• Journal of Chest Surgery
• /
• 제26권5호
• /
• pp.355-359
• /
• 1993

Ten consecutive patients with abdominal aortic aneurysm were treated in Chungnam National University Hospital from May of 1985 to June of 1993. Pulsating palable mass was the most common first sign [7 patients]. The ratio of male to female was 8:2. The age ranged from 53 to 73 years with mean age of 65 years. The etiology and location of the aneurysm was atherosclerosis and infrarenal aorta in all. Dacron graft interposition [straight graft-1, bifurcation graft-7] and wrapping with aneurysmal sac were performed in 8 patients. In one patient with infected abdominal aortic aneurysm, we performed aneurysmectomy and left axillo-bifemoral bypass with 8 mm PTFE graft. And in another patient with complete thrombotic obstruction of infrarenal aortic aneurysm, we performed the suturing of the proximal part of the abdominal aortic aneurysm and aorto-bifemoral bypass with 18 x 9 mm PTFE graft. There was one operative death with the mortality rate of 11 % and 8 complications in 4 patients; ARF[2], duodenal ulcer[1], mechanical ileus[1], genitourinary dysfunction[2] and wound infection with abdominal abscess[1]. Because of the high operative mortality after rupture of the aneurysm, we think it is better to operate on early at the diagnosis of abodominal aortic aneurysm is made.

• Journal of Chest Surgery
• /
• 제25권11호
• /
• pp.1185-1191
• /
• 1992

Cell mediated immunity is depressed following surgical procedure and the degree of immunosuppression is directly related to the magintude of the procedure, blood transfusion, and length of operation. So we would expect cardiac operations to be highly immunosuppressive, although little is konwn about their immunosuppressive effect. The nearly complete consumption of complement factors and decreased levels of IgM and IgG resulting in an impaired opsonizing capacity. Additionally, peripheral blood mononuclear cell counts including T-and B-lymphocytes and T-cell subsets are reduced. Depression of cell-mediated immunity following open-heart surgery is potentially detrimental because it could increase the susceptability of patients to viral and bacterial infection. We reviewed 20 patients after cardiac operation to search for changes in peripheral blood lymphocyte subsets. Lymphocyte subsets were measured by flow cytometer and the preoperative values of lymphocyte subsets were compared with those from the first, fourth, and seventh days after operation. After cardiac operation, total mumbers of T lymphocyte was severely depressed on the first postoperative day and returned to the preoperative level by the seventh day after operation. CD3, CD4, and CD8 lymphocytes were decreased on the first postoperative day and returned to the preoperative level by the seventh day also. There was four cases of wound infection and these patients had increased CD4 lympocyte and more decreased CD19 lymphocyte compared with the non-infected group. It is concluded from these data that cell-mediated immunity is significantly depressed for at least one week following open-heart surgery and this result was closely related to the postoperative infection.

• 한국식물병리학회지
• /
• 제14권6호
• /
• pp.654-660
• /
• 1998

Colletotrichum gloeosporioides and Glomerella cingulata are the most important pathogens causing anthracnose which may reduce the stand rate and yield on wide kinds of plants including strawberry. Average occurrence rate of anthracnose is 36.9% on major strawberry cropping areas in Korea. We newly found that C. gloeosporioides which does not forming a sexual stage, infects strawberry and differs in some characteristics concerning virulence, cultural and morphological properties to G. cingulata which has a sexual stage. C. gloeosporioides was mainly isolated from the crown with 35.2% rate, while G. cingulata was largely isolated from petiole, runner with 40.9% rate in infected strawberry plants. These two pathogens showed significant differences in cultural characteristics such as perfect stage formation, temperature response as well as benomyl resistance. It was demonstrated that C. gloeosporioides has significantly stronger pathogenicity than G. cingulata in pathogenicity test carried on strawberry plants to various strawberry cultivars. Akihime, Akaneko and Nyoho forcing cultured strawberry cultivars, considered to be susceptible, while semiforcing cultured cultivars, such as Suhong and Holowase, were shown resistant to both pathogens. In non-wound inoculation, C. gloeosporioides was shown pathogenicity on the apple fruit, but G. cingulata could not infect it.

• 한국해양바이오학회지
• /
• 제2권4호
• /
• pp.263-266
• /
• 2007

Vibrio vulnificusis a causative agent of serious diseases in humans resulting from the contact of wound with seawater or consumption of raw seafood. Several studies aimed at detecting V. vulnificus have targeted vvh as a representative virulence toxin gene belonging to the bacterium. In this study, we targeted the rpoS gene, a general stress regulator, to detect V. vulnificus. PCR specificity was identified by amplification of 8 V. vulnificus templates and by the loss of a PCR product with 36 non-V. vulnificus strains. The PCR assay had the 273-bp fragment and the sensitivity of 10 pg DNA from V. vulnificus. SYBR Green I-based real-time PCR assay targeting the rpoS gene showed a melting temperature of approximately $84^{\circ}C$ for V. vulnificus strains. The minimum level of detection by real-time PCR was 2 pg of purified genomic DNA, or $10^3$ V. vulnificus cells from pure cultured broth and $10^3$ cells in 1g of oyster tissue homogenates. These data indicate that real-time PCR is a sensitive, species-specific, and rapid method for detecting this bacterium using the rpoS gene in pure cultures and in infected oyster tissues.

• The Plant Pathology Journal
• /
• 제35권5호
• /
• pp.530-537
• /
• 2019

Fuji, a major apple cultivar in Korea, is susceptible to white rot. Apple white rot disease appears on the stem and fruit; the development of which deteriorates fruit quality, resulting in decreases in farmers' income. Thus, it is necessary to characterize molecular markers related to apple white rot resistance. In this study, we screened for differentially expressed genes between uninfected apple fruits and those infected with Botryosphaeria dothidea, the fungal pathogen that causes white rot. Antimicrobial tests suggest that a gene expression involved in the synthesis of the substance inhibiting the growth of B. dothidea in apples was induced by pathogen infection. We identified seven transcripts induced by the infection. The seven transcripts were homologous to genes encoding a flavonoid glucosyltransferase, a metallothionein-like protein, a senescence-induced protein, a chitinase, a wound-induced protein, and proteins of unknown function. These genes have functions related to responses to environmental stresses, including pathogen infections. Our results can be useful for the development of molecular markers for early detection of the disease or for use in breeding white rotresistant cultivars.

• 식물병연구
• /
• 제10권4호
• /
• pp.345-348
• /
• 2004

2001년과 2003년 경기도 여주시 관엽재배 농가에서 세이브리찌야자의 줄기에 암갈색의 불규칙한 모양을 가진 병반이 형성되며 병든 줄기를 타고 끈적끈적한 연갈색 내지 암갈색의 고무액이 흐르는 증상이 발생하였다. 심하게 괴사된 줄기의 조직 속에는 분홍색 내지 오렌지색의 분생포자퇴가 다량 형성되어 있었다. 병든 식물의 병반으로부터 병원균을 분리하여 균학적 특징과 병원성을 검정한 결과 Gliocladium vermoseni으로 동정되었다. 분생포자의 모양은 타원형이며 무색으로 크기가 3.2${\sim}$4.0${\times}$4.8${\sim}$6.0 ${\mu}m$이었고 균사생장은 $25^{\circ}C$와 $30^{\circ}C$에서 가장 좋았고 $35^{\circ}C$이상 에서는 생장이 급격히 억제되었다. 본 연구에서는 야자에 발생하는 Gliocladium vermoseni에 의한 분홍썩음병(가칭)으로 명명하고자 제안한다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제31권6호
• /
• pp.544-549
• /
• 2009

Failure to use effective methods of reduction, fixation and immobilization may lead to osteomyelitis with the exposed necrotic bone, as the overzealous use of transosseous wires & plates that devascularizes bone segments in the compound comminuted fractures of mandible. Once osteomyelitis secondary to fractures has become established, intermaxillary fixation should be instituted as early as possible. Fixation enhances patient comfort and hinders ingress of microorganisms and debris by movement of bone fragments. Teeth and foreign materials that are in the line of fracture should be removed and initial debridement performed at the earliest possible time. Grossly necrotic bone should be excised as early as possible ; no attempt should be made to create soft tissue flaps to achieve closure over exposed bone. The key to treatment of chronic osteomyelitis of the mandible is adequate and prolonged soft tissue drainage. If good soft tissue drainage is provided over a long period, sequestration of infected bone followed by regeneration or fibrous tissue replacement will occur so that appearance and function are not seriously altered. Localization and sequestration of infected mandible are far better performed by natural mechanism of homeostasis than by cutting across involved bone with a cosmetic or functional defect. As natural host defenses and conservative therapy begin to be effective, the process may become chronic, inflammation regresses, granulation tissue is formed, and new blood vessels cause lysis of bone, thus separating fragments of necrotic bone(sequestra) from viable bone. The sequestra may be isolated by a bed of granulation tissue, encased in a sheath of new bone(involucrum), and removed easily with pincettes. This is a case report of the long-term conservative drainage care in osteomyelitis associated with mandibular fractures.

• Archives of Plastic Surgery
• /
• 제47권3호
• /
• pp.217-222
• /
• 2020

Background Surgical reconstruction of chronic wounds is often infeasible due to infection, comorbidities, or poor viability of local tissues. The aim of this study was to describe the authors' technique for improving the regenerative and antimicrobial potential of a combination of modified nanofat and platelet-rich plasma (PRP) in nonhealing infected wounds. Methods Fourteen patients met the inclusion criteria. Fat tissue was harvested from the lower abdomen following infiltration of a solution of 1,000 mL of NaCl solution, 225 mg of ropivacaine, and 1 mg of epinephrine. Aspiration was performed using a 3-mm cannula with 1-mm holes. The obtained solution was decanted and mechanically emulsified, but was not filtered. Non-activated leukocyte-rich PRP (naLR-PRP) was added to the solution before injection. Patients underwent three sessions of injection of 8-mL naLR-PRP performed at 2-week intervals. Results Thirteen of 14 patients completed the follow-up. Complete healing was achieved in seven patients (53.8%). Four patients (30.8%) showed improvement, with a mean ulcer width reduction of 57.5%±13.8%. Clinical improvements in perilesional skin quality were reported in all patients, with reduced erythema, increased thickness, and increased pliability. An overall wound depth reduction of 76.6%±40.8% was found. Pain was fully alleviated in all patients who underwent re-epithelization. A mean pain reduction of 42%±33.3% (as indicated by visual analog scale score) was found in non-re-epithelized patients at a 3-month follow-up. Conclusions The discussed technique facilitated improvement of both the regenerative and the antimicrobial potential of fat grafting. It proved effective in surgically-untreatable infected chronic wounds unresponsive to conventional therapies.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권1호
• /
• pp.85-92
• /
• 2000

Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment : do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications(syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after $1{\sim}2$ weeks. The final prognosis was comfortable without common complications.

• Journal of Chest Surgery
• /
• 제34권11호
• /
• pp.848-853
• /
• 2001

배경 및 목적: 정중 흉골 절개 후 발생한 흉골 감염과 열개(dehiscence)는 드물지만 적절한 치료를 하지 않을 경우 그 사망률은 높다. 본 교실은 개심술 후 발생한 12예의 흉골 감염 및 열개 환자에서 광범위한 괴사조직 제거와 근육편 이식술로 치료하고 그 수술 결과를 보호하고 효과적인 치료 방법을 찾고자 하였다. 대상 및 방법: 개심술 후 흉골 감염과 열개가 발생한 13예 중 흉골감염의 치료 전에 뇌경색으로 사망했던 1예를 제외하고 12예를 치료대상으로 하였다. 6예가 판막치환술 환자였고, 다른 6예가 관상동맥우회로술 환자였다. 1991년 이후에 수술한 7예에서는 짧은 기간의 배액(배농)과 세척으로 발열이 없어지면 바로 수술하였다. 감염 및 괴사된 연부조직 및 뼈를 절제하고 흉골의 사장을 우측 대흉근편 (회전편), 좌측 대흉근편 (회전편 또는 전진편), 우복직근을 단독 또는 복합으로 보강하였다. 결과: 12예의 흉골 감염 및 별개의 수술 치료 후 사망은 없었다 흉골 감염 및 열개가 발견된 후 평균 6.6$\pm$3.9일에 근육편의 이식수술을 하였다. 4예에서 우측 대흉근편을, 8예에서 양측 대흉근편을 사용하였으며, 각각 1예와 2예에서는 우복직근도 사용하였다. 1예에서 좌측 대흉근의 전진편이 괴사되고 흉벽농양이 발생하여 우복직근을 이용하여 재수술하였다. 근래에 수술한 3예에서는 우측 대흉근의 전진편만을 넓게 펴서 흉골사강을 보강하여 한 근육 편으로 흉골열개를 치료하였으며 3주 이상 개방성 배액관의 거치가 필요했다. 결론: 개심술 후 합병된 흉골절개부위의 열개 및 감염에서 짧은 기간의 세척 후 조기 수술에 의한 괴사조직의 제거와 주위 근육편 이식으로 쉽게 치료할 수 있으며, 우측의 대흉근만으로도 흉골 열개의 수술치료가 가능하다고 생각된다.