The purpose of this study was the development and evaluation of an experimental model allowing the investigation of hamster anti-Clostridium difficile coecal microflora. The existence of this "barrier" was verified in conventional hamsters. Such hamster coecal flora was then orally transferred to C3H germ-free mice. In such animals, the "barrier effect" was maintained. After treatment with erythromycin, the colonization resistance was always maintained; despite two subsequent processes, dilutions of coecal contents (10(-2] and subsequent heating of this fluid (70 degrees C, 10 min), the inhibitory activity against C. difficile was partially maintained (10(4) UFC/g faeces). The isolation of anaerobic strains implicated in colonization resistance will next be carried out in an anaerobic chamber using this microflora.

Animals↗

PubMedDate not supplied

Takayasu's arteritis with aortoaortic bypass graft and renal autotransplantation: report of one case.

Takayasu's arteritis is a rare inflammatory disease of the aorta and its major branches which occurs predominantly in young women. The clinical course has been described as two stages: 1) initial phase, with inflammatory process and systemic manifestations; and later 2) pulseless phase, with multiple arterial occlusions. A 20-year-old female came to visit this hospital for the first time at 10 years of age with occlusion of the left subclavian artery and of the thoracoabdominal aorta. Aortoaortic bypass surgery was performed using a 14 mm woven graft from the ascending aorta to the descending aorta on the infrarenal portion. The postoperative course was uneventful. Exertional dyspnea and hypertension progressively developed. However, in the past year, angiograms have shown a marked stenosis on the proximal portion of the left renal artery. Autotransplantation for the left-sided kidney was performed. The patient did well, and remained free of symptoms until this time of writing, 12 months after the operation.

Aorta↗

PubMedDate not supplied

[Congenital coronary arteriovenous fistula: analysis of five cases].

The records of 5 patients with congenital coronary arteriovenous fistula, diagnosed by echocardiogram, cardiac catheterization, angiocardiography and confirmed by cardiac surgery between 1982 and 1988, were studied. Their ages ranged from 3 months to 13 years. Among them, 3 were asymptomatic; one developed congestive heart failure shortly after birth, and was treated with digoxin and furosemide. Another patient had exertional dyspnea and fatigue. A grade 3-4/6 continuous murmur was heard over the right or left lower sternal border in four patients; only a pansystolic murmur was heard over the left lower sternal border in the remaining one patient. All the five patients had right coronary arteriovenous fistula terminating into the right ventricle. All received cardiac surgery. Direct epicardial ligation of the fistula was performed in one patient. The rest four cases required cardiopulmonary bypass and suture closure through the right ventricle by direct suture of the orifice in one patient, and Dacron patch closure in other three patients. No postoperative complications occurred in all patients. In conclusion, since the operation was quite safe, if patient had significant shunts and/or clinical symptoms, surgical correction should be considered.

Adolescent↗

PubMedDate not supplied

[Scrub typhus--report of two cases].

Explore the source record for details and available documents.

Antibodies, Bacterial↗

PubMedDate not supplied

Non-hyperventilation respiratory therapy of persistent pulmonary hypertension of the newborn.

Persistent pulmonary hypertension of the newborn (PPHN) is one of the most challenging situations in the neonatal intensive care nursery and it is associated with a high mortality rate. Hyperventilation therapy has been recommended as the primary ventilator management during recent decades. The associations of pulmonary barotrauma, chronic lung disease and hearing impairment raised the questions of significant pulmonary and neurological complications with this therapeutic modality. From July 1990 to April 1993, 14 cases of neonatal persistent pulmonary hypertension were treated with nonhyperventilation respiratory therapy at the Chang Gung Memorial Hospital. The goals of this therapy were to attain a pH level between 7.40 and 7.50, a PaO2 level between 60 and 90 mmHg and a PaCO2 level between 30 and 50 mmHg. High peak inflating pressure (> 35 cmH2O) and high ventilator rates (> 60/min) were avoided. The average duration on a ventilator was 6.8 +/- 2.9 days. Four patients had pulmonary barotrauma (29%); three of which were pulmonary interstitial emphysema and one pneumothorax. Three patients died (21%). Only one patient had neurological sequelae. No one had developed chronic lung disease. The non-hyperventilation approach for PPHN may be considered as an alternative ventilator management before starting a more aggressive hyperventilation therapy.

Female↗

PubMedDate not supplied

Arterial switch operation in a neonate with simple transposition of great arteries.

Transposition of the great arteries (TGA) is characterized by severe and life-threatening hypoxemia during a newborn period. Without treatment, most of the patients die during early infancy. We reported a 20-day-old male newborn who was referred to our hospital due to severe cyanosis and respiratory distress. Echocardiograms revealed D-TGA with an intact ventricular septum. There was no pulmonary stenosis or other major cardiac anomalies. The cardiac catheterization and angiographic findings which were performed 4 days later were consistent with the diagnosis of echocardiography. The systolic left and right ventricular pressures were 65 and 69 mmHg respectively. Arterial switch operation was performed at the age of 28 days. Postoperative course was uneventful. The cardiac recatheterization and angiographic study performed 6 months after operation, and the latest non-invasive examination including chest X-ray, electrocardiogram and echocardiographic assessment revealed good ventricular performance and normal semilunar valve function. There was no obstruction at the anastomotic site. The patient has been doing well with regular follow-up at our clinic for 2 years and 6 months without medication.

Arteries↗

PubMedDate not supplied

Endocarditis due to Neisseria sicca: report of one case.

Many species of the Neisseria, which are respiratory commensals in humans, have been regarded as being nonpathogenic or as causing disease in only immunocompromised hosts. We report a case in which Neisseria sicca was the cause of infective endocarditis in a child with a ventricular septal defect and review the literature on endocarditis due to N. sicca infection. Most of these patients had an underlying heart disease. Dental caries and poor oral hygiene may be two factors that predispose patients to the infection. N. sicca endocarditis usually results in a subacute onset of symptoms and, if not diagnosed early and treated, is associated with a high rate of embolic complications.

Child↗