• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.1-5
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• 2000

The microsurgical reconstruction is necessary for elderly patients to treat severe trauma and head and neck tumor. The aim of this study is to analyze the risks of microvascular surgery and whether or not happening of more complication in elderly patients who are older than 60 years old and to suggest the solution of the complication. The retrospective study included 41 elderly patients who underwent treatment of 44 microsurgical reconstructions among total 271 cases of microsurgical reconstruction from July, 1988 to December, 1998. Their ages ranged from 61 years to 79 years. There were 26 males and 15 females. The involved sites were 23 head and necks, 13 upper gastrointestinal tracts, 3 lower extremities, 1 chest and 1 sacral region. The causes of microsurgical reconstruction were 36 head and neck tumors, 2 radionecrosis, 2 traumas and 1 melanoma in lower limb. The used flaps were 14 radial forearm flaps, 13 jejunal flaps, 10 latissimus dorsi muscle flaps, 3 rectus abdominis muscle flaps, 2 lateral arm flaps, 1 scapular flap, and 1 iliac osteocutaneous flap. They had medical problems which were 29 tobacco abuse, 14 hypertensions, 13 alcohol abuse, 10 chronic obstructive pulmonary diseases, 7 diabetes mellituses, 3 ischemic heart diseases. All patients have had successful results without specific complications except 3 cases of free flap failure and 3 perioperative death. The causes of 3 flap failures were 2 flap necrosis due to arterial insufficiency and 1 flap loss due to secondary infection. All of these cases were treated with secondary free flap surgery. However 3 patients died perioperatively due to 2 respiratory arrests and 1 sepsis. It was not related to operate microsurgical reconstruction itself, but was correlated with the complication of postoperative care after head and neck surgery. We conclude that plastic surgeons consider the importance of prevention of expected complication as thorough analysis of operative risk factor and appropriate treatment. We had to select the donor and recipient vessel appropriately to perform successful microsurgery in elderly patients and consider vein graft and end-to-side anastomosis to reduce complication if necessary. In addition, we emphasize the importance of pre, peri and postoperative care in head and neck cancer patients to reduce postoperative complication and morbidity.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.49 no.4
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• pp.454-459
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• 2016

Pre- or post-harvest processing is required to mitigate the risk of norovirus infection mediated by shellfish or seafood. We investigated the environmental resistance of human norovirus (HuNoV) under various conditions of temperature, salinity, and pH in seawater. Male-specific coliphage (MSC) was as the reference virus for all tests. At 4℃, HuNoV GII4 spiked into seawater was continually detected by RT-PCR for 35 days, regardless of salinity or pH level. It maintained nearly stable concentrations, meaning HuNoV can sustain a viral population in seawater long enough to be accumulated by shellfish and other filter feeders during winter. MSC was also stable at 4℃ although viral infectivity dropped sharply after 28 days. The effects of salinity and pH on MSC were indistinct. At 25℃ the detectable period of HuNoV GII4 by RT-PCR in seawater decreased to about one-third or half of the period at 4℃. High salinity (32 psu) and alkaline pH (8.5) were also unfavorable for sustaining HuNoV abundance at 25℃ in seawater. The resistance patterns of MSC to high temperature, high salinity, and alkaline pH were more dramatic and viral infectivity decreased over time, almost in direct proportion to experimental days. MSC was undetectable after 12 days under all salinities and pH levels at 25℃.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.2
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• pp.143-149
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• 2020

The study examined the seasonal pattern of larvae, nymph, and adult life stages for Haemaphysalis longicornis and the rate of infection with severe fever from the thrombocytopenia syndrome virus in ticks collected from 12 sections (Jichukdong), 14 sections (Uldaeri), and 18 sections (Howondong) in Bukhansan dullegil for April-October 2019. Haemaphysalis longicornis ticks have been considered the main vector for severe fever with thrombocytopenia syndrome (SFTS). Haemaphysalis flava and Ixodes nipponensis were collected using the dragging and flagging method. The ratios of Haemaphysalis longicornis of the collected ticks were 91% (Jichukdong), 94% (Uldaeri), and 98% (Howondong). Monthly distributional studies of Haemaphysalis longicornis based on the developmental stage showed that the adults peaked in September while nymphs were collected more frequently from April through June. The larvae peaked in September and October. SFTS virus detection was performed using 2 × OneStep RT-PCR and nested PCR. On the other hand, no SFTS virus-specific gene was detected in 1,158 ticks of Haemaphysalis longicornis. This result provides estimates of the population densities for the life stages of Haemaphysalis longicornis and the associated disease risk in Bukhansan dullegil, where many people have visited since opening in 2010.

• The Journal of Internal Korean Medicine
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• v.44 no.2
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• pp.167-177
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• 2023

Background: Pressure injuries are localized areas of damage to the skin and/or underlying tissue, usually over a bony prominence due to pressure. Cerebrovascular disease increases the risk of pressure injuries due to the immobility caused by physical paralysis. The general approach to managing a patient with pressure injuries should include pain relief, the treatment of the infection, optimizing nutritional intake, proper positioning, and contamination prevention. Nonetheless, the duration of treatment for pressure injuries varies from person to person. Case report: An 80-year-old female intracerebral hemorrhage patient developed a pressure injury. To improve the injury faster, a Radix Astragali pharmacoacupuncture solution was applied to the pressure sore. The pressure injury's width, length, and depth was assessed using a ruler, and the exudate amount and tissue types were assessed. The treatment was performed for 35 days. The rate at which the size of the pressure sore lessened increased since the Radix Astragali pharmacoacupuncture solution was applied to the pressure sore. In addition, the tissue type of the pressure injury improved, and the exudates decreased. There was no significant difference in the Pressure Ulcer Scale for Healing Tool 3.0, since the Radix Astragali pharmacoacupuncture solution was applied to the pressure injury. Conclusion: This clinical case study suggests that the Radix Astragali pharmacoacupuncture solution might be effective in speeding up the healing of pressure injuries.

• Fisheries and Aquatic Sciences
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• v.22 no.12
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• pp.30.1-30.11
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• 2019

Marine natural products isolated from the sponge Fascaplysinopsis cf reticulata, in French Polynesia, were investigated as an alternative to antibiotics to control pathogens in aquaculture. The overuse of antibiotics in aquaculture is largely considered to be an environmental pollution, because it supports the transfer of antibiotic resistance genes within the aquatic environment. One environmentally friendly alternative to antibiotics is the use of quorum sensing inhibitors (QSIs). Quorum sensing (QS) is a regulatory mechanism in bacteria which control virulence factors through the secretion of autoinducers (AIs), such as acyl-homoserine lactone (AHL) in gram-negative bacteria. Vibrio harveyi QS is controlled through three parallel pathways: HAI-1, AI-2, and CAI-1. Bioassay-guided purification of F. cf reticulata extract was conducted on two bacterial species, i.e., Tenacibaculum maritimum and V. harveyi for antibiotic and QS inhibition bioactivities. Toxicity bioassay of fractions was also evaluated on the freshwater fish Poecilia reticulata and the marine fish Acanthurus triostegus. Cyclohexanic and dichloromethane fractions of F. cf reticulata exhibited QS inhibition on V. harveyi and antibiotic bioactivities on V. harveyi and T. maritimum, respectively. Palauolide (1) and fascaplysin (2) were purified as major molecules from the cyclohexanic and dichloromethane fractions, respectively. Palauolide inhibited QS of V. harveyi through HAI-1 QS pathway at 50 ㎍ ml^-1 (26 μM), while fascaplysin affected the bacterial growth of V. harveyi (50 ㎍ ml^-1) and T. maritimum (0.25 ㎍). The toxicity of fascaplysin-enriched fraction (FEF) was evaluated and exhibited a toxic effect against fish at 50 ㎍ ml^-1. This study demonstrated for the first time the QSI potential of palauolide (1). Future research may assess the toxicity of both the cyclohexanic fraction of the sponge and palauolide (1) on fish, to confirm their potential as alternative to antibiotics in fish farming.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.6
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• pp.478-482
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• 2011

Purpose: Free flap reconstruction is performed on defects including benign and malignant tumors as well as trauma in the department of oral and maxillofacial surgery, but there are few reports of free flap reconstruction cases for oral cancer in patients in Korea. Methods: This study was designed to retrospectively analyze surgical outcomes and complications of 164 free-flap reconstructions performed at the Oral Oncology Clinic, National Cancer Center, during 2002~2011. A total of 164 free flaps were performed for reconstruction of oral and maxillofacial defects which were caused by oral cancer and osteoradionecrosis in 155 patients. Results: The present study had 162 successful cases and 2 failed cases for a total of 164 cases. The study had a success rate of 98.8% for free-flap reconstructions. Flap donor sites included radial forearm free flap (n=93), fibula osteocutaneous free flap (n=25), anterolateral thigh flap (n=18), latissimus dorsi myocutaneous flap (n=16) and other locations (n=12). Postoperative medical complications were generally pneumonia and delirium. Postoperative local complications occurred including partial flap necrosis, delayed wound healing of the donor site, infection of the recipient site and salivary fistula. The incidence of postoperative complications and patient-related characteristics including age, sex, smoking, history of radiotherapy, hypertension (HTN) and diabetes Mellitus (DM) were retrospectively analyzed. Patient age ($P$=0.003) and DM ($P$=0.000) and HTN ($P$=0.021) were significant risk factors for complications overall. Conclusion: The present study had no mortality and confirms that free-flap reconstructions are extremely reliable in achieving successful results.

• Journal of Life Science
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• v.21 no.11
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• pp.1652-1657
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• 2011

The production of blood cells is regulated by more than 20 different growth factors, called hematopoitic growth factors. These factors have been produced in prokaryotic and mammalian systems for their clinical use. Glranulocyte-Colony Stimulating Factor (G-CSF) is an important therapeutic factor for cancer patients as well as patients with congenital conditions. These patients do not have enough neutrophils and have a high risk of infection. Two groups of recombinant G-CSF have been used to specially treat cancer patients after chemotherapy because chemotherapy induces neutropenia, a major side effect of chemotherapy drugs. Here, structural and biological characteristics of G-CSF are presented. In addition, the relationship between chemotherapy and neutropenia, which is a severe reduction of neutrophils in the blood, and clinical application of G-CSF is discussed. Recombinant G-CSFs are grouped in two forms. Non-glycosylated G-CSF, filgrastim, is produced in Escherichia coli and glycosylated G-CSF, lenograstim, is produced in Chinese hamster ovary cells. Differences in structure and biological activity are compared and challenges for biosimilar production are also highlighted.

• Pediatric Infection and Vaccine
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• v.28 no.3
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• pp.149-159
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• 2021

Purpose: Antibiotic exposure during pregnancy may affect the fetus and newborn in many ways. This study investigated the impact of prenatal antibiotic exposure duration on neonatal outcomes in very preterm (VP) or very low birth weight (VLBW) infants. Methods: From September 2015 to December 2020, preterm infants with gestational age less than 32 weeks or with a BW less than 1,500 g who were admitted to the neonatal intensive care unit, and their mothers were enrolled. Prenatal antibiotic exposure was defined as antibiotics received by mothers before delivery, and the patients were categorized into the non-antibiotic group, short-duration (SD; ≤7 days) group, or long-duration (LD; >7 days) groups. Results: A total of 93 of 145 infants were exposed to prenatal antibiotics, among which 35 (37.6%) were in the SD group and 58 (62.4%) were in the LD group. Infants in the LD group had a significantly higher birth weight-for-gestational-age (BW/GA) Z-score than those in the non-antibiotic group, even after the adjustment for confounding factors (beta, 0.258; standard error, 0.149; P<0.001). Multivariate logistic regression analysis showed that prolonged prenatal antibiotic exposure was independently associated with death (adjusted odds ratio [aOR], 8.926; 95% confidence interval [CI], 1.482-53.775) and composite outcomes of death, necrotizing enterocolitis (NEC), and late-onset sepsis (LOS) (aOR, 2.375; 95% CI, 1.027-5.492). Conclusions: Prolonged prenatal antibiotic exposure could increase the BW/GA Z-score and the risk of death and composite outcomes of death, NEC, and LOS in VP or VLBW infants.

• Pediatric Infection and Vaccine
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• v.21 no.1
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• pp.29-36
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• 2014

Purpose: The objective of this study was to find the predictors and generate a prediction scoring model of nonresponse to intravenous immunoglobulin in patients with Kawasaki disease. Methods: We examined 573 children diagnosed with KD at the Severance Children's Hospital between January 2009 and december 2012. We retrospectively reviewed their medical records. These patients were divided into 2 groups; the experimental group (N=433) and the validation group (N=140). Each group were divided into 2 groups the intravenous immunoglobulin nonresponders and the responders. Multivariate logistic regression analysis identified predictive factors of intravenous immunoglobulin nonresponders which make predictive scoring model. We practice internal validation and external validation. Results: Multivariate logistic regression analysis identified male, cervical lymphadenopathy, changes of the extremities, platelet, total bilirubin, alkaline phophatase, lactate dehydrogenase, C-reactive protein as significant predictors for nonresponse to intravenous immunoglobulin. We generated prediction score assigning 1 point for (1) male, (2) cervical lymphadenopathy, (3) changes of the extremities, (4) platelet (${\leq}368,000/mm^3$), (5) total bilirubin (${\geq}0.4mg/dL$), (6) alkaline phophatase (${\geq}227IU/L$), (7) lactate dehydrogenase (${\geq}268IU/L$), (8) C-reactive protein (>77.1 mg/dL). Using a cut-off point of 4 and more with this prediction score, we could identify the intravenous immunoglobulin nonresponder group. Sensitivity and specificity were 52.5% and 82.4% in experimental group and 37.8% and 81.8% in validation group, respectively. Conclusion: Our predictive scoring models had high specificity and low sensitivity in Korean patients. Therefore it is useful in predicting nonresponse to intravenous immunoglobulin with Kawasaki disease.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.212-219
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• 2007

Purpose : It is difficult to diagnose acute pyelonephritis(APN) in young children, because of their nonspecific symptoms. The younger the age, the higher the risk of renal scars after APN, which can be prevented by early diagnosis and treatment. We compare the significance of renal imaging studies by age for diagnosis of APN in febrile urinary tract infection(UTI) in children. Methods : Fifty-three hospitalized children(34 patients under age 2 and 19 patients over age 2) with febrile UTI and who had undergone dimercaptosuccinic acid(DMSA) scan, renal ultra sonography(RUS) and voiding cystourethrography(VCUG) during the acute stage were re-viewed. We compared the renal imaging studies between the different age groups. Results : The DMSA scan showed cortical defects in 23.5% of patients under age 2, which was significantly lower than 63.2% of patents over age 2(P<0.05). The renal cortical defects on DMSA scan were associated only with a high peripheral leukocyte count, but not with fever duration, erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP). And there was no correlation between the DMSA scan, VCUG or RUS findings. Conclusions : The DMSA scan is not sensitive for diagnosis of APN in children less than 2 years of age and the findings cannot predict the presence of vesicoureteral reflux(VUR). VCUG may be necessary for proper management in this age group.