• 기본간호학회지
• /
• 제21권2호
• /
• pp.151-161
• /
• 2014

Purpose: The purpose of this study was to identify the risk factors that influence surgical site infections after surgery. Methods: This study was a retrospective research utilizing Electronic Medical Records. Data collection targeted 4,510 adult patients who had 8 different kinds of surgery (gastric surgery, colon surgery, laparoscopic cholecystectomy, hip & knee replacement, hysterectomy, cesarean section, cardiac surgery) in 4 medical care departments, at one general hospital between January 2006 and December 2011. Multivariate logistic regression analyses were used to identify the risk factors affecting surgical site infections after surgery. Results: Risk factors for increased surgical site infection following surgery were confirmed to be age (OR=1.59, p<.001), BMI (Body Mass Index)(OR=1.25, p=.034), year of operation (OR=2.45, p<.001), length of operation (OR=3.06, p<.001), ASA (American Society of Anesthesiology) score (OR=1.36, p=.025), classification of antibiotic used (OR=2.77, p<.001), duration of the prophylactic antibiotics use (OR=1.85, p<.001), and interaction between classification of antibiotic used and duration of the prophylactic antibiotics use (OR=1.90, p=.016). Conclusions: Results suggest that risk factors affecting surgical site infections should be monitored before surgery. The results of this study should contribute to establishing effective infection management measures and implementing surveillance systems for patients who have actual risk factors.

• Journal of Chest Surgery
• /
• 제23권2호
• /
• pp.275-284
• /
• 1990

A serious problem after cardiovascular surgery known as Multiple Organ Failure[MOF] whereby several vital organs successively demonstrate dysfunction in spite of intensive postoperative treatment has recently arisen. We have made a retrospective study of the clinical records of 137 patients who underwent cardiovascular surgery during past two years [1987-1988]. Fourteen patients [10%] developed multi-organ failure postoperatively with the results of seven death [50%]. In fatal group, preoperative poor cardiac function [Cardiac Index<2.0L/min/m2] was considered important prognostic factor and infection 5 disseminated intravascular coagulation complicating gastrointestinal bleeding were the leading cause of death. In conclusion, evaluation of multiple factors concerning multi-organ failure demonstrates preoperative poor functional preservation of vital organs is the main factor. So early diagnosis k management for each of the failing organs & prevention of infection are mandatory of the treatment of these critically ill patients.

• Tuberculosis and Respiratory Diseases
• /
• 제78권2호
• /
• pp.56-63
• /
• 2015

A small number of viable tuberculosis bacilli can reside in an individual with latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal chest radiographs. Diagnosis and treatment for LTBI are important for tuberculosis (TB) control in public and private health, especially in high-risk populations. The updated 2014 Korean guidelines for TB recommend that tuberculin skin tests, interferon-gamma release assays, or a combination of the two can be used for LTBI diagnosis according to age and immune status of the host as well as TB contact history. The regimens for LTBI treatment include isoniazid, rifampicin, or isoniazid/rifampicin. However, results of drug susceptibility test from the index case must be considered in selecting the appropriate drug for recent contacts. Standardized LTBI diagnosis and treatment based on the new 2014 guidelines will contribute to the effective TB control in Korea as well as to the establishment of updated guidelines.

• Parasites, Hosts and Diseases
• /
• 제59권5호
• /
• pp.523-529
• /
• 2021

The endemicity of zoonotic trematode metacercariae (ZTM) was investigated with total 871 freshwater fishes (19 species) from Deokcheon-gang (a branch stream of Gyeongho-gang) in Sancheong-gun, Gyeongsangnam-do, Korea for 3 years (2018-2020). All fishes were examined with the artificial digestion method. The metacercariae of Clonorchis sinensis (CsMc) were detected in 233 (36.3%) out of 642 fish in 11 positive fish species (PFS), and their infection intensity was 27 per fish infected (PFI). Especially, in index fish, Puntungia herzi, of CsMc infection, prevalence was 64.2% and infection intensity was 37 PFI. Metagonimus spp. metacercariae (MsMc) were found in 760 (87.5%) out of 869 fish in 18 PFS and their infection intensity was 228 PFI. In sweet smelt, Plecoglossus altivelis, the prevalence of MsMc was 97.6% and their infection intensity was 3,570 PFI. Centrocestus armatus metacercariae were detected in 209 (29.4%) out of 710 fish in 8 PFS and their infection intensity was 1,361 PFI. Echinostoma spp. metacercariae were found in 293 (42.6%) out of 688 fish in 15 PFS and their infection intensity was 5 PFI. Metacercariae of Clinostomum complanatum and Metorchis orientalis were also detected in 2.7% and 21.2% fish in 4 PFS and their infection intensities were 3.1 and 3.4 PFI respectively. By the present study, it was confirmed that some species of ZTM including CsMc and MsMc are more or less prevalent in fishes from Deokcheon-gang in Sancheong-gun, Gyeongsangnam-do, Korea.

• Journal of Preventive Medicine and Public Health
• /
• 제32권2호
• /
• pp.228-235
• /
• 1999

Objectives: Despite the importance of human immunodeficiency virus(HIV) transmission through heterosexual contact, the features of heterosexual transmission has not been well studied in Korea. So we conducted a cross sectional study to determine the transmission rates in married couples and assess risk factors for male to female heterosexual transmission of HIV. Methods: 169 HIV-infected males and their female sex partners were recruited from 1985 to tune 1998. We examined female sex partner's HIV infection status and interviewed male index partners and their female sex partners about demographic characteristics and sexual practices. We analysed heterosexual transmission rate by epidemiologic characteristics, disease status and sexual practices. And we assessed risk factors for HIV infection by univariate and multivariate analysis. Results: 30 female sex partners were infected at enrollment, yielding an transmission rate of 17.8%. Among couples who had used condoms consistently, none of the female sex partners was infected with HIV. In univariate analysis the significant risk factors were full blown AIDS status (OR=4.1, 95% CI: 1.49-11.43) and low CD4 T cell count of index partners at enrollment (OR=7.8, 95% CI: 2.19-27.80). In multivariate analysis HIV-1 RNA levels was significant risk factor when adjusted by CD4 T cell courts and mean sexual contacts per month (OR=19.2, 95% CI: 1.03-357.59) Conclusion: The risk of male to female heterosexual transmission increased with advanced stages of HIV infection in the index male partners.

• 대한임상검사과학회지
• /
• 제36권2호
• /
• pp.178-184
• /
• 2004

This research focuses on the overall evaluation of tumor protein (p53) and cell growth marker (Ki-67) in their functions as carcinogenic factors in both a HPV-infected group and in a HPV-noninfected group with the precancerous dysplasia of uterine cervix. Histological grades were determined by the H&E staining and the expression level of p53 and Ki-67 were tested by the immunohistochemistry method. The results were as follows. Among the total of 66 cases, p53 (+) was observed in 19 cases (29.0%) from the mild grade group, 22 cases (33.0%) from the moderate grade group, and 19 cases (29.0%) from the severe grade group. The values correlate with the increase of dysplasia intensity in HPV-noninfected group and showed significant correlation (p<0.05), but there were no significant difference from the HPV-infected group. Among a total of 66 cases, the mitotic index of Ki-67 (+) were observed in 19 cases (29.0%) from the mild grade group, 22 cases (33.0%) from the moderate grade group, and 19 cases (29.0%) from the severe grade group. The values were significantly different against dysplasia intensity (p<0.05), but showed no significant difference from HPV infection. After cross comparing the statistical parameters of p53 and ki-67 in their significance, p53 was shown to be statistically significant with Ki-67 while there was no statistically significant difference with Ki-67 (p<0.05). Taken together, tumor protein (p53) and an index of Ki-67 observed in cervical dysplasia and in HPV related dysplasia of cervix uterine did not have any notable significance with HPV infection. The incidence rate of p53, however, had some significant correlation with dysplasia while Ki-67 had no particular statistical significance. As a result, p53 and Ki-67 can be considered as effective diagnostic markers in predicting the disease progression of dysplasia to cervical cancer.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권5호
• /
• pp.2565-2571
• /
• 2016

A cross-sectional survey was conducted among 730 participants from 4 rural districts of Nakhon Ratchasima province, Thailand, with a reported high incidence of liver fluke infection. This study was aimed to examine and evaluate the nutritional status in relation to Opisthorchis viverrini infection. Participants were purposive selected from Chum Phuang, Mueang Yang, Bua Yai, and Kaeng Sanam Nang districts. Stool samples were prepared by Kato Katz technique and then assessed by microscopy. Anthropometry was evaluated according to the body mass index from weight and height. Descriptive statistics and Spearman rank correlation coefficients were used to evaluate the association between the nutritional status and O. viverrini infection. Of 1.64% infected with O. viverrini the highest proportions were found in age groups ${\geq}61$ and 41-50 years old, Mueang Yang district. The majorities of participants had normal weight (32.2%), followed by class II obesity (28.1 %), class I obesity (21.8%), underweight (10.3%), and class III obesity (8.63%). Nutritional status with class II obesity (rS=0.639, p<0.01) and class I obesity (rS=0.582, p<0.05), had moderately statistical significant correlations with O. viverrini infection. Meanwhile, normal weight (rS=0.437, p<0.05) and class III obesity (rS=0.384, p<0.05) demonstrated lower statistical significance. These findings raise the possibility that infection with O. viverrini may contribute to fat deposition and thereby have long-term consequences on human health. Further studies are needed to better understand whether O. viverrini contributes directly to fat deposition and possible mechanisms.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제35권4호
• /
• pp.236-242
• /
• 2013

Purpose: The objective of this retrospective study is to evaluate the factors affecting the spread of odontogenic infection. Furthermore, this study was performed to apply to future treatments. Methods: A total of 65 patients, who had received treatment for odontogenic infections from 2010 to 2012 for 3 years, were enrolled in this study. The causes of infection, presence of systemic disease, and complications, durations of treatment, treatment methods, and inflammation levels were compared with the data. Results: Patients over 70 years with systemic disease required immediate drainage, systemic antibiotic therapy and hospitalization. We can determine the direction of the early diagnosis and treatment through blood tests (white blood cells, neutrophil, C-reactive protein [CRP]) and computed tomography. Patients over 70 years with systemic disease had the highest percentage. In addition, these patients showed high levels of inflammation index, such as CRP average of 24.8 and needed for a long-term treatment period and a wide range of surgical incision & drainage several times. Systemic diseases, particularly diabetes mellitus and hypertension, accelerate the spread of infection and had a negative effect that delays healing. Eventually, five of the 65 patients showed serious systemic complications. Conclusion: When evaluating cervico-facial infected patients due to odontogenic infection, the most important thing is deciding the appropriate diagnosis and degree of disease. Considering the patient's systemic status and age, we need to decide the treatment plan. Especially, those patients over 70 years with systemic disease should be treated with rapid surgical approach, and the use of a wide range of antibiotics and intensive care. If proper treatment principle does not apply, severe life-threatening complications will result, such as necrotizing fascitis, acute airway obstruction, mediastinitis, and others.

• Pediatric Infection and Vaccine
• /
• 제23권2호
• /
• pp.87-93
• /
• 2016

목적: 신생아 중환자실(neonatal intensive care unit, NICU)에서 인플루엔자 바이러스 집단 발병의 보고는 흔하지 않으며 그 증상은 다양하다. 저자들은 국내 단일기관 NICU에서 발생한 A형 인플루엔자 바이러스 감염의 집단발병에 대해 보고하고 신생아 특히 미숙아에서의 임상적 특성을 알아보고자 하였다. 방법: 2011-2012년 국내 인플루엔자 바이러스 감염 유행 시기에 고신대학교 복음병원 NICU에 입원한 환자들 중 인플루엔자 바이러스 RT-PCR 검사를 시행한 29명 환자들의 의무기록을 후향적으로 조사하였다. 결과: 대상 환자 중 11명에서 A형 인플루엔자 바이러스 양성이었는데(37.9%), 모두 미숙아였고 이들 중 3명(27%)은 증상이 없었으며 상기도 감염 증상 없이, 발열(18%, 2/11), 호흡곤란(72.7%, 8/11), 소화기 증상(27.3%, 3/11)이 있었다. 증상 소실까지 기간의 중앙값은 5일이었다. 이들은 모두 합병증 없이 생존하여 퇴원하였다. A형 인플루엔자 바이러스 RT-PCR 양성군과 음성군 사이에 검체 채취시 재원기간, CRIB 점수, 기계환기 과거력, 덱사메타손 사용 과거력의 차이가 있었다. 결론: 신생아 특히 미숙아에서 A형 인플루엔자 바이러스 감염의 증상은 비특이적이므로 지역 내 인플루엔자 유행시기에는 NICU 입원 중인 신생아에서 감염질환의 원인 병원체로 인플루엔자 바이러스를 고려해야 한다.

• 한국수산과학회지
• /
• 제32권3호
• /
• pp.303-309
• /
• 1999

이 연구를 통하여 바지락 대량 폐사가 발생한 전라북도 곰소만에 서식하고 있는 패류, 바지락, R. philipinarium, 굴 C. gigas, 피조개, S. broughtonii, 피뿔고둥, R. venosa, 등을 대상으로 바지락포자충, Perkinsus sp. 감염 여부 및 정량적인 분석을 수행하였다. 바지락포자충의 감염 진단은 Ray(1952)의 방법에 따라 혐기성배양액인 FTM(Fluid Thioglycollate Media)을 이용하여 배양하였으며, Rugol's iodine으로 염색한 후 해부현미경 하에서 검사하였다. 바지락포자충의 감염 정도는 Mackin (1961)의 기준을 따랐으며 일부 시료는 Choi et al. (1989)의 정량적인 방법에 따라 NaOH로 처리한 후 혈구 계수기로 계수하였다. FTM 분석 결과 곰소만에서 채집된 모든 바지락 개체들은 바지락포자충에 감염된 것으로 나타나 감염율 (prevalence)은 $100\%$였다. Mackin의 기준에 따른 감염 정도 판정에서 평균 2.87로 나타나 중간 정도의 감염 정도를 나타냈다. 바지락 육중량 1g 당 바지락포자충의 개체수는 평균 709,028 개체였으며, 바지락 1개체당 최고 4,091,667 개체의 바지락포자충이 발견되었다. 곰소만에서 채집된 패류를 대상으로한 FTM 검사 결과, 굴에서는 바지락 포자충이 전혀 발견되지 않았으며, 새로막과 피뿔고둥에 대한 조사에서는 피조개 2 개체에서만 각 각 6, 10 개의 바지락 포자충이 발견되었고 피뿔고둥에서는 전혀 발견되지 않았다. 조직병리학적 관찰결과 바지락 아가미의 연결조직에서 무정형의 결절에 쌓여있는 직경 $6\~10\;\mu$m의 tropozoites를 발견하였다. 바지락의 비만도는 개체의 각장이 클수록 낮게 나타나는 경향을 보였으며, 바지락 포자충의 감염정도는 각장이 클수록 높게 나타났다. 바지락포자충은 개체에서 개체로 감염되는 관계로 바지락밀도가 높은 지역에서는 그 전염 속도가 높은 것으로 알려져 대량폐사의 원인 중 하나는 밀식으로 판단되었다.