Restoration of Sinus Rhythm by Defibrillation After Sudden Cardiac Arrest in a Patient with Chronic Atrial Fibrillation

Atrial fibrillation (AF) is a relatively common cardiac arrhythmia that can have adverse consequences due to a reduction in cardiac output and thrombus formation. For patients hemodynamically unstable due to AF, we recommend urgent direct current (DC) cardioversion. The importance of an automated external defibrillator (AED) in the emergency medical field for this purpose is very high. In addition, the distribution rate of an AED in public health care is on the rise. We herein describe a patient whose chronic AF was converted to a sinus rhythm by defibrillation during an episode of sudden cardiac arrest (SCA) which consequently improved left ventricular systolic function. We have experienced the importance of active use of AED.

Capecitabine and Oxaliplatin (XELOX) for the Treatment of Patients with Metastatic Gastric Cancer and Severe Liver Dysfunction

Gastric cancer patients with severe liver dysfunction secondary to hepatic metastases have limited treatment options. Most cytotoxic drugs have a narrow therapeutic index. Although both capecitabine and oxaliplatin have been well tolerated as single agents for patients with severe hepatic dysfunction, the combination of these drugs has not been investigated. We report here on a case of successful treatment of a patient suffering with severe liver dysfunction and metastatic gastric cancer; the patient was treated with a combination of capecitabine and oxaliplatin (XELOX). The initial bilirubin level of the patient was 10.9 mg/dL. After two cycles of treatment, his bilirubin level decreased to 2.1 mg/dL. He has experienced an excellent radiological response and he has received six cycles of XELOX chemotherapy. XELOX chemotherapy is feasible and it can be associated with positive outcomes for the patients suffering with metastatic gastric cancer and severe liver dysfunction.

Pseudobacteremic Outbreak of Leclercia adecarboxylata and Pseudomons aeruginosa Related to Contaminated Saline Cotton / 병원감염관리

BACKGROUND: During a 1-month period in 2005 , a series of 4 Leclercia adecarboxylata and 8 Pseudomonas aeruginosa bacteremias were reported from patients admitted to the emergency room. METHODS: An outbreak of L. adecarboxylata and P. aeruginosa bacteremia that occurred from February to March 2005 was investigated. The infection control nurse reviewed medical records and observed the procedures of blood cultures at the clinical microbiology laboratory. Specimens were obtained for investigational cultures from alcohol sponge, tray, sink, water of sink, saline cotton, microscope, computer, and telephone. RESULTS: L. adecarboxylata was isolated from 4 patients and P. aeruginosa from 8 patients during a 1-month period. Observation of the culture procedure revealed that saline cotton was used to prevent betadin skin discoloration. The culture of the saline solution yielded a heavy growth of P. aeruginosa, which was not isolated from any other specimens. CONCLUSIONS: This was a pseudoepidemic caused by contaminated saline cotton. The use of the saline cotton was stopped, and during the follow-up period of 3 months, no additional L. adecarboxylata or P. aeruginosa bacteremia were reported.