• Archives of Aesthetic Plastic Surgery
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• 제23권3호
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• pp.143-145
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• 2017

Medical leech therapy is a treatment for the venous congestion of tissue flaps, grafts, and replants. We report a case of methicillin-resistant Staphylococcus aureus (MRSA) following leech application at a congested flap after mastectomy. A 45-year-old woman had an invasive ductal carcinoma. Modified radical mastectomy was performed. The chest wall defect was reconstructed with a local rotation flap. On postoperative day (POD) 1, congestion and color change were observed, and 10 medical leeches were applied to the congested area. On POD 4, another 10 medical leeches were applied. On POD 12, wound necrosis progressed and a pus-like discharge appeared. A wound swab culture revealed MRSA. Debridement was carried out on POD 15. From POD 16, vancomycin and piperacillin/tazobactam were injected for 18 days. The wound culture on POD 18 also revealed MRSA. A split-thickness skin graft was performed on POD 28. MRSA has not been clearly identified in the literature as a leech enteric bacterium. Although MRSA may have come from another source, the present case raises the possibility of MRSA infections following leech application at congested flaps. When medical leeches are applied at the congestion site of a flap, an aseptic cradle will be helpful. Vancomycin irrigation may be needed if infection occurs.

• Journal of Trauma and Injury
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• 제33권4호
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• pp.260-263
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• 2020

Necrotizing fasciitis is an infection of the subcutaneous tissue that results in destruction of the fascia and is disproportionately common in patients with chronic liver disease or diabetes. Necrotizing fasciitis of the head and neck is rare, but has a high fatality rate. A 50-year-old man with a past medical history of diabetes reported a chief complaint of a wound in the posterior neck due to trauma. The wound had grown and was accompanied by pus and redness, and the patient had a fever. When the patient was referred to department of plastic & reconstructive surgery, the sternocleidomastoid muscle, semispinalis capitis muscle, splenius capitis muscle, and trapezius muscles were exposed, and the size of the defect was about 25×20 cm. Dead tissue resection was performed before negative-pressure wound therapy, followed by a split-thickness skin graft (STSG). After a 2-week course of aseptic dressing post-STSG, the patient recovered completely. No postoperative complications were observed for 1 year. Necrotizing fasciitis is a life-threatening, rapidly spreading infection, requiring early diagnosis and active surgical treatment. In addition, broad-spectrum antibiotics are required due to the variety of types of causative bacteria. Broad necrotizing fasciitis of the posterior neck is rare, but can quickly progress into a life-threatening stage.

• 대한정형외과학회지
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• 제56권1호
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• pp.87-92
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• 2021

방사선 검사상 골용해성 병변이 슬관절에서 발견되는 경우 다양한 원인을 감별해야 한다. 특히 슬관절 전치환술을 받은 수술력이 있다면 골용해도 가능한 원인이 될 수 있다. 저자들은 우측 무릎 통증으로 내원한 83세 여성 환자에서 시멘트를 사용한 슬관절 전치환술의 경골 삽입물의 비감염성 해리가 선행된 비골 두의 골용해성 병변을 진단하였고 슬관절 재치환술을 통해 치료한 경험을 문헌 고찰과 함께 보고하는 바이다.

• 대한물리치료과학회지
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• 제14권1_4호
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• pp.11-23
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• 2007

This study was performed to evaluate the effects of low-intensity ultrasound application to the peripheral nerve injury animal model on enhancement of nerve regeneration and functional recovery. Using aseptic microsurgical techniques, the sciatic nerve of adult male Sprague-Dawley rats was crushed at the outside of right mid-thigh for 30 seconds with fine forceps. Beginning just after surgery, various continuous-wave ultrasound treatments with intensities of 0.2 W/$cm^2$, 0.5 W /$cm^2$ and 1.0 W /$cm^2$ operated at 1 MHz or sham treatment were applied to the opposite inside of the crush site for 1 minute every other day with a transducer moving speed of 2cm/sec. For evaluation of the progress of sciatic nerve regeneration, c-Fos expression in the lumbar spinal cord (L4-5) dorsal horn was investigated. c-fos expression was markedly increased at 1hour after sciatic nerve crush injury, then gradually decreased thereafter. The c-fos expressions were significantly decreased (p<0.05) in all the experimental groups in comparison with the control group until 3days post-crush, and the degrees of decrease were higher in 0.5 W/$cm^2$ and 1 W/$cm^2$ intensity ultrasound application groups. It is suggested that low-intensity ultrasound application to an animal model of sciatic crush injury may suppress pain transmission and promote nerve regeneration, and which may result in delayed progress of muscle atrophy and accelerated progress of muscle recovery and eventually may result in accelerated and improved foot function recovery.

• Clinical and Experimental Pediatrics
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• 제54권1호
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• pp.11-16
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• 2011

Purpose: Enterovirus 71, one of the enteroviruses that are responsible for both hand-foot-and-mouth disease and herpangina, can cause neural injury. During periods of endemic spread of hand-foot-andmouth disease caused by enterovirus 71, CNS infections are also frequently diagnosed and may lead to increased complications from neural injury, as well as death. We present the results of our epidemiologic research on the clinical manifestations of children with CNS infections caused by enterovirus 71. Methods: The study group consisted of 42 patients admitted for CNS infection by enterovirus 71 between April 2009 and October 2009 at the Department of Pediatrics of 5 major hospitals affiliated with the Catholic University of Korea. We retrospectively reviewed initial symptoms and laboratory findings on admission, the specimen from which enterovirus 71 was isolated, fever duration, admission period, treatment and progress, and complications. We compared aseptic meningitis patients with encephalitis patients. Results: Of the 42 patients (23 men, 19 women), hand-foot-and-mouth disease was most prevalent (n=39), followed by herpangina (n=3), upon initial clinical diagnosis. Among the 42 patients, 15 (35.7%) were classified as severe, while 27 (64.3%) were classified as mild. Factors such as age, fever duration, presence of seizure, and use of intravenous immunoglobulin (IVIG) were statistically different between the 2 groups. Conclusion: Our results indicate that patients with severe infection caused by enterovirus 71 tended to be less than 3 years old, presented with at least 3 days of fever as well as seizure activity, and received IVIG treatment.

• Hip & pelvis
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• 제36권1호
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• pp.12-25
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• 2024

Protrusio acetabuli, or abnormal protrusion of the femoral head into the acetabulum, requires performance of a total hip arthroplasty (THA) for which various reconstruction techniques and outcomes have been described. The aim of this systematic review is to provide a comprehensive analysis of the current evidence, evaluate treatment efficacy, compare surgical techniques, and identify topics for future research along with improving evidence-based decision-making, improving patient outcomes in the management of this condition. A thorough systematic review of the PubMed, Embase, Cochrane Library databases, and Scopus library was conducted, and articles describing techniques of THA for treatment of protrusion acetabuli were extracted. The initial search generated 751 results. After exclusion, 18 articles were included. Of these, eight were prospective studies and 10 were retrospective. Surgery was performed on 783 hips with a mean age of 60 years; 80% of females who mostly had inflammatory arthritis were followed up for 8.86 years (range, 2-15.4 years). Good outcomes have been achieved with THA using uncemented cups with bone graft; however, no conclusion could be drawn with regard to the femoral side. It can be concluded that the concept of restoration of the anatomical hip center of rotation is paramount for good outcome and better survival of the implant is important when using uncemented cups with a bone graft. In addition, screw augmentation for fixation is not recommended unless absolutely necessary. The most common complications were aseptic loosening and heterotopic ossification. While the former required revision, conservative management was administered for the latter.

• 생물환경조절학회지
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• 제17권4호
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• pp.297-305
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• 2008

치커리와 쑥갓에 있어 기내 파종 시 발아 및 무균묘 생산을 증진시키기 위한 적절한 방법을 제안하기 위해 일련의 실험들이 수행되었다. NaOCl의 적정 처리농도와 시간 검정을 통해 치커리 'Precole'과 'Chiavari' 및 쑥갓 'Okiku 3' 모두 Naocl 5%로 15분간 처리하는 것이 발아 및 유묘형성을 촉진시키고 오염발생을 억제하는 것으로 관찰되었다. 배지조성에 있어 MS와 1/2 MS처리구들의 발아반응성은 뚜렷이 차이가 나타나지 않았으며, sucrose 농도가 높아짐에 따라 발아 및 유묘형성이 지연되었다. 배양용기에 따른 반응성의 차이는 치커리 'Precole'의 경우 petri-dish에서 양호한 발아율 및 유묘형성율을 보여주었지만, 치커리 'Chiavari'와 쑥갓 'Okiku 3'에서는 용기에 큰 영향을 받지 않았다. 초음파 처리는 치커리의 발아율 및 유묘형성율을 증가시켰지만, 쑥갓 'Okiku 3'에서는 초음파 처리효과가 나타나지 않았다. 따라서 치커리와 쑥갓 모두에서 NaOCl 5%, 15분간 종자소독하고, sucrose가 무첨가된 1/2 MS 배지로 petri-dish를 이용하며, 초음파 처리는 NaOCl 5% 용매에서 120분간 하는 것이 기내 발아향상에 적당한 조건으로 선정되었다.

• 한국미생물·생명공학회지
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• 제35권2호
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• pp.135-141
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• 2007

생마의 이용성과 저장성을 증대시키기 위해, 유기산을 처리한 생마 신선편이 제품을 제조하였다. 저온 부패미생물의 초기오염이 없는 생마 신선편이의 경우, 1% 농도의 초산, 구연산, 말레산 및 아스코르빈산을 각각 처리한 후 $4^{\circ}C$에서 14일간 저장한 경우, 구연산 및 아스코르빈산 처리구에서는 갈변 및 부패가 유의적으로 진행되었으나, 초산 및 말레산 처리구에서 우수한 갈변 및 부패 억제 활성이 나타났다. 이러한 억제활성은 기존에 사용되고 있는 NaOCl(100 ppm), 과산화수소수(100 ppm) 및 1종 세척제(L사, 한국)처리보다 우수하였으며, 특히 초기 부패미생물이 $10^5\;CFU/g-yam$ 이상 오염된 신선편이의 경우에도 초산 및 말레산은 강력한 부패억제 및 갈변억제효과를 나타내었다. 생마의 저온 부패미생물(Pseudomonas rhodesiae YAM-12 및 P. cepacia YAM-10)을 대상으로 초산 및 말레산의 최소처리농도를 조사한 결과 $4^{\circ}C$에서는 0.1% 처리로 우수한 항균력이 나타남을 확인하였으며, 실제 오염되지 않은 신선편이의 경우 0.1% 처리로 유의적인 갈변 및 부패현상 없이 14일간 저온저장이 가능하였다. 이러한 결과는, 초기 저온 부패미생물의 오염이 심각하지 않은 신선편이의 경우에는, 0.1% 초산 및 말레산 처리로 $4^{\circ}C$에서 14일 장기저장이 가능함을 나타내며, 적절한 진공포장 등이 병행된다면 생마 및 근채류 신선편이 농산물의 장기간 저온 유통이 가능할 것으로 판단된다.

• 대한정형외과스포츠의학회지
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• 제4권1호
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• pp.55-59
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• 2005

목적: 낭액의 흡인 후 견 봉합사로 배액을 유도하는 방법이 만성 슬개골전 점액낭염의 조기 치료로써 효과가 있는지를 확인하고자 하였다. 대상 및 방법: 2주 이상의 병력이 있는 슬개골전 점액낭염 환자 중 1년 이상 추시가 가능했던 12명을 대상으로 하였으며, 추시기간은 평균 18.3개월이었고, 증상 발현 후 본 시술까지의 기간은 평균 2.2개월이었다. 무균적 방법으로 척수액 천자용 또는 주사용 주사침으로 점액낭을 천자하고, 주사침을 통해 7번 견 봉합사를 삽입하였다. 시술 후 최소 1년에 재발, 감염, 통증 및 관절 운동 제한 유무를 조사하였다. 결과: 전례에서 봉합사의 삽입 부위에 발적이 발견되었으나 11예에서 발사 후 소실되었고, 1예에서는 시술 5일에 감염이 발생하였다. 92%의 환자에서 만족의 결과를 얻었으며, 치료기간은 평균 14.5일이었다. 결론: 점액낭의 천자 흡인 후 견 봉합사로 배액을 유도함으로써 만성 슬개골전 점액낭염을 치료하는 방법은 효과적이고 비교적 비침습적인 방법이다.

• Asian-Australasian Journal of Animal Sciences
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• 제17권3호
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• pp.401-409
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• 2004

Two experiments were conducted to evaluate the effects of a complex Lactobacilli preparation on performance, resistance to E. coli infection and gut microbial flora of weaning pigs. In exp. 1, twelve pigs (7.65$\pm$1.10 kg BW), weaned at 28 d, were randomly allotted into 2 groups and placed in individual metabolic cages. During the first 7 d, one group of pigs was provided ad libitum access to water containing $10^5$ colony forming units (CFU) Lactobacilli per ml and the control group was provided tap water. The Lactobacilli preparation included Lactobacillus gasseri, L. reuteri, L. acidophilus and L. fermentum, which were isolated from the gastrointestinal (GI) tract mucosa of weaning pigs. On d 8, 20 ml of $10^8$ CFU/ml E. coli solution (serovars K99, K88 and 987P at the ratio of 1:1:1) was orally administered to each pig. Diarrhea scores and diarrhea incidence were recorded from d 7 to 14. On d 14, pigs were euthanized and digesta and mucosa from the stomach, duodenum, jejunum, ileum, cecum and colon were sampled using aseptic technique to determine microflora by culturing bacteria in selective medium. The results showed that Lactobacilli treatment significantly decreased E. coli and aerobe counts (p<0.01) but increased Lactobacilli and anaerobe counts (p<0.01) in digesta and mucosa of most sections of the GI tract. A 66 and 69.1% decrease in diarrhea index and diarrhea incidence, respectively, was observed in the Lactobacilli treated group. In exp. 2, Thirty-six crossbred Duroc$\times$Landrace$\times$Yorkshire piglets, weaned at 28$\pm$2 days, were selected and randomly allocated into 2 groups. There were 18 piglets in each group, 3 piglets in one pen and 6 replicates in each treatment with 3 pens of barrow and 3 pens of female piglet in each treatment. Piglets had ad libitum access to feed and water. The initial body weight of piglet was 7.65$\pm$1.09 kg. Dietary treatments included a non-medicated basal diet with Lactobacilli ($10^5$ CFU/g diet) or carbadox (60 mg/kg) as control. On d 21, six pigs per group (one pig per pen) were euthanized. Ileal digesta was collected to determine apparent amino acid digestibility. Microflora content was determined similarly to exp.1. The results showed that Lactobacilli treatment significantly improved average daily feed intake (ADFI) of pigs compared to carbadox (p<0.05) during the first 2 wks after weaning and average daily gain (ADG) and ADFI increased significantly (p<0.05) from d 8 to 14. Nitrogen and total phosphorus digestibility also increased (p<0.05). Bacterial counts were similar to exp. 1. The results indicate that the complex Lactobacilli preparation improved performance for 2 wks after weaning, enhanced resistance to E. coli infection, and improved microbial balance in the GI tract.