• Tuberculosis and Respiratory Diseases
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• 제60권1호
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• pp.97-101
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• 2006

Coccidioidomycosis is a rare systemic fungal infection in Korea. However, the incidence of coccidioidomycosis has recently begun to increase due to the increasing incidence of people traveling overseas to endemic areas. In previously reported cases of coccidioidomycosis in Korea, the radiographic findings usually showed a solitary pulmonary nodule, pleural effusion, cavitation, and hilar lymphadenopathy, but no miliary nodules. We report a case of disseminated coccidioidomycosis with miliary nodules in an immunocompetent patient. A 32 year old male, who had traveled in Corona, New Mexico, USA, was admitted for an evaluation of persistent cough with fever. Chest radiography revealed initially diffuse multiple small nodules that appeared to be miliary tuberculosis. However, a subsequent evaluation revealed that he had disseminated coccidioidomycosis.

• 한국동물위생학회지
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• 제13권2호
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• pp.130-140
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• 1990

A field test using Nophazin (drying off period therapeutics) was done from May, 1989 to October, 1989. 299 quarters of 75 cows from 28 herds were tested. The results were summarized as follows. 1. At the day 7 after parturition, CMT-was 81.60%, clots were removed perfectly, removal rate of hard, hot, pain was 99.6%, only one hard 0.35% was maintained. Recovery rate of general symptoms was 100%. 2. Recovery rate in Nophazin treatment was 100% in Micro-coccus SPP, Corynebacterium SPP, and unisolated, 97.06% in Enterobacterid SPP, 95.58% in Staphylococcus SPP, 91.67% in other Bacilli, 89.19% in Streptococcus SPP, Overall recovery rate was 95.32%, And fungi did not react. 3. The ratio of isolated microorganisms was Staphylococcus SPP 49.8%, Streptococcus SPP 16.3%, Enterobacteria SPP 15.0%, Micrococcus SPP 7.9% Corynebacterium SPP 4.4%, Pseudomonas SPP 2.6%, Bacilli 2.6% and Fungi 1.3%. 4. The range of sensitivity of each microorganism to therapeutics is as follow : Staphylococcus SPP 61.1∼94.7%, Streptococcus SPP 51.4∼91.9%, Micrococcus SPP 44.4∼94.4%, Corynebacterium SPP 70∼80%, Enterobacteria SPP 11.8∼88.2%, and other Gram negative bacilli 8.3∼83.3%. Overall sensitivity was in the range of 50.4∼92.0%, Microorganisms showed the highest sensitivity (80∼94.7%) to Nophazin. 5. New intramammary infection rate was 3.96% (9 strains) at paturition, 8.37% (19 strains) at the day 7 after paturition. Persistent organism wits 6.17% .(14 strains). 6. There was no side effect of Nophazin treatment.

• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.22-28
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• 2012

Purpose: In accordance to an increased interest in facial appearance and the popularization of computed tomography scanning, the number of diagnosis and treatment of blowout fractures has been increased. The purpose of this article is to review pure blowout fracture surgery through transconjunctival incision focusing on complications and their management. Methods: In this retrospective study, 583 patients, who had been treated for pure blowout fracture through transconjunctival incision from 2000 to 2009, were evaluated. Their hospital records were reviewed according to their sex, age, fracture site, preoperative presentations, time interval between trauma and surgery, and postoperative complications. Results: According to postoperative follow-up results, there were early complications that included wound dehiscence and infection (0.2%), hematoma (insomuch as extraocular movement is limited) (0.7%), lacriminal duct injury (0.5%), and periorbital nerve injury (0.7%). In addition, there were late complications that lasted more than 6 months, that included persistent diplopia (1.7%), extraocular movement limitation (0.9%), enophthalmos (1.0%), periorbital sensation abnormalities (1.0%), and entropion (0.5%). Conclusion: We propose the following guidelines for prevention of postoperative complications: layer by layer closure; bleeding control with the epinephrine gauzes, Tachocomb, and Tisseel; conjunctival incision 2 to 3 mm away from punctum; avoidance of excessive traction; performing surgical decompression and high dose corticosteroid therapy upon confirmation of nerve injury; atraumatic dissection and insertion of Medpor Barrier implant after securing a clear view of posterior ledge; using Medpor block stacking technique and BioSorb FX screw fixation; performing a complete resection of the anterior ethmoidal nerve during medial wall dissection; and making an incision 2 to 3 mm below the tarsal plate.

• Pediatric Infection and Vaccine
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• 제9권1호
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• pp.110-116
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• 2002

결핵성 중이염은 매우 드문 질환이나 최근 결핵의 유병률이 증가하는 추세이므로 장기간의 항생제 치료에도 반응하지 않는 만성 중이염의 경우 결핵성 중이염의 가능성을 염두에 두어 감별진단 하여야 한다. 이런 관심은 조기 진단과 이에 따른 적절한 치료를 하게 되어 고막 파열, 청력 소실 및 안면신경마비와 같은 중한 합병증을 줄일 수 있을 것이다.

• Pediatric Infection and Vaccine
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• 제25권1호
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• pp.54-59
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• 2018

기생충 감염은 소아 인구에게서 드물기 때문에 진단이 어려울 수 있다. 환아는 6개월 동안 간헐적인 상복부 통증과 양손과 양측 팔 모두에 발생한 홍반성 발진을 동반한 늑막 삼출을 주소로 내원하였다. 환아는 검사상 혈청 호산구증가와 현저한 삼출성, 호산구성 흉막삼출액이 확인되었다. 동시에 폐렴 미코플라스마에 대한 높은 항체가 때문에 항생제 치료를 받았으나 흉막삼출은 호전되지 않았다. 환아의 분변에서 시행한 기생충 알의 검사상 음성이었으나 혈청 및 흉막삼출액의 기생충 특이 항원에 대한 면역효소측정법에서 폐흡충 특이 IgG에 대해 양성을 보였다. Praziquantel의 치료 후 호흡기 증상, 흉수 및 피부 증상이 호전되었다. 이에 만성 복통과 홍반성 발진을 주소로 내원한 소아 환자에서 폐흡충에 의한 흉막삼출액을 진단 및 치료하였기에 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권1호
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• pp.21-28
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• 2019

Objectives: Osteoradionecrosis (ORN) is one of the most severe complications resulting from radiotherapy (RT) in patients with head and neck cancer (HNC). It is characterized by persistent exposed and devitalized bone without proper healing for greater than 6 months after a high dose of radiation in the area. To describe the profile and dental management of ORN in HNC patients undergoing RT in an oncological clinical research center. Materials and Methods: A retrospective descriptive study was performed to analyze dental records from HNC patients with ORN treated at an oncological clinical research center from 2013 to 2017. A total of 158 dental records for HNC patients were selected from a total of 583 records. Afterwards, this number was distributed to three examiners for manual assessments. Each examiner was responsible for selecting dental records that contained an ORN description, resulting in 20 dental records. Results: Mean patient age was 60.3 years with males being the most affected sex (80.0%). The most affected area was the posterior region of the mandible (60.0%) followed by the anterior region of the mandible (20.0%) and the posterior region of the maxilla (10.0%). The factors most associated with ORN were dental conditions (70.0%) followed by isolated systemic factors (10.0%) and tumor resection (5.0%). There was total exposed bone closure in 50.0% of cases. The predominant treatment was curettage associated with chlorhexidine 0.12% irrigation (36.0%). Conclusion: Poor dental conditions were related to ORN occurrence. ORN management through less invasive therapies was effective for the closure of exposed bone areas and avoidance of infection.

• Infection and chemotherapy
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• 제50권4호
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• pp.357-361
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• 2018

While carbapenems are the drug of choice to treat extended-spectrum-${\beta}$-lactamase (ESBL)-producing strains, some alternative carbapenem-sparing regimens are suggested for antibiotic stewardship. We experienced a case of ciprofloxacin treatment failure for acute pyelonephritis caused by an apparently susceptible Escherichia coli. A 71-year-old woman presented the emergency department with fever for 7 days and bilateral flank pain for 2 days. The laboratory results and abdominopelvic computed tomography finding were compatible with acute pyelonephritis. During 3-day ciprofloxacin therapy, the patient remained febrile with persistent bacteremia. After the change in antibiotics to ertapenem, the patient's clinical course started to improve. ESBL-producing E. coli isolates were identified in all three consecutive blood samples. Pulsed-field gel electrophoresis (PFGE) patterns, serotypes, and sequence types showed the three isolates were derived from the identical strain. The isolates produced CTX-M-14 type ESBL belonging to the ST69 clonal group. Despite in vitro susceptibility, the failure was attributed to a gyrA point mutation encoding Ser83Leu within quinolone resistance-determining regions. This case suggests that ciprofloxacin should be used cautiously in the treatment of serious infections caused by ciprofloxacin-susceptible, ESBL-producing E. coli, even in acute pyelonephritis because in-vitro susceptibility tests could fail to detect certain genetic mutations.

• 대한의생명과학회지
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• 제27권1호
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• pp.28-34
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• 2021

The main cause of cervical cancer is a persistent infection with high-risk human papillomavirus (HR-HPV). Cervical cancer is reported as a preventable cancer in more than 80% of cases with early diagnosis and appropriate treatment. Papanicolaou test (Pap test) has been a global strategy to prevent cervical cancer, and recently, HPV test has been reported to be effective against cervical cancer and precancerous lesions. However, pelvic examinations give patients anxiety, discomfort, pain, distress, and psychological stress. HPV test via a urine sample caused less physical and psychological stress and more advantage than the Pap test. Therefore, it is necessary to study the usefulness of the HPV test for easy-to-collect urine samples. A total of 220 samples were collected from a pair of cervical and urine samples from 110 women and only 108 pairs of samples out of 110 were used because 2 cases were not amplified by β-globin. Among 108 pairs of cervical and urine samples, the prevalence of HPV was 37.0% (40/108) in cervical samples, 34.3% (37/108) in urine samples and HR-HPV was 22.2% (24/108) in cervical samples, 18.5% (20/108) in urine samples. In this study, urine samples showed a lower positive rate of HPV than cervical samples. There were many variables that could affect the condition of the urine sample. However, the HR-HPV agreement rate of the cervix and urine samples was 94.44% and the Kappa value was 0.823, which was "almost perfect". Through these results showed the significance of cervical cancer screening using a urine sample. Cervical screening is crucial, as cervical cancer can be prevented in more than 90% of cases. Urine samples collected by non-invasive methods may have the potential advantage of increasing acceptance of cervical cancer screening. Therefore, it is necessary to develop a new cervical cancer screening strategy using urine samples through further study based on the results of this study.

• 대한후두음성언어의학회지
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• 제32권1호
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• pp.29-34
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• 2021

Background and Objectives Tracheostomy lead to persistent bacterial colonization of the respiratory tract. Surgical site infection and restenosis by the pathogenic bacteria is the most fatal complication after open airway surgery. The aim of this study is to describe the culture results of larynx and tracheostoma in patients with tracheostomy and the preoperative, intraoperative culture results in patients underwent open airway surgery. Materials and Method A retrospective review was performed on 18 patients who underwent culture between 2017 and 2019. Results Pseudomonas or antibiotic resistance bacteria were identified in 11 patients out of 18 patients (61.1%); Ceftriaxone-resistant Streptococcus (38.9%), Pseudomonas (33.3%), Methicillin-resistant Staphylococcus aureus (16.7%), extended-spectrum β-lactamases (ESBL) producing Klebsiella pneumoniae (11.1%). Among 18 patients, 6 patients showed the different culture result between larynx and tracheostoma. In 4 out of 10 patients who underwent open airway surgery, the bacteria were not identified before surgery, but the bacteria were isolated in the intraoperative culture. In one patient, the bacteria detected intraoperatively were different from those detected before surgery. Conclusion Preoperative respiratory tract culture and usage of perioperative antibiotics according to the culture are necessary. It is crucial to verify the bacterial culture in both tracheostoma and larynx. And it should be performed immediately before open airway surgery.

• Pediatric Infection and Vaccine
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• 제28권2호
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• pp.124-131
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• 2021

Cryptococcus neoformans는 주로 면역이 저하된 환자에서 기회 감염을 일으키는 진균이다. 그러나 면역이 정상인 환자에서도 다양한 감염을 일으킬 수 있다. 림프절을 침범한 폐 크립토코쿠스증은 정상 면역을 가진 사람에서는 상대적으로 드물게 발생한다. 고열과 지속적인 기침을 주소로 병원에 온 17세 여자 청소년이 가슴X선 영상검사 및 컴퓨터단층촬영에서 전방 종격동에서 우측 쇄골하 부위까지 침범된 종괴를 보여 초음파 유도하 총생검 검사로 크립토코쿠스증을 진단하였다. 각종 면역 검사에서는 이상 소견이 발견되지 않았다. 환자는 2주간 암포테리신 B와 플루시토신으로 치료 후 8개월간 플루코나졸로 치료하였고 완쾌되었다. 본 증례를 통해 크립토코쿠스증의 특징을 이해하고 정상 면역 환자에게서도 크립토코쿠스증이 발생할 수 있음을 염두에 두고 진단을 내리는 것이 바람직하겠다.