• 제목/요약/키워드: dual infection

검색결과 76건 처리시간 0.03초

횡유륜 유두주위절개를 통한 이중포켓 유방확대술 (Transareolar-Perinipple Dual Pockets Breast Augmentation)

  • 이백권;김지훈;서병철;오득영;이종원;안상태
    • Archives of Plastic Surgery
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    • 제34권1호
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    • pp.93-98
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    • 2007
  • Purpose: Many options are available for the incision and pocket selection in breast augmentation. Each method has its advantages and disadvantages. To leave an invisible operation scar and to achieve easier pocket dissection by the central location of the incision on the breast, we made a transareolar-perinipple incision. To overcome the disadvantages of the transareolar incision, originally advocated by Pitanguy in 1973, we modified the direction of incision line and dissection plane. Methods: To avoid the injury of 4th intercostal nerve responsible for nipple sensation, we made perinipple incision on the medial side of the nipple instead of trans-nipple incision and made the transareolar incision as 11-5 o'clock on the left side and 1-7 o'clock on the right side instead of 3-9 o'clock on both sides. To avoid the possible infection and breast feeding problem caused by the injury to the lactiferous duct, and the possible implant hernia caused by the incisions lying on a same plane of pocket dissection, we made a subcutaneous dissection just above the breast tissue medially down to the bottom of breast tissue and made a subglandular or subfascial pocket, which may avoid the injury of lactiferous duct and create different planes for skin incision and pocket dissection. Other advantages of the transareolar-perinipple incision include easier pocket dissection, less chance of hematoma, and as a result less postoperative pain because of the central location of the approach which allow finger dissection and meticulous bleeding control with direct vision, without any specialized instrument such as an endoscope or long mammary dissectors. As for pocket selection, we made dual pockets. We prefer subglandular or subfascial pocket. Also, we made a subpectoral pocket in the upper 1/4 of the pocket to add more volume on the upper part of the augmented breast, which can make aesthetically more desirable breasts in thin Asian women with small breasts. Possible disadvantages of our method are subclinical infection and scar widening, which could be overcome by meticulous operation techniques, antibiotic therapy, and intradermal tattooing. Results: From September, 2003 to August, 2005, 12 patients underwent breast augmentation using round smooth surface saline implants by our method. During the mean follow-up period of 13 months, there were no complications such as infection, hematoma, capsular contracture, and sensory change of nipple, and results were satisfactory. Conclusion: We suggest breast augmentation via transareolar-perinipple incision and dual pockets(subpectoral-subglandular or subfascial) as a valuable method in thin oriental women with small breasts.

병원감염관리 질에 대한 인식이 재이용의도에 미치는 영향 -지각된 위험과 신뢰의 매개효과를 중심으로- (The Effect of Perception on the Quality of Nosocomial Infection Control on the Intention to Revisit : Focusing on the Mediating Effect of Perceived Risk and Trust)

  • 강재신;김광점
    • 한국병원경영학회지
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    • 제24권3호
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    • pp.11-26
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    • 2019
  • Objectives: The purpose of this study was to investigate the effect of the perception on the quality of nosocomial infection control on perceived risk, trust, and the intention to revisit among the medical consumers. Method: 361 patients and their guardians who were hospitalized in women's hospital, Gangnam-gu, Seoul, participated in this study. The data was analyzed using SPSS Statistics 21.0. Results: The perception on the quality of nosocomial infection control had a negative(-) effect on perceived risk, a positive(+) effect on trust, a positive(+) effect on the intention to revisit. The perceived risk had a negative(-) effect on trust, a negative(-) effect on the intention to revisit. The trust had a positive(+) effect on the intention to revisit. The perceived risk was partially mediated by the perception on the quality of nosocomial infection control and the intention to revisit, while the trust was fully mediated by the perception on the quality of nosocomial infection control and the intention to revisit. Thus, it indicated that the perceived risk and trust had dual mediated effects as well as full mediated effects in the relationship between the perception on the quality of nosocomial infection control and the intention to revisit. Conclusions: The nosocomial infection control can be an important factor to contribute to hospital management by attract the loyal medical customers, not just cost-expenditure. The nosocomial infection control can help hospital revenue and customer management strategy. Thus, it will contribute to the effective marketing strategy in the medical field.

Immunogenicity and Protective Efficacy of a Dual Subunit Vaccine Against Respiratory Syncytial Virus and Influenza Virus

  • Park, Min-Hee;Chang, Jun
    • IMMUNE NETWORK
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    • 제12권6호
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    • pp.261-268
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    • 2012
  • Respiratory syncytial virus (RSV) and influenza virus are the most significant pathogens causing respiratory tract diseases. Composite vaccines are useful in reducing the number of vaccination and confer protection against multiple infectious agents. In this study, we generated fusion of RSV G protein core fragment (amino acid residues 131 to 230) and influenza HA1 globular head domain (amino acid residues 62 to 284) as a dual vaccine candidate. This fusion protein, Gcf-HA1, was bacterially expressed, purified by metal resin affinity chromatography, and refolded in PBS. BALB/c mice were intranasally immunized with Gcf-HA1 in combination with a mucosal adjuvant, cholera toxin (CT). Both serum IgG and mucosal IgA responses specific to Gcf and HA1 were significantly increased in Gcf-HA1/CT-vaccinated mice. To determine the protective efficacy of Gcf-HA1/CT vaccine, immunized mice were challenged with RSV (A2 strain) or influenza virus (A/PR/8/34). Neither detectable viral replication nor pathology was observed in the lungs of the immune mice. These results demonstrate that immunity induced by intranasal Gcf-HA1/CT immunization confers complete protection against both RSV and homologous influenza virus infection, suggesting our Gcf-HA1 vaccine candidate could be further developed as a dual subunit vaccine against RSV and influenza virus.

일개 병원 내 의료종사자에서의 결핵 접촉자 조사 (A Tuberculosis Contact Investigation on Health Care Workers in One Hospital)

  • 김태희;장윤숙;정선주;김연재;배현주;오성희
    • Pediatric Infection and Vaccine
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    • 제23권2호
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    • pp.94-101
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    • 2016
  • 목적: 대학병원에 근무하던 중 활동성 폐결핵으로 진단된 전공의에게 노출된 의료종사자들에 대하여 실시한 접촉자 조사의 결과를 보고한다. 방법: 활동성 폐결핵 환자와 밀접한 접촉을 한 사람(접촉자) 101명 중 89명이 접촉자 조사에 응하여 조사를 받았다. 1차 접촉자 조사는 지표환자의 증상 개시 후 30일경에, 2차 조사는 1차 조사 10주 후에 기침, 발열, 인후통, 체중 감소와 같은 임상증상 확인 및 단순흉부촬영과 함께 결핵반응검사(Tuberculin skin test, TST)/QuantiFERON-TB Gold (QFT-G) 2단계 검사법을 시행하였다. 결과: 1차 TST 양성자는 34명(38.2%)이었고, TST 양성자 중 35세 이하 접촉자에서 시행한 QFT-G 양성률은 37.5% (6/16)이었다. 1차 TST 음성 대상자 41명에게서 시행한 2차 TST에서 17명(41.5%)이 양전을 보였고 그들 중 시행한 QFT-G 검사에서 3명(17.6%)이 양성이었다. 활동성 결핵으로 진단된 접촉자는 없었으며 지표환자에 노출되어 발생한 결핵 전파율은 2단계 검사법으로는 7.3% (3/41)였고, TST 진단법으로는 41.5% (17/41)였다. 결론: 국내에서 처음 보고되는 병원 내 결핵 접촉자 조사 연구로서 LTBI 발생률이 그 진단 기법에 따라 달랐으며 따라서 앞으로 발생할 수 있는 의료종사자들에 대한 병원 내 결핵 접촉자 조사를 위해 조직적이고 실용적인 가이드라인이 필요할 것이다.

돼지생식기호흡기증후군 바이러스가 흉막폐렴에 미치는 영향 - 혈청학적 및 백혈구아군 분포율에 관한 연구 - (Effect of porcine reproductive and respiratory syndrome virus on pigs with pleuropneumonia - Studies on serology and proportion of porcine subpopulation of peripheral blood -)

  • 정현규;박용호;한정희
    • 한국동물위생학회지
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    • 제30권1호
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    • pp.51-66
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    • 2007
  • The purpose of this study was to evaluate the effect of a subsequent infection of porcine reproductive and respiratory syndrome(PRRS) virus to pigs with A pleuropneumonia. Twenty three 7-week-old commercial pigs were infected intratracheally with PRRS virus and/or A pleuropneumoniae serotype 5. Serum antibody titers were examined by an enzyme-linked immunosorbent assay(ELISA) and proportion of porcine leukocyte subpopulations in peripheral blood was examined by flow cytometry. In this experiment, antibodies against PRRS virus and A pleuropneumoniae were detected at 2 weeks and 1 week postinfection and the number of antibody positive pigs were gradually increased. And in proportion to leukocyte subpopulations in peripheral blood of pigs infected with A pleuropneumoniae compared with pigs administrated with saline, the proportion of PoCD4 and N cells were increased(P<0.1). Furthermore, in proportion to leukocyte subpopulations in peripheral blood of pigs infected with PRRS virus followed by A pleuropneumoniae compared with pigs administrated with saline, the proportion of MHC class II, PoCD4 and B cells were significantly increased(P<0.1). The results indicated that dual infection with PRRS virus and A pleuropneumoniae induced the stronger immune responses associated with macrophages and Th cells in pigs than single infection with PRRS virus or A pleuropneumoniae.

흰쥐의 일주기조절중추내 바이러스 감염에 대한 매개변수 분석 (Parametric Analysis on the Viral Infection in The Rat Circardian Control Center)

  • 김진상
    • The Journal of Korean Physical Therapy
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    • 제10권2호
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    • pp.113-125
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    • 1998
  • The neurotropic psudorabies virus(PRV) to replicate within neurons is very useful pathogen for neuronal tracing. I carried out this study to investigate the parametric analysis on the viral infection in the rat circadian control center with two genetically engineered strains out of PRV. The two strains are isogenic with the attenuated Bartha strain of PRV ; in one strain a lacZ reporter gene was inserted into the gC locus (PRV-BaBlu ; $4.75\times10^8pfu/ml$) and the other strain contained a PRV envelope glycoprotein gene(PRV-D ; $2.5\times10^8pfu/ml$) theat is absent in PRV-BaBlu. simultaneous or temporally separated sequential injection of$2{\mu}l$ of each strain into the vetreous body of eye produced a course of transsynaptic infection of retinohypothalamic circuitry. The results were as follows; 1. PRV-BaBlu and PRV-D infected the suprachiasmatic nucleus in hypothalamus and intergeniculate leaflet in lateral geniculate nucleus of thalamus. 2. The rate of PRV infection was dependent upon PRV strain. 3. Pre-infected neurons by PRV-D were interfered with the replication of PRV-BaBlu. 4. Dual injection of PRV-D and PRV-BaBlu showed more virulent than the parental strain.

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폐결핵 또는 기타 질환환자에 있어서의 폐진균증에 관한 연구 (Pulmonary Fungal Infection in Patients with Healed Tuberculosis or Other Underlying Diseases)

  • Kim Sang Jae;Hong Young Pyo;Kim Sung Chin
    • 미생물학회지
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    • 제19권3호
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    • pp.142-152
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    • 1981
  • One hundred and thirteen healed pulmonary tuberculosis patients and 11 patients with other underlying diseases were studied for evidence of pulmonary fungal infection because of persisting hemoptysis or chronic cough. Rediological, mycological and serological investigations revealed that 54 out of 124 patients were evidently infected with one or more species of fungi. A. fumigatus was isolated from 4 out of 70 patients whose sera did not react with antigens from this fungus, while it was isolated from 43 out of 47 serological reactors to this fungus. Chest radiography showed a distinct fungus ball in a cyst of one patient and in a preformed cavity in the lung of 17 healed tuberculosis patients and two other patients. The latter two patients were infected with A.flavus. Two patients, who were under the long period of immunosuppressive therapy, apparently succumbed to invasive aspergillosia due to A.fumigatus. A single or dual infection with A. flavus, A. nidulans, A.nidulans var. latus, C. albicans, and P. boydii were noticed in some patients without mycetomal shadow on chest radiographs. Young mycelial extract (ME) of A.fumigatus detected antibody in 95.8 percent of the sera from patients infected with this fungus, while it was isolated from 43 out of 47 serological reactors to this fungus. Chest radiography showed a distinct fungus ball in a cyst of one patient and in a performed cavity in the lung of 17 healed tuberculosis patients and two other patients. The latter two patients were infected with A. flavus. Two patients, who were under the long period of immunosuppressive therapy, apparently succumbed to invasive aspergillosis due to A.fumigatus. A single or dual infection with A. flavus, A. nidulans, A. niduans var. latus, C. albicans, and P. boydii were noticed in some patients without mycetomal shadow on chest radiographs. Young mycelial extract (ME) of A.fumigatus detected antibody in 95.8 percent of the sera from patients infected with this fungus, while the commercial culture filtrate antigen (GL) yielded 78.7 per cent positive result. Culture filtrate antigen, however, was comparable with ME. There was no single antigen with which all the serum specimens reacted. Fractionation of ME resulted in a loss of some activity although it excluded substances that reacted with C-reactive protein in a loss of some activity although it excluded substances that reacted with C-reactive protein. Most reactive and specific precipitinogens distributed in the fraction (FB) which was precipitable at 75 percent saturation with ammonium sulfate and eluted in a second peak in order from gel-filtration and which contained mostly proteinic components. Glycoproteins or polysaccharides rich fractions (FA and ASI) were relatively less effective in detecting antibody. Demonstration of antibody in the serum from patients using a battery of fungal antigens and of etiologically related fungi from clinical specimens are very useful laboratory procedures for the diagnosis of pulmonary fungal infection which is a common complication of tuberculosis.

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Bronchopulmonary Sequestration with Dual Arterial Supply from Celiac Artery and Thoracic Aorta

  • Kim, Won-Hak;Jeong, So-Hee;Ha, Kyung-Won;Lee, Woo-Sung;Kim, Dong-Chan;Chon, Gyu-Rak
    • Tuberculosis and Respiratory Diseases
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    • 제68권2호
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    • pp.101-104
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    • 2010
  • Bronchopulmonary sequestration (BPS) is a rare congenital malformation of the lower respiratory tract. Most intralobar BPSs are provided with an arterial blood via the thoracic or abdominal aorta but such a supply is rarely found in patients older than 50 years. We report a case of an intralobar BPS with a dual arterial supply from the celiac artery and thoracic aorta in a 50-year-old man presenting with a respiratory tract infection and haemoptysis. To our knowledge, this is the first case report of a BPS supplied by the celiac artery and thoracic aorta in a 50-year-old man.

Dual-Target Gene Silencing by Using Long, Synthetic siRNA Duplexes without Triggering Antiviral Responses

  • Chang, Chan Il;Kang, Hye Suk;Ban, Changill;Kim, Soyoun;Lee, Dong-ki
    • Molecules and Cells
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    • 제27권6호
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    • pp.689-695
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    • 2009
  • Chemically synthesized small interfering RNAs (siRNAs) can specifically knock-down expression of target genes via RNA interference (RNAi) pathway. To date, the length of synthetic siRNA duplex has been strictly maintained less than 30 bp, because an early study suggested that double-stranded RNAs (dsRNAs) longer than 30 bp could not trigger specific gene silencing due to the induction of non-specific antiviral interferon responses. Contrary to the current belief, here we show that synthetic dsRNA as long as 38 bp can result in specific target gene silencing without non-specific antiviral responses. Using this longer duplex structure, we have generated dsRNAs, which can simultaneously knock-down expression of two target genes (termed as dual-target siRNAs or dsiRNAs). Our results thus demonstrate the structural flexibility of gene silencing siRNAs, and provide a starting point to construct multifunctional RNA structures. The dsiRNAs could be utilized to develop a novel therapeutic gene silencing strategy against diseases with multiple gene alternations such as viral infection and cancer.

Dual-Toehold-Probe-Mediated Exonuclease-III-Assisted Signal Recycles Integrated with CHA for Detection of mecA Gene Using a Personal Glucose Meter in Skin and Soft Tissue Infection

  • Jiaguang Su;Wenjun Zheng
    • Journal of Microbiology and Biotechnology
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    • 제33권12호
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    • pp.1692-1697
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    • 2023
  • Staphylococcus aureus integrated with mecA gene, which codes for penicillin-binding protein 2a, is resistant to all penicillins and other beta-lactam antibiotics, resulting in poor treatment expectations in skin and soft tissue infections. The development of a simple, sensitive and portable biosensor for mecA gene analysis in S. aureus is urgently needed. Herein, we propose a dual-toehold-probe (sensing probe)-mediated exonuclease-III (Exo-III)-assisted signal recycling for portable detection of the mecA gene in S. aureus. When the target mecA gene is present, it hybridizes with the sensing probe, initiating Exo III-assisted dual signal recycles, which in turn release numerous "3" sequences. The released "3" sequences initiate catalytic hairpin amplification, resulting in the fixation of a sucrase-labeled H2 probe on the surface of magnetic beads (MBs). After magnet-based enrichment of an MB-H1-H2-sucrase complex and removal of a liquid supernatant containing free sucrase, the complex is then used to catalyze sucrose to glucose, which can be quantitatively detected by a personal glucose meter. With a limit of detection of 4.36 fM for mecA gene, the developed strategy exhibits high sensitivity. In addition, good selectivity and anti-interference capability were also attained with this method, making it promising for antibiotic tolerance analysis at the point-of-care.