• 제목/요약/키워드: Skin infection

검색결과 730건 처리시간 0.026초

Incidence of Active Tuberculosis within One Year after Tumor Necrosis Factor Inhibitor Treatment according to Latent Tuberculosis Infection Status in Patients with Inflammatory Bowel Disease

  • Kang, Jieun;Jeong, Dae Hyun;Han, Minkyu;Yang, Suk-Kyun;Byeon, Jeong-Sik;Ye, Byong Duk;Park, Sang Hyoung;Hwang, Sung Wook;Shim, Tae Sun;Jo, Kyung-Wook
    • Journal of Korean Medical Science
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    • 제33권47호
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    • pp.292.1-292.10
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    • 2018
  • Background: We investigated the incidence of active tuberculosis among patients with inflammatory bowel disease (IBD) treated with tumor necrosis factor (TNF) inhibitors, with or without latent tuberculosis infection (LTBI). Methods: The study was performed at a Korean tertiary referral center between January 2011 and June 2017. In total, 740 patients with IBD who underwent LTBI screening tests and were followed-up for ${\geq}1$ year after TNF inhibitor treatment initiation were enrolled. LTBI was detected on the basis of tuberculin skin test results, interferon-gamma release assay results, chest X-ray findings, and previous tuberculosis treatment history. The patients were classified into LTBI (n = 84) or non-LTBI (n = 656) group. The risk of developing tuberculosis in each group was assessed on the basis of standardized incidence ratio (SIR) and 95% confidence interval (CI) for active tuberculosis. Results: Mean patient age was 33.1 years, and patients with Crohn's disease were predominant (80.7%). Within 1 year after the initiation of TNF inhibitor treatment, 1 patient in the LTBI group (1/84; 1.2%) and 7 patients in the non-LTBI group (7/656; 1.1%) developed active tuberculosis. The overall 1-year incidence of tuberculosis among the patients was significantly higher than that among the general population (SIR, 14.0; 95% CI, 7.0-28.0), and SIR was not affected by LTBI status (LTBI group: 14.5, 95% CI, 2.0-102.6; non-LTBI group: 14.0, 95% CI, 6.7-29.4). Conclusion: Patients with IBD undergoing TNF inhibitor treatment showed a higher 1-year incidence of tuberculosis than the general population irrespective of LTBI status.

Analysis of Five Years of US Immigration Medical Exams (5년간의 미국 이민 비자 신체검사 결과 분석)

  • Lim, Juwon
    • Korean journal of aerospace and environmental medicine
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    • 제31권3호
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    • pp.77-81
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    • 2021
  • Purpose: The United States of America have pre-migration screening program are mandated through legislation. The one of purpose of this program is to prevent the importation of certain communicable diseases. Examinations of migration applicants are performed by panel physicians who are licensed physicians in the countries of origin that have agreements with the government departments of the country of destination to undertake this activity. In recent decades, the number of US migrants has increased, however COVID-19 impacted this trend of international migrants. The Aim of this study is to examine trends of US applicants and outcomes of tuberculosis and sexual transmitted infections (STIs) screening in South Korean applicants for US visa. Methods: A total of 4,442 applicants participated in US visa health check-up in 2016 to 2020. Results: The numbers of applicant for US visa in males and females was 1,814 and 2,628. The positive results in tuberculosis and STIs screening was noted with 0.66% in nontuberculous mycobacteria (NTM), 0.03% in tuberculosis, 0.03% in gonorrhea, 0.08% in syphilis, and 0.74% in chlamydia. The age groups of 2 to 14 years showed higher positive rate (13.89%) in tuberculin skin test (TST) tests compared to the rate of interferon gamma release assay (IGRA) tests (0.44%, P<0.001). The positive ratio of NTM and abnormal chest X-ray (CXR) which required sputum tests among the applicants over 15 years old has trends to increase with age. The age groups of over 70 years showed high positive rate in NTM and abnormal CXR (4.10%, 20.51%). However, ages 15 to 49 years groups showed 0.00% to 0.30% in NTM and 1.08% to 3.91% in abnormal CXR. In the study population, the positive rates of STIs were 0.03%, 0.08%, and 0.74% in gonorrhea, syphilis, and chlamydia, respectively. Among the participants who underwent sputum smears and cultures were just 1 case of active tuberculosis (0.03%) and 25 cases of NTM infection (0.66%). Conclusion: This study found that rate of positivity in tuberculosis and STIs screening among South Korean applicants for US visa in 2016 to 2020. Regarding tuberculosis, the positivity of CXR among the aged 15 to 59 years applicants was lower than that among over 60 years old. Among 2 to 14 years, positivity of IGRA was very low. And IGRA test can reduce effort of further evaluation compared to TST test in South Korea, so IGRA test among young adults can be useful. High positive rates in STI among young adult could result in high active sexuality, especially chlamydia infection is most common. Therefore Chlamydia polymerase chain reaction should be considered formal protocol among the Korean applicant for US visa.

Transcriptomic Profile in Pear Leave with Resistance Against Venturia nashicola Infection (배 검은별무늬병 감염과 저항성 방어반응 연관 전사체 프로파일)

  • Il Sheob Shin;Jaean Chun;Sehee Kim;Kanghee Cho;Kyungho Won;Haewon Jung;Keumsun Kim
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 한국자원식물학회 2022년도 추계학술대회
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    • pp.36-36
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    • 2022
  • The molecular understanding of resistance and susceptibility of host plants to scab, a most threatful disease to pome fruit production worldwide, is very limited. Comparing resistant line '93-3-98' to susceptible one 'Sweet Skin' at seven time points of 0, 0.5, 1, 2, 3, 4, 8 days post inoculation, RNA-sequencing data derived from infected and mock-inoculated young leaves were analyzed to evaluate the tolerant response and to mine candidate genes of pear to the scab pathogen Venturia nashicola. Analysis of the mapped reads showed that the infection of V. nashicola led to significant differential expression of 17,827 transcripts with more than 3-fold change in the seven pairs of libraries, of which 9,672 (54%) are up- and 8,155(46%) are down-regulated. These included mainly receptor (NB-ARC domains-containing, CC-NBS-LRR, TIR-NBS-LRR, seven transmembrane MLO family protein) and transcription factor (ethylene responsive element binding, WRKY DNA-binding protein) related gene. An arsenal of defense response of highly resistant pear accessions derived from European pear was probably supposed no sooner had V. nashicola infected its host than host genes related to disease suppression like Polyketide cyclase/dehydrase and lipid transport protein, WRKY family transcription factor, lectin protein kinase, cystein-rich RLK, calcium-dependent phospholipid-binding copine protein were greatly boosted and eradicated cascade reaction induced by pathogen within 24 hours. To identify transcripts specifically expressed in response to V. nashicola, RT-PCRs were conducted and compare to the expression patterns of seven cultivars with a range of highly resistant to highly susceptible symptom. A DEG belonging to the PR protein family genes that were higher expressed in response to V. nashicola suggesting extraordinary role in the resistance response were led to the identification. This study provides the first transcriptional profile by RNA-seq of the host plant during scab disease and insights into the response of tolerant pear plants to V. nashicola.

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The Effect of Total Patellectomy in the Prosthetic Replacement of Proximal Tibia (경골 근위부 종양에서 인공 삽입물 사용시 슬개골 전적출술이 관절기능 회복에 미치는 영향)

  • Park, Il-Hyung;Kim, Jae-Do;Ihn, Joo-Chul;Chun, In-Ho
    • The Journal of the Korean bone and joint tumor society
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    • 제2권1호
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    • pp.8-17
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    • 1996
  • The purpose of this study is a comparative evaluation of range motion, especially extension deficit between the group of total patellectomy and that of intact patella, after reconstruction of the patellar tendon in the prosthetic replacement of a proximal tibia. Between 1990 and 1994, 15 patients who had a primary malignancy on proximal tibia were operated on. All patients were evaluated clinically and radiographically. Two patients were excluded because one had a deep infection treated with arthrodesis of the knee and the other was a composite allograft. The mean follow-up of the 13 patients was 27 months(15-47), including 10 osteosarcomas, 1 chondrosarcoma, 1 malignant fibrous histiocytoma and 1 malignant giant cell tumor. Eleven patients had a resection of the proximal tibia and 2 had an extracapsular total knee resection with distal femur. Reconstruction of the defect was done in 8 cases with a custom-made Link Endo-Model Total Rotation Knee Joint Prosthesis, and in 5 with How Medica Modular Resection System (HMRS). We used two methods to reconstruct the ligamentum patellae. Fixation of the patellar tendon to the prosthesis only with suturing and/or stapling(group SS) was done in 7. Transposition of gastrocnemius muscle to enhance fixation and to cover the prosthesis(group TG) was done in 6. Regardless of fixation methods, total patellectomy was done in 5 either to lengthen the patellar tendon or to make primary skin closure easier or for both. In 8 cases, patella was left intact or resurfaced with polyethylene prosthesis. Active extension was measured while the patient was in a sitting position. There is no statistically meaningful difference in terms of extension deficit (Wilcoxon rank test, p=0.8800) between patellectomy group and intact patella group, and between group of fixation only with suturing and that of gastrocnemius transposition. Two cases of extension deficit over 30 degree were seen in group SS and in the group of intact patella. Conclusively, total patellectomy could be an option without increasing the risk of extension deficit when primary skin closure is difficult or patellar tendon is a little bit short to be fixed. There is no rating in the Enneking system of functional evaluation that this finding into consideration.

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Treatment of Distal Tibia Fracture using MIPPO Technique with Locking Compression Plate: Comparative Study of the Intraarticular Fracture and Extraarticular Fracture (잠김-압박 금속판을 사용하여 MIPPO 수기를 적용한 원위부 경골 골절의 치료: 관절내 골절과 관절외 골절의 비교)

  • Chung, Soo-Tae;Kim, Hyung-Soo;Cha, Seung-Do;Yoo, Jeong-Hyun;Park, Jai-Hyung;Kim, Joo-Hak;Jung, Jin-Ha
    • Journal of Korean Foot and Ankle Society
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    • 제13권2호
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    • pp.162-168
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    • 2009
  • Purpose: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. Materials and Methods: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. Results: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. Conclusion: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.

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Eucalyptus globulus extracts inhibit Propionibacterium acnes-induced inflammation signaling (유칼립투스 추출물의 Propionibacterium acnes에 의해 유도되는 염증반응 억제 효과)

  • Lee, Sol Ji;Lee, Eun Hye;Shin, Jin Hak;Kim, Seon Sook;Kim, Nam Kyoung;Choi, Eunmi;Seo, Su Ryeon
    • Korean Journal of Microbiology
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    • 제52권4호
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    • pp.421-427
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    • 2016
  • Acne is known as the most common skin disease. It commonly occurs during adolescents, but it is also present in children and adults because of air pollution, drug abuse and so on. In addition to the hormonal, genetic and environmental factors, Propionibacterium acnes (P. acnes) have also critical roles in outbreak of acne by inducing inflammatory mediators. Increase of sebum production provides an ideal environment for P. acnes that induce inflammation on the skin by activation of monocytic cells and stimulation of inflammatory cytokines. In this study, natural extracts were investigated for anti-inflammatory effects against inflammatory acne by P. acnes infection in terms of reducing cytokine production. Eucalyptus globulus extracts effectively suppressed mRNA synthesis of inflammatory mediators such as $TNF-{\alpha}$, $IL-1{\beta}$, IL-2, and NLRP3 in P. acnes-activated macrophages. Moreover, Eucalyptus globulus extracts inhibit activation of transcription factors, $NF-{\kappa}B$ and NFAT, which are known as key regulators of inflammatory cytokine production. This study suggests the potential of using Eucalyptus globulus extracts as alternative agents for the treatment of acne.

Clinical Significance of Interferon $\gamma$ Release Assay for Diagnosis of Tuberculosis in Children (소아 결핵 진단에 있어서 결핵 특이항원자극 인터페론 감마 측정검사의 임상적 의의)

  • Lee, Hee Woo;Park, Hwa Young;Ahn, Young Min;Sohn, Keun Chan
    • Pediatric Infection and Vaccine
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    • 제17권2호
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    • pp.137-147
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    • 2010
  • Purpose : The purpose of this study is to evaluate the usefulness and limitation of QuantiFERON-TB Gold (QTB) for diagnosis of latent tuberculosis in children. Methods : The medical records of 112 children who were tested by tuberculin skin test (TST) and QTB for detection of latent tuberculosis (TB) in Eulji General Hospital during the period from January 2007 to June 2009 were retrospectively reviewed. Results : Of the 112 participants, the clinical TB group included 15 (13.4%), the contact group included 43 (38.4%), and the non-contact group included 54 (48.2%). Positive rates of TST and QTB were 100% and 80% in the clinical TB group, 64% and 14% in the close contact group, 27% and 0% in the casual contact group, and 52% and 2% in the non-contact group, respectively. Sensitivity of QTB was 80.0% and specificity was 92.6%. Agreement between QTB and TST was poor ($\kappa$=0.209). We also confirmed that the positive rate of QTB increased as the age of the patient increased (P=0.011). A QTB indeterminate result was observed in 11 (9.8%) subjects. QTB was retested in 15 subjects. In 5 of the 6 subjects who had positive results initially, positive results persisted for a median 2.2 months after termination of treatment. Conclusion : Although QTB was associated with several problems, including low sensitivity and a high rate of indeterminate results, it had clinical importance due to its high specificity. We found good correlation with regard to exposure and QTB positivity, including that of young children under 5 years of age. However, clinical application of interferon-$\gamma$ releasing assay for young children for diagnosis of active and latent tuberculosis will require additional prospective studies.

Giant Neurofibroma on Both Buttocks (양측 엉덩이의 거대 신경섬유종)

  • Kim, Ji Hoon;Burm, Jin Sik;Kim, Yang Woo;Kang, So Ra;Kim, Hyoung Kyoung
    • Archives of Plastic Surgery
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    • 제36권4호
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    • pp.512-515
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    • 2009
  • Purpose: Neurofibromatosis(NF) is an autosomal - dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop - shaped ligation before removal of the giant NF in both buttocks. And then we could successfully reduce the amount of hemorrhage during the operation. Methods: A 46 - year - old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about $30{\times}20cm$ in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop - shaped suture ligation(weaving the thread up and down in a loop - shaped pattern, leaving a space of 2 cm between each loop) with a straight needle and prolene 2 - 0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged - shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop - shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscense did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow - up, the functional and cosmetic result was excellent. Conclusion: A continuous loop - shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.

A Comparative Study according to Diagnostic Time on Meningitis (무균성 뇌막염에서 증상발현부터 진단까지 걸린 시간에 따른 시기별 유병기간의 검토)

  • Kim, Tag Soo;Hur, Ji Yeon;Park, Young Hee;Jung, Min Goo;Kim, Sung Won
    • Pediatric Infection and Vaccine
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    • 제3권2호
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    • pp.168-174
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    • 1996
  • Purpose : Aseptic meningitis is relatively frequent in children and caused mostly by enterovirus. The aim of the present study was to determine the effect of early diagnosis (spinal tapping) on symptom duration of childhood aseptic meningitis. Methods : One hundred fifty-three children who were hospitalized due to aseptic menigitis in the Department of Pediatrics St. Benedict Hospital from July 1996 through October 1996 were included in this study. Patients were divided to two groups according to the duration from first symptom onset to diagnosis. Early diagnosis group is diagnosed within 3 days from first symptom onset. Later diagnosis group is diagnosed after 4 days from first symptom onset. Results : 1) The average age of these patients was 4.3 years old in early diagnosis group and 4.1 years old in later diagnosis group. The sex ratio(male: female) was 2.04:1 in early diagnosis group and 2.5:1 in later diagnosis group. 2) The mean duration of diagnosis of this study was 2.04 day in early diagnosis group and 5.12 day in later diagnosis group. 3) The percentage of symptom and sign of the early diagnosis group were fever(100%), headache(88.4%), vomiting(86.9%), abdominal pain(39%), neck stiffness(36.2%), skin rash(18.8%), diarrhea(16.9%) and that of later diagosis group were fever(100%), headache(83.3), vomiting(80.9%), abdominal pain(47.6%), neck stiffness(41.6%), skin rash(29.7%), diarrhea(16.6%). 4) Initial CSF findings revealed leukocyte $146.8{\pm}386.3/mm^3$ with PMNL 38%, protein 32.47mg/dl, sugar 66.23mg/dl in early diagnosis group and leukocyte $458.1{\pm}663.2/mm^3$, protein 31.22mg/dl, sugar 64.21 mg/dl in later diagnosis group. 5) There was no statistically significant differance in the peripheral blood findings between early diagnosis group and later diagnosis group. 6) The duration of disappearance of symptom after spinal tap were 2.3 days in early diagnosis group and 2.24 days in later diagnosis group. Total symptom duration was 4.34 days in early diagnosis group and 7.36 days in later diagnosis group. Conclusions : Our results demonstrate that early diagnosis(early spinal tap) shortened duration of clinical symptoms.

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Clinical Analysis on 106 cases of $Henoch-Sch{\ddot{o}}nlein$ Purpura (알레르기성 자반증 106례에 대한 임상적 고찰 : $Henoch-Sch{\ddot{o}}nlein$ 자반증을 중심으로)

  • Han, Dong-Ha
    • The Journal of Internal Korean Medicine
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    • 제28권3호
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    • pp.570-585
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    • 2007
  • A clinical study of 106 cases of $Henoch-Sch{\ddot{o}}nlein$ purpura was made. The author analyzed the result of Korean traditional medical therapy. It was observed more frequently in female at the sex ratio of 1:1.3. The most prevalent age group was $4{\sim}9$ years(56.6%). In seasonal incidence, the cases were frequent during spring(50%), and the main specific history was upper respiratory tract infection(48.1%). The duration of contraction was $420.9{\pm}1079.3$ days. The adults were more chronic than children (p<0.05), The clinical manifestation showed in the skin (100%), the gastrointestinal tract(62.3%), the joints(64.2%), the kidney(25.3%), genitourinary system(11.3%), headache(6.6%), and scalp edema(4.7%) respectively. The first outbreak of symptoms was showing of skin purpura in 77 cases(72.6%) the highest frequency. and the gastrointestinal tract and joints were 16(15.1%) and 12 cases(11.3%) respectively. Of all patients, 22 cases(20.8%) experienced recurrences and 47 patients(44.3%) experienced hospitalization treatment. In the patients group which were recurrence experiences, the recurrence rate was high with patients(63.2%) who usually enjoyed meats and convenience foods and in patients(84%) who treated URI with chemical drugs(p<0.05). The patients group(68.9%) that took steroids also experienced a relatively high recurrence rate. Out of the patients(68.9%) who took treatment with steroids, 46.6% experienced side effects, in orders moon face(100%), weight gain(47.1%), appetite increase(52.9%), and acne. alopecia(11.8%), etc. There was a statistically significant relationship between the period of taking the steroid and the side effects(p<0.05), As the result of the herbal medicine treatment(treatment period: $6.7{\pm}6.2$ weeks, a follow-up survey during $15{\sim}24$ months), 67 patients(91.8%) among the 73 patients(68.9%) under 18 years old recovered completely but 3 cases(4.5%) recurred. 23 patients(69.7%) among the 33 patients(31.3%) above 19 years recovered completely but 5 cases(21.7%) recurred.

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