• Archives of Plastic Surgery
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• 제47권3호
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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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• 제21권3호
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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.

• 대한임상검사과학회지
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• 제51권4호
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• pp.420-427
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• 2019

쯔쯔가무시증은 가을철 대표적인 발열성 질환으로 매년 환자가 지속적으로 증가하고 있지만, 환자 발생 및 지역적으로 차이가 생기는 원인은 연구가 부족한 실정이다. 이 연구에서는 고발생 지역과 저발생 지역에서 발생하는 환자의 역학적 특성과 지역적 발생 차이를 분석하였다. 2012~2016년 신고된 환자 47,717명을 대상으로 연도별, 월별, 지역별, 인구 10만 명당 발생률을 Microsoft Excel 2013과 지리정보분석시스템을 이용하여 분석하였고, 확진 환자 18,851명의 역학적 특성을 분석하였다. 월별 환자 발생은 가을철인 10~12월이 전체 신고의 90% 이상으로 높았다. 역학조사서 18,851명을 분석한 결과 다발생 지역은 14,777명(78.4%), 저발생 지역은 4,074명(21.6%), 성별은 남자 7,233명(38.4%)보다 여자가 11,618명(61.6%)으로 더 많았다(P<0.001). 임상증상은 발열이 16,688건(89.1%), 오한은 11,533건(61.2%), 근육통은 11,439명(60.7%) 순이었다. 가피(Eschar)는 몸통(어깨, 겨드랑이, 가슴, 복부, 허리) 부위가 6,005건(45.4%)으로 가장 많았고, 인구 10만 명당 환자발생 지역 중 고발생 지역은 경남, 전남, 전북, 충남 지역 순이다. 이 연구는 고발생 지역과 저발생 지역의 차이를 분석하였고, 고발생 지역은 활순털진드기의 분포 지역과 일치하였다. 쯔쯔가무시증은 온난화로 인한 털진드기의 증가와 농작업 및 야외활동의 증가가 예상되므로 환자 및 환경의 지속적인 관리 강화가 필요하다.

• 농촌의학ㆍ지역보건
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• 제29권1호
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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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• 제5권1호
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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.

• 대한수의학회지
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• 제45권1호
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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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• 제13권1_2호
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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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• 제13권1_2호
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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.

• 대한한의학회지
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• 제21권4호
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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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• 제46권7호
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• pp.710-713
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• 2003

목 적 : 쯔쯔가무시병의 치료제로는 클로람페니콜 또는 독시싸이클린이 사용되고 있으나 소아에서는 재생불량성 빈혈의 위험성, 치아 착색 등의 합병증으로 연령에 따라 치료제의 선택에 어려움을 겪을 수 있다. 새로운 마크로라이드계 항생제의 하나인 록시쓰로마이신의 쯔쯔가무시병 환아에 대한 치료 효과을 알아보고자 하였다. 방 법 : 쯔쯔가무시병으로 치료받은 환아 39명을 대상으로 치료 약제에 따라 독시싸이클린으로 치료받은 16명(DC군), 클로람페니콜로 치료받은 14명(CM군)과 록시쓰로마이신으로 치료받은 9명(RM군)으로 나눈 후 각군의 평균 나이, 입원 전 발열일, 백혈구 수, 비정상 간효소치를 포함한 합병증 및 치료 시작 후 해열 시간을 후향적으로 비교하였다. 결 과 : 환아의 평균 연령은 $6.1{\pm}3.4$세이었고, 5세 이하의 환아가 20명(51%)을 차지하였으며, 남녀비에서 2.9 : 1를 보였다. 거의 모든 환아가 10, 11월에 발병하였으며 10월에 24명(62%), 11월에 14명(36%)이 발생하였다. 임상 증상으로 발열과 발진은 39명 모두에서 나타났으며, 가피(eschar)는 36명(92%)에서 발견되었다. 평균 나이는 DC군 $7.1{\pm}3.7$세, CM군 $5.8{\pm}3.1$세, RM군 $4.2{\pm}2.4$세로 DC군이 높았으나 통계학적으로 차이는 없었다. 입원 전 발열일, 백혈구수, CRP 및 비정상 간효소치를 보인 비율은 3군간의 통계학적 차이를 볼 수 없었다. 대부분의 환아는 24시간 안에 해열되었으며(35명, 89.7%), 24-48시간 사이에 해열된 환아는 DC군에서 2명, CM군에서 1명, RM군에서 2명이었으며 통계학적으로는 차이를 보이지 않았다. 결 론: 소아의 쯔쯔가무시 병의 치료에서 록시쓰로마이신이 기존의 독시싸이클린이나 클로람페니콜과 같은 효과를 보였으며, 두 약제에서 볼 수 있는 합병증이 없어 사용하기 더 안전할 것으로 사료된다.