• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.189-192
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• 2008

흉쇄 관절의 화농성 관절염은 드문 질환으로 정맥주사 약물 남용, 당뇨 그리고 외상 등과 같은 선행성 요인과 연관되어 주로 발생한다. 진단이 지연될 경우 종격동염, 흉벽 농양 등과 같은 위험한 합병증이 발생할 수 있으므로 전산화 단층촬영이나 자기공명영상 검사 등을 시행하여야 하고 종격동염 및 흉벽 농양 등과 같은 합병증 발생 시는 흉쇄 관절 절제술을 고려하여야 한다. 저자들은 감염 유발 소인이 전혀 없는 건강한 52세 남자에서 발생하였으며 균 배양 검사상 포도상구균으로 동정되었고 감수성 항생제인 cefminox(첫 4주는 정맥주사, 그 후 2주는 경구투여)만으로 치유되었던 일차성 흉쇄 관절 화농성 관절염에 대해 보고하는 바이다.

• 대한간호학회지
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• 제44권2호
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• pp.219-227
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• 2014

Purpose: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. Methods: A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program. Results: Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer. Conclusion: MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.

• BMB Reports
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• 제49권4호
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• pp.214-219
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• 2016

A nucleosomal protein, high mobility group box 1 (HMGB1) is known to be a late mediator of sepsis. Dabrafenib is a B-Raf inhibitor and initially used for the treatment of metastatic melanoma therapy. Inhibition of HMGB1 and renewal of vascular integrity is appearing as an engaging therapeutic strategy in the administration of severe sepsis or septic shock. Here, we examined the effects of dabrafenib (DAB) on the modulation of HMGB1-mediated septic responses. DAB inhibited the release of HMGB1 and downregulated HMGB1-dependent inflammatory responses by enhancing the expressions of cell adhesion molecules (CAMs) in human endothelial cells. In addition, treatment with DAB inhibited the HMGB1 secretion by CLP and sepsis-related mortality and pulmonary injury. This study demonstrated that DAB could be alternative therapeutic options for sepsis or septic shock via the inhibition of the HMGB1 signaling pathway.

• 대한관절경학회지
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• 제13권1호
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• pp.63-67
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• 2009

21세 남자 환자로 반월상 연골 이식술 후 발생한 급성 화농성 관절염에 대해 반복적 관절경하 변연 절제술 및 세척술을 이용 성공적으로 치료 하였던 증례에 대해 보고 하고자 한다. 저자들의 치료 과정은 관절경을 이용한 변연 전제술과 10L 식염수 세척술, 5회의 반복적 관절경 시술, 항생제 정맥 주사로 진행하였다. 반복적 관절경 시술은 임상적 소견과 검사실 결과을 기준으로 결정하였다. 본 증례는 반월상 연골 이식술 후 발생한 급성 화농성 관절염의 치료로 조기에 시행한 관절경 변연 절제술 및 세척술, 이후의 반복적 관절경하 세척술이 효과적 치료 방법의 하나로 고려 될 수 있다고 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제69권2호
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• pp.124-128
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• 2010

Septic pulmonary embolism is the process in which an infected thrombus becomes detached from its site of origin and lodges in a pulmonary artery, and is usually associated with infective endocarditis, especially right-sided, or infection-associated with indwelling catheters, peripheral septic thrombophlebitis, and periodontal diseases, etc. Here, we report a case of septic pulmonary embolism associated with tricuspid valve infective endocarditis. A 23-year-old female was admitted to our hospital, due to fever, sore throat, and myalgia. In her past medical history, she had undergone a surgical operation for closure of a ventricular septal defect, but was informed that the operation resulted in an incomplete closure. The initial chest radiograph demonstrated multiple rounded, parenchymal nodules in various sizes; several nodules had central lucency suggesting cavitations. Echocardiography demonstrated a large vegetation attached to the septal tricuspid valve leaflet, extending from right ventricular inflow tract to outflow tract. Computed tomography of thorax revealed bilateral peripheral nodules and wedge-shaped consolidation at various sizes, mostly accompanied by cavitations.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.232-235
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• 2009

목적: 71세 여자에서 견관절 감염 후 발생된 관절연골의 파괴와 회전근 개의 소실에 대한 처치를 보고하고자 한다. 대상 및 방법: 치료를 선택 전 임상적, 방사선학적, 실험실적으로 세심한 평가를 시행하여 현재 잔존할 수 있는 활동성 감염과 병소의 가능성을 배제한 후 통증과 기능적 관절운동을 회복하기 위하여 일차적 역 견관절 치환술을 시행하였다. 결과: 수술 22개월후 추시에서 UCLA, ASES 평가상 우수의 결과를 얻을 수 있었다. 결론: 감염후 심각한 회전근개의 손상이 동반되는 경우 일차적 역 견관절 치환술은 통증과 기능적 관절운동을 회복할 수 있는 술식으로 보인다.

• Environmental Engineering Research
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• 제19권3호
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• pp.269-274
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• 2014

On-site sanitation systems are typically installed to treat grey and toilet wastewaters in areas without sewer and centralized treatment systems. It is well known that, due to inappropriate design and operation, treatment performance of these systems in developing countries is not satisfactory in the removal of pathogens and organic matters. This research aimed to investigate the hydraulic conditions occurring in some on-site sanitation systems and the effects of hydraulic retention times (HRTs) on the system performance. The experiments were conducted with a laboratory-scale septic tank (40L in size) and an actual septic tank (600L in size), to test the hydraulic conditions by using tracer study with HRTs varying at 12, 24 and 48 hr. The experimental results showed the dispersion numbers to be in the range of 0.017-0.320 and the short-circuit ratios in the range of 0.014-0.031, indicating the reactors having a high level of sort-circuiting and approaching complete-mix conditions. The removal efficiency of $BOD_5$ was found to be 67% and the $k_{30}$ values for $BOD_5$ was $2.04day^{-1}$. A modified complete-mix model based on the relationship between $BOD_5$ removal efficiencies and HRTs was developed and validated with actual-scale septic tank data having a correlation coefficient ($R^2$) of 0.90. Therefore, to better protect our environment and minimizing health risks, new generation toilets should be developed that could minimize short-circuiting and improving treatment performance.

• 한국한의학연구원논문집
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• 제15권3호
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• pp.75-82
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• 2009

Anti-mutagenic and anti-septic effects of $\beta$-1,3/1,6-glucan from Aureobasidium pullulans SM-2001 were evaluated on the on the cyclophosphamide (CPA)-cecal ligation puncture (CLP) and CPA-treated mice. To induce immunosuppression and mutagenicity, 150 and 110 mg/kg of CPA were single intraperitoneally injected at 3 or 1 day before CLP or initial $\beta$-glucan administration. In CLP animals, the cecum was mobilized and ligated below the ileocecal valve, punctured through both surfaces twice with a 22-gauge needle. 125 mg/kg of $\beta$-glucan were dissolved in saline and subcutaneously or orally administered in a volume of 10 ml/kg (of body weight), 4 times, 12 hrs intervals from 6 hrs after CLP or 1 day after second dose of CPA. After treatment of $\beta$-glucan, the mortalities were observed in CPA-CLP model, and the appearance of a micronucleus is used as an index for genotoxic potential in CPA model. As results of CPA-CLP sepsis, all animals (9/9, 100%) in CPA-CLP control were dead within 2 days after CLP. In addition, increase of the number of bone marrow MNPCEs indicated mutagenicity were also observed by treatment of CPA. However, $\beta$-glucan treatment effectively inhibited the mortalities in CPA-CLP, and it also reduced the CPA treatment-related mutagenicity, respectively. These results indicated that $\beta$-glucan has effective anti-septic and anti-mutagenic effects and can be used as an agents for treating sepsis and mutagenicity related to high-dose chemotherapy or radiotherapy. However, further studies should be conducted to observe more detail action mechanisms of it's anti-septic and anti-mutagenic effects.

• Hip & pelvis
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• 제35권2호
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• pp.73-87
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• 2023

The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multi-centric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.

• 대한두개안면성형외과학회지
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• 제21권2호
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• pp.127-131
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• 2020

A 60-year-old woman with a history of diabetes mellitus and chronic renal failure was admitted to the hospital with severe pain in the upper lip, which began 4 days prior to admission, accompanied by a bullous lesion and suspected cellulitis in the upper lip. Immediately after admission, as the patient's general condition worsened, tests revealed a non-ST elevated myocardial infarction, septic embolism of the lung, as well as septic shock. Her upper lip suddenly presented a gangrenous and necrotic change, which the tissue and blood culture confirmed to be a Klebsiella pneumoniae infection. After a quick response, the patient's general condition improved. Subsequently, serial debridement was performed to effectively clear away the purulent discharge. While under general anesthesia, the process confirmed full-layer necrosis of the upper lip including the orbicularis oris muscle. Almost half of the entire upper lip sustained a full-layer skin and soft tissue defect, with scar contracture. Six months later, to correct the drooling and lip sealing following the defects, a scar release and an Abbe flap coverage were performed considering both functional and aesthetic aspects. The follow-up revealed a favorable corrective result of the upper lip drooling, and the patient was satisfied from a functional perspective.