Influence of Duration of Prophylactic Antibiotics Therapy on Uncertainty of Recovery in Elective Laparoscopic Uterine Myomectomy Patients / 기본간호학회지

PURPOSE: The study was done to explore whether the duration of perioperative prophylactic antibiotics therapy influenced uncertainty of recovery in patients with elective laparoscopic uterine myomectomy. METHODS: A prospective study was conducted using self-report questionnaires and electrical medical records for patients with uterine myomectomy. According to the length of the perioperative prophylactic antibiotics therapy, the patients were divided into three groups: single-dose antibiotic treatment group, short-term antibiotic treatment group, and long-term antibiotic treatment group. Data were collected from December 20, 2016 to July 31, 2017 from 161 patients who underwent laparoscopic myomectomy at a metropolitan city general hospital. RESULTS: Level of uncertainty of recovery was 2.98±0.22. The uncertainty was highest in the long-term antibiotic treatment group, followed by the short-term antibiotic treatment group and the single-dose antibiotic treatment group (F=89.40, p < .001). In the regression analysis, factors influencing uncertainty of recovery among uterine myomectomy patients were duration of perioperative prophylactic antibiotic therapy (β=.70, p < .001) and duration of NPO (β=−.11, p=.047) which explained 51.5% of the variance (F=83.75, p < .001). CONCLUSION: Based on these results, information including the administration of antibiotics before surgery should be provided to the patients to help reduce the uncertainty of postoperative recovery.

Optimization of Large-Scale Expansion and Cryopreservation of Human Natural Killer Cells for Anti-Tumor Therapy

Allogeneic natural killer (NK) cell therapy is a potential therapeutic approach for a variety of solid tumors. We established an expansion method for large-scale production of highly purified and functionally active NK cells, as well as a freezing medium for the expanded NK cells. In the present study, we assessed the effect of cryopreservation on the expanded NK cells in regards to viability, phenotype, and anti-tumor activity. NK cells were enormously expanded (about 15,000-fold expansion) with high viability and purity by stimulating CD³⁺ T cell-depleted peripheral blood mononuclear cells (PBMCs) with irradiated autologous PBMCs in the presence of IL-2 and OKT3 for 3 weeks. Cell viability was slightly reduced after freezing and thawing, but cytotoxicity and cytokine secretion were not significantly different. In a xenograft mouse model of hepatocellular carcinoma cells, cryopreserved NK cells had slightly lower anti-tumor efficacy than freshly expanded NK cells, but this was overcome by a 2-fold increased dose of cryopreserved NK cells. In vivo antibody-dependent cell cytotoxicity (ADCC) activity of cryopreserved NK cells was also demonstrated in a SCID mouse model injected with Raji cells with rituximab co-administration. Therefore, we demonstrated that expanded/frozen NK cells maintain viability, phenotype, and anti-tumor activity immediately after thawing, indicating that expanded/frozen NK cells can provide ‘ready-to-use’ cell therapy for cancer patients.

Effects of a Trunk Stabilization Exercise with Gym Ball on Scapular Position for Patients with Arthroscopic Rotator Cuff Repair

PURPOSE: The present study was to investigate effects of scapular position and pain on a trunk stabilization exercise with gym ball for patients with arthroscopic rotator cuff repair. METHODS: Subjects were patients after 2 weeks of rotator cuff repairs. Subjects were randomly assigned to conservative treatment group (CTG, n=10) or trunk stabilization with gym ball group (SBG, n=10), and participated one of those groups for 2 weeks. Measurements about pain and scapular position were assessed in before and after treatment programs. RESULTS: Pain reduced in both rest and night in SBG compared to CTG. In the case of scapular position, decreased scapular retraction (increased protraction) was found in CTG and vice versa in SBG. Reduced scapular anterior tilting was also found on SBG. CONCLUSION: The present study showed that early performed trunk stabilization with gym ball could bring a scapular alignment that increases subacromial space and reduces pain. This suggests early trunk stabilization with gym ball programs to restore shoulder functions for patients with rotator cuff repair.

Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy

PURPOSE: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. METHODS: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for χ2 test, t-test and ANCOVA. RESULTS: Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). CONCLUSION: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.

A Case of Cutaneous Metastatic Cholangiocarcinoma on the Percutaneous Transhepatic Biliary Drainage Catheter Insertion Site

No abstract available.

Antibiotic Susceptibility of Staphylococcus aureus in Atopic Dermatitis: Current Prevalence of Methicillin-Resistant Staphylococcus aureus in Korea and Treatment Strategies

BACKGROUND: Staphylococcus aureus is a well-known microbe that colonizes or infects the skin in atopic dermatitis (AD). The prevalence of methicillin-resistant S. aureus (MRSA) in AD has recently been increasing. OBJECTIVE: This study aimed to determine the antimicrobial susceptibility patterns in AD skin lesions and evaluate the prevalence of MRSA in Korea. We also recommend proper first-line topical antibiotics for Korean patients with AD. METHODS: We studied S. aureus-positive skin swabs (n=583) from the lesional skin of infants, children, and adults who presented to our outpatient clinic with AD from July 2009 to April 2012. RESULTS: S. aureus exhibited high susceptibility against most antimicrobial agents. However, it exhibited less susceptibility to benzylpenicillin, erythromycin, clindamycin, and fusidic acid. The prevalence of MRSA was 12.9% among 583 S. aureus isolates, and the susceptibility to oxacillin was significantly lower in infants in both acute and chronic AD lesions. CONCLUSION: S. aureus from AD has a high prevalence of MRSA and multidrug resistance, especially in infants. In addition, the rate of fusidic acid resistance is high among all age groups, and mupirocin resistance increases with age group regardless of lesional status. This is the first study comparing the antimicrobial susceptibility rates of S. aureus isolates from AD cases with respect to age and lesion status in Korea.

Clinical Course of Segmental Vitiligo: A Retrospective Study of Eighty-Seven Patients

BACKGROUND: Vitiligo is an acquired disorder characterized by a progressive loss of melanocytes, which is difficult to manage and has an unknown prognosis. The subtype of segmental vitiligo (SV) has been established but it has not been adequately characterized. OBJECTIVE: To collect long-term follow-up data for evaluating the clinical course of SV. METHODS: This study included 87 patients who were diagnosed with SV and were monitored at a clinic. Patients were classified into the following three groups according to disease activity. RESULTS: Among the patients with SV, 63.2% had stable disease, 14.9% had disease recurrence between two and four years after disease onset, and 21.8% had disease recurrence at four or more than four years after disease onset. Among the 44 patients (50.2%) who were monitored continuously over a four-year period, 19 (43.2%) experienced a recurrence at four or more than four years after disease onset. CONCLUSION: Our results suggest that, contrary to previous reports, some patients with SV may not experience disease stability over an extended period of time. Disease recurrence can occur after years of stability, and we propose that long-term follow-up data can be used to characterize SV. This information about the clinical course of SV has implications for treatment and prognosis.

Cutaneous Mycobacterium massiliense Infection of the Sole of the Feet

Mycobacterium massiliense which is recognized as a separate species from M. abscessus is little known regarding its clinical patterns and the response to treatment. We present a case of a localized cutaneous infection due to M. massiliense of the sole associated with acupuncture. M. massiliense was identified via polymerase chain reaction-hybridization analysis. We treated the patient with single-drug therapy consisting of clarithromycin for 4 months and the patient showed a significant response to this treatment.

The Principle and Clinical Application of Radiofrequency Devices in Dermatology / 대한피부과학회지

Radiofrequency (RF) device is a novel non-ablative technology which differs from laser devices that uses an electric current rather than a light source. RF device can deliver thermal energy to the dermis and stimulate neocollagenesis and dermal collagen remodeling, so that it is frequently used in cosmetic dermatology for skin rejuvenation. However, some questions remain regarding the optimal treatment parameter such as energy levels and number of passes. Unwanted adverse effects like burn and erythema with edema would occur at any time during the procedures. Therefore, it is very important that RF should be performed by skilled and well-trained clinicians. In this review, we summarized the basic principles of RF and its use to determine the evidence-based efficacy. In addition, various adverse effects and management of them will be addressed in this article.

A Clinical Study of Chemotherapy-Induced Permanent Alopecia / 대한피부과학회지

BACKGROUND: Anagen Effluvium is one of the typical side effects of chemotherapy, which is completely reversible. However, there are growing numbers of chemotherapy-induced permanent alopecia (CIPAL) which are characterized by an absence of or an incomplete hair regrowth 6-months beyond the cessation of chemotherapy. OBJECTIVE: The purpose of this study is to reveal the clinical characteristics of CIPAL patients. METHODS: We retrospectively included 54 cases with CIPAL whom are being diagnosed from January 1996 to December 2011. The age, gender, duration of alopecia, familial history of alopecia, past medical history (including the types of chemotherapy agents), clinical patterns of alopecia and treatment responses were all analyzed. RESULTS: There was no sexual predominance. Mean age of the onset was 31.5 years old. There were two morphological types of CIPAL: diffused (69%) and androgenetic patterned (31%). Cyclophosphamide is the most commonly used chemotherapy agent in both types of alopecia. The response to treatment with topical minoxidil and/or oral finasteride was rather restrictive. CONCLUSION: In some cases of hair loss due to chemotherapic agents, the hair regrowths after the cessation of chemotherapy are rather restricted. This study demonstrated the clinical features of CIPAL. The patterns of CIPAL are either diffused or androgenetic. Thus, it is necessary to consider the possibilities of permanent alopecia which may occur after chemotherapy.

Lichenoid Drug Eruption after Low-Dose Imatinib Mesylate Treatment

No abstract available.

A Localized Cutaneous Paecilomyces lilacinus Infection Treated with Voriconazole / 대한피부과학회지

Paecilomyces is a hyaline hyphomycete that exists worldwide. Paecilomyces lilacinus is associated most frequently with human infection. A 72-year-old male presented with a 1-month history of pruritic erythematous scaly plaque on his left shoulder. Tissue specimen from his cutaneous lesion showed granulomatous inflammation in the dermis and revealed fungal hyphae and spores within giant cells. The pathogen was identified as Paecilomyces lilacinus through fungus culture. Oral itraconazole was begun, but there was no improvement after 14 weeks. The lesions improved after treatment with oral voriconazole. We suggest that voriconazole as a promising useful therapeutic option in Paecilomyces lilacinus infection.

Staphylococcus aureus Colonization in Acute and Chronic Skin Lesions of Patients with Atopic Dermatitis

BACKGROUND: Staphylococcus aureus (SA) has peculiar abilities to colonize the skin in atopic dermatitis (AD) patients. OBJECTIVE: We sought to determine the colonization rates of SA in acute and chronic skin lesions of AD patients, to find any difference in colonization rates according to age and to find the influences of total immunoglobulin E (IgE) and eosinophil counts to the colonization of SA. METHODS: We evaluated the total IgE level and eosinophil counts, and cultured SA from the skin lesions of 687 AD patients (131 acute and 556 chronic skin lesions) and 247 control urticaria patients (July 2009 to November 2010; Samsung Medical Center Dermatology Clinic, Seoul, Korea). RESULTS: The SA colonization rates were 74%, 38% and 3% in acute, chronic skin lesions and control skin, respectively, and they were increased with age in AD patients. The colonization rate in chronic skin lesions was higher in the high IgE/eosinophilia groups as compared to the normal IgE/eosinophil groups. CONCLUSION: The SA colonization rate was higher in AD patients and especially in acute lesions, and had a tendency to increase with age. As the colonization rates were only higher in the high IgE/eosinophilia groups of chronic skin lesions, we suggested that SA may invade the skin through barrier defects in acute skin lesions, but the colonization in chronic lesions may be orchestrated through many different factors.

Effects of Postoperative Oral Care Using Cold Therapy on Nausea, Vomiting and Oral Discomfort in Patients with Laparoscopic Myomectomy / 기본간호학회지

PURPOSE: The purpose of the study was to evaluate the effects of postoperative oral care using cold therapy on nausea, vomiting and oral discomfort after laparoscopic myomectomy. METHOD: The study was conducted with an experimental group (n=29) and a control group (n=35) sampled from patients admitted to a women's hospital in a metropolitan city in Korea. Data were collected between October 10, 2011 and January 31, 2012 and analyzed using Chi-square, Fisher's exact test, t-test, and repeated measure ANCOVA with SPSS/WIN 19.0. RESULTS: After the intervention, postoperative nausea (p<.001) and oral discomfort for patients in the experimental group were significantly lower than in the control group. There were significant differences in the presence of vomiting between both groups at 12 hours (p<.001) and 24 hours (p=.003) after leaving the recovery room. CONCLUSION: Oral care using cold therapy was found to be an effective nursing intervention for reducing postoperative nausea, vomiting and oral discomfort up to 24 hours after recovery in patients with laparoscopic myomectomy.

A Case of Plexiform Palisaded Encapsulated Neuroma of the Penis / 대한피부과학회지

Palisaded encapsulated neuroma (PEN) is a benign cutaneous neural tumor. It usually presents in adults as a solitary asymptomatic skin-colored papule that is almost always on the face. We report here on an uncommon case of plexiform PEN that developed on the penis of a 43-year-old man. It was 6 mm-sized skin colored papule. Histologically, there is an encapsulated nodule with a plexiform growth pattern in the dermis and a palisading arrangement of nuclei. On immunohistochemical staining, the tumor cells of the nodule were positive for S-100 and neurofilament.

Assessment of Relationship between Fyn-related Kinase Gene Polymorphisms and Overweight/Obesity in Korean Population

The fyn-related kinase (FRK) belongs to the tyrosine kinase family of protein kinases. Recent studies have shown that Frk affects pancreatic beta cell number during embryogenesis and promotes beta cell cytotoxic signals in response to streptozotocin. To investigate the genetic association between FRK polymorphisms and the risk of obesity in Korean population, single nucleotide polymorphisms (SNPs) in the FRK gene region were selected and analyzed. The body mass index (BMI) was calculated, and biochemical data (systolic blood pressure, diastolic blood pressure, hemoglobin A1C, triglyceride, total cholesterol, high density lipoprotein, and low density lipoprotein) of blood sample from each subject were also measured. One hundred fifty five healthy control and 204 overweight/obesity subjects were recruited. Genotype frequencies of six SNPs [rs6568920 (+8391G>A), rs3756772 (+56780A>G), rs3798234 (+75687C>T), rs9384970 (+68506G>A), rs1933739 (+72978G>A), and rs9400883 (+75809A>G)] in the FRK gene were determined by Affymetrix Targeted Genotyping Chip data. According to the classification of Korean Society for the Study of Obesity, control (BMI 18 to or =23) subjects were recruited. For the analysis of genetic data, EM algorithm, SNPStats, Haploview, HapAnalyzer, SNPAnalyzer, and Helixtree programs were used. Multiple logistic regression analysis (codominant, dominant, and recessive models) was performed. Age and gender as covariates were adjusted. For biochemical data, Student's t test was used. The mean value of BMI in the control and overweigh/obesity groups was 21.1+/-1.2 (mean+/-SD) and 25.6+/-2.0, respectively. All biochemical data of the overweight/obesity group were statistically significance, compared with the control group. Among six SNPs, two linkage disequilibrium (LD) blocks were discovered. One block consisted of rs1933739 and rs9400883, and the other comprised rs3756772 and rs3798234. One SNP (rs9384970, +68506G>A) showed an association with overweight/obesity in the codominant model (p=0.03). Interestingly, the AA genotype distribution in the overweight/obesity group (n=7, 3.5%) was higher than those in the control group (n=1, 0.6%), which is not found in either Japanese or Chinese subjects. Therefore, the AA genotype of rs9384970 may be a risk factor for development of obesity in Korean population. The results suggest that FRK may be associated with overweight/obesity in Korean population.

Evaluation of Chondrogenesis in Collagen/Chitosan/Glycosaminoglycan Scaffolds for Cartilage Tissue Engineering / 대한정형외과연구학회지

PURPOSE: The scaffold is essential for cartilage tissue engineering. Collagen, chitosan, or glycosaminoglycan( GAG) has separately been proposed as in vitro scaffolds. However, the influence of collagen:chitosanchondroitin sulfate(Col:Chi-CS) composites on cell behavior has not yet been thoroughly examined. Therefore, the aim of this study is to develop a novel Col:Chi-CS blended scaffold that binds covalently with CS for cartilage tissue engineering. MATERIALS AND METHODS: The behavior of rabbit chondrocytes seeded in vitro into collagen/chitosan/GAG scaffolds with different chitosan contents (collagen:chitosan ratios of 20:1, 5:1, and 1.25:1) was investigated. The porous scaffolds containing collagen and chitosan were fabricated by using a freeze drying technique and crosslinked using 1-ethyl-3-(3-dimethyl aminopropyl)carbodiimide(EDC) in the presence of CS. The physicochemical/ mechanical properties of scaffolds were determined by analyzing scanning electron microscopy, compression modulus, immobilized GAG content, and water-binding capacity. Rabbit chondrocytes seeded onto these scaffolds were cultured for 1, 3, 7, and 14 days. The cell proliferation rate was evaluated with 3H-thymidine uptake and total GAG content assay was done via DMB assay using ELISA method. For the histological assessment of extracellular matrix, staining with safranin-O/fast green and immunohistochemistry were used. RESULTS: Scanning electron microscope(SEM) views of the scaffolds showed that all three had interconnected pores of mean diameter 164, 353, and 567 micrometer at collagen:chitosan ratios of 20:1, 5:1, and 1.25:1. GAG was covalently bound onto these scaffolds at 6.4%(w/w) in all three cases, i.e., regardless of chitosan content. However, increased chitosan content resulted in enhanced mechanical properties and increased pore size. Biochemical analysis of these scaffolds showed that proliferation rate and GAG synthesis increased with time, and this became most significant in the collagen:chitosan(20:1)-CS scaffold on day 14. The histology of the cell-seeded constructs showed a significantly higher percentage of cells with spherical morphology, which is specific to mature chondrocyte, especially in the collagen:chitosan(20:1)-CS scaffold at each time point. This finding was consistent with the observation that the pericellular matrix was stained positive for proteoglycans and type II collagen on day 14. CONCLUSION: The novel collagen:chitosan(20:1)-CS scaffold seems to be a useful carrier material for cartilage tissue engineering.

New Synthesis of Sestamibi and Comparison of Stability of Its Formulation / 대한핵의학회잡지

No abstract available.