• 대한족부족관절학회지
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• 제13권2호
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• pp.150-155
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• 2009

Purpose: To help the empirical antibiotics selection in diabetic foot infection patients, we investigated prevalence of microorganisms and their antibiotics sensitivity results. Materials and Methods: Patients who came to our clinics to treat diabetic foot infections with deep ulceration and were followed up more than 6 months until complete recovery were adopted. From March 2006 to June 2009, there were 140 patients who corresponded with such a inclusion criteria. Wound cultures were done by deep tissue or bone debris at first visit to our clinics. Microorganisms which was documented by wound culture and most susceptible antibiotics by minimum inhibitory concentrations were surveyed retrospectively. Results: Microorganisms were confirmed in 113 cases (80.7%). In the other 27 cases (19.3%), there were no cultured microorganisms. In bacterial growth group, there were 72 cases (63.7%) of gram-positive bacteria and 41 cases (36.3%) of gram-negative bacteria. All of them were aerobic microorganisms and there were no anaerobic microorganisms. Methicillin-sensitive staphylococcus aureus was the most common pathogen and accounted for 35 cases (31.0%). As other common pathogens, there were Enterobacter cloacae (11 cases, 9.7%), pseudomonas aeruginosa (10 cases, 8.8%), Methicillin-resistant staphylococcus aureus (10 cases, 8.8%) and enterococcus faecalis (6 cases, 5.3%), and so on. Common susceptible antibiotics in gram positive microorganism were vancomycin (60 cases, 83.3%), teicoplanin (60 cases, 83.3%), nitrofurantoin (60 cases, 83.3%) and ciprofloxacin (53 cases, 73.6%). In gram negative ones, common susceptible antibiotics were imipenem (35 cases, 85.3%), piperacillin/tazobactam (33 cases, 80.5%) and gentamicin (31 cases, 75.6%). Conclusion: Methicillin-sensitive Staphylococcus aureus in gram positive and enterobacter cloacae in gram negative was the most common pathogen in each group. Ciprofloxacin and gentamicin might be adaptable as a first-line empirical antibiotics in infected diabetic foot patients.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.1-6
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• 2010

Purpose: Diabetic foot infection is one of the most common and severe complications of diabetes mellitus that delays healing of the wound. Deep tissue biopsy is considered to be the gold standard method for antibiotic selection in treating infected chronic diabetic ulcers. However, swab culture or superficial tissue biopsy is often performed for a microbiologic test since deep tissue biopsy has limitations in application. The purpose of this study is to find out whether microbiologic results of swab culture or superficial tissue biopsy could be used for selection of antibiotics in treating diabetic ulcers. Methods: This study involved 42 patients with diabetic foot ulcers with negative results in bone probing test. Tissue samples for microbiologic tests were collected from all the patients by using superficial cotton swab, superficial tissue, and deep tissue. The microbiologic results of deep tissue biopsy were compared with swab culture and superficial tissue biopsy statistically. Results: Microbiology of the deep tissue showed the same results with those of the swab culture and superficial tissue in 67% and 71%, respectively. Statistical analysis demonstrated that the microbiology of the swab culture and superficial tissue does not coincide with that of the deep tissue. Conclusion: These results suggest that the microbiology of the swab culture and superficial tissue is not concordant with that of the deep tissue in infected chronic diabetic ulcers. To select appropriate antibiotic regimen, the speci specimen for the microbiologic test should be obtained from deep tissue.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.509-518
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• 2010

Purpose: Major drawbacks of conventional bone marrow stromal cells (BSCs) transplantation method are mainly caused by direct transplanted cell to host cell interactions. We hypothesized that separation of the transplanted cells by a microporous membrane might inhibit most of the potential adverse effects and induce superior effect. The purpose of the study is to determine the optimal condition of the microporous membrane. Methods: First, BSCs were placed in polyethylene terephthalate (PET) transwell inserts with 3, 8, or $12{\mu}m$ pore size, and cultured in 24 well culture plates. After 5 days, bottoms of the plates were observed for presence of attached BSCs in monolayer and cell numbers were evaluated. Second, BSCs were placed PET, polycarbonate (PCT), and mixed cellulose esters (MCE) transwell inserts with 3 and $8{\mu}m$ pore size, and cultured in 24 well culture plates. After 3 days, the supernatants of the media left in culture plate were analyzed for collagen, vascular endothelial growth factor (VEGF), platelet derived growth factor BB (PDGF-BB), and basic fibroblast growth factor (bFGF). Third, BSCs were placed in 15% and 70% of the PET membrane with $3{\mu}m$ pore size. All the experimental conditions and methods were same as the second study. Results: The optimal pore sizes to prevent BSC leakage were $3{\mu}m$ and $8{\mu}m$. The amounts of type I collagen and three growth factors tested did not show significant differences among PET, PCT, and MCE groups. However, the collagen, VEGF, and bFGF levels were much higher in the high (70%) density group than in the low (15%) density group. Conclusion: This study revealed that the optimal pore size of membrane to prevent direct BSC to recipient cell contact is in between $3{\mu}m$ and $8{\mu}m$. Membrane materials and pore sizes do not influence the collagen and growth factor passage through the membrane. The most striking factor for collagen and growth factor transport is pore density of the membrane.

• Journal of Animal Science and Technology
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• 제51권5호
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• pp.413-420
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• 2009

본 연구는 성체우의 FS, MS, C-MS를 배양액에 첨가하여 세포증식과 난포의 성장과 배란에 미치는 영향을 관찰하기 위하여 실시하였다. 세포증식은 세포수와 MTT assay을 실시하여 확인하였다. 그 결과 세포증식은 혈청첨가 배양액에 따라 유의적인 차이를 나타내었다. 특히 근육위성세포의 세포증식은 MS를 첨가한 배양액에서 높은 반면 면역세포의 증식은 FBS에서 배양한 세포에 비해 낮은 것을 확인하였다. 또한 난포의 성장 및 배란을 관찰한 결과 난포의 성장에 유의한 차이가 없었으나 군간 차이를 보였으며 배란율과 비례적이었고, 배란율은 FBS와 C-MS가 첨가된 배양액에서 유의적으로 높은 것을 관찰할 수 있었다(P<0.05). FBS군과 C-MS 군 간에는 차이가 없었다. 3T3-L1 세포에서 창상치유는 FS에서 배양한 세포에서 빠른 회복을 나타냈으며, 증식은 MS에서 높게 나타났다(p<0.001). 따라서 본 결과는 세포배양 과정에서 세포에 따른 혈청의 선택은 매우 중요하다는 근거자료를 제시 하였으며, 분리 된 성별 특이 한우 혈청은 FBS의 대체 물질로서 사용이 가능할 것으로 사료된다.

• KSBB Journal
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• 제9권1호
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• pp.26-34
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• 1994

챙파홍섬무우의 모상근 배양에서 몇 가지 외재 호르몬에 대한 반응을 조사하였던 바, auxins중의 2, 4-D는 안토시아닌의 생성을 촉진하였으며 동시에 뿌리의 탈분화를 유도하였다. Cytokinins은 이식 초기의 비교적 소량의 색소능 촉진효과를 나타내었으며, ABA는 색소의 발현억제 효과를 보이고 GA3 는 색소 생성에 별다른 영향을 마치지 않았다. 1mg/l의 농도에서 2, 4-D 이외의 호르몬은 모상근의 탈분화를 유도하지 않았으며, 모상근의 생장을 대조구 이하로 억제하였다. 2, 4-D와 kinetin를 처리하여 시간경과에 따른 안토시아닌 함량의 변화와 PAL, CHS의 활성변화를 조사하였다. 색소능의 변화를 볼 때, 대조구는 6일 에서 kinetin은 6-9일의 이식초기에 일시적인 색소의 증가를 보였으며, 2, 4-D 처리구는 9엘부터 증가하여 18일경에 peak를 보이며 가장 높은 색소 생성을 나타내었다. PAL의 활성 변화에 있어서는, 대조구에 비하여 kinetin, 2, 4-D처리구 둘 다 활성의 증가를 보이고 kinetin은 6 일에 서 2, 4-D는 9 일에 셔 각각 활성의 peak를 나다내였으며, 특히 2, 4$\longrightarrow$D 의 경우는 18일에서 또 한번의 약한 활성 증가를 보였다. CHS는, 대조구에서는 이식 후 3일에 활성의 일시적인 증가가 있었을 뿐 이후 계속 낮은 상태를 유지하였고 Kinetin 처리구는 6일에서 활성이 증가하여 9일에 최대활성을 보이고 이후 감소하게 된다. 2,4-D 처리구는 9일부터 활성이 증가하여 18일경 최대활성을 나타내고 이후 비교적 높은 활성수준에서 유지되였다. 이외에 이식 후 hormone free 배지 에서 2주간의 전배양 후 kinetin의 처리는 색소축적에 별다른 영향을 미치지 않았다. 이러한 결과에 따라, 2, 4-D, kinetin에 의한 안토시아닌 생성의 촉진효과는 PAL, CHS의 활성 증 가와 유의적인 연관을 나타내였으며, 특히 시간경과 에 따른 CHS의 활성 변화와 색소의 축적은 비례하여 색소 생성에 있어 CHS의 rate-limiting 역할을 제시하였다. Kinetin를 포함하는 cytokinins은 뿌리의 상처에 의한 “wound-response"에 따른 배양초기의 색소 발현을 촉진하는 작용을 하는 것으로 사료되었다. 2, 4-D와 kinetin에 의해 발현되는 PAL, CHS의 활성증감의 정도는 물론 peak를 보이는 경과시간에서의 차이는 각기 다른 조절기작을 갖는 Isozyme의 존재에 의한 것으로 추정되었다.정되었다.

• 한국임상약학회지
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• 제21권3호
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• pp.276-279
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• 2011

We report an unusual case of lupus flare induced by intravenous vancomycin in a patient with systemic lupus erythematosus. Due to methicillin resistant staphylococcus aureus in wound culture, intravenous vancomycin was administered to the patient. The patient had been on vancomycin for several days then she experienced fever, malar rash, and vomiting. Based on laboratory results, it was confirmed as lupus flare. Oral prednisolone was given to the patient for symptom control. However, when vancomycin was readministered, the patient had similar symptom to the previous one more intensively. Vancomycin was stopped then the patient became stable. This case report demonstrates that intravenous vancomycin may manifest as lupus flare in patients with systemic lupus erythematosus.

• Journal of Microbiology
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• 제43권spc1호
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• pp.118-131
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• 2005

Vibrio vulnificus is an opportunistic pathogen of humans that has the capability of causing rare, yet devastating disease. The bacteria are naturally present in estuarine environments and frequently contaminate seafoods. Within days of consuming uncooked, contaminated seafood, predisposed individuals can succumb to sepsis. Additionally, in otherwise healthy people, V. vulnificus causes wound infection that can require amputation or lead to sepsis. These diseases share the characteristics that the bacteria multiply extremely rapidly in host tissues and cause extensive damage. Despite the analysis of virulence for over 20 years using a combination of animal and cell culture models, surprisingly little is known about the mechanisms by which V. vulnificus causes disease. This is in part because of differences observed using animal models that involve infection with bacteria versus injection of toxins. However, the increasing use of genetic analysis coupled with detailed animal models is revealing new insight into the pathogenesis of V. vulnificus disease.

• Archives of Plastic Surgery
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• 제43권6호
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• pp.590-594
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• 2016

Recently, the number of cases of animal bite wounds has increased significantly in concordance with an increase in the pet population around the world. The authors report two rare cases of osteomyelitis of the phalanx following cat and dog bites. On initial physical examination, signs of a severe infection were observed. Radiographs of both patients showed the presence of osteomyelitis, and in one of the patients, the diagnosis was confirmed with a bone biopsy. After use of empirical antibiotics, intravenous antibiotic therapy that matched the identified bacterium's sensitivity was initiated, and at the same time, secure dressing including debridement was performed to induce secondary healing. In addition, the patients were closely monitored with serial X-rays, and culture and blood test follow-up. One patient fully recovered without sequelae, but the other patient suffered a loss of distal interphalangeal joint motion. When dealing with bite wounds located on the hand, it is important to visit the hospital as soon as possible and receive the appropriate treatment early. Moreover, to prevent severe complications such as osteomyelitis, it is important to administer antibiotic therapy to which the cultured bacteria are sensitive, along with proper wound management and prophylactic antibiotic treatment.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.245-249
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• 2010

Purpose: High-pressure injection injury is caused by accidental injection of the high-pressure injection devices in industry. The initial benign appearance of the wound fools patients into delays in an adequate treatment. And it can result in disastrous outcomes such as necrosis and amputation. To avoid the poor prognosis, the injuries require a prompt surgical intervention. The purpose of this article is to recognize the poor outcome of the highpressure injection injury and to introduce an adequate treatment in need. Methods: We have 4 cases of the high-pressure injection injuries in the hand from April, 2005 to March, 2009. Average age is 39 years (30 - 49 years old), 2 cases are the palm of dominant hand, 1 case is the thumb of dominant hand, and 1 case is the palm of non-dominant hand, respectively. We followed up these patients for 20 months on average. In 3 cases, the immediate, aggressive surgical intervention was carried out, but the other one was delayed in early adequate treatment. The wounds were covered by local advancement flap, anterolateral thigh free flap, conservative treatment with antibiotics and dressing. Results: No pathogens after culture were found nor any findings of fracture in imaging study. Conservative treatment, local advancement flap and anterolateral thigh free flap for the open wound resulted in a desirable aesthetic outcome. In a long-term follow up, functional capability of the patient was also satisfactory. Conclusion: Upon initial evaluation, most high-pressure injection injuries present as innocuous wounds with very few symptoms and result in delaying the proper management. And the majority of high-pressure injection injuries will produce significant morbidity to the hand, amputation. And the initial aggressive surgical debridement was needed to prevent the poor outcome. The key to success in treating high-pressure injection injuries of the hand is the prompt aggressive surgical intervention.

• Journal of Oral Medicine and Pain
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• 제20권1호
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• pp.53-65
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• 1995

The growth and synthetic activities of fibroblasts are regulated by cytokines and growth factors derived from activated inflammatory cells. Stimulatory effect of low level laser (LLL) radiation on wound healing seems to be in part due to direct stimulatory action on cell proliferation and synthetic activities of fibroblasts. Also indirect stimulatory effect on the fibroblast function through inflammatory or immune cells is another possible mechanism of biostimulatory action of LLL. This study was performed to determine the growth rate of human gingival fibroblasts obtained biopsy and culture, fibroblast cell line, and immune cell line by using $[^3H]-$ thymidine incorporation test. And gene expression pattern was also analyzed by using the DNA probe such as Hsp70, IL-1$\beta$, MIP-1$\alpha$ and actin cDNA. Proliferation rate of gingival fibroblast was increased by LLL irradiation, but no more effect was added by LPS or IL-1$\beta$ pretreatment Enhanced Hsp70 gene expression was found from gingival fibroblasts and fibroblast cell line COS by LLL irradiation., which was not more increased by LPS or IL-1$\beta$ pretreatment. LLL-irradiated promyelcytic cell line HL-60 and macrophage cell line RAW264.7 showed significant stimulatory effect of proliferation rate when compared with respective control. However there were no changes in growth rate of other immune cell tested in this study, such as B cell line WR19n.l and 230, helper T cell line Jurkat and Hut78, cytolytic T cell line CTLL-r8. By LLL-irradiation Hsp70 gene expression was increased in RAW246.7 and HL-60, not in CTLL-R8. And IL-1$\beta$ and MIP-1$\alpha$ gene expression were induced only from LLL-irradiated RAW264.7. These results led us to presume that LLL radiation may affect to the immune cells, especially to macrophage, through which it might promote wound healing process.