• Title/Summary/Keyword: Wound infection control

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REGENERATION OF THE ALVEOLAR BONE AND TRANSPLANTED ROOTS INTO THE PERIODONTALLY INVOLVED EXTRACTION SOCKETS IN DOGS;I : EFFECT OF ROOT PLANING PROCEDURE (성견치주질환 이환 발치와내 이식 치근과 발치와 치조골 재생에 대한 연구;I. 치근활택술의 영향)

  • Kim, Chong-Kwan;Chai, Jung-Kiu;Cho, Kyoo-Sung;Kim, Jin;Han, Soo-Boo;Choi, Sang-Mook
    • Journal of Periodontal and Implant Science
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    • v.24 no.1
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    • pp.64-86
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    • 1994
  • The authors have transplanted periodontally involved roots which had been root planed into healthy and periodontally involved extraction sockets, and studied the root resorption patterns as well as its effect on new bone formation and wound healing. Alveolar bone around mandibular premolars of 6 adult dogs has been surgically removed, followed by ligation of orthodontic elastic wires for 8 weeks inducing chronic periodontal disease. After removing the crown portions, roots were extracted, and notches were made on the root surfaces discriminating healthy and periodontally involved areas using burs. Controls and experimental groups were divided as follows. Control I : Transplantation of periodontally involved root into healthy extraction sockets. Control II : Transplantation of periodontally involved root into diseased extraction sockets. Experimental group I : Transplantation of root planed roots into healthy extraction sockets. Experimental group II : Transplantation of root planed roots into diseased extraction sockets. Extraction sockets were sutured after transplantations, completely submerging the roots. Healing progress was histologically observed at 2nd, 8th, 12th, and 20th weeks, and the results were as follows ; 1. No inflammation or infection within the extraction sockets had been observed in all groups throughout the experimental period. 2. Reversal lines were observed at week 2 in all groups, clearly discriminating socket walls and new bone, and numerous blood vessels were observed in the new bone trabeculae. 3. Experimental groups showed markedly less root resorption compared to the controls at week 2, but as time progressed, severe resorptions were present in all groups. 4. Localized areas of new bone ankylosis were observed, and the rest of the areas showed collagen fiber insertion with new bone formation at its periphery. 5. No clear differences were found in healing and alveolar bone regeneration between healthy and diseased extraction sockets. 6. The amount of root resorption and ankylosis had increased up to week 8 and 12, showing ankylosis of new bone and the roots. However, no further increase in ankylosis was observed at week 20. 7. Most of the cementum on healthy roots was directly ankylosed to new bone at week, 2, and were gradually resorbed and replaced by new bone thereafter. These results appear to indicate that root planing may inhibit early root resorption of transplanted roots, but gradual replacement by alveolar bone and collagen fibers eventually occur. Condition of the roots or presence of disease in extraction sockets do not appear to make marked differences in alveolar bone regeneration process.

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Feasibility of TRPM8 Agonist Agent for Management of Skin Graft Donor Site (화상 재건을 위한 식피술 공여부의 반흔 관리에 있어 TRPM8 Agonist 제재의 유용성)

  • Choi, Jangyoun;Jung, Ee Room;Cho, Jin Tae;Seo, Bommie Florence;Choi, Jong Yun;Kwon, Ho;Jung, Sung-No
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.30-33
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    • 2019
  • Purpose: Wound healing and scar management of donor site after skin graft should not be overlooked. Patients continue to complain of dryness, itching sensation. Such discomfort can cause irritation to the patients and lead to delayed healing or secondary infection. Thus, the author predicted Eucalyptus Oil, which acts on Transient Receptor Potential Melastatin 8 would be effective in regulating scar by reducing itching sensation in donor site when combining conventional silicone materials. Methods: The study was performed on 30 patients who underwent split thickness skin graft with lateral thigh as donor site between January 2017 and August 2018. First, primary evaluation of fully epithelized donor site scar three weeks after surgery was conducted. Control group (n=15) applied silicone gel (Kelo-cote, USA) solely two times a day. study group (n=15) applied Eucalyptus oil, combined with silicone gel. After 3 months of follow up, donor scar was evaluated using Vancouver scar scale and VAS scores of subjective patient reports regarding pain and itching sensation. Results: It was confirmed that both groups showed stable scar improvement comparing scar quality for 3 months. After 3 months, scar quality in study group showed superiority in pigmentation, pliability and pruritus compared to control group. Conclusion: Application of Eucalyptus Oil combined with conventional silicone gel is favorable to scar management and may give additional benefit of alleviating pruritis symptoms.

Clinical Analysis of Patients with Multiple Organ Injuries Who Required Open thoracotomy (개흉술이 필요했던 다발성 외상환자에 대한 임상적 고찰)

  • 이성광;정성운;김병준
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.804-810
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    • 1998
  • Background: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. Materials and methods: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. Results: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control(48.6%), repair of diaphragm(35.7%), and repair of lung laceration(25.7%) in this order of frequency and additional procedures were splenectomy(14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations(5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia(4.3%). Postoperatively six patients died(The mortality rate was 8.6%) and the causes of death were respiratory failure(2), acute renal failure(2), sepsis(1), and hypovolemic shock(1).

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Thoracoscopic Talc Pleurodesis of Malignant Pleural Effusion (악성늑막삼출증의 흉강경 탈크늑막유착술)

  • 손동섭;기양수
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.266-270
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    • 1998
  • The management of malignant pleural effusion is a difficult problem. Tetracycline was probably the most commonly used sclerosing agent, but parenteral tetracycline is no longer available. This prospective study was designed to determine the efficacy of insufflated talc in producing plerodesisin patients with malignant pleural effusions. Fifteen patients managed between March 1995 and March 1997 underwent thoracoscopy and had 4 gm sterile asbestos-free talc insufflation throughout the pleural space. The mean interval between the procedure and last follow-up was 101 days(range: 25-233 days). The results of treatment were clinically and radiologically compared with pre-operative status. The results were as follows: 1. The patients were 6 men and 9 women with a mean age of 55.1 years(range: 31-74 years). The primary tumors were lung cancer in 10 patients, breast cancer in two, hepatoma in one, stomach cancer in one, and adenocarcinoma of unkown origin in one. 2. Cancer cell positive ratio was 36% in sputum cytology study and 100% in thoracoscopic biopsy. 3. Symptoms improved in 94% of patients treated by talc pleurodesis. 4. After 30 days of the procedure, there was radiologically no recurrence of plural fluid in 94% patients. 5. There were wound infection in one, respiratory failure in one. In conclusion, the insufflation of 4 gm sterile asbestos-free talc in the pleural space is an effective method to control malignant pleural effusions and patients selection is important factor for reexpansion the lung.

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Clinical Analysis of Coronary Artery Bypass Surgery for Ischemic Heart Disease (허혈성 심질환의 치료에서 관동맥우회술의 임상적 고찰)

  • Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.225-233
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    • 1996
  • From August 1992 to July 1996, 63 consecutive patients underwent coronary artery bypass surgery. The mean age of these patient was 57 years(range form 30 to 71years). There were 44 men and 19 women. Preoperative 12 patients had stable angina pectoris and 23 patients were unstable angina pectoris. 8 patients had previous myocardial infarctation history and emergency or urgent myocardial revascularization were performed in 9 cases. In the risk factors of coronary atherosclerosis, 25 patients(40%) were hypercholesterolemia, 38 patients(60%) have smoking history and 19 patients(30%) have hypertension history. In the patterns of disease, 9 patients were single vessel disease, 18 patients were two vessele disease and 33 patients were three vessel disease. We performed total 284 distal anastomosis(mean 3.5 anastomosis per patient) and performed one case of ascending aorta graft interposition, two cases of mitral valve replacement, one case of aortic valve replacement, one case of ventricular septal defect repair and one case of atrial septal defect repair and the mean aortic cross clamp time was 115.3 minutes. The common complications were arrhythmia(7cases), wound infection(5cases), perioperative myocardial infarction(4cases), reoperation for bleeding control(4cases) and stroke(4cases). There were six hospital deaths due to low cardiac output syndrome, ventricular arrhythmia and respiratory failure. In the evaluation of operative risk factors, preoperative intravenous nitroglycerin requirement and prolonged aortic cross clamp tirne(>2hours) were found to be predective factor of morbidity and old age(>65years) was found to be predective factor of mortality.

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The Bone Formation Potency on the Titanium Cap According to the Pore on the Rabbit Calvarium (가토의 두개골에서 Pore의 유무에 따른 티타늄 반구에서의 골형성 능)

  • Park, Jung-Pyo;Oh, Chul-Jung;Jung, Seunggon;Park, Hong-Ju;Oh, Hee-Kyun;Ryu, Sun-Youl;Kook, Min-Suk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.1
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    • pp.18-24
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    • 2013
  • Purpose: This study is performed to determine the effects of titanium cap with various sizes of pores on bone formation during guided bone regeneration (GBR). Methods: Calvaria from 10 adult male rabbits were chosen as the recipient sites. A trephine bur with a diameter of 10 mm was used to form one round groove on each side of sagittal suture of the cranium, and a round bur with a diameter of 1.5 mm was used to form 6 small holes on the inner circles of round grooves to induce bleeding. In the control group, bone graft was not conducted, and closed titanium cap was fixed in the round groove. Bone graft was not performed in groups 1 and 2, but fixed on titanium caps with 0.2 mm, and 0.5 mm sized pores, respectively. For groups 3, 4, and 5, a synthetic bone graft material (${\beta}$-tricalcium phosphate, Cerasorb$^{(R)}$, Germany) was transplanted, and titanium caps without pore, with 0.2 mm and 0.5 mm sized pore were fixed, respectively. The animals were sacrificed 4 weeks after, and clinical, radiographical, and histomorphometrical evaluation of bone regeneration was performed. Results: In all groups, there were no clinical signs of infection, inflammation or wound dehiscence. Radiographic evaluation revealed well-defined semi-circular radiopacity inside the titanium cap of groups 3, 4, and 5. Histologically, the inner surface of the hemisphere was evenly lined with newly formed bone tissue, as well as grafted bone material in the group 3. In groups 4 and 5, the insertion of connective tissue was observed along the inner surface. However, the overall surface area between the grafts with different holes yielded no statistical significance in the histomorphometrical evaluation. Conclusion: Although the total area of newly formed bone showed no significant difference, excellent bone formation tendency was observed histologically when closed caps were used with bone graft was accompanied.

Effects of Helicobacter pylori Antigen on Producton of Transforming growth factor-$\beta$1 and Nitric oxide in Human Fibroblast (사람성유아세포의 Transforming growth factor-$\beta$1과 Nitric oxide 생성에 미치는 Helicobacter pylori 항원의 효과)

  • 박무인;박선자;구자영;김광혁
    • Journal of Life Science
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    • v.11 no.2
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    • pp.181-189
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    • 2001
  • Cytokines are hormone-like proteins which mediate and regulast inflammatory and immune responses. Transforming growth factor -$\beta$1(TGF-$\beta$) plays an important role in the control of the immune response and wound healing, and in the development o various tissues and organs, Nitric oxide(NO) is major messenger molecule regulating immune function and blood vessel dilation and serving as a neurotransmitter in the brain and peripheral nervous system. Also, NO is to be a potent mutagen that cause mutation in the p53 tumor suppressor gene in early phases of human gastric carcinogenesis. The purpose of this study was to investigate the effect of Helicobacter phlori lystes, lipopolysaccharide (LPS), and Staphylococcus enterotoxin B(SEB) on production of TGF-$\beta$1 and NO by human fibroblasts. Primary cultured human fibroblasts were incubated with H. pylori lysates(Hp), LPs, SEB, Hp+LPS, Hp+SEB, Hp+LPS+SEB. Cultured supernatants that were collected at 24, 48 and 72 hr were assessed for TGF-$\beta$1 by enzyme-linked immunosorbent assay and NO production by quantification of nitrite ion. TGF-$\beta$1 production in fibroblasts exposed with Hp, LPS or SEB for 48 hrs was enhanced, but for 72 hrs inhibited. Its production by doble exposure such as Hp+LPS, Hp+SEB, Hp+LPS+SEB was lowered in comparison with single exposure of Hp in cases of 24 and 48 hrs incubation, but for 72 hrs decreased in Hp vaculoating toxin(+), increased in Hp vacuolating toxin(-). No production in fibroblasts increaed at all doses of LPS. But its production by exposure of SEB increased or decreased according to dose and incubation time. Also, NO production by Hp vacuolating toxin(+) increased at all doses, but its production by Hp vacuolating toxin(-) decreased. Its production by doble exposure such as Hp+LPS, Hp+SEB, Hp+LPS+SEB decreased in comparison with single exposure Hp Therefore, quantities pf TGB-$\beta$1 and NO released by human fibroblasts shows differences according to kinds of stimulants. Also, in care stimulated with same kinds of stimulants, its productions exhibit quantitative differences according to exposure times. These results suggest that the decreased of TGF-$\beta$1 in fibroblasts by mixed exposure with Hp producing vacuolating toxin and bacterial toxins such as LPS and SEB may effect negatively in healing of host tissue and increased of NO by infection oh H. pylori may related to the increased susceptibility for human gastric carcinogenesis.

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The Overlapping Running Suture Method Using Single Knotless Barbed Absorbable Suture Material for Abdominal Wall Closure after Single Incision Laparoscopic Appendectomy: Comparison with the Traditional Interrupted Closure Technique

  • Kim, Dong Hyun;Park, Jung Ho;Joo, Jung Il;Jeon, Jang Yong;Lim, Sang Woo
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.160-167
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    • 2018
  • Purpose: The aim of our study was to present an abdominal wall closure technique using barbed suture $V-Loc^{TM}$ 90 after single incision laparoscopic appendectomy (SILA) and to compare perioperative outcomes with conventional layer by layer abdominal wall closure after SILA. Methods: From March 2014 to July 2016, a retrospective case-control study was conducted for a total of 269 consecutive patients who underwent SILA. According to abdominal wall closure methods, 129 patients were classified into the V-Loc closure group and 140 patients were assigned into the conventional layer by layer closure group. In the V-Loc group, abdominal wall closure was performed from the fascia to the skin with a single thread of unidirectional absorbable barbed suture $V-Loc^{TM}$ 90 2-0 using continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time ($40.0{\pm}15.4min$ vs. $44.9{\pm}16.3min$, p=0.013) and abdominal wall cusing continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time losure time ($5.5{\pm}0.9min$ vs. $6.5{\pm}0.8min$, p<0.001). Postoperative incision length was significantly shorter in the V-Loc closure group ($1.1{\pm}0.3cm$ vs. $1.8{\pm}0.4cm$, p<0.001). Postoperative wound pain, time to resume diet, postoperative hospital stay, complications including surgical site infection, or mean patient satisfaction score at one month after hospital discharge was not significantly different between the two groups. Conclusion: In conclusion, unidirectional knotless barbed suture is a safe alternative method for abdominal wall closure after SILA. It can save time while providing comparable cosmesis.

Analysis of whole genome sequencing and virulence factors of Vibrio vulnificus 1908-10 isolated from sea water at Gadeok island coast

  • Hee-kyung Oh;Nameun Kim;Do-Hyung Kim;Hye-Young Shin;Eun-Woo Lee;Sung-Hwan Eom;Young-Mog Kim
    • Fisheries and Aquatic Sciences
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    • v.26 no.9
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    • pp.558-568
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    • 2023
  • Vibrio vulnificus is an aquatic bacterium causing septicemia and wound infection in humans. To understand this pathogen at the genomic level, it was performed whole genome sequencing of a cefoxitin-resistant strain, V. vulnificus 1908-10 possessing virulence-related genes (vvhA, viuB, and vcgC) isolated from Gadeok island coastal seawater in South Korea. The genome of V. vulnificus 1908-10 consisted of two circular contigs and no plasmid. The total genome size was estimated to be 5,018,425 bp with a guanine-cytosine (GC) content of 46.9%. We found 119 tRNA and 34 rRNA genes respectively in the genome, along with 4,352 predicted protein sequences. Virulence factor (VF) analysis further revealed that V. vulnificus 1908-10 possess various virulence genes in classes of adherence, antiphagocytosis, chemotaxis and motility, iron uptake, quorum sensing, secretion system, and toxin. In the comparison of the presence/absence of virulence genes, V. vulnificus 1908-10 had fur, hlyU, luxS, ompU, pilA, pilF, rtxA, rtxC, and vvhA. Of the 30 V. vulnificus comparative strains, 80% of the C-genotype strains have all of these genes, whereas 40% of the E-genotype strains have all of them. In particular, pilA were identified in 80% of the C-type strains and 40% of the E-type strains, showing more difference than other genes. Therefore, V. vulnificus 1908-10 had similar VF characteristics to those of type C strains. Multifunctional-autoprocessing repeats-in-toxin (MARTX) toxin of V. vulnificus 1908-10 contained 8 A-type repeats (GXXGXXXXXG), 25 B.1-type repeats (TXVGXGXX), 18 B2-type repeats (GGXGXDXXX), and 7 C-type repeats (GGXGXDXXX). The National Center for Biotechnology Information (NCBI) Basic Local Alignment Search Tool (BLAST) showed that the RtxA protein of V. vulnificus 1908-10 had the effector domain in the order of cross-liking domain (ACD)-C58_PaToxP-like domain- α/β hydrolase-C58_PaToxP-like domain.

Clinical Analysis of Infantile Hypertrophic Pyloric Stenosis (영아 비후성 유문 협착증의 임상적 분석)

  • Huh, Young-Soo;Lim, Myeung-Kook;Kim, Kyu-Rak
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.39-47
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    • 1998
  • Infantile hypertrophic pyloric stensosis(IHPS) occurs in three of 1000 live births, and is a major cause of nonbilious vomiting of early infancy. It's etiology and pathogenesis however are still obscure. The operation of pyloromyotomy described by Ramstedt in 1912 remains the standard treatment. From January 1990 to July 1997, 64 infants with IHPS were treated at the Department of Pediatric Sursery, Yeungnam University Hospital. The ratio of male to female was 7:1, and the most prevalent age ranged from 2 weeks to 8 weeks(81.2 %) of age. Fifty-seven infants were first born (57.8 percent). The body weight of all patients at admission was below the 50 percentile. Age of onset of symptoms was between 2 and 4weeks of age in 23 cases(35.9 %). All infants had a history of nonbilious vomting, generally projectile in nature. Hypokalemia was noted in 14 cases(21.9 %) and hypochloremia in 26 cases(40.6 %). In the preoperative ultrasonography, the average muscle thickness, diameter, and length of the pylorus were 6.3 mm, 12.3 mm, and 17.8 mm. A total of 13 associated anomalies were noted in 12 patients. All cases were treated with Fredet-Ramstedt pyloromyotomy. Postoperative wound infection occured in 3 cases. Thirteen cases(20.3 %) presented intermittent nonprojectile vomiting after operation. With control of oral intake vomiting subsided within one week in 63 patients, and in thirteen days in another.

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