• Title/Summary/Keyword: INFECTION INDEX

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Korean Guidelines for Diagnosis and Treatment of Tuberculosis in Children and Adolescents (소아청소년 결핵의 진료 지침)

  • Choi, Kyong Min;Kim, Nam Hee;Kim, Dong-Ho;Kim, Yae Jean;Kim, Jong-Hyun;Oh, Sung Hee;Eun, Byung Wook;Lee, Soo-Young;Lee, Taek Jin;Chun, Jin-Kyong;Hong, Jung Yun
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.1-14
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    • 2011
  • Tuberculosis is a disease with high morbidity and mortality in children worldwide. Despite the decrease in the incidence of tuberculosis in Korea, more than 30,000 new patients are diagnosed each year. Active tuberculosis is less frequent in children compared to adults but the risk of miliary tuberculosis and CNS tuberculosis is much higher. The diagnosis of tuberculosis in children and adolescents is difficult due to the nonspecific symptoms upon presentation. Diagnostic work up is based on the confirmation of tuberculosis infection by tuberculin skin test, abnormal radiologic findings, and contact with an adult with active tuberculosis. Anti-tuberculosis medications are prescribed according to the drug susceptibility of the index patient. Latent tuberculosis infection plays an important role in adult tuberculosis by reactivation. Thus, it is critical to accurately diagnose latent tuberculosis in children to prevent reactivation in adulthood. Korean guidelines for diagnosis and treatment of tuberculosis in children and adolescents provide evidence based recommendations in the optimal diagnosis and treatment for active and latent tuberculosis in children and adolescents based on the current Korean situation.

Influence of Chongcao Yigan Capsule on Function of Intestinal Flora and Chemoprevention for Patients with Chronic Hepatitis B-Induced Liver Fibrosis

  • Zhao, Xiao-Hu;Cao, Zheng-Yu;Shen, Yang;Lv, Yu-Feng;Tao, Guang-Rong;Chen, Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9423-9426
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    • 2014
  • Objective: Hapatitis B visus (CHB)-induced fibrosis is a precancerous condition of liver. To explore the influence of Chongcao Preparation (Chongcao Yigan Capsule) on the function of intestinal flora and chemoprevention for patients with CHB-induced liver fibrosis. Methods: A total of 136 patients with CHB-induced liver fibrosis were randomly divided into control group treated with lamivudine (LAM) and research group added with Chongcao Yigan Capsule for totally 48 weeks. The changes of intestinal flora, secretory immunoglobin A (SIgA), serum albumin (ALB), prealbumin (PALB), IgA and IgG at different time points in both groups were observed. Results: Before treatment, there was no significant difference between two groups in each index (P>0.05). After treatment, the intestinal flora were evidently optimized in research group than treatment before (P<0.05 or P<0.01), and were apparently better than those in control group (P<0.05 or P<0.01); SIgA was obviously increased and ALB, PALB, IgA and IgG were markedly improved in research group than treatment before (P<0.05 or P<0.01), and were significantly better than those in control group (P<0.05 or P<0.01). Conclusions: Chongcao Yigan Capsule could regulate the intestinal flora, increase SIgA, serum ALB and PALB concentrations and significantly improve serum IgA and IgG as well as strengthen the immunological function and autologous repair capacity of patients with CHB-induced liver fibrosis.

Evaluation of Anti-Herpes Simplex Virus Type 1 Activity of Acyclovir by Using Mouse Intracerebral Infection Model (마우스 대뇌감염모델을 이용한 Acyclovir의 항Herpes Simplex Virus Type 1 약효평가)

  • Lee, Chong-Kyo;Kim, Hae-Soo
    • The Journal of Korean Society of Virology
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    • v.28 no.1
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    • pp.63-69
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    • 1998
  • To establish in vivo antiviral evaluation system by using murine herpesvirus intracerebral infection model, 5-6 female BALB/c mice per group aged 5 weeks were inoculated i.c. into cerebrum with different inocular HSV-1 F. Signs of clinical disease noted everyday for one month. Observed were body weight decrease, neurological signs and death caused by encephalitis. Mice discontinued body weight decrease were recovered from the disease, and keratitis was often observed during recovery. The groups inoculated with higher than 1,000 PFU showed 100% mortaltiy and $LD_{50}$ was <100 PFU/mouse. To study the effect of virus inoculum sizes on antiviral effect of acyclovir (ACV), mice inoculated with different inocula were administered i.p. with different doses of ACV immediately after infection, and twice a day for 5 days. The higher inculum size, the less protective. $ED_{50}$ of ACV was >25, >25, 18.4 and 8.0 mg/kg b.i.d. in the group infected with 1,000,000, 100,000, 10,000 and 1,000 PFU/mouse, respectively. $LD_{50}$ of ACV was 62.5 mg/kg b.i.d. Therapeutic index of ACV was <2.5, <2.5, 3.0 and 7.0 in the groups with inocula 1,000,000, 100,000, 10,000 and 1,000 PFU/mouse, respectively. Inoculum size 1,000 PFU/mouse showing 100% mortaltiy and 5-6 days mean time to death, 5 days drug administration and 14 days observation will be future experimental conditions.

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Necrotizing Fasciitis in a Patient with Systemic Lupus Erythematosus (전신성 홍반성 루푸스 환자에서 발생한 괴사성 근막염의 치험례)

  • Cho, Hye-In;Chang, Hak
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.309-314
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    • 2011
  • Purpose: Necrotizing fasciitis is a life-threatening, destructive soft tissue infection with a very high rate of mortality that needs early diagnosis and aggressive treatment. Systemic Lupus Erythematosus (SLE) is a systemic, autoimmune disease and it's major cause of mortality is an infection. But necrotizing fasciitis in SLE is very rare and there have been only 22 cases reported in the literatures. We reported a patient of necrotizing fasciitis with SLE and reviewed 22 others from literature research. Methods: A 40-year-old female patient with a history of SLE for 6 years came to the emergency room. The patient complained of severe pain and swelling on her right leg. She was diagnosed as necrotizing fasciitis and underwent emergency fasciotomy. As wound cultures showed variable organisms, she was treated with broad-spectrum antibiotics and underwent several surgical debridements. Then, the wound was treated with the V.A.C (Vacuum Assisted Closure) device and split thickness skin grafting was performed two times. Results: Skin graft was well taken within 2 weeks after operations and the patient was discharged to outpatient follow up. There was no complication related with surgery and she could walk without cane after 3 months. Conclusion: We treated a necrotizing fasciitis in a patient with SLE and reviewed 22 others from literature research. The case presented here suggests that necrotizing fasciitis is a rare disease in SLE patients, but should be considered in the differential diagnosis of soft tissue infection in SLE patients. A high index of suspicion is needed for early diagnosis and proper management in these patients.

Trichinella spiralis Infection Suppressed Gut Inflammation with $CD4^+CD25^+Foxp3^+$ T Cell Recruitment

  • Cho, Min Kyoung;Park, Mi Kyung;Kang, Shin Ae;Choi, Seon Hee;Ahn, Soon Cheol;Yu, Hak Sun
    • Parasites, Hosts and Diseases
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    • v.50 no.4
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    • pp.385-390
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    • 2012
  • In order to know the effect of pre-existing Trichinella spiralis infection on experimentally induced intestinal inflammation and immune responses, we induced colitis in T. spiralis-infected mice and observed the severity of colitis and the levels of Th1, Th2, and regulatory cytokines and recruitment of $CD4^+CD25^+Foxp3^+$ T (regulatory T; $T_{reg}$) cells. Female C57BL/6 mice were infected with 250 muscle larvae; after 4 weeks, induction of experimental colitis was performed using 3% dextran sulfate sodium (DSS). During the induction period, we observed severity of colitis, including weight loss and status of stool, and evaluated the disease activity index (DAI). A significantly low DAI and degree of weight loss were observed in infected mice, compared with uninfected mice. In addition, colon length in infected mice was not contracted, compared with uninfected mice. We also observed a significant increase in production of pro-inflammatory cytokines, IL-6 and IFN-${\gamma}$, in spleen lymphocytes treated with DSS; however, such an increase was not observed in infected mice treated with DSS. Of particular interest, production of regulatory cytokines, IL-10 and transforming growth factor (TGF)-${\beta}$, in spleen lymphocytes showed a significant increase in mice infected with T. spiralis. A similar result was observed in mesenteric lymph nodes (MLN). Subsets of the population of $T_{reg}$ cells in MLN and spleen showed significant increases in mice infected with T. spiralis. In conclusion, T. spiralis infection can inhibit the DSS-induced colitis in mice by enhancing the regulatory cytokine and $T_{reg}$ cells recruitment.

Infection Status of Freshwater Fish with Metacercariae of Clonorchis sinensis in Korea

  • Kim, Eun-Min;Kim, Jae-Lip;Choi, Sung-Yil;Kim, Jae-Whan;Kim, Si-Won;Choi, Min-Ho;Bae, Young-Mee;Lee, Soon-Hyung;Hong, Sung-Tae
    • Parasites, Hosts and Diseases
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    • v.46 no.4
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    • pp.247-251
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    • 2008
  • This study investigated freshwater fish for their current infection status with metacercariae of Clonorchis sinensis in Korea. Twenty-one species of freshwater fish (n = 677) were collected from 34 regions nationwidely from February 2007 to June 2008. They were individually examined by digestion technique. Eight species of freshwater fish from 17 different regions were recognized positive for the metacercariae of C. sinensis. The positive rates (range of metacercariae number per fish) of fish by the species were as follows: 48% (1-1,142) in Pseudorasbora parva, 60% (1-412) in Pungtungia herzi, 15.7% (1-23) in Pseudogobio esocinus, 29% (1-7) in Acheilognathus intermedia, 21% (1-4) in Odontobutis interrupta, 33% (1-6) in Zacco temmincki, 3.6% (1-4) in Zacco platypus, and 26.3% (1) in Hemibarbus labeo. The two species, P. parva and P. herzi, are able to be the index fish for estimation of C. sinensis transmission in a certain locality. Still several species of freshwater fish are briskly transmitting C. sinensis infection in many riverside areas of southern Korea.

Relationship between White Spot Symptom and Physiological Status of Two Penaeid Shrimps

  • Kim, Su Kyoung;Kim, Myung Seok;Park, Myoung Ae;Kim, Su mi;Jang, In Kwon;Kim, Seok Ryel;Cho, Miyoung
    • Korean Journal of Environmental Biology
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    • v.35 no.4
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    • pp.461-467
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    • 2017
  • Shrimps infected with WSSV(White Spot Syndrome Virus) generally exhibit white spots in their inner space of carapaces as an acute clinical sign. In an effort to identify the correlation between this acute clinical sign and the condition, the index factors (RNA/DNA concentration and ratio, trypsin activity) were analyzed. A total 580 farmed Fenneropenaeus chinensis and 130 Lithopenaeus vannamei were collected from western and southern fifteen outdoor ponds in Korea. The status of the white spot pathology was divided into four stages (stage 0, stage I, stage II, and stage III), in accordance with the clinical signs as to the size and area of white spots. A significant decrease in RNA concentration and RNA/DNA ratio for multi-infected fleshy prawn (WSSV and vibrio sp.) occurred during the stage III (the whole carapace is covered with a white spot). In particular, RNA/DNA ratio was significantly lower as $1.47{\pm}0.04$ than other groups. A similar trend was also found in the single infection (WSSV), but the decrease was less than the multi-infection. In the species comparison, both species were vulnerable to the multi-infection, but L. vannamei was more sensitive than F. chinensis(ANOVA, p<0.05): A significant decrease in RNA concentration and RNA/DNA ratio was first found in stage II for the former species, while it was found in stage III for the latter species. Trypsin activity was also showed a similar tendency with nucleic acid variation. Multi-infected shrimp showed drastically decrease of trypsin activity. According to the results, clinical signs of the white spot under carapace have an only physiological effect on shrimp if they covered entirely with white spots.

Research on Reimbursement of Therapeutic Medical Device through Delphi Method and Analytic Hierarchy Process (치료재료 별도산정 기준 개선을 위한 델파이 및 계층분석과정 조사)

  • Noh, Jin-Won;Lee, Yejin;Jang, Suk Yong;Kim, Mi Kyung;Cho, Kyoung Hee;Kim, Jae-Hyun;Yoo, Ki-Bong
    • Korea Journal of Hospital Management
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    • v.23 no.4
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    • pp.15-25
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    • 2018
  • Purposes: The objectives of this study present the direction of the criteria for the separately reimbursement of therapeutic medical device. Methodology: We summarized experts' opinion using Delphi survey and Analytic Hierarchy Process(AHP). 48 experts were gathered from Medical Insurance Review Nurses Association, medical device industry, academy and association, Medical Device Expert Evaluation Committee. Descriptive statistics, consistency index, content validity ratio were analyzed. Findings: Clinical utility, patient safety, infection control, cost-homogeneity, cost-effectiveness showed high feasibility and importance, but market contribution and functional utility showed low feasibility and importance in a relative sense. The results of functional utility differed between clinical and non-clinical experts. Measurability was low across the whole area. Among the criteria for the separately reimbursement of therapeutic medical device. Patient safety/infection control and clinical utility showed the highest relative importance values, analyzed using AHP. Practical Implications: Patient safety and infection control are needed to be considered as one of Value Assessment Criteria. It is important to find out how to improve the measurability of therapeutic medical device.

Intraoperative Cerebrospinal Fluid Leak in Extradural Spinal Tumor Surgery

  • Ropper, Alexander E.;Huang, Kevin T.;Ho, Allen L.;Wong, Judith M.;Nalbach, Stephen V.;Chi, John H.
    • Neurospine
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    • v.15 no.4
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    • pp.338-347
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    • 2018
  • Objective: Patients with extradural spine tumors are at an increased risk for intraoperative cerebrospinal fluid (CSF) leaks and postoperative wound dehiscence due to radiotherapy and other comorbidities related to systemic cancer treatment. In this case series, we discuss our experience with the management of intraoperative durotomies and wound closure strategies for this complex surgical patient population. Methods: We reviewed our recent single-center experience with spine surgery for primarily extradural tumors, with attention to intraoperative durotomy occurrence and postoperative wound-related complications. Results: A total of 105 patients underwent tumor resection and spinal reconstruction with instrumented fusion for a multitude of pathologies. Twelve of the 105 patients (11.4%) reviewed had intraoperative durotomies. Of these, 3 underwent reoperation for a delayed complication, including 1 epidural hematoma, 1 retained drain, and 1 wound infection. Of the 93 uncomplicated index operations, there were a total of 9 reoperations: 2 for epidural hematoma, 3 for wound infection, 2 for wound dehiscence, and 2 for recurrent primary disease. One patient was readmitted for a delayed spinal fluid leak. The average length of stay for patients with and without intraoperative durotomy was 7.3 and 5.9 days, respectively, with a nonsignificant trend for an increased length of stay in the durotomy cases (p=0.098). Conclusion: Surgery for extradural tumor resections can be complicated by CSF leaks due to the proximity of the tumor to the dura. When encountered, a variety of strategies may be employed to minimize subsequent morbidity.

Interregional Epidemic Model with Multi-Group Compartmental Model (다 집단 구획모델을 적용한 지역 간 감염모델)

  • Gwak, Seung Hyun
    • Journal of the Korea Society for Simulation
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    • v.30 no.3
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    • pp.19-29
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    • 2021
  • To explain the interregional infections in COVID-19, we designed a multi-group compartmental model by applying the SEIQRD model, a compartmental model of a single group. The model is segmented by compartments to account for hidden infections, such as latent periods and asymptomatic cases, and is capable of comparing infection indices and test rates between regions. Through this, it estimated which region was centered during the second wave in August 2020 and the third wave in November 2020. Subgroups were set up in Seoul, Gyeonggi (including Incheon), and a non-metropolitan area. We fit the model to the Ministry of Health and Welfare's data to estimate the average infection index between regions, average rate of rT-PCR test by region, and the expected number of hidden infections by region.