• 제목/요약/키워드: asymptomatic infection

검색결과 221건 처리시간 0.027초

대장 내시경 생검으로 진단된 결핵성 복막염 1례 (A Case of Tuberculous Peritonitis Diagnosed by Colonoscopic Biopsy)

  • 박혜진;이수민;김선미;정대철;정승연;강진한
    • Pediatric Infection and Vaccine
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    • 제11권1호
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    • pp.131-135
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    • 2004
  • 결핵성 복막염은 소아에 있어 드문 결핵이다. 영양실조, 결핵유행지역에 거주하는 경우, 행려자, HIV감염이 위험인자이며, 복통, 체중감소, 구토, 병색소견 등의 증상이 나타난다. 복수는 삼출액이며 전산단층촬영과 초음파 검사상 두꺼워진 대망과 복막, 격벽화된 복수 소견 보이고, 치료는 isoniazid, rifampicin, pyrazinamide, streptomycin으로 하며 치료에 반응 잘 한다. 저자들은 위험인자 없었으며 체중감소나 병색소견 없이 7일간 열을 동반한 복부팽만으로 내원하여 시행한 복수 검사상 여출액 소견이였으나 전산단층촬영과 초음파 검사상 결핵성 복막염 의심하에 시행한 대장내시경 조직검사로 결핵을 확진하였고 항결핵제 투여 및 보존적 치료로 호전보인 예를 경험하였기에 보고하는 바이다.

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Clinical Characteristics of Rhabdomyolysis in Children : Single Center Experience

  • Park, Yesul;Song, Ji Yeon;Kim, Su Young;Kim, Seong Heon
    • Childhood Kidney Diseases
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    • 제22권2호
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    • pp.52-57
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    • 2018
  • Purpose: Rhabdomyolysis is a metabolic disorder in which the content of damaged muscle cells is released into plasma. Its manifestations include asymptomatic, myalgia, gross hematuria, and complications of acute kidney injury. Because of limited data on rhabdomyolysis in children, we performed this study to determine clinical characteristics of rhabdomyolysis in children. Methods: We retrospectively reviewed the records of patients with rhabdomyolysis who were treated at the Pusan National University Children's hospital from January 2011 to July 2016. The diagnostic criteria were serum myoglobin level of ${\geq}80ng/mL$, exclusive of acute myocardial injury, cardiac arrest, and brain damage. Results: Forty-five patients were enrolled; mean age, $116{\pm}68$ months. Of these, 35 were boys and 10 were girls. Twenty-six patients experienced myalgia and 12 patients showed gross hematuria. Among these, seven patients initially had both myalgia and gross hematuria. The most common causes of rhabdomyolysis were infection, physical exertion, prolonged seizures, metabolic abnormalities, and drug addiction. Acute kidney injury (AKI) was the most common complication, followed by disseminated intravascular coagulation. Thirty-seven patients improved with sufficient fluid supply but two patients underwent hemodialysis due to deterioration of kidney function. Gross hematuria, positive occult blood test, and positive urine protein were more common in patients with AKI than in those without AKI. Conclusions: In children, infection was the most common cause of rhabdomyolysis. Most patients recovered by sufficient fluid therapy. However, in severe cases, especially in patients with underlying kidney disease, hemodialysis may be necessary in the present study.

급성신우신염에서 $^{99m}TC-DMSA$ 신장스캔의 임상적 의의 (Clinical Significances of $^{99m}TC-DMSA$ Renal Scan in Patients with Acute Pyelonephritis)

  • 목차수;신동진;최호천;김경욱;이강욱;최대섭
    • 대한핵의학회지
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    • 제23권2호
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    • pp.201-207
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    • 1989
  • Patients with acute pyleonephritis may present with a spectrum of clinical symptoms and signs. There are few noninvasive diagnostic studies, however, to confirm or exclude this diagnosis. To evaluate the clinical utility of $^{99m}Tc-DMSA$ renal scan in diagnosis of acute pyelonephritis, we performed $^{99m}Tc-DMSA$ renal scan in 37 patients suspected with urinary tract infection. Simultaneously, kidney ultrasonography was done in 21 patients diagnosed with acute pyelonephritis, clinically. And we performed the followup scan after treatment in two to six weeks. The results were as follows: 1) $^{99m}Tc-DMSA$ renal scan disclosed single or multiple cortical defects and decreased radiouptake ratio of affected kidney in 23 patients among 25 patients diagnosed with acute pyleonephritis. 2) In the 21 patients with acute pyelonephritis, kidney ultrasonography showed abnormal finding in the 7 patients. And $^{99m}Tc-DMSA$ renal scan disclosed abnormal cortical defects in this 7 patients also. 3) Between the patients with acute pyelonephritis and those with lower urinary tract infection, asymptomatic bacteriuria or pyuria. right-to-left radiouptake ratios (R/L ratio) were significantly different (p < 0.001). 4) In two to six weeks after antibiotic therapy, we performed followup $^{99m}Tc-DMSA$ renal scan for 5 patients among 25 acute pyelonephritis patients. And we have found the improvement of cortical defects and the right-to-left radiouptake ratio. In conclusion, we thought that $^{99m}Tc-DMSA$ renal scan should be useful in diagnosis of acute pyelonephritis and follow-up examination.

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E형 간염 바이러스에 의한 제 1형 인터페론 신호전달분자 활성 억제 (Hepatitis E Virus Inhibits Activation of Signaling Molecules Involved in Induction of Type I Interferon)

  • 명진종
    • 한국미생물·생명공학회지
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    • 제46권4호
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    • pp.320-325
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    • 2018
  • E형 간염바이러스는 전세계적으로 매년 2천만건의 감염을 일으키는 것으로 알려져 있다. 흥미로운 것은 임산부에서 특히 높은 치사율을 보이는데, 무려 20-30%의 사망률을 보인다는 점이다. 면역능이 있는 감염환자에서는 E형 간염바이러스 감염은 별다른 증상 없이 자연 치유되지만, 면역능이 낮은 에이즈환자나 고령환자에서는 만성감염을 일으킬 수도 있으며 사망에 이르게 할 수도 있다. 따라서, E형 간염바이러스의 증식억제에 면역반응의 중요성이 높으며, 특히 인터페론 반응이 중요한 역할을 할 것으로 사료된다. 본 연구팀은 E형 간염바이러스의 프로티아제가 RIG-I 의존적 제 1형 인터페론 반응을 유의미하게 억제하는 것을 관찰하였다. 또한 바이러스 프로티아제가 RIG-I의 하위 신혼전달 분자의 하나인 MAVS의 활성도 농도 의존적으로 억제하는 것으로 분석하였다. E형 간염바이러스에 의한 제 1형 인터페론 반응 억제의 구체적인 작용 기작을 밝힌다면 효과적인 항바이러스제제의 개발의 초석을 놓을 수 있을 것으로 기대된다.

Comparison of Seropositivity to Trichomonas vaginalis between Men with Prostatic Tumor and Normal Men

  • Kim, Jung-Hyun;Moon, Hong-Sang;Kim, Kyu-Shik;Hwang, Hwan-Sik;Ryu, Jae-Sook;Park, Sung-Yul
    • Parasites, Hosts and Diseases
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    • 제57권1호
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    • pp.21-25
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    • 2019
  • Trichomoniasis is the most common curable sexually-transmitted infection. Most Trichomonas vaginalis-infected men are asymptomatic and can remain undiagnosed and untreated, and this has been thought to result in chronic persistent prostatic infection. Chronic inflammation is regarded as the major factor in the pathogenesis and progression of benign prostatic hyperplasia (BPH) and prostatic cancer (PCa). The aim of this study is to identify seropositivity to T. vaginalis in men with prostate tumors (BPH or PCa) visited to Hanyang University Hospital. A total of 183 men were enrolled between October 2013 and November 2014. They consisted of 139 with BPH (mean age: $64.0{\pm}0.07$) and 44 with prostate cancer (mean age: $73.3{\pm}0.18$). We carried out ELISA to identify the seropositivity to T. vaginalis. Mixed lysate antigen extracted from 8 strains of T. vaginalis was used in the ELISA. Also 58 male outpatients visited to Health Promotion Center in Hanyang University Hospital were evaluated for comparing group. As a results, seropositivity to T. vaginalis in patients with prostatic diseases was 19.7% (BPH: 18.7%, PCa: 22.7%) and it was significantly higher than the 1.7% of the comparing healthy group (P=0.001). Therefore, prostatic tumor showed higher seropositivity against T. vaginalis than normal men. As far as we know, this is the first report about seroprevalence in prostatic tumor in Korea.

B형 간염 바이러스 만성 감염 소아의 추적 관찰 (Follow-up of Children with Chronic Hepatitis B Virus Infection)

  • 황성현;김종현;강진한;허재균;이경일;오진희;이승희;고대균
    • Pediatric Infection and Vaccine
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    • 제11권1호
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    • pp.73-80
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    • 2004
  • 목 적 : 소아 HBV 만성 감염 환자들에 대한 연속적인 임상적 소견, 생화학 검사 및 혈청학적 표지자의 변화를 분석하여 이들간의 연관성을 알아보았다. 방 법 : 1995년 7월 1일부터 2000년 6월 30일까지 5년간 가톨릭대학교 성빈센트병원 소아과를 방문하여 6개월 이상 추적이 가능하였던 HBV 만성감염 소아 90명을 대상으로 하였다. 이들 모두는 HBV 표지자인 HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc IgG와 간기능 검사를 시행하였다. 결 과 : 첫 내원시 대상 모두가 무증상이었고 HBV 만성 감염의 가족력이 83%에서 있었다. HBeAg 양성이 81%, HBeAg 음성, anti-HBe 양성이 16%, HBeAg, anti-HBe 모두 음성인 경우가 3%로 성별간의 차이는 없었고, 대상군의 연령을 0~5, 6~10, 11~15세로 나누었을 때 HBeAg 양성은 각각 90%, 96%, 61%로 10세 이하의 양성률이 11~15세에 비해 의미있게 높았다(P=0.001). 혈청 ALT치는 40 IU/L 이하, 41~80 IU/L, 81~200 IU/L, 201 IU 이상인 경우가 각각 64%, 17%, 10%, 9%이었고 HBeAg 양성군이 음성군에 비해 ALT의 비정상인 경우가 의미있게 많았다(P=0.036). HBeAg에서 anti-HBe로 전환된 경우가 73명 중 11명에서 발생하였고 이들 모두에서 anti-HBe의 전환 전에 ALT치의 증가가 관찰되었다. HBeAg 및 HBsAg의 연간 자연소실율은 각각 9.7%, 0.6%이었다. 결 론 : HBV 표지자 및 생화학적 검사치의 변화양상을 숙지하는 것은 이와 관련된 연구를 시행할 때 대상을 선정하고 또한 질환에 대한 치료 여부, 치료제의 선택 및 효과를 검토할 때 필요한 사항이며 각 개인의 HBV 만성 감염의 악화 예후인자를 찾기 위하여 증상이 없더라도 보유자에 대한 계속적인 관찰은 매우 중요하다고 생각된다.

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코로나 바이러스 대유행에 따른 치과 의료 관리 가이드라인 (Guidelines for dental clinic infection prevention during COVID-19 pandemic)

  • 김진
    • 대한치과의료관리학회지
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    • 제8권1호
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    • pp.1-7
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    • 2020
  • Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

심방중격결손증의 혈류역학적 상관관계 및 임상적 고찰 (Clinical and Hemodynamic Investigation of Atrial Septal Defect)

  • 정상조
    • Journal of Chest Surgery
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    • 제24권5호
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    • pp.445-450
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    • 1991
  • Forty eight patients diagnosed as atrial septal defect, had been operated from April 1986 to December 1990 at the Department of Thoracic and Cardiovascular Surgery, Inha University Hospital, were analysed retrospectively. Of the 48 patients, 12 patients, were male and 36 patients were female, Their ranged from 8 months to 51 years old, and the mean was 18.0 years old. The proceeding two symptoms were exertional dyspnea and frequent upper respiratory infection. But 10 patients [20.8%] were asymptomatic. Electrocardiographic findings were regular sinus rhythm in 100.0%, RVH in 29.2%, incomplete RBBB in 27.1%, and first degree AV block in 2.1%. Hemodynamic studies were performed in 38 of 48 patients. Significant pulmonary hypertension[over 50mmHg in systolic pulmonary arterial pressure], which is the most serious risk factor, was developed in 4 patients[8.3%]. There was statistical significance between size of defect[cm2/BSA-M2] and systolic pulmonary arterial pressure[sPAP] retrospectively[p=0.036]. We could not find the correlationship between age and Qs % size. Anatomically, secundum type constituted 97.9%, in which 43 patients were PFO type[91.6%] and 3 patients were IVC type[6.3%]. 38 of 48 ASD patients were repaired with patch closure[72.9%] and remains were repaired with direct closure[27.1%]. The operative result was excellent except two cases of transient postoperative arrhythmia. There was no operative mortality.

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폐 Aspergillosis 의 외과적 치료 (Surgical treatment of pulmonary aspergillosis)

  • 유회성
    • Journal of Chest Surgery
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    • 제17권2호
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    • pp.269-274
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    • 1984
  • Since tuberculosis was a common pulmonary disease in Korea, Aspergillosis was easily misdiagnosed as tuberculosis and an acute form of Aspergillosis was misinterpreted as pneumonia because of their similarities in the X-ray findings. This investigation is designed to illustrate the clinical features and preoperative diagnosis and surgical role in the management of this disease. In a retrospective review of operative cases from Jan. 1963 through Dec. 1983, 36 cases were analyzed. Peak age incidence lies in the 3rd decade [41.7%]. All cases had a history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis and the most common chief complaint was hemoptysis [69.5%]. Only nine cases [25%] showed cavitary lesions with mycetoma and preoperative sputum study for fungus showed low positive valve [42.3%]. Anatomical location of lesion was located mainly upper lobe [66.7%] and most of cases were managed by lobectomy. We experienced 7 cases of complication; they were postoperative empyema, hepatic failure, esophageal varix bleeding. Postoperative pathologic findings showed that 29 cases [80.5%] were combined with tuberculosis 3 cases were combined with bronchiectasis and 4 cases were not combined with other disease. In conclusion, when the patient has a longstanding history of pulmonary tuberculosis and has a hemoptysis, he must be suspected fungus super infection. Resectional surgery is the treatment of choice for symptomatic localized disease and needed resection in asymptomatic patient to prevent possible fatal sequelae in the future.

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골결손을 동반한 비구개관 낭종의 치험례 (A Clinical Experience of Nasopalatine Duct Cyst with Bony Defect)

  • 김영진;서제원;전영준;김성식
    • Archives of Plastic Surgery
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    • 제32권2호
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    • pp.255-258
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    • 2005
  • The nasopalatine duct cyst, known as the incisive canal cyst, is the most common nonodontogenic cyst in the maxillofacial area. It is believed to arise from epithelial remnants of the embryonic nasopalatine duct. Nasopalatine duct cysts are most often detected in patients between forties and sixties. The trauma, bacterial infection, or mucous retention has been suggested as etiological factors. The cysts often present as asymptomatic swelling of the palate but can present with painful swelling or drainage. Radiologic findings include a well demarcated cystic structure in a round, ovoid or heart shape presenting with a well-defined bone defect in the anterior midline of the palate between and posterior to the central incisors. Most of them are less than 2cm in size. On MRI, the cyst is identified as a high-intensity, well-marginated lesion, which indicates that it contains proteinaceous material. We experienced a case of a 61-year-old female patient who had a $2.3{\times}2.6{\times}1.7cm$ sized nasopalatine duct cyst. The bony defect after a surgical extirpation was restored with hydroxyapatite. So we report a good results with some reviews of the literatures.