• Title/Summary/Keyword: Infection exposure

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Treatment of Soft Tissue Defect on Ankle or Dorsum of Foot with Extended Gracilis Muscle Free Flap (확장된 박근 유리 피판을 이용한 족관절 및 족배부 연부조직 결손의 치유)

  • Kim, Sug Won;Kim, Kwang Seop;Seo, Dong Wan;Lee, Hoon Bum;Chung, Yoon Kyu
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.147-153
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    • 2000
  • Soft tissue defects of the dorsum of foot and ankle can be covered from skin graft to free tissue transfer. The extent of injury which may be complex including the exposure of paratenons or bones requires free flap reconstruction. Some of the precautions for reconstruction are providing minimal bulkiness and well conforming to irregular contour thus making normal footwear possible. Though the muscle flap having its advantages and versatility, the fascial flap such as temporoparietal fascial flap has been considered the choice for reconstruction of the dorsum of foot and ankle. The purpose of our study is to utilize the advantages and versatility of the muscle flap as a first choice for reconstruction for the defects involving the dorsum of foot and ankle. The gracilis muscle with its anatomic and donor characteristics, it can be utilized to maximal effect by expanding its slim muscle width removing the epimysium and reducing its bulk by muscle atrophy through denervation. We present our experience with ten cases of reconstruction for the dorsum of foot and ankle using the gracilis muscle free flap. Results were satisfactory without flap loss, skin loss and infection. The contour and aesthetic aspect of the foot was satisfactory. Gait analysis showed near normal gait without limitations from everyday activities. Normal footwear was tolerable in all the cases. The keys to consider in the reconstruction of the dorsum of foot and ankle are appropriate bulkiness, conforming to its contour and able to apply normal footwear. With minimal donor morbidity and satisfying results, the extended gracilis muscle should be considered as the first line for reconstruction of the ankle and dorsum of foot.

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Acute Kidney Injury Accompanied by Acute Pyelonephritis and Renal Abscess in a Child with Vesicoureteral Reflux (소아에서 방광 요관역류가 동반된 급성 신우신염 및 신장 농양으로 인한 급성 신부전 1례)

  • Park, Cheol;Kim, Min-Sang;Kim, Mi-Kyung;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.16 no.1
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    • pp.63-67
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    • 2012
  • Acute pyelonephritis (APN) is a relatively common bacterial infection in children. In previously healthy children, acute kidney injury (AKI) is very rare in the course of APN without urinary tract obstruction, renal hypoperfusion due to hypotension or exposure to nephrotoxic agents. We describe a case of AKI secondary to APN and renal abscess in a child with vesicoureteral reflux. With antibiotic treatment and adequate hydration, the patient was improved. APN should be included in the differential diagnosis of AKI and adequate treatment by proper antibiotics is crucial for full recovery of renal function.

Seroprevalence and Risk Factors of Toxoplasma gondii Infection in High School Students in Cheju Province (제주도 고등학교 학생의 톡소포자충 항체 양성률 및 감염 위험요인)

  • Yang, Hyun-Jong;Bae, Jong-Myon;Choi, Hyun-Sik;Hwang, Hwan-Sik;Oh, Hoon-Kyu;Yun, Dong-Hyun;Hong, Seong-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.271-279
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    • 2000
  • Objectives : To assess the seroprevalence and risk factors of toxoplasmosis in high school students in Cheju Province, Korea. Methods : A total of 4,570 high school students from 18 schools in Cheju Province were investigated for Toxoplasma gondii antibodies(IgG) by enzyme linked immunosorbent assay (ELISA). Risk factors for toxoplasmosis, such as place of residence, type of house, contact with cats and other pets, and rare meat consumption, were examined by questionnaire. Results . The overall antibody positive rate was 5.5% and ranged from 2.6 to 11.5% by school. There was no significant difference between males and females. Statistical analyses of the questionnaire data indicated that the risk factors for seropositivity were: (1) birth place (Cheju/others), (2) place of residence (rural/urban), (3) dietary habits (vegetarian/non vegetarian), (4) eating rare meat, (5) exposure to pets and (6) hepatitis B. Conclusion : We confirmed that the prevalence of the anti-Toxoplasma gondii antibody in a population of high school students in Cheju Province was to the previously reported prevalence.

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A STUDY OF BONE APPOSITION AND MARGINAL ALVEOLAR BONE LOSS AROUND IMMEDIATE IMPLANSTS (발치 직후 매식 임프란트의 골침착과 변연골 상실에 대한 연구)

  • Jun, Chul-Oh;Vang, Mong-Sook
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.1
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    • pp.165-180
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    • 1997
  • The purpose of this study was to observe bone apposition and marginal bone loss and to check the possibility of success on titanium implant, HA coated implant and the implant with natural coral that were place immediately after teeth extraction in dogs. Experimental subjects were divided into 4 groups ; the 1st group is the titanium implant, second the HA coated implant, third the implant with natural coral, and the last the control group that was prepared in the extraction sockets. After 12 weeks, the dogs were sacrificed for visual observation and microscopic examination approaching histologic and histomorphometric analysis. The results were as follows : 1. Neither the infection nor the exposure of implant was found at the sites of all implant. 2. In a histomorphometric analysis, mean percentage of direct bone contact with the titanium implant was 80.7% and the HA coated implant showed 81.5% apposition, but the implant with natural coral showed 64.9% apposition(P<0.05). 3. In a microscopic examination, mature lamellated bone was found around the immediate implants and control group, while unabsorbed natural coral around the immediate implants with natural coral was found. 4. All immediate implant groups showed the loss of marginal bone in order from implant with natural coral, titanium implant, and HA coated implant. 5. Implant with natural coral that was placed by the type I interface of the Barzilay's classification immediately after teeth extraction showed low percentage of direct bone contact area, low success rate and a lot of marginal bone loss. Above results suggested that the immediate implants are osseointegrated successfully, although slightly marginal bone was loss.

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Two Pediatric Cases of Dengue Fever Imported from Philippines (필리핀에서 유입된 소아 뎅기열 2례)

  • Oh, Mi Ae;Shim, Jae Won;Kim, Duk Soo;Jung, Hye Lim;Park, Moon Soo;Shim, Jung Yeon
    • Pediatric Infection and Vaccine
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    • v.20 no.2
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    • pp.98-104
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    • 2013
  • Dengue fever is an important health problem for international travelers to all endemic areas. The steadily increasing numbers of tourists visiting endemic areas raise the risk of exposure, and imported dengue cases are increasingly observed in nonendemic area. Dengue has a wide spectrum of clinical presentations, often with unpredictable clinical evolution and outcome. While most patients recover following a self-limiting, non-severe clinical course, a small proportion progress to severe disease such as dengue hemorrhagic fever or dengue shock syndrome. Therefore, it is important to suspect dengue fever in every febrile patient returning from the tropics. Whenever it is suspected, a quick diagnosis and adequate managements are essential to avoid complications. We report two cases of imported dengue fever in Korean children presenting with fever, headache, nausea, and rash.

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Anti-adipogenic Pregnane Steroid from a Hydractinia-associated Fungus, Cladosporium sphaerospermum SW67

  • Lee, Seoung Rak;Kang, Heesun;Yoo, Min Jeong;Yu, Jae Sik;Lee, Seulah;Yi, Sang Ah;Beemelmanns, Christine;Lee, Jaecheol;Kim, Ki Hyun
    • Natural Product Sciences
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    • v.26 no.3
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    • pp.230-235
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    • 2020
  • A pregnane steroid, 3α-hydroxy-pregn-7-ene-6,20-dione (1), was isolated from a Hydractinia-associated Cladosporium sphaerospermum SW67 by repetitive column chromatographic separation and high-performance liquid chromatography (HPLC) purification. The planar structure of 1 was elucidated from the analysis of the spectroscopic data (1D and 2D NMR spectra) and LC-MS data. The absolute configuration of 1 was determined by interpretation of ROESY spectrum of 1, together with the comparison of reported spectroscopic values in previous studies. To the best of our knowledge, this is the first report of the identification of the pregnane scaffold from C. sphaerospermum, a natural source. Compound 1 was evaluated for its effects on lipid metabolism and adipogenesis during adipocyte maturation and showed that compound 1 substantially inhibited lipid accumulation compared to the control. Consistently, the expression of the adipocyte marker gene (Adipsin) was reduced upon incubation with 1. Further, we evaluated the effects of 1 on lipid metabolism by measuring the transcription of lipolytic and lipogenic genes. The expression of the lipolytic gene ATGL was significantly elevated upon exposure to 1 during adipogenesis, whereas the expression of lipogenic genes FASN and SREBP1 was significantly reduced upon treatment with 1. Thus, our findings provide experimental evidence that the steroid derived from Hydractinia-associated C. sphaerospermum SW67 is a potential therapeutic agent for obesity.

Forehead Island Flap For Nasal Reconstruction (이마 섬피판을 이용한 코재건술)

  • Lee, Keun-Cheol;Kwon, Yong-Seok;Jung, Ki-Hwan;Han, Jae-Jung;Park, Jung-Min;Kim, Seok-Kwun
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.199-204
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    • 2005
  • The nose is the most prominent area of the face, therefore susceptible to trauma and skin cancer. When small sized defect is in nasal tip, it results in disturbance of the facial harmony even if replantation, composite graft, skin graft or median forehead flap has been used for the reconstruction. So it is needed that the best method reconstruction is performed according to the degree of defect or deformity. And at the same time the physiology and anatomy of nose were clarified and its aesthetic subunits were employed. How can we cover the about 3 cm sized nasal defect in nasal tip with cartilage exposure? At first, we can think forehead island flap is most appropriate. We performed 7 cases of the forehead island flap for reconstruction of the defect in nasal tip(4 cases: cancer, 3 cases: trauma) from March, 2001 to August, 2004. This result was satisfactory in the point of texture, color, donor scar, and there were no complication such as wound disruption, infection, flap atrophy, and hematoma. The advantages of forehead island flap are: 1) No injury of deep vessel and nerve, 2) control of shape and volume, 3) Short operation time, 4) primary closure of donor site, 5) one stage operation. Also, forehead island flap can cover the defect in nose where skin graft and local flap can not cover. But, operator always must take care for flap congestion and donor site scar. We thought forehead island flap is one of the best option of reconstruction of nasal tip defect.

Effectiveness of Temporal Augmentation Using a Calvarial Onlay Graft during Pterional Craniotomy

  • Kim, Yoon Soo;Yi, Hyung Suk;Kim, Han Kyu;Han, Yea Sik
    • Archives of Plastic Surgery
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    • v.43 no.2
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    • pp.204-209
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    • 2016
  • Temporal hollowing occurs to varying degrees after pterional craniotomy. The most common cause of temporal hollowing is a bony defect of the pterional and temporal regions due to the resection of the sphenoid ridge and temporal squama for adequate exposure without overhang. The augmentation of such bony defects is important in preventing craniofacial deformities and postoperative hollowness. Temporal cranioplasty has been performed using a range of materials, such as acrylics, porous polyethylene, bone cement, titanium, muscle flaps, and prosthetic dermis. These methods are limited by the risk of damage to adjacent tissue and infection, a prolonged preparation phase, the possibility of reabsorption, and cost inefficiency. We have developed a method of temporal augmentation using a calvarial onlay graft as a single-stage neurosurgical reconstructive operation in patients requiring craniotomy. In this report, we describe the surgical details and review our institutional outcomes. The patients were divided into pterional craniotomy and onlay graft groups. Clinical temporal hollowing was assessed using a visual analog scale (VAS). Temporal soft tissue thickness was measured on preoperative and postoperative computed tomography (CT) studies. Both the VAS and CT-based assessments were compared between the groups. Our review indicated that the use of an onlay graft was associated with a lower VAS score and left-right discrepancy in the temporal contour than were observed in patients undergoing pterional craniotomy without an onlay graft.

Detection of Human Cytomegalovirus UL97 D605E Mutation in Korean Stem Cell Transplantation Recipients and Donors

  • Lee, Gyu-Cheol;Choi, Su-Mi;Lee, Chan Hee;Lee, Dong-Gun;Choi, Jung-Hyun;Yoo, Jin-Hong
    • Journal of Microbiology and Biotechnology
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    • v.23 no.8
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    • pp.1154-1158
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    • 2013
  • Ganciclovir resistance of human cytomegalovirus is associated with mutations in the viral UL97 gene and poses severe problems for immunocompromised patients. In this study, PCR-based restriction fragment length polymorphism and sequencing analyses detected the UL97 D605E mutation in all five clinical isolates from patients with ganciclovir-resistant human cytomegalovirus infection during prolonged ganciclovir therapy, whereas the M460V mutation was only present in 1 of 5 isolates. On the other hand, the detection rates of the D605E mutation in the stored available DNA samples from the donor and allogeneic stem cell transplantation recipients were 66.7% and 93.7%, respectively, suggesting that the presence of D605E mutation was not associated with the ganciclovir exposure. Although the D605E mutation may not be related to ganciclovir resistance, we suggest that this mutation could be an important molecular marker of human cytomegalovirus evolution in East Asian countries. Moreover, the restriction fragment length polymorphism method using the restriction enzyme HaeIII, which is generally used to detect the UL97 A591V mutation, could also detect the D605E mutation and may therefore be a useful tool for future research on the investigation of UL97 gene mutations.

COVID-19 Risk Factors Among Health Workers: A Rapid Review

  • Mhango, Malizgani;Dzobo, Mathias;Chitungo, Itai;Dzinamarira, Tafadzwa
    • Safety and Health at Work
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    • v.11 no.3
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    • pp.262-265
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    • 2020
  • Coronavirus disease 2019 (Covid-19) poses an important occupational health risk to health workers (HWs) that has attracted global scrutiny. To date, several thousand HWs globally have been reported as infected with the severe acute respiratory syndrome coronavirus 2 virus that causes the disease. It is therefore a public health priority for policymakers to understand risk factors for this vulnerable group to avert occupational transmission. A rapid review was carried out on 20 April 2020 on Covid-19 risk factors among HWs in PubMed, Google Scholar, and EBSCOHost Web (Academic Search Complete, CINAHL Complete, MEDLINE with Full Text, CINAHL with Full Text, APA PsycInfo, Health Source-Consumer Edition, Health Source: Nursing/Academic Edition) and WHO Global Database. We also searched for preprints on the medRxiv database. We searched for reports, reviews, and primary observational studies (case control, case cross-over, cross-sectional, and cohort). The review included studies conducted among HWs with Covid-19 that reported risk factors irrespective of their sample size. Eleven studies met the inclusion criteria. Lack of personal protective equipment, exposure to infected patients, work overload, poor infection control, and preexisting medical conditions were identified as risk factors for Covid-19 among HWs. In the context of Covid-19, HWs face an unprecedented occupational risk of morbidity and mortality. There is need for rapid development of sustainable measures that protect HWs from the pandemic.