• Title/Summary/Keyword: early infection

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First Detection of $bla_{IMP-1}$ in Clinical Isolate Multiresistant Acinetobacter baumannii from Korea

  • Jeong Seok-Hoon;Bae Il-Kwon;Sohn Seung-Ghyu;Park Kwang-Ok;An Young-Jun;Sung Kwang-Hoon;Jang Seon-Ju;Heo Myong-Jin;Yang Ki-Suk;Lee Sang-Hee
    • Journal of Microbiology and Biotechnology
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    • v.16 no.9
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    • pp.1377-1383
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    • 2006
  • Among 46 Acinetobacter baumannii isolates collected in 2004, two imipenem-resistant isolates were obtained from clinical specimens taken from patients hospitalized in Busan, Republic of Korea. Two carbapenemase-producing isolates were further investigated to determine the mechanism of resistance. These isolates were analyzed by antibiotic susceptibility testing, microbiological tests of carbapenemase activity, determination of pI, transconjugation test, enterobacterial repetitive consensus (ERIC)-PCR, and DNA sequencing. Two cases of infection by A. baumannii producing the IMP-1 ${\beta}$-lactamase were detected. The isolates were characterized by a modified cloverleaf synergy test and EDTA-disk synergy test. Isoelectric focusing of crude bacterial extracts revealed nitrocefin-positive bands with a pI value of 9.0. PCR amplification and characterization of the amplicons by direct sequencing indicated that the isolates carried a $bla_{IMP-l}$ determinant. The isolates were characterized by a multidrug resistance phenotype, including penicillins, extended-spectrum cephalosporins, carbapenems, and aminoglycosides. These results indicate that the observed imipenem resistance of two Korean A. baumannii isolates was due to the spread of an IMP-1-producing clone. Our microbiological test of carbapenemase activity is simple to screen class B metallo-${\beta}$-lactamase-producing clinical isolates to determine their clinical impact and to prevent further spread. This study shows that the $bla_{IMP-l}$ resistance determinant, which is emerging in Korea, may become an emerging therapeutic problem, since clinicians are advised not to use extended-spectrum cephalosporins, imipenem, and aminoglycosides. This observation emphasizes the importance of having effective control measures in Asian hospitals, such as early detection of colonized patients, isolation procedures, and a judicious use of antibiotics.

Do the Rotating Hinge-Flexible Intramedullary Nail Composites Alleviate Junctional Osteolysis in Megaprothesis Reconstruction for Bone Tumor? (탄력성 있는 골수강 내고정물과 회전경첩형 슬관절 전치환물을 조합한 종양인공관절로 자가골의 골 용해를 감소시킬 수 있는가?)

  • Song, Won-Seok;Cho, Wan-Hyeong;Cho, Sang-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.96-104
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    • 2007
  • Purpose: The authors investigated whether 35 flexible nail-rotating hinge composite reconstructions around knee joint minimize junctional osteolysis of host bone. Material and Method: The reconstructive technique was as follows: 1) en bloc tumor resection, 2) filling of the host bone marrow cavity with multiple Ender nails, 3) assembling the Ender nails and an Endo-Link type total knee component with wire and bone cement. Result: Mean follow-up was 53 months (ranged 30~79). At final follow-up, 29 patients retained a mobile joint. Resection of more than 40% of bone showed a positive relationship with junctional hypertrophy (p=0.028). Eight patients showed nail breakage and eight prostheses were removed due to early or late infection. The cumulative prosthetic survival rate was 33% at 6 year. Average functional score according to the MSTS criteria was 26.8. Conclusion: Mid-term evaluations showed that results were fair. The revision process was straightforward. Junctional hypertrophy observed appears to give some clues as to how to minimize osteolysis at the prosthesis-host junction after modular prosthesis fixation.

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ENDODONTIC TREATMENT OF A PERIRADICULAR LESION ON AN INVAGINATED TYPE III MAXILLARY LATERAL INCISOR (Type III 치내치를 동반한 상악 측절치에 이환된 치근단 병소의 근관 치료)

  • Kim, Ki-Rim;Lee, Jae-Ho;Kim, Seong-Oh;Song, Je-Seon;Choi, Byung-Jai;Kim, Seung-Hye;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.181-185
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    • 2012
  • Dens invaginatus is a developmental anomaly resulting in a deepening or invagination of the enamel organ into the dental papilla prior to calcification of the dental tissues. The most widely used classification of dens invaginatus is the system described by Oehler categorizes invaginations into three classes as determined by how far they extend radiographically from the crown into the root. Oehler's classification type III is that the invagination extends through the root and communicates with the periodontal ligament. There is usually no communication with the pulp. In Type III lesions, any infection within the invagination can lead to an inflammatory response within the periodontal tissues giving rise to a 'peri-invagination periodontitis'. In the cases presented here, we treated two patients who were refered for 'peri-invagination periodontitis' on maxillary lateral incisor with Oehler's type III invagination by different approaches each, and they have shown satisfactory outcomes. Although there are several approaches to the management of dens invaginatus, the most important objective is to preserve the health of the pulp, which can be achieved by early diagnosis and the prophylactic treatment regardless of severity. When disease has developed, decision has to be made whether to treat the invagination and the pulp separately.

The Clinical Aspects of Pulmonary Tuberculosis Patient Failed in Retreatment (재치료실패 폐결핵환자의 임상 양태)

  • Im, Young-Jae;Song, Ju-Young;Jeong, Jae-Man;Kim, Young-Jun;Kim, Moon-Shik
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.404-409
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    • 1993
  • Background: There are many retreatment failure patients admitted in National Kongju Tuberculosis Hospital. But there is not satisfactory treatment method for them at present. We think that more attentions and active measures for them are needed. Method: We reviewed sex and age, duration of illness, previously used antituberculosis drugs, drug resistance, extent of disease, reasons for early stopping or irregular medication and schooling of 50 retreatment failure patients admitted in National Kongju Tuberculosis Hospital from April 1992 to February 1993. Results: 1) The male to female ratio was 3:2 and 62% of the patients were between 21 and 40 years of age. 2) Twenty eight cases (56%) had the duration of illness over 10 years. 3) All cases had used most of the antituberculosis drugs. 4) Drug sensitivity test showed resistance to RMP in 46 cases (96%), INH in 40 cases (83%) and other drugs in 3-32 cases (6-67%). 5) Forty eight cases (96%) had far advanced disease on chest P-A film. 6) Twenty eight cases (56%) in primary chemotherapy and twenty one cases (42%) in retreatment had the histories of premature stopping or irregular ingestion of the drug. The reasons for premature stopping or irregular ingestion of the drug were as follows; in primary chemotherapy, 29 cases (75%) were due to 'having no symptoms', while in retreatment, 6 cases (29%) were due to 'having no symtoms', 6 cases (29%) were 'too, busy' and 3 cases (14%) were for 'financial problem'. 7) Twenty seven cases (54%) had at least graduated from high school. Conclusion: Greater efforts are needed to prevent tratment failure. More supports and admission treatment for retreatment failure patients are needed to prevent infection and to treat properly.

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Occurrence of Major Diseases in Vegetable Growing under the Furnihsed Condition in Southern Part of Korea (남부 시설원예지대의 주요병 발생생태에 관한 연구)

  • Choi Jin-Sik;Park Chang-Seuk
    • Korean journal of applied entomology
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    • v.21 no.3 s.52
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    • pp.153-158
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    • 1982
  • The study was conducted to obtain the basic information on the diseases epidemics of vegetable crops grown in Namji, Jinju, Gimhae and Suncheon under the extremely varied and specified conditions, plastic film house. The disease survey was conducted from the end of April, 1951 to April 1982. Leaf mold and late blight were serious foliar disease in tomato during the seedling stage, especially when the infected seeds were sown. The diseases increased rapidly 35 days after seeding. In both continuous cultivation of cucumber and rotation with upland crops, incidence of Fusarium wilt was severe while incidence of the disease was negligible in cultivations after paddy rice or grafting on pumpkin. Downy mildew of cucumber was severe in Jinju and Suncheon area, however, it was not so serious in Namji area where the growing season of cucumber was unfavorable for the maximum disease incidence. Cucumber mosaic virus disease was prevalent in the areas surveyed and the disease incidence was increased rapidly after June. Powdery mildew prevailed at the early stage of cucumber growth after transplanting in Namji area. Root rot and wilting caused by Phytophthora capsici was as the most destructive disease in pepper grown under the vinyl house, especially in Namji and Jinju area where the pepper has been cultivated intensively. The Phytophthora attacked most parts of young plants during the winter time and then induced crown rot on the adults plants. Cultivation of pepper in vinyl house was almost impossible because of the Phytophora disease by the end of June. Virus diseases to tomato plants were prevalent throughout the surveyed area and the damage was also severe. In Jinju and Gimhae area leaf mold and late blight showed high infection rate in tomato during the harvest time.

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Survival analysis of dental implants in maxillary and mandibular molar regions; A 4$\sim$5 year report ($\cdot$하악 대구치 부위에 식립된 임플란트의 생존율에 대한 후향적 연구)

  • Jang, Jin-Wha;Ryoo, Gyeong-Ho;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.37 no.2
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    • pp.165-180
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    • 2007
  • Dental Implants have been proved to be successful prosthetic modality in edentulous patients for 10 years. However, there are few reports on the survival of implant according to location in molar regions. The purpose of this study was to evaluate the $4{\sim}5$ years' cumulative survival rate and the cause of failure of dental implants in different locations for maxillary and mandibular molars. Among the implants placed in molar regions in Gwangju Mir Dental Hospital from Jan. 2001 to Jun. 2002, 473 implants from 166 patients(age range; $26{\sim}75$) were followed and evaluated retrospectively for the causes of failure. We included 417 implants in 126 periodontally compromised patients, 56 implants in 40 periodontal healthy patients, and 205 maxillary and 268 mandibular molar implants. Implant survival rates by various subject factors, surgical factors, fixture factors, and prosthetic factors at each location were compared using Chi-square test and Kaplan-Meier cumulative survival analysis was done for follow-up(FU) periods. The overall failure rate at 5 years was 1O.2%(subject level) and 5.5%(implant level). The overall survival rates of implants during the FU periods were 94.5% with 91.3% in maxillary first molar, 91.1% in maxillary second molar, 99.2% in mandibular first molar and 94,8% in mandibular second molar regions. The survival rates differed significantly between both jaws and among different implant locations(p<0.05), whereas the survival rates of functionally loaded implants were similar in different locations. The survival rates were not different according to gender, age, previous periodontal status, surgery stage, bone graft type, or the prosthetic type. The overall survival rate was low in dental implant of too wide diameter(${\geq}5.75$ mm) and the survival rate was significantly lower for wider implant diameter(p

Surgical Treatment of Metastatic Pathologic or Impending Pathologic Fractures (전이성 병적 골절 또는 병적 임박 골절의 수술적 치료)

  • Kim, Kap-Jung;Lee, Sang-Ki;Choy, Won-Sik;Seo, Dong-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.44-51
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    • 2009
  • Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

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Treatment of Two- and Three-Part Fracture of Proximal Humerus using LCP (잠김 압박 금속판(LCP)을 이용한 상완골 근위부 이분 및 삼분 골절의 치료)

  • Shin, Sung-Il;Song, Kyung-Won;Lee, Jin-Young;Lee, Seung-Yong;Kim, Gab-Rae;Hyun, Yoon-Suk;Park, Deok-Yong
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.204-211
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    • 2007
  • Purpose: To evaluate the result and complication of treatment using Locking Compression Plate (LCP) for fracture of proximal humerus. Materials and Methods: Between 2004 and 2006, 21 patients with two-part and three-part fractures of the proximal humerus were treated by LCP fixation. Their average age was 54.9 years. Postoperative mean follow-up period was 22.9 months. The reduction was qualified and complication were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system. Results: By Neer's functional evaluation, mean score of shoulder function was 86.3 and 18 case (86%) had excellent or satisfactory results. There was one case of nonunion but no infection or avascular necrosis of the humeral head. No correlation was found between the final result and the type of fracture, age, gender or quality of reduction. Conclusion: We obtained satisfactory result of LCP fixation for fracture of proximal humerus in this study. LCP fixation for proximal humerus fracture is a reliable method to obtain satisfactory reduction, rigid fixation and early exercise.

Distribution of Bursaphelenchus xylophilus in Naturally Infected Pinus densiflora and P. koraiensis and Migration of B. xylophilus in Artificially Inoculated P. densiflora Seedlings (자연감염된 소나무와 잣나무 내 소나무재선충 분포 및 인공접종한 소나무 묘목 내에서의 소나무재선충 이동)

  • Kim, Jae-Geun;Kim, Byung-Kwan;Lee, Seung-Kyu;Kim, Jin-Cheol;Han, Sang-Sub;Cha, Byeong-Jin
    • Research in Plant Disease
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    • v.18 no.2
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    • pp.101-108
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    • 2012
  • In 2006, pinewood nematode, Bursaphelenchus xylophilus, was isolated from about 50 years old trees of Pinus densiflora and P. koraiensis showing leaf-wilt and -drying symptoms in Gwangju, Gyeonggi-do and Chuncheon, Gangwon-do. Isolation of pinewood nematodes from sapwood of infected pine trees showed no difference in population density between tree species and among the sampling heights on the main stem. Migration of pinewood nematodes in the host tree were investigated by inoculation of red pine (P. densiflora, 3 years old) seedlings with B. xylophilus. The nematodes seemed to move in red pine seedlings prior to multiplication and it might have taken about 20 days to start multiplication and expression of symptoms including wilt and dieback. In initial time after inoculation, nematodes started migration through the cortical resin canal from inoculated site and further showed upward and downward movements. More nematodes were observed in cortical resin canal during early period of inoculation and later in resin canal of xylem and tracheid also while, the pith still remained free from nematode. The density of B. xylophilus was higher in seedlings of low-vigor with poor root growth than in seedlings of normal root growth. Seedlings showing high density of B. xylophilus exhibited stem discoloration and secondary infection by fungus at the inoculation site.

Bilateral Fasciocutaneous Sliding V-Y Advancement Flap for Meningomyelocele Defect (척수수막류 결손 재건을 위한 양측 V-Y 전진피판술)

  • Shin, Jong-Weon;Oh, Deuk-Young;Lee, Jung-Ho;Moon, Suk-Ho;Seo, Je-Won;Rhie, Jong-Won;Ahn, Sang-Tae
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.823-826
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    • 2010
  • Purpose: Meningomyelocele is the most common type of neural tube defect disease. Early surgical treatment is recommended to prevent central nervous system infection. Several reconstruction methods were reported previously regarding surgical wound defect closure following meningomyelocele excision. In this article, we report two successful patients using the bilateral fasciocutaneous sliding V-Y advancement flap as a covering for meningomyelocele defects. Methods: Two patients with meningomyelocele were evaluated. Both patients were male and received their operations on the 1st and 4th day of life. After neurosurgeons completed their part of the operation, the V-Y advancement flap was used to close the defect. Initially a bilateral V-shape incision design was made on the skin such that the base of the V-flap measures identical to the size of the wound defect. An incision was made down to the fascia in order to allow the V-flaps to slide into the defect. Subfascial dissection was performed up to 1/3 to 1/4 the length of the V-flap from the wound while minimizing injury to the perforating vessels. Results: Both patients were treated successfully and there was no evidence of complication in 2 months follow up. Conclusion: Several reconstruction methods such as local flaps, skin graft and myocutaneous flaps were reported regarding meningomyelocele surgical wound defect closure. Bilateral fasciocutaneous sliding V-Y advancement flap is an easy method without involving the underlying muscles or a secondary skin graft in a short operation time. Therefore we recommend this treatment option for reconstruction of the wound defect following meningomyelocele excision.