• 제목/요약/키워드: Persistent Infection

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Helicobacter pylori 감염과 비타민 C: 과거, 현재, 미래 (Helicobacter pylori Infection and Vitamin C: Past, Present and Future Perspectives)

  • 윤희상;이광호
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제11권sup1호
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    • pp.83-92
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    • 2008
  • Helicobacter pylori is the causative agent of chronic gastritis and has a role in the pathogenesis of peptic ulcer diseases, and gastric cancer. There have been reports suggesting a close link between these gastroduodenal disorders and a state of vitamin C deficiency. In this paper, the past, present and future perspectives on H. pylori infection and vitamin C will be discussed under the following view points. Since the ecological niche of H. pylori is the mucus layer and intercellular junctions of the gastric epithelium, the various kinds of host inflammatory cells motivated by the local and systemic immune responses cannot eliminate the microorganisms. When the invading foreign body is not removed, despite full activation of defense mechanisms, adverse consequences of the immune responses develop on the host gastric mucosa. The reasons for the body vitamin C depletion could be explained as follows; 1) the increased vitamin C consumption by increased oxygen free radical production through the prolonged hypersensitivity reactions in the gastric mucosa, 2) the increased vitamin C oxidation by the nitrite which is formed from nitrate reduction by the intragastric bacteria proliferated in the hypochlorhydric gastric cavity, 3) the strong ${\gamma}$-glutamyltranspeptidase activity of H. pylori which depletes the glutathiones in gastric mucosa. Depletion of glutathiones in the stomach favors irreversible oxidative destruction of ascorbic acid. Both persistent inflammatory burdens in the stomach by H. pylori and resultant vitamin C depletions synergistically and uninhibitedly might aggravate the hypothetical sequence of gastric carcinogenesis: atrophic gastritis${\rightarrow}$intestinal metaplasia${\rightarrow}$dysplasia${\rightarrow}$gastric adenocarcinoma. High intake of vitamin C could reverse the hypothetical sequence of the gastric carcinogenesis via direct and indirect effects on H. pylori and host-parasite relationships.

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Systematic Review and Comparative Meta-Analysis of Outcomes Following Pedicled Muscle versus Fasciocutaneous Flap Coverage for Complex Periprosthetic Wounds in Patients with Total Knee Arthroplasty

  • Economides, James M.;DeFazio, Michael V.;Golshani, Kayvon;Cinque, Mark;Anghel, Ersilia L.;Attinger, Christopher E.;Evans, Karen Kim
    • Archives of Plastic Surgery
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    • 제44권2호
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    • pp.124-135
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    • 2017
  • Background In cases of total knee arthroplasty (TKA) threatened by potential hardware exposure, flap-based reconstruction is indicated to provide durable coverage. Historically, muscle flaps were favored as they provide vascular tissue to an infected wound bed. However, data comparing the performance of muscle versus fasciocutaneous flaps are limited and reflect a lack of consensus regarding the optimal management of these wounds. The aim of this study was to compare the outcomes of muscle versus fasciocutaneous flaps following the salvage of compromised TKA. Methods A systematic search and meta-analysis were performed to identify patients with TKA who underwent either pedicled muscle or fasciocutaneous flap coverage of periprosthetic knee defects. Studies evaluating implant/limb salvage rates, ambulatory function, complications, and donor-site morbidity were included in the comparative analysis. Results A total of 18 articles, corresponding to 172 flaps (119 muscle flaps and 53 fasciocutaneous flaps) were reviewed. Rates of implant salvage (88.8% vs. 90.1%, P=0.05) and limb salvage (89.8% vs. 100%, P=0.14) were comparable in each cohort. While overall complication rates were similar (47.3% vs. 44%, P=0.78), the rates of persistent infection (16.4% vs. 0%, P=0.14) and recurrent infection (9.1% vs. 4%, P=0.94) tended to be higher in the muscle flap cohort. Notably, functional outcomes and ambulation rates were sparingly reported. Conclusions Rates of limb and prosthetic salvage were comparable following muscle or fasciocutaneous flap coverage of compromised TKA. The functional morbidity associated with muscle flap harvest, however, may support the use of fasciocutaneous flaps for coverage of these defects, particularly in young patients and/or high-performance athletes.

연부조직 결손을 동반한 감염성 경골 불유합 및 골결손의 치료(유리피판술과 동시에 시행한 Ilizarov기구를 이용한 골연장술의 유용성) (Treatment of Infected Tibial Nonunion Combined with Soft Tissue Defect (Effectiveness of Simultaneous Free-tissue Transfer and Ilizarov Distraction Osteogenesis))

  • 송준영;정현균;서승용;장현호
    • Archives of Reconstructive Microsurgery
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    • 제14권1호
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    • pp.37-41
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    • 2005
  • Purpose: The purpose of this study was to evaluate the effectiveness of internal transport using Ilizarov apparatus with free flap surgery for infected tibial nonunion. Materials and Methods: We reviewed 8 patients of infected tibial nonunion treated with internal transport using Ilizarov apparatus and free flap surgery. Seven of eight patients were available for at least 1 year follow-up. All patients were male. The mean age at the time of the surgery was All fractures were Gustilo's type III B open fracture. The mean length of the bone defect was 8.5 cm. All used flaps for covering the soft tissue defect were free rectus abdominis muscle flap. We evaluated bone and functional results with use of the Paley and Catagni's classification. And we classified the complication with use of the Paley's classification. Results: Acceptable length and solid union of bone was achieved in all cases. The mean size of the bone length was 7.2 cm. The mean healing index was 69.5 days/cm. All but one case needed bone graft at docking site. All flaps were survived. There was no recurrence of infection. According to Paley and Catagni's classification, all cases showed excellent or good results. Complications were pin tract infection in 3 cases, persistent pain in 2 cases and limitation of joint motion in 2 cases. Conclusion: Simultaneous free-tissue transfer and Ilizarov distraction osteogenesis was thought to be an attractive treatment modality for infected nonunion of the tibia.

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Human Papillomavirus Genotypes Profile in Cervical Cancer Patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

  • Tobing, Maringan Diapari Lumban;Sahiratmadja, Edhyana;Dinda, Mufti;Hernowo, Bethy Suryawathy;Susanto, Herman
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5781-5785
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    • 2014
  • Background: As in other developing countries, cervical cancer is the most frequent gynecologic malignancy in Indonesia. Persistent high risk genotypes of human papillomavirus (HPV) that infect the cervical tissue have been established as the etiology of cervical cancer. This study aimed to explore the profile of cervical cancer patients and the infected HPV genotypes at Dr. Hasan Sadikin General Hospital-Bandung. Materials and Methods: During the year 2010, 554 cervical cancer patients were registered. In a subset of the patients during July - November 2010, 40 randomized fresh biopsies were tested for HPV genotype after obtained informed consent. The distribution of HPV genotypes and the association to risk factors were analysed. Results: The result showed that 62.5% of the tested biopsies were infected by multiple HPV infections, with HPV-16 found in most of the cervical cancer patients (90%). Marriage at age younger than 16 years old was statistically significant in relation to multiple HPV infection (p=0.003), but not parity more than three times (p=0.59). Conclusions: Although high paritiy in our study was not associated with multiple HPV infection, good family planning programs and reproductive health education need to be emphasized in Indonesia as high parity and marriage at young age might increase the chance of cervical cancer development.

Nested Multiplex PCR Based Detection of Human Papillomavirus in Cervical Carcinoma Patients of North- East India

  • Das, Debabrata;Rai, Avdhesh Kumar;Kataki, Amal Chandra;Barmon, Debabrata;Deka, Pankaj;Sharma, Jagannath Dev;Sarma, Anupam;Shrivastava, Sushruta;Bhattacharyya, Mouchumee;Kalita, Apurba Kumar;Sharma, Mousumi;Ahmed, Shiraj
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.785-790
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    • 2013
  • Background: Persistent infection of one or more of about 15 high-risk human papillomaviruses (HR-HPVs), most commonly HPV types 16/18, has a significant role in cervical cancer initiation and progression. There are limited data available from north-east India about HPV prevalence though this region has high incidence rates of cervical cancer. The aim of this study was to investigate the HPV genotypes prevalent in cervical cancer patients of north-east India. Materials and Methods: We analyzed 107 cervical cancer patient samples. Nested multiplex PCR assays were employed for detection of 13 high risk and 5 low risk HPV types. Results: HPV was confirmed in 105 samples. The presence of 6 'carcinogenic' HPV types, HPV-16 (88%), -18 (15%), -31(4%),-45 (3%), -59 (4%), -58(1%), and one non carcinogenic, HPV-6/11 (6%), was recorded. Among various demographic and clinical factors only tumour stage showed a statistically significant association with HPV type infection (P=0.019). Conclusions: We suggest that the most prevalent genotype is HPV-16 followed by HPV-18 in cervical carcinoma patients of the north-eastern region of India. Advanced tumour stage may be associated with increased possibility of harbouring multiple HPV genotypes.

A case of nonserotypable Escherichia coli infection in a Korean rabbit farm

  • Camer, Gerry A.;Roh, Yoon-Seok;Cho, A-Ra;Kim, Jong-Won;Umanets, Alexander;Kim, Bum-Seok;Lim, Suk-Kyung;Lee, Hee-Soo;Lim, Chae-Woong
    • 한국동물위생학회지
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    • 제35권1호
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    • pp.69-71
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    • 2012
  • Rabbits are highly susceptible to colibacillosis, and no treatment is able to control the disease effectively. Rabbits raised in a farm in Chonbuk province presenting persistent diarrhea and death were submitted for diagnosis. Ninety percent of the infected animals died; weanlings suffered the most mortality. Necropsies showed prominent hemorrhagic foci along the intestinal and cecal serosae. In histopathological examination, rod-shaped bacteria were observed in the necrotic areas of the tips of villi in the small intestine and neutrophils infiltration was found around the necrotic villous areas. The affected animals consistently yielded Escherichia coli isolates from the intestines. The isolated organism was atypically indole-negative and was nonserotypable using 62 known O group-typing sera. Further microbiological and epidemiological works to recognize and control colibacillosis infection in farmed rabbits in Korea is therefore critical.

Prevalence of Sexually Transmitted Pathogen Coinfections in High Risk-Human Papillomaviruses Infected Women in Busan

  • Choi, Sun Hee;Jin, Hyunwoo;Lee, Kyung Eun
    • 대한의생명과학회지
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    • 제25권4호
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    • pp.390-397
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    • 2019
  • High risk-human papillomavirus (HR-HPV) is known to be a major cause of cervical cancer, and coinfection of sexually transmitted pathogen (STP) has been reported to cause persistent HPV infection. However, the relationship between HPV and STP coinfection remains unclear. The purpose of this study was to analyze the coinfection rate with STP in high-risk human papillomavirus infected women in Busan and to collect basic data for the prevention of cervical lesions. This study was carried out in 355 women who had concurrent HPV and STP screening at Busan local hospital between January 2016 and December 2017. HPV and STP coinfection was found in 187 (52.7%) out of 355 cases. HR-HPV and STP coinfection was 82.9% higher than LR-HPV and STP coinfections 17.1%. In HR-HPV infection, Ureaplasma species was the most common pathogen (47.1%), followed by C. trachomatis (21.9%) and Mycoplasma species (12.3%). In the analysis of HR-HPV genotype according to STP, HPV 16 (12.0%) was the most frequent, followed by HPV 58 (11.6%), HPV 39 (11.1%) and HPV 52 (10.2%), but HPV 18 showed a low coinfection rate of 1.3%. According to the results of age, HR-HPV and STP coinfection rate was the highest at 41.9% among women aged 18 to 29. HR-HPV and Ureaplasma species showed the highest coinfection rates at all ages, followed by C. trachomatis and Mycoplasma species. Further studies with more samples will be needed to determine if the coinfection of HR-HPV and STPs is involved in the development of cervical tumors through histologic changes.

주산기 모체 감염과 미숙아 간농양 1례 (Liver Abscess Associated with Maternal Perinatal Infection in a Premature Infant)

  • 이주희;서봉옥;서은선;김성미;김준형
    • Neonatal Medicine
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    • 제15권1호
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    • pp.105-110
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    • 2008
  • 신생아 간농양은 특별한 증상이 발현되지 않거나 비특이적인 증상 때문에 진단이 늦어지는 경우가 많다. 항생제의 사용에도 불구하고 염증 반응이 지속되며 복부증상이 함께 나타나는 경우, 주산기 산모의 심한 감염, 융모양막염 등의 선행인자가 있고, 제대혈관 도관과 관련된 패혈증이 있는 경우에는 간농양의 가능성을 고려해야 한다. 저자들은 생후 9일된 미숙아에서 제대정맥 도관과 함께 산모의 폐렴 및 심한 융모양막염이 선행요인이 되어, 단일성 간농양이 발생한 진단된 사례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Comparison of Seropositivity to Trichomonas vaginalis between Men with Prostatic Tumor and Normal Men

  • Kim, Jung-Hyun;Moon, Hong-Sang;Kim, Kyu-Shik;Hwang, Hwan-Sik;Ryu, Jae-Sook;Park, Sung-Yul
    • Parasites, Hosts and Diseases
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    • 제57권1호
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    • pp.21-25
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    • 2019
  • Trichomoniasis is the most common curable sexually-transmitted infection. Most Trichomonas vaginalis-infected men are asymptomatic and can remain undiagnosed and untreated, and this has been thought to result in chronic persistent prostatic infection. Chronic inflammation is regarded as the major factor in the pathogenesis and progression of benign prostatic hyperplasia (BPH) and prostatic cancer (PCa). The aim of this study is to identify seropositivity to T. vaginalis in men with prostate tumors (BPH or PCa) visited to Hanyang University Hospital. A total of 183 men were enrolled between October 2013 and November 2014. They consisted of 139 with BPH (mean age: $64.0{\pm}0.07$) and 44 with prostate cancer (mean age: $73.3{\pm}0.18$). We carried out ELISA to identify the seropositivity to T. vaginalis. Mixed lysate antigen extracted from 8 strains of T. vaginalis was used in the ELISA. Also 58 male outpatients visited to Health Promotion Center in Hanyang University Hospital were evaluated for comparing group. As a results, seropositivity to T. vaginalis in patients with prostatic diseases was 19.7% (BPH: 18.7%, PCa: 22.7%) and it was significantly higher than the 1.7% of the comparing healthy group (P=0.001). Therefore, prostatic tumor showed higher seropositivity against T. vaginalis than normal men. As far as we know, this is the first report about seroprevalence in prostatic tumor in Korea.

A Case of Successful Treatment of Congenital Syphilis in an Extremely Preterm Baby With Severe Respiratory Distress

  • Yoon Kyung Cho;Yeon Kyung Lee;Sun Young Ko
    • Pediatric Infection and Vaccine
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    • 제29권3호
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    • pp.161-165
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    • 2022
  • We report a case of successful treatment of congenital syphilis in an extremely preterm baby. A 1,395 g female infant was born by emergency Caesarean section due to preterm labor and breech presentation at gestational age at 29 weeks and 3 days with an Apgar score of 2 and 4 at 1 minute and 5 minutes, respectively. The mother of the newborn, an illegal immigrant who did not receive any antenatal care, was diagnosed as active syphilis infection by reactive rapid plasma regain (RPR) (titer 1:128) just before the delivery. Upon birth, the newborn presented with various clinical manifestations, including severe respiratory distress syndrome, persistent pulmonary hypertension of the newborn, disseminated intravascular coagulopathy, desquamation and scaling of the whole body, and osteolytic changes of long bone ends. Results of laboratory tests showed signs of early congenital syphilis, including positive syphilis reagin test (12.7 R.U.), reactive with RPR titer of 1:64, and positive for immunoglobulin (Ig) M and IgG fluorescent treponemal antibody absorption test. However, after completion of penicillin G treatment for two weeks, laboratory results dramatically improved, showing a negative syphilis reagin test (0.5 R.U.) and non-reactive in RPR. In conclusion, the incidence of congenital syphilis is prone to be resurgent in South Korea, neonatologists should be fully aware of the clinical features of congenital syphilis because early diagnosis and prompt treatment are essential in order to reduce the social and economic burden due to congenital syphilis.