- 著者
- Emi CHIKUIE Seiji FUGISAKI Soutarou FUKUHARA Kouki IMAOKA Yuzo HIRATA Saburo FUKUDA Mamoru TAKAHASHI Hiroshi SAKAI Masafumi SUESHIRO Hideto SAKIMOTO
- 出版者
- Hiroshima University Medical Press
- 雑誌
- Hiroshima Journal of Medical Sciences (ISSN:00182052)
- 巻号頁・発行日
- vol.67, no.2, pp.47-49, 2018 (Released:2020-03-28)
- 参考文献数
- 12
An 82-year-old woman swallowed a fish bone and presented to our hospital 3 days later when she had breathing difficulty and became hypotensive. Chest computed tomography (CT) showed a linear structure with high bone density extending from the oesophagus into the pericardium, along with pericardial effusion, air, and a left pleural effusion. We diagnosed the patient with oesophageal perforation by a foreign body (a fish bone) leading to pericardial penetration, cardiac tamponade, and left empyema. The patient underwent emergency surgery. Pericardial fenestration and drainage of the pericardial and thoracic cavities were performed. Chest CT showed a recurrent abscess cavity in the pericardium on day 6. A pigtail catheter was placed in the recurrent abscess cavity under CT guidance for drainage. The patient gradually improved and was discharged after 5 months.
- 著者
- Irandi Putra Pratomo Fathiyah Isbaniyah Yumiko Koba Hiroki Ohge Taijiro Sueda Eiso Hiyama
- 出版者
- 広島大学医学出版会
- 雑誌
- Hiroshima Journal of Medical Sciences (ISSN:00182052)
- 巻号頁・発行日
- vol.66, no.2, pp.31-38, 2018 (Released:2019-04-30)
- 参考文献数
- 18
This study aimed to elucidate retrospectively the correlations between the genome and phenotype in clinical methicillin-resistant Staphylococcus aureus (MRSA) gentamicin (GEN), clindamycin (CLI), and minocycline (MIN) susceptibility using next-generation sequencing (NGS) technology. Ninety two MRSA strains were isolated from individual inpatients treated in Hiroshima University Hospital, Hiroshima, Japan, extracted for their genomic DNA, and sequenced using an Illumina® MiSeq sequencer to obtain their de novo whole-genome assembly. An in silico analysis using ResFinder was performed to obtain the genomic antimicrobial susceptibility profile which was analyzed together with GEN, CLI, and MIN minimum inhibitory concentration (MIC) levels. This study found aac(6')aph(2")+,spc+,ermA+,tetM+ MRSA strains were predominant (42/92) and were shown to exhibit >16 mg/L GEN (40/42), >4 mg/L CLI (26/42), and >8 mg/L MIN MIC levels (30/42). Associations between aac(6’)aph(2”) detections and GEN MIC levels (p <0.001), ermA detections and CLI MIC levels (p <0.001), and tetM detections and MIN MIC levels (p <0.001) were revealed in this study. Correlations between simultaneous detections of aac(6’)aph(2”)-spc-ermA-tetM and GEN MIC levels (φc= 0.398, p <0.001), CLI MIC levels (φc= 0.448, p <0.001), and MIN MIC levels (φc= 0.515, p <0.001) were revealed in this study. The genomic-phenotypic correlation analyses in this study provided an insight of a rapid antimicrobial detection in MRSA using in silico genomic antimicrobial susceptibility profiling.
- 著者
- SADATOMO Takashi YUKI Kiyoshi MURAKAMI Taro MIGITA Keisuke TANIGUCHI Eiji KODAMA Yasunori
- 出版者
- 広島大学
- 雑誌
- Hiroshima journal of medical sciences (ISSN:00182052)
- 巻号頁・発行日
- vol.52, no.4, pp.91-97, 2003-12
A 35-year-old man presented with a sudden headache and disturbance of consciousness. On admission, his consciousness level was Japan Coma Scale 100. Computed tomography disclosed a subarachnoid hemorrhage (SAH) and right cerebellar hematoma. Angiography was performed and, at first, arteriovenous malformation of the posterior fossa was diagnosed. Then external decompression of the posterior fossa and ventricular drainage were performed, followed by barbiturate therapy. Repeat angiography revealed that the lesion was a venous angioma with arteriovenous shunts. On day 37, subtotal removal of the lesion was performed. Intraoperatively, acute brain swelling emerged and partial internal decompression of the right cerebellar hemisphere was performed. The postoperative course was comparatively good and the patient was discharged with very mild ataxia. The patient is now being followed up in our outpatient clinic.