Postantibiotic Effects of Photodynamic Therapy Using Erythrosine and Light Emitting Diode on Streptococcus mutans

Dental caries, the most common oral disease, is a multifactorial disease caused by interactions among bacteria within the dental plaque, food, and saliva, resulting in tooth destruction. Streptococcus mutans has been strongly implicated as the causative organism in dental caries and is frequently isolated from human dental plaque. Photodynamic therapy (PDT) is a technique that involves the activation of photosensitizer by light in the presence of tissue oxygen, resulting in the production of reactive radicals capable of inducing cell death. Postantibiotic effect (PAE) is defined as the duration of suppressed bacterial growth following brief exposure to an antibiotic. In this study, the in vitro PAE of PDT using erythrosine and light emitting diode on S. mutans ATCC 25175 was investigated. The PAE of PDT for 1 s irradiation and 3 s irradiation were 1.65 h and 2.1 h, respectively. The present study thus confirmed PAE of PDT using erythrosine on S. mutans.

A Case of Sepsis Caused by Cellulitis in a Patient with Rheumatoid Arthritis after Tocilizumab Treatment

Tocilizumab, a humanized monoclonal antibody against the interleukin-6 receptor, is therapeutically effective in patients diagnosed with rheumatoid arthritis (RA) compared with placebo. However patients treated with tocilizumab are at increased risk of several adverse effects including anaphylaxis and serious infections that may lead to hospitalization or death. Therefore, the risks and benefits of treatment with tocilizumab should be considered carefully and close monitoring of patients for development of signs and symptoms of side effects is required during and after treatment. Here, we report on a rare case of anaphylaxis and severe sepsis caused by cellulitis in a patient with RA after tocilizumab treatment.

Identification of streptococcus dysgalactiae subsp. equisimilis from septic knee by 16S rRNA gene sequencing / 고신대학교의과대학학술지

Septic arthritis is the infection of a joint by an infectious agent, leading to arthritis. It is therefore important to identify and treat the correct bacteria in septic arthritis. However, accurate identification of bacteria by conventional methods is difficult because of the distinct biochemical characteristics of individual bacteria. This case report aims at assessing septic arthritis caused by Streptococcus dysgalactiae subsp. equisimilis(SDSE) using nucleotide sequences and discusses the associated treatment. Here, Streptococcus agalactiae was determined to be the causative bacteria for septic arthritis in a 77 year-old woman using the conventional method of hemolysis pattern interpretation and morphology. However, nucleotide sequence analysis of 16S ribosomal RNA revealed that SDSE was the causative strain. 16S rRNA gene sequencing can correctly identify bacteria strains that are difficult to be identified by traditional method, and this correct identification can provide patients with the opportunity for adequate treatment using the proper antibiotics.

Pulmonary thromboembolism combined with intracardiac thrombus occurred during the steroid reduction in nephrotic syndrome patient / 영남의대학술지

Nephrotic syndrome is associated with a hypercoagulable state, which results in thromboembolism as one of its main complications. Various pathogenetic factors that cause the hypercoagulable state in nephrotic syndrome have been recognized. We report on a 19-year-old female with a minimal-change disease who developed pulmonary thromboembolism combined with intracardiac thrombus while on tapering steroid. Our patient showed hypoalbuminemia with an episode of shock, and was successfully treated with thrombolysis and anticoagulation therapy.

Lower limb ischemia after bee sting / 영남의대학술지

Bee sting causes mild symptoms such as urticaria and localized pain, and severe symptoms including anaphylaxis, cardiovascular collapse, and death. We reported on a patient with arterial thrombotic occlusion and severe ischemia in the lower limb after multiple bee stings. The patient was stung 5 times and complained of pallor, pain, and coldness in the left toe, and did not have dorsalis pedis pulsation. Computed tomography angiography showed multiple thrombotic occlusion of the anterior and posterial tibial artery below the knee. Local thrombolytic therapy using urokinase was administered and the occluded arteries were successfully recanalized.

Experimental Study of Gross and Histopathological Changes after Extravasation of Adriamycin and Efficacy of Intralesional Injection of Steroid / 대한피부과학회지

BACKGROUND: Extravasation of chemotherapeutic agents during intravenous infusion may cause extensive inflammatory reaction, ulceration, crust formation, and skin necrosis. But the exact mechanism of cutaneous reactions after extravasation of adriamycin remains unknown. OBJECTIVE: Our purpose was to evaluate the clinical and histological features in rabbits after injection of adriamycin and a mixed solution of adriamycin and triamcinolone. METHODS: Three rabbits were divided into three groups and were subcutaneously injected with the following materials on the back:adriamycin, a mixed solution of adriamycin and triamcinolone and 0.9% saline respectively. The injection sites including the skin and subcustaneouskfat were excised and fixed with natural huffered formalin. The biopsied specimens were stained with hematoxylin and eosin. RESULTS: l. In the adriamycin injected group, there were induration, crust formation and ulceration after three weeks. After seven weeks crust and focal ulceration were found. Histologically, after one day mild epidermal necrosis, dermal inflammatory infiltration, destruction of epidermal appendag es, edema and hemorrhage were seen. After one week collagen necrosis was advanced and granulation tissue formation and calcium deposition were found. After seven weeks granulation tissue formation and calcium d position still remained. 2. In the adriamycin and triamcinolone injected group, focal healing ulceration was seen after three weeks. After seven weeks the ulceration healed and normal gross finding was seen. Histologically, destructior of epidermal appendages and edema were found after one day. After three weeks granulation tissue formation and fatty changes in the dermis were seen. After five weeks normal histologic findings were seen in the epidermis. Collagen necrosis became less prominent and hyalinizationand transepidermal elimination were found. After seven weeks nearly normal histological findings in the epidermis and dermis were seen. CONCLUSION: We conclude that there was a marked difference in the gross and histological findings between two groups of adriamycin injected and a mixed solution of adriamycin and triamcinolone injected rabbits. Therefore, we suggest triamcinolone can be used as an adjuvant mode in the treatment of lesions where adriamycin is extravasated.

Cryotherapy of Alopecia Areata / 대한피부과학회지

BACKGROUND: 1. Conventional topical treatments of alopecia areata such as intralesional injection and topical application of glucocorticosteroids, and induction of conttact sensitivity using DPCP have had dieadvantages as follow 1) a time -consuming treatment perioed 2) various forms of discomfort during and after treatment 3) many side effects. 2. Though hair follicllee are easily damaged by intense cryo-application, we anticipate the regrowth of hair without damage to the tissue when applied to the scalp lightly OBJECT: We evaluated the efficacy of treatment and side effect of cryotherapy in patients with alopecia areata and whether this method can be used for the firstiline treatment of small alopecic patches, avoiding the above disadvantages of conventional methods METHOD: 19 patients witt alopecia areata lesion(s) confined within one fourth of the totaI scalp area were treated by dip-stick method with liquid nitrogen once a week luring the first 4 weeks, then at a two week interval. A cotten tip was lightly applied to the alopecic, patches for one to two seconds. We surveyed side effects and regrowth of hair during a periodic follow up. RESULT: The results can be summurized as follows : 1. Therapeutic responses were noted in 17(89%) of 19 patients studid. 2. In all the patients who responded, vellus hair appeared within 4 weeks of treatment, and terminal hair appeared within 6 weeks of treatment. 3. There were no specific fectors showing statistical significance between therapeutic responses. 4. There were no significanf, side effects except very faint pain during cryoapplication. 5. Recurrence was observed in only patieni during a 9-12 months follow-up CONCLUSION: Cryotherpy of the alopecia areata can be regarded as an effective mode of treatment with many advantages. These include relatively good therapeutic results, short-term treatment, a simple and convenient method, and nearly no side effects. We recommerld cryotherapy as a first-line mode of treatment of alopecia area.ta lesions which are small in size and few in number.

Contact Urticaria due to Bee Sting Therapy in a Patient with Chronic Pain / 대한피부과학회지

Contact Urticaria is a wheal-and-flare response to chemicals applied to the skin. Contact urticaria due to bee sting therapy has never been reported in Korea. A 45-year-old male was seen for erythematous plsques and patches with the duration of 3 days. Histologicall, the skin biopsy specimen showed necrosis and dyskeratotic cells in the epidermis. Collagen degenerati in and perivascular lymphocytic infiltrates were seen in the upper dermis.