• Journal of the Korean Burn Society
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• v.22 no.2
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• pp.66-70
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• 2019

Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found. Conclusion: The only method to increase the survival rate is to 'suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.

• Korean Journal of Microbiology
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• v.48 no.2
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• pp.109-115
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• 2012

Helicobacter pylori is an important factor of chronic gastritis, digestive ulcer, and stomach cancer. CagL, a virulence factor of H. pylori, is well-known as a pilus protein which acts as adhesion to host cell and a component of Type 4 secretion system. In this study, we evaluated the protective response of recombinant CagL protein (rCagL) using Mongolian gerbil animal model for H. pylori infection. The cagL gene was cloned from 26695 H. pylori followed by over-expression and purification of the protein in E. coli. Mongolian gerbils were immunized with rCagL protein mixed with aluminum adjuvant via intramuscular injections once a week during 4 weeks. At a week after the last immunization, the Mongolian gerbils were administrated with H. pylori 7.13 strain into the stomach and sacrificed to measure antibody titer on rCagL by ELISA and bacterial colonization in the stomach, and to examine the histopathological changes and cytokine expression at 6 week after challenge. Antibody titers on recombinant protein were significantly increased from a week after the first immunization. There was no significant change of the number of bacterial colony between control group and immunized group. The relative stomach weight was significantly decreased in immunized group, but the significant change of histopathological assessment was not observed in the stomach. Cytokine expression such as IL-$1{\beta}$ and KC also was not significantly different between control and immunized groups. These results indicate that rCagL could effectively induce the formation of the specific IgG antibodies. However, bacterial colonization and histopathological lesions could not be inhibited by the immunization in the stomach, indicating not enough protection against H. pylori infection. We consider that along with CagL other adequate antigens could be needed stimulating immune response and inducing protective effects against gastric disease, and also a better adjuvant could be considered.