• Clinical and Experimental Pediatrics
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• 제59권10호
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• pp.395-401
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• 2016

Since the outbreak of the enterovirus 71 (EV71) infection in Malaysia in 1997, large epidemics of EV71 have occurred in the Asia-Pacific region. Many children and infants have died from serious neurological complications during these epidemics, and EV71 infection has become a serious public health problem in these areas. EV71 infection causes hand, foot and mouth disease (HFMD) in children, and usually resolves spontaneously. However, EV71 occasionally involves the central nervous system (CNS), and induces diverse neurological complications such as brainstem encephalitis, aseptic meningitis, and acute flaccid paralysis. Among those complications, brainstem encephalitis is the most critical neurological manifestation because it can cause neurogenic pulmonary hemorrhage/edema leading to death. The characteristic clinical symptoms such as myoclonus and ataxia, cerebrospinal fluid (CSF) pleocytosis, and brainstem lesions on magnetic resonance imaging, in conjunction with the skin rash of HFMD and the isolation of EV71 from a stool, throat-swab, or CSF sample are typical findings indicating CNS involvement of EV71 infection. Treatment with intravenous immunoglobulin and milrinone are recommended in cases with severe neurological complications from EV71 infection, such as brainstem encephalitis. Despite the recent discovery of receptors for EV71 in human cells, such as the scavenger receptor B2 and P-selection glycoprotein ligand 1, it is not known why EV71 infection predominantly involves the brainstem. Recently, 3 companies in China have completed phase III clinical trials of EV71 vaccines. However, the promotion and approval of these vaccines in various countries are problems yet to be resolved.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권6호
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• pp.427-431
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• 2021

Objectives: The aim of this study was to describe a simple, convenient, and reliable new technique using local full-thickness skin graft (FTSG) for skin coverage of a donor-site defect of the radial forearm free flap (RFFF). Patients and Methods: Between April 2016 and April 2021, five patients with oral squamous cell carcinoma underwent mass resection combined with RFFF reconstruction. After RFFF harvesting, donor-site defects were restored by proportional local FTSG. Results: The donor-site defects ranged in size from 24 to 41.25 cm², with a mean of 33.05 cm². Good or acceptable esthetic outcomes were obtained in all five patients. There was no dehiscence, skin necrosis, wound infection, or severe scarring at the graft site through the end of the postoperative follow-up period, and no patient had any specific functional complaint. Conclusion: The proportional local FTSG showed promising results for skin coverage of the donor-site defect of the RFFF. This technique could decrease the need for skin grafts from other sites.

• 대한치과의사협회지
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• 제48권5호
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• pp.365-370
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• 2010

Herpes virus family is highly infectious to patients, their families and dentists. The diagnosis of herpes infection is based on the characteristic clinical appearance and the location of the lesions. Herpes Simplex Virus(HSV) usually acquired through direct contact with infected lesions or body fluids, and the prevalence of HSV infection increases progressively from childhood. Primary infections provoke herpetic gingivostomatis typically affects the tongue, lips, gingival, buccal mucosa and palate. Recurrent infections give rise to vesiculo-ulcerative lesions at vermilion border of lip(herpes labialis). In the form of chickenpox, Varicella Zoster Virus(VZV) usually is infected in childhood. VZV spreads in the affected primary afferent nerve to the skin and produces a vesicular rash and pain. Epstein-Barr Virus(EBV) infects B cells and cause infectious mononucleosis. Latent EBV infection has also been implicated in Burkitt lymphoma, nasopharyngeal carcinoma. Cytomegalovirus(CMV) is associated with immune-compromised patient such as organ transplantation and AIDS patients.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.405-412
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• 2022

Although modern medicine has made great strides in the management of burn injuries, associated complications such as pain, infection, dyspigmentation, and scarring have yet to be fully dealt with. Although skin grafting and meshing are routinely performed on burn patients, this method poses a risk for adverse effects. Activated autologous platelet-rich plasma (aaPRP), which is increasingly used in the field of plastic surgery, contains growth factors beneficial for wound regeneration. Seven cases of burns with varying severity and conditions that were treated with intralesional subcutaneous injection and intravenous aaPRP are presented and discussed herein. This case series indicates that subcutaneous and intravenous aaPRP is a safe procedure with the potential to be an alternative when skin grafting cannot be done or as an adjunct treatment to skin grafting.

• 한국임상수의학회지
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• 제40권2호
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• pp.113-118
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• 2023

Skin and joint diseases are relatively common in dogs. Nutritional complementation is one of the various management strategies for these disorders. This study evaluated the safety and clinical efficacy of Kyungokgo-gamibang in dogs with skin and joint diseases. Thirty dogs with diseases were included and divided into three groups: control group (n = 15), skin group (n = 10), and joint group (n = 5). The skin and joint groups were fed skin and joint gums composed of Kyungokgo-gamibang extract with standard treatment for four weeks. The control group included dogs with skin diseases who were administered standard skin infection treatment for 4 weeks. The physical and laboratory results showed no remarkable adverse effects of Kyungokgo-gamibang extract after its administration in dogs. Clinical efficacy was evaluated using quality of life scale, and levels of cytokines, including interferon-γ, interleukin (IL)-2, IL-6, IL-8, IL-10, monocyte chemoattractant protein-1, and tumor necrosis factor-α, for 4 weeks in all groups. Dermatologic clinical scales were performed for 4 weeks in the control and skin groups. Both the control and skin groups had significantly decreased dermatologic clinical scales, including pruritus and erythema scales (p < 0.05). Among the cytokine levels, only IL-2 concentration was significantly decreased in the skin group after 4 weeks of administration of the Kyungokgo-gamibang extract (p = 0.032). There was no significant difference between the levels of cytokines on days 0 and 28 in the joint group. The quality of life scale was significantly increased after week 4 compared to week 0 in the skin (p = 0.008) and joint groups (p = 0.041). This study suggests that Kyungokgo-gamibang extract can be applied in managing dogs affected by skin and joint diseases without adverse effects.

• Archives of Plastic Surgery
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• 제43권6호
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• pp.586-589
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• 2016

A pressure sore wound is often extensive or complicated by local infection involving adjacent soft tissue and bone. In this case, a regional flap after simple debridement is not adequate. Here, we present a case of an extensive pressure sore in the sacral area with deep tissue infection. A 43-year-old female patient with a complicated sore with deep tissue infection had a presacral abscess, an iliopsoas abscess, and an epidural abscess in the lumbar spine. After a multidisciplinary approach performed in stages, the infection had subsided and removal of the devitalized tissue was possible. The large soft tissue defect with significant depth was reconstructed with a free latissimus dorsi musculocutaneous flap, which was expected to act as a local barrier from vertical infection and provide tensionless skin coverage upon hip flexion. The extensive sacral sore was treated effectively without complication, and the deep tissue infection completely resolved. There was no evidence of donor site morbidity, and wheelchair ambulation was possible by a month after surgery.

• 대한방사선기술학회지:방사선기술과학
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• 제43권5호
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• pp.359-365
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• 2020

This study aimed to investigate the causes of bacterial growth to prevent infection caused by ultrasound gel and gel containers in contact with patients during ultrasonography. To investigate bacterial contamination during manufacturing or storage, we cultured ultrasound gels originally supplied from three manufacturers. To analyze bacterial growth according to the lapse of time and frequency of use of the ultrasound gel container, the gel and container were cultured at regular intervals every week for 4 weeks. In addition, to determine the source of infection, the examiner's hand was inspected with hand plate and the degree of bacterial contamination was measured before the test. As a result of the study, bacteria were not detected in the gel provided at the initial supply, and in the gel and gel container used repeatedly for 4 weeks, the same bacteria residing on the skin were identified in the examiner's hand, such as Staphylococcus epidermidis, Micrococcus luteus, Leuconostoc mesenteroid spp cremoris, Kocuria rhizophila, and etc. Separated strains were classified as those of the low- or non-pathogenicity; however, most of these strains may render fatal consequences to patients of lower level of immunity due to acquired tolerance to antibiotics. At week 1, when the number of tests was the highest, 44 colonies were identified, and at week 4, when the number of tests was the lowest, 4 colonies were identified. As r=0.994, it was found that the number of colonies increased as the number of tests increased. In conclusion, it was confirmed that the cause of the infection was not the ultrasound gel, but the examiner's hand. The ultrasound gel or gel container may be contaminated by skin flora of examiner's hands, which can cause opportunistic infection in patients with low immunity. The ultrasound gel or gel container may be contaminated by skin flora of examiner's hands, which can cause opportunistic infection in patients with low immunity. Therefore, it was confirmed that thorough hand disinfection was necessary to block healthcare-associated infections.

• Tuberculosis and Respiratory Diseases
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• 제53권4호
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• pp.401-408
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• 2002

목 적 : 투베르쿨린 피부반응 검사는 결핵균 감염을 조사하는 방법으로, 전 세계적으로 널리 사용되고 있다. 그러나 여러 가지 요소에 의해 검사 결과의 판독에 어려움이 따른다. 2000년 미국흉부학회에서는 피검사자의 위험요소를 고려하여 피부반응 검사의 결과를 판단하도록 권장하였다. 우리나라의 경우 높은 결핵 감염율과 BCG 백신 접종률로 인해 피부반응 검사를 통해 현감염, 과거감염, 그리고 비감염을 구별하기 어렵다. 본 연구는 항결핵 약제의 투여를 결정하는데 피부반응 검사가 얼마나 도움이 되는지 알아보기 위해, 피부반응 검사의 음성 예측도를 조사하였다. 방 법 : 2001년 3월 1일부터 7월 31일까지 한림대학교 부속 춘천성심병원의 호흡기 내과에 입원한 환자를 대상으로, 현재 국내에서 사용되고 있는 Tuber culin PPD RT23 2 TU (0.1 ml)를 Mantoux 검사에 따라 시행하였다. 결핵의 진단기준은 1) 세균학적 진단기준으로 객담에서 결핵균이 배양되거나 현미경 검사로 항산균을 증명한 경우 2) 임상적 진단기준으로는 상기 세균학적 검사에서 결핵균을 증명하지 못하였으나, 방사선학적 또는 조직학적으로 결핵에 합당한 소견이나 증상이 있어서 진료의사가 결핵치료를 시행하기로 결정한 경우로 하였다. 결 과 : 등록된 환자 230명중에서 재입원 및 다른 과에 입원 중 전과되거나 중환자실에 입원한 환자 20명 (8.7%)을 제외한 총 210명의 환자를 대상으로 평가하였다. 환자의 평균연령은 $60{\pm}16.8$세였고, 남녀비는 1.28 : 1 (남118명, 여 92병)이였다. 결핵으로 진단된 환자는 53명 (25.2%)이였다. 폐결행이 45명(84.9%)이었고, 세균학적 검사에서 항산균 도말 양성이 22명(배양 양성 13, 배양 음성 9) 이었고, 임상적 진단기준으로 판단한 경우가 23명이었다. 결핵성 늑막염이 8명(15.1%)이었고, 조직학적으포 진단 된 경우가 4명, 임상적으로 판단되어 치료한 경우가 4명이었다. 미국흉부학회의 피부반응 검사의 판단기준에 따라 각각의 환자를 음성 및 양성으로 판정하였을 때, 음성 예측도는 92.3%, 양성 예측도는 47.3%, 민감도와 특이도는 각각 83%, 68.8%이었다. 결 론 : 입원한 호흡기 내과 환자를 대상으로 시행한 투베르쿨린 피부반응 검사는 92.3%의 높은 음성 예측도를 보였으며, 피부반응 검사가 음성으로 판단된 환자에서 항결핵 약제의 투여 여부를 결정하는데 중요한 단서를 제공할 것으로 생각된다.

• 대한임상검사과학회지
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• 제48권3호
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• pp.225-229
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• 2016

결핵이란 결핵균에 의한 만성 감염질환으로 결핵균이 포함된 비말액을 통해 공기감염을 일으킨다. 대부분의 결핵감염자는 전염력이 없는 잠복감염상태만 유지하나 10%의 감염자 중 절반은 감염 후 1~2년 안에 발병하게 된다. 결핵감염자와 접촉이 있는 학생 74명을 대상으로 결핵 감염자 접촉관련 사전 조사 및 흉부 X-선 검사, TST 검사 및 IGRA 검사를 실시하였다. 1차 TST 검사에서 양성자는 9명, 음성은 65명으로 나타났으며, 음성 판독자는 2차 TST검사를, 양성 판독자는 IGRA 검사를 실시하였다. 1차 TST 양성자 9명 중 IGRA 검사에서 3명이 양성자로 나와 잠복 결핵감염 치료를 실시하였다. 1차 TST결과 음성자에 대한 재확인 TST 검사는 1차와 차이가 없었다. 결론적으로 잠복결핵감염율은 74명중 3명으로 4.05%로 나타났고, 잠복결핵감염자 색출을 위해서 다른 그룹에 대한 조사도 필요하다.

• Pediatric Infection and Vaccine
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• 제23권1호
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• pp.67-71
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• 2016

결절성 홍반은 소아에서 가장 흔한 피하지방층의 염증으로 하지의 압통을 동반한 결절을 특징으로 한다. 이 질환은 다양한 원인에 의해 발생되지만 공통된 조직소견을 보여준다. 저자들은 임상적 소견 및 혈청학적 방법으로 마이코플라즈마 폐렴균에 의한 결절성 홍반을 진단하였고 조직병리적인 접근을 통해 결절성 홍반의 면역병인에 대해 고찰해 보았다. 조직병리소견은 제 4형 면역반응 염증을 보였으며 이는 다양한 원인에 의한 결절성 홍반의 발생 기전을 이해하는데 도움을 줄 것이다.