plan, and implementation should be performed. We report a case of successful endotracheal intubation using bougie in the patient with unilateral vocal cord and narrow glottis who underwent thyroid cartilage fracture 10 years ago.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"341 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127580185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-31DOI: 10.30579/mbse.2022.5.1.41
Jiwon Park, Kyoung Sim Kim, Y. W. Kim, Eun Young Kim, Young Kim, Hae In Jang, Hyoung Min Cho
Congenital tuberculosis infection is very rare, but fatal. Congenital tuberculosis should always be considered among the many causes of pneumonia, especially if the newborn has pneumonia that does not respond to treatment. We report a case of a premature infant born to a mother who had no evidence of tuberculosis infection. The patient was the first of the twins born by cesarean section at 30 weeks and 1 day of gestation. The 21 st day after birth, the patient de veloped apnea, tachycardia, and tachypnea. The medical staff assumed sepsis and bacterial pneumonia. Despite antibiotic treatment, the patient’s condition worsened. On the 63 rd day after birth, the mother of the infant visited the emergency room complaining of fever and decreased consciousness and was diagnosed with tuberculous meningitis. Mycobacterium tuberculosis was detected in the AFB stain, TB PCR, and TB culture.
{"title":"A case of congenital tuberculosis-infected twins born to a mother with asymptomatic tuberculosis during pregnancy","authors":"Jiwon Park, Kyoung Sim Kim, Y. W. Kim, Eun Young Kim, Young Kim, Hae In Jang, Hyoung Min Cho","doi":"10.30579/mbse.2022.5.1.41","DOIUrl":"https://doi.org/10.30579/mbse.2022.5.1.41","url":null,"abstract":"Congenital tuberculosis infection is very rare, but fatal. Congenital tuberculosis should always be considered among the many causes of pneumonia, especially if the newborn has pneumonia that does not respond to treatment. We report a case of a premature infant born to a mother who had no evidence of tuberculosis infection. The patient was the first of the twins born by cesarean section at 30 weeks and 1 day of gestation. The 21 st day after birth, the patient de veloped apnea, tachycardia, and tachypnea. The medical staff assumed sepsis and bacterial pneumonia. Despite antibiotic treatment, the patient’s condition worsened. On the 63 rd day after birth, the mother of the infant visited the emergency room complaining of fever and decreased consciousness and was diagnosed with tuberculous meningitis. Mycobacterium tuberculosis was detected in the AFB stain, TB PCR, and TB culture.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"357 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115469064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-31DOI: 10.30579/mbse.2022.5.1.22
H. Bae, Kyungmi Kim, Dongho Kim, J. Chin, I. Choi
Corresponding author Ji-Hyun Chin Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-5632 Fax: +82-2-3010-6790 E-mail: cjh@amc.seoul.kr ORCID: https://orcid.org/0000-0001-9312-1685 Transesophageal echocardiography (TEE) has become a standard intraoperative monitor during cardiac surgery. Although generally considered safe, some cases of major TEE-related complications have been reported. We present a case of a 71-year-old man with aortic aneurysm and aortic regurgitation scheduled for total arch replacement and aortic valve replacement. During the cardiopulmonary bypass period, massive gastric bleeding occurred. Emergency esophagogastroduodenoscopy (EGD) was performed during surgery and a 2-cm deep laceration was observed at the gastroesophageal junction, suggesting Mallory-Weiss syndrome caused by TEE. Since it was impossible to control massive bleeding using EGD, Sengstaken-Blakemore tube was inserted through the stomach to compress the bleeding site. Massive gastric bleeding was controlled after reversal of the effect of heparin. Since TEE might cause complications, anesthesiologists should manipulate the TEE probe gently with caution. If massive gastric bleeding is suspected during surgery, immediate EGD should be considered for diagnosis and further management.
{"title":"Transesophageal echocardiography-related massive gastrointestinal bleeding during cardiac surgery","authors":"H. Bae, Kyungmi Kim, Dongho Kim, J. Chin, I. Choi","doi":"10.30579/mbse.2022.5.1.22","DOIUrl":"https://doi.org/10.30579/mbse.2022.5.1.22","url":null,"abstract":"Corresponding author Ji-Hyun Chin Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-5632 Fax: +82-2-3010-6790 E-mail: cjh@amc.seoul.kr ORCID: https://orcid.org/0000-0001-9312-1685 Transesophageal echocardiography (TEE) has become a standard intraoperative monitor during cardiac surgery. Although generally considered safe, some cases of major TEE-related complications have been reported. We present a case of a 71-year-old man with aortic aneurysm and aortic regurgitation scheduled for total arch replacement and aortic valve replacement. During the cardiopulmonary bypass period, massive gastric bleeding occurred. Emergency esophagogastroduodenoscopy (EGD) was performed during surgery and a 2-cm deep laceration was observed at the gastroesophageal junction, suggesting Mallory-Weiss syndrome caused by TEE. Since it was impossible to control massive bleeding using EGD, Sengstaken-Blakemore tube was inserted through the stomach to compress the bleeding site. Massive gastric bleeding was controlled after reversal of the effect of heparin. Since TEE might cause complications, anesthesiologists should manipulate the TEE probe gently with caution. If massive gastric bleeding is suspected during surgery, immediate EGD should be considered for diagnosis and further management.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121122513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-31DOI: 10.30579/mbse.2022.5.1.37
Yong S. Han, Y. Cho
Transient global amnesia (TGA) is characterized by a sudden episode of memory loss that usually lasts for minutes to several hours but never longer than 24 hours. TGA is triggered by events such as Valsalva maneuver, acute emotional stress, sexual intercourse, or pain. Since case reports of TGA occurring after pain interventions are extremely rare, it may be difficult for the phy-sician to respond appropriately. Although TGA is self-limiting, it is important for the physicians to be aware of this unique syndrome and to distinguish it from other neurological complications or local anesthetic toxicity. We report a case of a 57-year-old female patient who experienced TGA after pain interventions such as nerve block and intramuscular stimulation at a pain clinic. The symptoms disappeared within 1 hour without neurological sequelae.
{"title":"Transient global amnesia after pain interventions such as nerve block and intramuscular stimulation: a case report","authors":"Yong S. Han, Y. Cho","doi":"10.30579/mbse.2022.5.1.37","DOIUrl":"https://doi.org/10.30579/mbse.2022.5.1.37","url":null,"abstract":"Transient global amnesia (TGA) is characterized by a sudden episode of memory loss that usually lasts for minutes to several hours but never longer than 24 hours. TGA is triggered by events such as Valsalva maneuver, acute emotional stress, sexual intercourse, or pain. Since case reports of TGA occurring after pain interventions are extremely rare, it may be difficult for the phy-sician to respond appropriately. Although TGA is self-limiting, it is important for the physicians to be aware of this unique syndrome and to distinguish it from other neurological complications or local anesthetic toxicity. We report a case of a 57-year-old female patient who experienced TGA after pain interventions such as nerve block and intramuscular stimulation at a pain clinic. The symptoms disappeared within 1 hour without neurological sequelae.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117014968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-31DOI: 10.30579/mbse.2022.5.1.1
J. Lim, K. Ko, S. Jo
Hip pain in athletes is relatively common but is often underdiagnosed. Historically, surgery has been utilized only for hips with osteoarthritis or osteonecrosis, and pain from other causes was considered to be self-limiting. However, recent studies have reported that surgical treatment may benefit patients with recalcitrant pain that is derived from impingement around the hip. The current review aims to describe the common impingement syndromes around the hip joint which can be a cause of pain, as well as detrimental to function. The review also highlights surgical methods that have recently been developed for treating such impingements.
{"title":"Review of impingements around the hip joint","authors":"J. Lim, K. Ko, S. Jo","doi":"10.30579/mbse.2022.5.1.1","DOIUrl":"https://doi.org/10.30579/mbse.2022.5.1.1","url":null,"abstract":"Hip pain in athletes is relatively common but is often underdiagnosed. Historically, surgery has been utilized only for hips with osteoarthritis or osteonecrosis, and pain from other causes was considered to be self-limiting. However, recent studies have reported that surgical treatment may benefit patients with recalcitrant pain that is derived from impingement around the hip. The current review aims to describe the common impingement syndromes around the hip joint which can be a cause of pain, as well as detrimental to function. The review also highlights surgical methods that have recently been developed for treating such impingements.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127146754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-31DOI: 10.30579/mbse.2022.5.1.27
Dongseok Kim, S. Cho
As neck breathers have been proven to improve life expectancy, the chance of requiring neck breathing treatment is increasing. A 75-year-old man with a history of total laryngectomy in 1995 for laryngeal cancer was diagnosed with mechanical obstruction due to colorectal cancer. Emergency Hartmann’s operation was performed. We pre-evaluated a narrow stoma airway measuring 5 mm with chronic stenosis. Anesthesia was successfully induced using a 4.5-mm tube with a fiberoptic scope. After stomaplasty, we converted to a 7.0-mm tube. Moreover, we pre-evaluated the neck breather’s airway, and planned how to induce anesthesia and cope with emergency situations. Science and Engineering.
{"title":"Difficult tracheostomy tube placement to neck breather with chronic stenosis after total laryngectomy","authors":"Dongseok Kim, S. Cho","doi":"10.30579/mbse.2022.5.1.27","DOIUrl":"https://doi.org/10.30579/mbse.2022.5.1.27","url":null,"abstract":"As neck breathers have been proven to improve life expectancy, the chance of requiring neck breathing treatment is increasing. A 75-year-old man with a history of total laryngectomy in 1995 for laryngeal cancer was diagnosed with mechanical obstruction due to colorectal cancer. Emergency Hartmann’s operation was performed. We pre-evaluated a narrow stoma airway measuring 5 mm with chronic stenosis. Anesthesia was successfully induced using a 4.5-mm tube with a fiberoptic scope. After stomaplasty, we converted to a 7.0-mm tube. Moreover, we pre-evaluated the neck breather’s airway, and planned how to induce anesthesia and cope with emergency situations. Science and Engineering.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130881576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.30579/mbse.2021.4.2.98
Jeong-Wook Park, K. Jung, Young Joon Ki, Sang Hun Kim
Lung ultrasound can be used to assess adequate regional ventilation, similar to auscultation. Therefore, we evaluated whether the diagnostic accuracy of lung ultrasound was superior to that of auscultation in the assessment of proper double lumen tube (DLT) position, which were performed by anesthetic trainees. We conducted a single-center, prospective study of 69 patients. DLT insertion, auscultation, lung ultrasound, and fiberoptic bronchoscopy were sequentially conducted in the same patients in the supine and lateral positions. During lung ultrasound, the proper DLT position was defined when the lung pulse and barcode sign were visible on the non-ventilated lung, and lung sliding and seashore sign were observed in the ventilated lung. Fiberoptic bronchoscopy was performed for final verification of the DLT position as a standard test. Contingency tables were plotted to determine accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each method. The primary outcome of this study was the accuracy of each method. Accuracy (60.9%), sensitivity (100%), specificity (12.9%), PPV (58.5%), and NPV (100%) of ultrasound were equal to those of auscultation in the supine position. Accuracy (89.9%), sensitivity (100%), specificity (36.4%), PPV (89.2%), and NPV (100%) of ultrasound were equal to that of auscultation in the lateral position. The prevalence of proper lung isolation was 55.1% in the supine position, and it increased to 84.1% in the lateral position. Lung ultrasound is not superior to auscultation for determination of the proper DLT position in both the supine and lateral positions.
{"title":"Diagnostic accuracy of auscultation and lung ultrasound in the assessment of adequate double lumen tube position for anesthetic trainee doctors - a single center, prospective study","authors":"Jeong-Wook Park, K. Jung, Young Joon Ki, Sang Hun Kim","doi":"10.30579/mbse.2021.4.2.98","DOIUrl":"https://doi.org/10.30579/mbse.2021.4.2.98","url":null,"abstract":"Lung ultrasound can be used to assess adequate regional ventilation, similar to auscultation. Therefore, we evaluated whether the diagnostic accuracy of lung ultrasound was superior to that of auscultation in the assessment of proper double lumen tube (DLT) position, which were performed by anesthetic trainees. We conducted a single-center, prospective study of 69 patients. DLT insertion, auscultation, lung ultrasound, and fiberoptic bronchoscopy were sequentially conducted in the same patients in the supine and lateral positions. During lung ultrasound, the proper DLT position was defined when the lung pulse and barcode sign were visible on the non-ventilated lung, and lung sliding and seashore sign were observed in the ventilated lung. Fiberoptic bronchoscopy was performed for final verification of the DLT position as a standard test. Contingency tables were plotted to determine accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each method. The primary outcome of this study was the accuracy of each method. Accuracy (60.9%), sensitivity (100%), specificity (12.9%), PPV (58.5%), and NPV (100%) of ultrasound were equal to those of auscultation in the supine position. Accuracy (89.9%), sensitivity (100%), specificity (36.4%), PPV (89.2%), and NPV (100%) of ultrasound were equal to that of auscultation in the lateral position. The prevalence of proper lung isolation was 55.1% in the supine position, and it increased to 84.1% in the lateral position. Lung ultrasound is not superior to auscultation for determination of the proper DLT position in both the supine and lateral positions.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127584243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.30579/mbse.2021.4.2.91
H. Park, Sung Won Park
Corresponding author Sung Won Park Department of Pediatrics, Gangseo MizMedi Hospital, 295 Gangseo-ro, Gangseo-gu, Seoul 07639, Korea Tel: +82-2-2007-1323 Fax: +82-2-2007-7789 E-mail: swped@naver.com ORCID: https://orcid.org/0000-0001-8219-1880 A lot of congenital anomalies are detected in fetus and newborn through the use of prenatal and postnatal ultrasonography. This study aimed to assess the renal duplication incidences in neonates and provide solutions that would help in managing these patients. From January 1, 2001 to December 31, 2010, we retrospectively analyzed 113 patients with neonatal duplication of the renal collecting system who were diagnosed prenatally and confirmed postnatally kidney ultrasonography at single center. In this case, the duplication of the renal collecting system is the most common congenital malformation of the urinary tract with an incidence of 0.12%, which is lower than the general incidence of 1%. Out of the total 113 patients, the incomplete duplication kidney findings were 85 patients (75%) and complete duplication kidney findings were 18 patients (15.9%). As to whether they had other congenital anomalies, 13 out of 85 patients had incomplete duplication of the kidney and all of 18 patient had complete duplication of kidney. In our study, if there are no accompanying complications, we suggest that observing ultrasonography is sufficient without other evaluation to detect whether they are complete or incomplete.
{"title":"The incidence and complications of duplication of the renal collecting system in neonates diagnosed antenatally","authors":"H. Park, Sung Won Park","doi":"10.30579/mbse.2021.4.2.91","DOIUrl":"https://doi.org/10.30579/mbse.2021.4.2.91","url":null,"abstract":"Corresponding author Sung Won Park Department of Pediatrics, Gangseo MizMedi Hospital, 295 Gangseo-ro, Gangseo-gu, Seoul 07639, Korea Tel: +82-2-2007-1323 Fax: +82-2-2007-7789 E-mail: swped@naver.com ORCID: https://orcid.org/0000-0001-8219-1880 A lot of congenital anomalies are detected in fetus and newborn through the use of prenatal and postnatal ultrasonography. This study aimed to assess the renal duplication incidences in neonates and provide solutions that would help in managing these patients. From January 1, 2001 to December 31, 2010, we retrospectively analyzed 113 patients with neonatal duplication of the renal collecting system who were diagnosed prenatally and confirmed postnatally kidney ultrasonography at single center. In this case, the duplication of the renal collecting system is the most common congenital malformation of the urinary tract with an incidence of 0.12%, which is lower than the general incidence of 1%. Out of the total 113 patients, the incomplete duplication kidney findings were 85 patients (75%) and complete duplication kidney findings were 18 patients (15.9%). As to whether they had other congenital anomalies, 13 out of 85 patients had incomplete duplication of the kidney and all of 18 patient had complete duplication of kidney. In our study, if there are no accompanying complications, we suggest that observing ultrasonography is sufficient without other evaluation to detect whether they are complete or incomplete.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127785094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.30579/mbse.2021.4.2.69
Sung-Heui Shin
Vibrio vulnificus is a gram-negative ferrophilic bacterium that causes necrotizing wound infections and fatal septicemia, which mainly occur in patients with elevated levels of iron in serum or tissue, despite the presence of well-developed bacterial multiple iron-uptake systems (IUSs). These IUSs play important roles in the pathogenesis of V. vulnificus infections and are primarily regulated at the transcriptional level by a ferric uptake regulator called Fur responding to iron availability and their own specific regulators. Recent studies have shown that the IUSs are also controlled by other global regulators, including cyclic AMP-receptor protein responding to carbon availability and SmcR, a master regulator of the quorum-sensing system responding to bacterial density. This review presents an update on this sophisticated regulation of IUSs in V. vulnificus.
{"title":"Regulation of iron-uptake systems in Vibrio vulnificus, a ferrophilic bacterium","authors":"Sung-Heui Shin","doi":"10.30579/mbse.2021.4.2.69","DOIUrl":"https://doi.org/10.30579/mbse.2021.4.2.69","url":null,"abstract":"Vibrio vulnificus is a gram-negative ferrophilic bacterium that causes necrotizing wound infections and fatal septicemia, which mainly occur in patients with elevated levels of iron in serum or tissue, despite the presence of well-developed bacterial multiple iron-uptake systems (IUSs). These IUSs play important roles in the pathogenesis of V. vulnificus infections and are primarily regulated at the transcriptional level by a ferric uptake regulator called Fur responding to iron availability and their own specific regulators. Recent studies have shown that the IUSs are also controlled by other global regulators, including cyclic AMP-receptor protein responding to carbon availability and SmcR, a master regulator of the quorum-sensing system responding to bacterial density. This review presents an update on this sophisticated regulation of IUSs in V. vulnificus.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115202564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.30579/mbse.2021.4.2.116
Nam-Ho Kim
Corresponding author Nam Ho Kim Department of Internal Medicine, Chonnam National University Medical School, Baekseo-ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-6270 Fax: +82-62-225-8578 E-mail: nhk111@jnu.ac.kr ORCID: https://orcid.org/0000-0002-0898-5428 Metformin-associated lactic acidosis (MALA) is a rare but sometimes fatal complication. I report a case of MALA in a man aged 59 years treated with continuous ambulatory peritoneal dialysis and was taking metformin about a month ago. He was brought to the hospital for dyspnea and diarrhea. Laboratory finding showed high anion gap meta bo lic acidosis with elevated lactate level. He received continuous renal replacement therapy due to severe acidosis and hemodynamic instability occurred during admis sion. His pH and lactate level was normalized within 48 hours. Though obvious correlation between metformin and lactic acidosis in end-stage renal disease was not found, caution is needed to use metformin in these patients.
{"title":"Metformin-associated lactic acidosis (MALA) in a peritoneal dialysis patient","authors":"Nam-Ho Kim","doi":"10.30579/mbse.2021.4.2.116","DOIUrl":"https://doi.org/10.30579/mbse.2021.4.2.116","url":null,"abstract":"Corresponding author Nam Ho Kim Department of Internal Medicine, Chonnam National University Medical School, Baekseo-ro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-6270 Fax: +82-62-225-8578 E-mail: nhk111@jnu.ac.kr ORCID: https://orcid.org/0000-0002-0898-5428 Metformin-associated lactic acidosis (MALA) is a rare but sometimes fatal complication. I report a case of MALA in a man aged 59 years treated with continuous ambulatory peritoneal dialysis and was taking metformin about a month ago. He was brought to the hospital for dyspnea and diarrhea. Laboratory finding showed high anion gap meta bo lic acidosis with elevated lactate level. He received continuous renal replacement therapy due to severe acidosis and hemodynamic instability occurred during admis sion. His pH and lactate level was normalized within 48 hours. Though obvious correlation between metformin and lactic acidosis in end-stage renal disease was not found, caution is needed to use metformin in these patients.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133302940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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