• Archives of Plastic Surgery
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• v.47 no.3
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• pp.228-234
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• 2020

Background A patient's overall condition sometimes does not allow for the complete removal of a dead eschar or injured slough in cases involving a pressure-injury skin lesion. This frequently occurs in clinical practice, particularly in bedridden and older patients receiving home care or intensive care. Even after debridement, it is also difficult to manage open exudative wounds in these patients. Nevertheless, when a mature or immature eschar is treated without proper debridement, liquefaction necrosis underneath the eschar or slough tends to reveal a large, open wound with infectious exudates. We hypothesized that if the presence of any bacteria under the eschar can be evaluated and the progression of the presumed infection of the subeschar can be halted or delayed without creating an open wound, the final wound can be small, shallow, and uninfected. Methods Using a punch instrument, we performed 34 viable subeschar tissue cultures with a secure junction between the eschar and the normal skin. Results The bacterial study had 29 positive results. Based on these results and the patient's status, appropriate antibiotics could be selected and administered. The use of suitable antibiotics led to relatively shallow and small exposed wounds. Conclusions This procedure could be used to detect potentially pathogenic bacteria hidden under black or yellow eschars. Since subeschar infections are often accompanied by multidrug-resistant bacteria, the early detection of hidden infections and the use of appropriate antibiotics are expected to be helpful to patients.

• Toxicological Research
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• v.21 no.3
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• pp.249-253
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• 2005

The present study was carried out to investigate the skin irritation potential of lemon grass essential oil in rabbits. A volume of 0.5 ml of test article was applied to intact and abraded skins, respectively, for 24 h in 6 healthy male New Zealand White rabbits. Parameters measured during 72 h observation period were mortality, clinical signs, body weight changes, and local irritation. All rabbits showed severe edema at both 24 h and 72 h after the application of test article. These animals also showed very slight to severe erythema and/or slight eschar formation at both 24 h and 72 h. The edema and erythema induced by lemon grass essential oil were recovered on day 7 of additional 11-day recovery period, but the eschar formation was not recovered at the end of recovery period. On the other hands, there were no treatment-related adverse effects on clinical sign, body weight and gross finding in rabbits. Based on these results, it was concluded that a single dermal application of the undiluted lemon grass essential oil caused very slight to severe edema, erythema and eschar formation in rabbits and showed a primary irritation index score of 5.63 indicating severe irritation. The results of this study strongly suggest that lemon grass essential oil should be used with care and in highly diluted forms especially when directly applied to the skin.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.4
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• pp.420-427
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• 2019

Scrub typhus is a fever-related disease that is commonly diagnosed during the autumn season. The number of patients affected by this disease continues to increase every year. However, the cause of the disease and the regional differences of its incidence are poorly understood. This study examined the epidemiological features and regional differences in the incidence of scrub typhus. The monthly incidence of cases from all reports rose to more than 90% during the fall season (October~December). Based on the analysis of the 18,851 cases in the epidemiological investigation, 14,777 (78.4%) and 4,074 (21.6%) cases occurred in high and low occurrence areas, respectively. Moreover, there were more female cases than male cases (males: 7,233 [38.4%]; females: 11,618 [61.6%]; P< 0.001). The clinical symptoms, including fever, chills, myalgia, and eschar of the body, were noted in 16,688 (89.1%), 11,533 (61.2%),11,439 (60.7%), and 6,005 (45.4%) cases, respectively. The incidence rates were higher for Gyeongnam, Jeonam, Jeonbuk, and Chungnam provinces. The areas with a high occurrence of scrub typhus were consistent with the areas experiencing a high distribution of Leptotrombidium scutellare. The incidence of scrub typhus has been rising owing to the increasing population of ticks due to global warming and increased agricultural and outdoor activities. Thus, continuous management of patients and preventive environmental measures are needed to control this disease.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.177-184
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• 2004

Objectives: Tsutsugamushi disease is one of the most significant acute febrile illnesses, increasing in frequency of occurrence during the late autumn in rural areas of Korea. Methods: I have conducted a case-control study on 30 cases who had the fever as a chief complaint, then had been ruled out as having the Tsutsugamushi disease. Data was collected retrospectively by review of chart regarding their general characteristics, clinical and laboratory findings, then was analysed by chi-test. Results: Of 30 cases, 16 cases were seropositive and 14 cases were seronegative against O. tsutsugamushi. Of seropositive for tsutsugamushi disease, 56.3% were female; 37.5% were in their seventies; 50.0% were farmers; 62,6% had chances of exposure to fields or mountains. And 75.0% occurred in November. The main symptoms and signs were fever and chill(100.0%), headache(75.0%). weakness and fatigue(93.8%), and eschar(68.8%). The characteristic laboratory findings were elevated AST(50.0%), ALT(62.5%), and abnormal urinalysis(56.3%). On the other hand, of seronegative cases, 57.1% were male; 50.0% were in their fifties; 42.9% were farmers; 57.2% had chances of exposure to fields or mountains. And 71.4% occurred in November. The symptoms and signs were fever and chill(100.0%), headache(85.7%), eschar(64.3%). weakness, fatigue and skin(57.1%). The laboratory findings were elevated AST(71.4%) and ALT(64.3%), and abnormal urinalysis(42.9%). However, there were no significant differences between the seropositive and seronegative cases(P>.05). Conclusions: Acute febrile community inhabitants who have the epidemiological, clinical as well as laboratory features should be focused upon for the early diagnosis and treatment for tsutsugamushi disease whether or not possessing the serological antibody against O. tsutsugamushi.

• Journal of Korean Biological Nursing Science
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• v.5 no.1
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• pp.35-44
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• 2003

Objectives : Though Tsutsugamushi disease has been reported with increasing frequencies in rural communities in Korea, it is not easy to find the nursing investigations. Methods : We have conducted a survey on 30 cases who had the fever as a chief complaint, then clinically ruled out the Tsutsugamushi disease in autumn of $2000{\sim}2001$. Data were collected retrospectively by investigation of the general characteristics, clinical and laboratory findings, their nursing care. Findings: Of 30 cases, 46.7% were farmers, and 60.0% had chances of exposure to fields or mountains. The characteristic symptoms and signs were febrile sense and chill(100.0%), headache(80.0%), and eschar(66.7%). Abnormal laboratory findings were anemia (23.3%), elevated AST(60.6%), ALT(63.3%), and abnormal urinalysis findings(50.0%). 53.3% were serologically confirmed as Tsutsugamushi disease. Therapeutic nursing cares were composed with warm up by blancket(50.0%), Ice bag(50.0%) and doxycycline antibiotic therapy(100.0%). Other nursing care for them included fluid therapy(100.0%) and nutritional support with regular(56.7%) or soft diet(43.3%). Conclusion: The above results indicate nurses who take care of acute febrile clients should make her responsible for the fever and pain management as well as give education for infection control for the community inhabitants.

• Korean Journal of Veterinary Research
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• v.45 no.1
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• pp.39-43
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• 2005

The present study was carried out to investigate the skin irritation potential of oregano oil in rabbits. A volume of 0.5 ml of test article was applied to intact and abraded skins, respectively, for 24 h in 6 healthy male New Zealand White rabbits. Parameters measured during 72 h observation period were mortality, clinical signs, body weight changes, and local irritation. Treatment-related toxic symptoms, as evidenced by anorexia and decreased locomotor activity, were observed in all rabbits tested. Two rabbits out of the 6 total died on day 2 after the application of test article due to treatment-related toxicity. The mean body weight of test animals decreased progressively during the 72 h observation period. All animals showed very slight edema at 24 h and then recovered at 72 h. These animals also showed very slight to severe erythema and/or slight eschar formation at both 24 h and 72 h. The eschar formation induced by oregano oil was not recovered at the end of additional 11-day recovery period. Based on these results, it was concluded that a single dermal application of the undiluted oregano oil caused an increased incidence of clinical signs and death and a decrease in the body weight and showed a primary irritation index score of 2.79 indicating moderate irritation.

• Toxicological Research
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• v.13 no.1_2
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• pp.149-152
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• 1997

This test was performed to evaluate the ocular and skin irritation of EPO (Erythropoietin). The results as follows: 1. Ocular irritation test There were no observed clinical signs, body weght changes by EPO during experimental period. The acute ocular irritation index(A.O.I.), mean ocular irritation index(M.O.I.) and Day-7 individual ocular irritation index(I.O.I.) of EPO at dose of 1000U and 10, 000U were 0, respectively. Therefore we evaluated that EPO was non-toxic to eyes. 2. Skin irritation test There were no observed clinical signs, body weght changes and gross pathologic findings by EPO during experimental period. There were no observed erythema, eschar formation and edema formation on intact and abraded skin treated by EPO. The primary irritation index(P.I.I.) of EPO at dose of 1000U and 10, 000U were 0, respectively and were evaluated none irritating product about skin irritation.

• Toxicological Research
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• v.13 no.1_2
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• pp.157-160
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• 1997

The primary skin and eye irritancy of the combined vaccine (KGCC-95VI) for the prophylaxis against Japanese encephalitis and Hantaan virus infection recently developed by Korea Green Cross Corporation was investigated. The KGCC-95VI was applied to the back skins of the New Zealand White rabbits. The rabbits were observed for 72 hours and did not exhibit erythema, eschar and edema. The eyes of the rabbits were exposed to the KGCC-95VI. The rabbits were observed for 7 days and did not exhibit any ocular findings on cornea, iris and conjuntivae. The KGCC-95VI is considered not to have the primary skin and eye toxicity in rabbits.

• The Journal of Korean Medicine
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• v.21 no.4
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• pp.292-299
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• 2000

We experienced two cases of Tsutsugamushi disease which occurred in October, 2000. The patients, who were over 70 years old and living in a rural area, visited Wonkwang University Oriental Chonju Medicine Hospital because of suffering fever, chill, skin rash, abdominal discomfort, and general weakness for a duration of seven days. The diagnosis was confmned as Tsutsugamushi disease by clinical findings such as eschar and high antibody titers on Reverse Passive Hemagglutination(RPHA). As for treatment, we used Sengmagalgentang-gamibang during the acute and Chojungikitang during convalescent phases of the illness. The patients were treated with Doxycycline of western medicine. The patients improved within 3 days of admission and were discharged within one week.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.710-713
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• 2003

Purpose : Although chloramphenicol and doxycycline have been used for the treatment of tsutsugamuchi disease, a difficulty exists in determining which drugs to use in treating children because of potential complications such as aplastic anemia or teeth discoloration. We evaluated the effect of roxithromycin, a macrolide antibiotic, on tsutsugamushi disease in children. Methods : A retrospective analysis was conducted on 39 children with tsutsugamuchi disease(scrub typhus) who were treated with doxycycline(DC), chloramphenicol(CM), or roxythromycin(RM) between 1991 and 2000. We divided the patients into a DC-treated group(DC group; 16 children), a CM-treated group(CM group; 14 children), and RM-treated group(RM group; 9 children) and compared these groups. Results : Most cases(97%) developed in October and November. Fever and rash were observed in all 39 cases and an eschar was noted in 36 cases(92%). No statistical differences could be found between the three groups in mean age, duration of fever before admission, white blood cell(WBC) count, and complications including abnormal liver enzymes. In most cases defervescence after treatment was within 24 hours(34 cases, 87%), and during 24-48 hours in two cases in the DC group, one in the CM group, and two in the RM group(no statistical difference). Conclusion : Roxythromycin was as effective as conventional doxycycline or chloramphenicol, in children with scrub typhus and may be safer to use.