• Journal of Preventive Medicine and Public Health
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• 제23권3호
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• pp.345-357
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• 1990

Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

• 대한두개안면성형외과학회지
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• 제19권2호
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• pp.139-142
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• 2018

Foreign bodies impacted in the maxillofacial region are often a diagnostic challenge. They can be a source of chronic inflammatory reactions and infections leading to the formation of an orocutaneous fistula. Such orocutaneous fistulas cause significant morbidity in most patients, eventually requiring surgery. Recently, we encountered a very rare case of an orocutaneous fistula caused by multiple foreign bodies in the cheek. Precise removal of the foreign bodies was required, and a double-sided anterolateral thigh free flap was used to reconstruct the defect. Surgeons should be aware of the complications of multiple foreign bodies and should be able to diagnose these on careful clinical examination.

• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.441-443
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• 2013

Liver abscess following ventriculoperitoneal (VP) shunting occurs very rarely. We report an unusual case of multiple liver abscesses caused by Staphylococcus capitis in a 50-year-old compromised woman due to a complicating VP shunt infection. We reviewed the nine cases of VP shunt complications reported in the English literature, and speculated that the most likely pathogenetic mechanism in our case is an infected peritoneal tip that migrated to and penetrated the liver, which subsequently caused the formation of multiple liver abscesses. The patient was successfully treated with percutaneous aspiration, drainage of the abscesses, intravenous antibiotics, and shunt revision. Awareness and vigilance of the possibility of liver abscess formation caused by VP shunt infection will help establish an early accurate diagnosis and therapeutic strategy.

• 생명과학회지
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• 제24권9호
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• pp.1025-1029
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• 2014

자궁경부암은 전세계 여성의 사망원인 2위를 차지하며, 인유두종바이러스 감염과 상관성이 있다. 인유두종바이러스의 백신정책, 병인론, 추적관찰, 역학에서 유전형 검사는 중요하다. 후향적 연구를 위하여 파라핀 조직에서 역교잡반응을 이용하여 인유두종바이러스의 유전형을 검사하는 것은 명확하게 증명된 것은 아니다. 본 연구에서는 자궁경부암 파라핀 조직에서 역교잡반응을 사용하여 인유두종바이러스의 유전형 검사의 유용성을 평가하였다. 총 52개의 자궁경부암 파라핀 조직을 사용하여 역교잡반응을 실시하여 인유두종바이러스의 유전형을 검출하였다. 52개의 파라핀 조직중에서 32(61.5%) 건에서 인유두종바이러스가 검출되었으며, 단순감염이 27(84.4%) 건, 복합감염이 5(15.6%) 건으로 검출되었다. 단순감염에서 인유두종바이러스 유전형은 고위험군 18(8), 58(6), 16(5), 33(1), 35(1), 39(1), 56(1) 유전형과, 저위험군 11(2), 6(1), 70(1) 유전형으로 분석되었다. 복합감염에서 인유두종바이러스 유전형은 16/18(2), 18/52(1), 16/56(1), 16/18/33(1) 유전형으로 검출되었다. 본 연구를 통하여, 파라핀 조직으로 후향적 연구를 위한 인유두종바이러스 유전형 검사가 가능할 것으로 기대된다.

• Journal of Yeungnam Medical Science
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• 제28권2호
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• pp.133-144
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• 2011

Background: Tigecycline (TIG), a new broad-spectrum glycylcycline with anti-multidrug-resistant-(MDR)-pathogen activity, was launched in March 2009 in South Korea, but there are insufficient clinical studies on its use in the country. As such, this study was performed to analyze cases of severe MDR-pathogen-caused infections treated with TIG. Methods: Patients treated with TIG within the period from May 2009 to June 2010 were enrolled in this study. Their clinical and microbiologic data were reviewed retrospectively. Results: Twenty-one patients were treated with TIG for complicated skin and soft-tissue infections (cSSTIs) (42.9%), complicated intra-abdominal infections (cIAIs) (38.1%), or pneumonia (19.1%) caused by MDR pathogens like carbapenem-resistant $Acinetobacter$ $baumannii$ (76.2%), methicillin-resistant $Staphylococcus$ $aureus$ (61.9%), extended-spectrum beta-lactamase-producing $Escherichia$ $coli$ and $Klebsiella$ $pneumoniae$ (38.1%), and penicillin-resistant $Enterococcus$ species (33.3%). Thirteen patients (61.9%) had successful clinical outcomes while five (23.8%) died within 30 days. The rate of clinical success was highest in cSSTI (77.8%), followed by cIAI (50%) and pneumonia (50%), and the mortality rate was highest in pneumonia (50%), followed by cIAI (25%) and cSSTI (11.1%), Conclusion: Tigecycline therapy can be an option for the treatment of severe MDR-pathogen-caused infections in South Korea, Due to its high risk of failure and mortality, however, prudence is required in its clinical use for the treatment of severe infections like nosocomial pneumonia.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1151-1158
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• 2012

High-risk human papillomavirus (HPV) genotypes are the major cause of cervical cancer. Hence, HPV genotype detection is a helpful preventive measure to combat cervical cancer. Recently, several HPV detection methods have been developed, each with different sensitivities and specificities. The objective of this study was to compare HPV high risk genotype detection by an electrochemical DNA chip system, a line probe assay (INNO-LiPA) and sequencing of the L1, E1 regions. A total of 361 cervical smears with different cytological findings were subjected to polymerase chain reaction-sequencing and electrochemical DNA chip assessment. Multiple infections were found in 21.9% (79/361) of the specimens, most prevalently in 20-29-year olds while the highest prevalence of HPV infection was found in the 30-39-year age group. The most prevalent genotype was HPV 16 at 28.2% (138/489) followed by HPV 52 at 9.6% (47/489), with the other types occurring at less than 9.0%. The electrochemical DNA chip results were compared with INNO-LiPA and sequencing (E1 and L1 regions) based on random selection of 273 specimens. The results obtained by the three methods were in agreement except for three cases. Direct sequencing detected only one predominant genotype including low risk HPV genotypes. INNO-LiPA identified multiple infections with various specific genotypes including some unclassified-risk genotypes. The electrochemical DNA chip was highly accurate, suitable for detection of single and multiple infections, allowed rapid detection, was less time-consuming and was easier to perform when compared with the other methods. It is concluded that for clinical and epidemiological studies, all genotyping methods are perfectly suitable and provide comparable results.

• 치위생과학회지
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• 제8권3호
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• pp.189-198
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• 2008

치과위생사가 치과 진료실에서 감염예방 실천도의 관련 요인을 파악하여 치과위생사의 감염예방 실천도 제고를 위한 기초 자료로 제공하고자 본 연구를 수행하였다. 연구 대상은 2005년 10월과 11월에 인천경기도회와 서울시회 보수교육에 참여한 치과위생사 168명으로 하였으며, 감염예방에 관한 설문조사를 자기기입방식으로 시행하였다. 그 결과는 다음과 같다. 1. 일반적 특성과 실천도 분석 결과, 연령(F=3.237, p=0.024)과 근무 경력(F=3.333, p=0.021)에서 유의한 실천도 점수의 차이가 있었다. 2. 일반적 특성과 교육경험 여부는 근무처(X=19.823, p=0.001)에 따라, 지식도는 연령(F=4.895, p=0.003)에 따라 통계적으로 유의한 차이를 보였다. 3. 감염예방 교육경험이 있는 경우가 경험이 없는 경우에 비해 감염예방 실천도 점수가 높았다(t=3.315, p=0.001). 4. 지식도와 실천도의 상관관계 분석 결과는 통계적으로 유의하였다(p < 0.05). 5. 감염예방 교육경험에 따른 지식도 분석 결과, 교육경험이 있는 경우가 지식도 점수가 높게 나타났지만 통계적으로 유의한 차이는 없었다(t=1.336, p=0.183). 6. 조직관련요인과 실천도는 통계적으로 유의한 상관관계를 보였다(p < 0.01). 7. 감염예방 실천도의 관련요인 분석 결과에서는 조직관련요인이 높을수록 지식도가 높을수록 교육경험이 많을수록 근무경력이 많을수록 감염예방 실천도가 높게 나타났다.($R^2=0.32$). 위의 분석 결과 치과위생사의 감염예방 실천도 제고를 위해서는 학교의 교육과정에 감염 예방에 대한 내용을 다루어 치위생과 학생들의 감염예방 지식도를 높이고, 학교 졸업 후에도 근무병원 자체교육과 보수교육 등을 통한 지속적인 교육과 홍보를 할 수 있는 프로그램을 개발해야하며, 가장 중요한 것은 치과위생사들이 스스로에게 안전한 근무 환경을 조성하도록 조직의 적극적인 노력과 관심이 필요할 것으로 판단된다.

• Journal of Korean Biological Nursing Science
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• 제8권1호
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• pp.5-14
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• 2006

Staphyloccus aureus is one of the most important pathogens in clinical settings. It is also one of the leading causes of nosocomial infections and the dissemination of multiple drug-resistant strains, mainly methicillin resistant Staphyloccus aureus, and the recent emergence of a vancomycin resistant MRSA is the concern to hospital worldwide. MRSA strains have acquired multiple resistance to a wide range of antibiotics, including aminoglycosides and macrolides. $\beta$-Lactam resistance of methicillin-resistnat Staphyococcus aureus is determined by the function of penicillin binding protein 2'(PBP2') encoded by the methicillin resistance gene mec A. MRSA strains carry methicillin resistance gene mecA, encoded by a mobile genetic element designated staphylococoal cassette chromosome mec(SCCmec). MRSA clones are defined by the type of SCCmec element and the genotype of the methicilline-susceptible Staphyococcus aureus chromosome in which the SCCmec element is integrated.

• Biomolecules & Therapeutics
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• 제21권4호
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• pp.251-257
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• 2013

Inflammatory skin diseases such as atopic dermatitis (AD) and rosacea were complicated by barrier abrogation and deficiency in innate immunity. The first defender of epidermal innate immune response is the antimicrobial peptides (AMPs) that exhibit a broad-spectrum antimicrobial activity against multiple pathogens, including Gram-positive and Gram-negative bacteria, viruses, and fungi. The deficiency of these AMPs in the skin of AD fails to protect our body against virulent pathogen infections. In contrast to AD where there is a suppression of AMPs, rosacea is characterized by overexpression of cathelicidin antimicrobial peptide (CAMP), the products of which result in chronic epidermal inflammation. In this regard, AMP generation that is controlled by a key ceramide metabolite S1P-dependent mechanism could be considered as alternate therapeutic approaches to treat these skin disorders, i.e., Increased S1P levels strongly stimulated the CAMP expression which elevated the antimicrobial activity against multiple pathogens resulting the improved AD patient skin.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권1호
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• pp.81-85
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• 2021

Central venous catheter (CVC) insertion is commonly used in the operating room and intensive care unit to monitor central venous pressure and secure an intravenous route to deliver medications and nutritional support that cannot be safely infused into peripheral veins. However, CVC insertion may be associated with serious complications such as arterial puncture, hematoma, pneumothorax, hemothorax, catheter infections, and thrombosis. Several methods have been recommended to prevent these complications. Here we report a case of massive hemothorax caused by attempts of CVC insertion into the internal jugular vein and subclavian vein in a patient with multiple trauma. CVC placement should be performed or supervised by an experienced physician to decrease the incidence of CVC-related complications. CVC insertion under ultrasound guidance is recommended.