OBJECTIVE: To analyze the composition, incidence and clinical characteristics of oral and maxillofacial infections in oral emergency. METHODS: A retrospective study on patients with oral and maxillofacial infections who visited the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2017 to December 2019 was conducted. General characteristics, such as disease composition, gender, age distribution and position of involved teeth were analyzed. RESULTS: A total of 8 277 patients with oral and maxillofacial infections were finally collected, including 4 378 male patients (52.9%) and 3 899 female patients (47.1%), with gender ratio of 1.12:1. The common diseases were periodontal abscess (3 826 cases, 46.2%), alveolar abscess (3 537 cases, 42.7%), maxillofacial space infection (740 cases, 9.0%), sialadenitis (108 cases, 1.3%), furuncle & carbuncle (56 cases, 0.7%) and osteomyelitis (10 cases, 0.1%). Male patients were more easily affected by periodontal abscess, space infection and furuncle & carbuncle than female patients with the gender ratios 1.24:1, 1.26:1, 2.50:1 individually, while the incidence of alveolar abscess, sialadenitis, furuncle & carbuncle had no significant gender difference. Different diseases were prone to occur at different ages. The peak ages of alveolar abscess were 5-9 and 27-67 years, while the peak age of periodontal abscess was 30-64 years. Space infection tended to occur between 21-67 years. There were 7 363 patients with oral abscess (3 826 patients with periodontal abscess and 3 537 patients with alveolar abscess), accounting for 88.9% of all the patients with oral and maxillofacial infections, involving 7 999 teeth, including 717 deciduous teeth and 7 282 permanent teeth. Periodontal abscess usually occurred in permanent teeth, especially the molar teeth. Alveolar abscess may occur in both primary teeth and permanent teeth. In primary teeth, the most vulnerable sites were primary molar teeth and maxillary central incisors while in permanent teeth the most vulnerable sites were first molar teeth. CONCLUSION Understanding the incidence of oral and maxillofacial infection was conducive to the correct diagnosis and effective treatment of clinical diseases, as well as targeted education for patients of different ages and genders to prevent the occurrence of diseases.
Humans ; Male ; Female ; Animals ; Adult ; Middle Aged ; Abscess ; Retrospective Studies ; Periodontal Abscess ; Carbuncle ; Furunculosis ; Incisor ; Sialadenitis/epidemiology*

To explore the methods of the explicitation of implicit knowledge and the construction of knowledge graph on moxibustion in medical case records of ZHOU Mei-sheng's Jiusheng. The medical case records data of Jiusheng was collected, the frequency statistic was analyzed based on Python3.8.6, complex network analysis was performed using Gephi9.2 software, community analysis was performed by the ancient and modern medical case cloud platform V2.3.5, and analysis and verification of correlation graph and weight graph were proceed by Neo4j3.5.25 image database. The disease systems with frequency≥10 % were surgery, ophthalmology and otorhinolaryngology, locomotor, digestive and respiratory systems. The diseases under the disease system were mainly carbuncle, arthritis, lumbar disc herniation and headache. The commonly used moxibustion methods were fumigating moxibustion, blowing moxibustion, direct moxibustion and warming acupuncture. The core prescription of points obtained by complex network analysis included Yatong point, Zhiyang(GV 9), Sanyinjiao(SP 6), Dazhui(GV 14), Zusanli(ST 36), Lingtai(GV 10), Xinshu(BL 15), Zhijian point and Hegu(LI 4), which were basically consistent with high-frequency points. A total of 6 communities were obtained by community analysis, corresponding to different diseases. Through the analysis of correlation graph, 13 pairs of strong association rule points were obtained. The correlation between Zhiyang(GV 9)-Dazhui(GV 14) and Yatong point-Lingtai(GV 10) was the strongest. The acupoints with high correlation with Yatong point were Zhiyang(GV 9), Lingtai(GV 10), Dazhui(GV 14), Zusanli(ST 36) and Sanyinjiao(SP 6). In the weight graph of the high-frequency disease system, the relationship of the first weight of the surgery system disease was fumigating moxibustion-carbuncle-Yatong point, and the relationship of the first weight of the ophthalmology and otorhinolaryngology system disease was blowing moxibustion-laryngitis-Hegu (LI 4). The results of correlation graph and weight graph are consistent with the results of data mining, which can be used as an effective way to study the knowledge base of moxibustion diagnosis and treatment in the future.
Humans ; Moxibustion ; Carbuncle ; Pattern Recognition, Automated ; Acupuncture Therapy ; Acupuncture Points

Dianthus superbus (D. superbus) is a traditional crude drug used for the treatment of urethritis, carbuncles and carcinomas. The objective of this study was to confirm the cognitive enhancing effect of D. superbus in memory impairment induced mice and to elucidate the possible potential mechanism. Effect of D. superbus on scopolamine induced memory impairment on mice was evaluated using the Morris water maze and passive avoidance tests. We also investigated acetylcholinesterase (AChE) activity and brain-derived neurotropic factor (BDNF) expression in scopolamine-induced mice. HPLC-DAD analysis was performed to identify active compounds in D. superbus. The results revealed that D. superbus attenuated the learning and memory impairment induced by scopolamine. D. superbus also inhibited AChE levels in the hippocampi of the scopolamine-injected mice. Moreover, D. superbus increased BDNF expression in the hippocampus. Eight compounds were identified using HPLC-DAD analysis. The content of 4-hydroxyphenyl acetic acid was higher than contents of other compounds. These results indicated that D. superbus improved memory functioning accompanied by inhibition of AChE and upregulation of BDNF, suggesting that D. superbus may be a useful therapeutic agent for the prevention or treatment of Alzheimer's disease.
Acetic Acid ; Acetylcholinesterase ; Alzheimer Disease ; Animals ; Brain-Derived Neurotrophic Factor ; Carbuncle ; Dianthus* ; Hippocampus ; Learning ; Memory* ; Mice* ; Scopolamine Hydrobromide ; Up-Regulation ; Urethritis ; Water

Although pandemic community-associated (CA-) methicillin-resistant Staphylococcus aureus (MRSA) ST30 clone has successfully spread into many Asian countries, there has been no case in Korea. We report the first imported case of infection caused by this clone in a Korean traveler returning from the Philippines. A previously healthy 30-yr-old Korean woman developed a buttock carbuncle while traveling in the Philippines. After coming back to Korea, oral cephalosporin was given by a primary physician without any improvement. Abscess was drained and MRSA strain isolated from her carbuncle was molecularly characterized and it was confirmed as ST30-MRSA-IV. She was successfully treated with vancomycin and surgery. Frequent international travel and migration have increased the risk of international spread of CA-MRSA clones. The efforts to understand the changing epidemiology of CA-MRSA should be continued, and we should raise suspicion of CA-MRSA infection in travelers with skin infections returning from CA-MRSA-endemic countries.
Adult ; Bacterial Toxins/metabolism ; Carbuncle/microbiology ; Cephalosporins/therapeutic use ; Community-Acquired Infections/drug therapy/microbiology ; Exotoxins/metabolism ; Female ; Humans ; Leukocidins/metabolism ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus/*isolation & purification ; Philippines ; Republic of Korea ; Staphylococcal Skin Infections/*drug therapy/surgery ; Travel ; Vancomycin/therapeutic use

Tsutsugamushi disease is an acute febrile illness that is caused by infection with Orientia tsutsugamushi. The diagnosis is based on the patient's history of exposure, the characteristic clinical features and serologic testing. But the diagnosis can be difficult when an eschar is overlooked or it is absent. Making the differential diagnosis with drug eruption is especially difficult when a skin rash develops with a prior medication history for fever or myalgia. We report here on 3 cases of Tsutsugamushi disease. Two of the cases were misdiagnosed as drug eruption due to medication for carbuncle or back pain. For the other case, Tsutsugamushi disease was accompanied with allergic contact dermatitis due to Rhus (lacquer tree). All the patients had fever, myalgia and an atypical skin rash that differed from that of drug eruption and allergic contact dermatitis. The detection of eschar was possible by having a clinical suspicion of Tsutsugamushi disease. Thus, we report here on three cases of Tsutsugamushi disease and these cases show the importance of taking a complete medical history and performing a thorough physical examination.
Back Pain ; Carbuncle ; Dermatitis, Allergic Contact ; Diagnosis, Differential ; Drug Eruptions ; Exanthema ; Fever ; Humans ; Orientia tsutsugamushi ; Physical Examination ; Rhus ; Scrub Typhus ; Serologic Tests

BACKGROUND: Bacterial infections of the skin are treatable and reversible, so clinicians should be alert for the cutaneous signs of the skin infection. However, there have been only a few reports about the epidemiology of skin infections. OBJECTIVE: This study was done to evaluate the trend of the clinical features, the results of cultures and the prevalence of MRSA in the dermatology outpatients who had suspected bacterial skin infection in 1996, 2001 and 2006 and we wanted to compare the trends of bacterial skin infection over the last eleven years. METHODS: The survey was conducted via the medical records of 24 patients in 1996, 77 patients in 2001 and 88 patients in 2006 who visited the our dermatology department and who underwent Gram-stain and bacterial culture. RESULTS: Of the 347 samples, bacteria were cultured in 197 samples. Among them, 77 samples had coagulase negative Staphylococci, which were excluded as normal skin flora. Among 120 samples, the number of cases of secondary pyoderma, folliculitis, furuncle or carbuncle and cellulitis were 63, 17, 17 and 15, respectively. There was no change in the type of diagnosis during eleven years. The most common pathogen of skin infection was S. aureus (42.7%) and there was no trend to increase for ten years. However, the prevalence of methicillin resistant S. aureus (MRSA) increased for eleven years. CONCLUSION: The most common pathogen in pyogenic skin infections of the dermatology outpatients was S. aureus, which was sensitive to beta-lactamase resistant beta-lactam antibiotics, but there was an increase of the prevalence of MRSA for eleven years, and the first therapeutic choice for MRSA is vancomycin or teicoplanin.
Anti-Bacterial Agents ; Bacteria ; Bacterial Infections ; beta-Lactamases ; Carbuncle ; Cellulitis ; Coagulase ; Dermatology ; Folliculitis ; Furunculosis ; Humans ; Medical Records ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Outpatients ; Prevalence ; Pyoderma ; Skin ; Staphylococcus aureus ; Teicoplanin ; Vancomycin

Paralytic lagophthalmos and ectropion by leprosy are serious complications of facial paralysis, which may lead to exposure keratitis, corneal ulceration, and further lead to blindness. In 1995 and 1997, we reported in this journal on the surgical treatment of 38 patients and 98 patients suffering with paralytic lagophthalmos and ectropion. In the first report of 1995, for lid closing I(Ahn) performed the method of traditional surgery such as temporal muscle transfer, medial and lateral canthoplasty as well as gold implant. In the 2nd report of 1997, we(Ahn and Park) presented the results of our combination treatment that changed the design and weight of the gold plate inserted in upper lid, and the medial canthoplasty and horizontal shortening in lower lid. Combination treatment provided for near normal eye closure and aesthetically pleasing appearance without the drawbacks associated with other methods such as eye clinching in concert with mouth closure, donor site deformities resulting from temporalis muscle transfer, and over exposure of carbuncle due to stretching effects of lateral canthoplasty. We have now found that raising the level of the lower lid margin to the sclera is important in concealing the scleral show due to drooping of the lower lid. We grafted conchal cartilage in a 5 x 35 mm sized band, which was fixed at the medial and lateral canthal area in 57 patients during the recent 3 years. We also added the ancillary procedure of the horizontal shortening in cases of highly atonic lower lid. We have noted that gold implantation in the upper eyelid and cartilage graft in the lower eyelid, with optional horizontal shortening, successfully corrected the lagophthalmos and ectropion due to facial nerve palsy.
Blindness ; Carbuncle ; Cartilage* ; Congenital Abnormalities ; Corneal Ulcer ; Ectropion* ; Eyelids ; Facial Nerve ; Facial Paralysis ; Humans ; Keratitis ; Leprosy ; Mouth ; Paralysis ; Sclera ; Temporal Muscle ; Tissue Donors ; Transplants

This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1. 1988 to June 30, 1989 and the post-implementation period was from July 1. 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respcetively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased form 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Department of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments (form 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 22. to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased form 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.
Angina Pectoris ; Carbuncle ; Communicable Diseases ; Diabetes Mellitus ; Duodenitis ; Fissure in Ano ; Gastritis ; Humans ; Hypertension ; Insurance ; Internal Medicine ; Outpatients* ; Pediatrics ; Referral and Consultation*

We report on a patient with spontaneous rupture of hemorrhagic renal cyst into the pyelocaliceal system. He had no history of trauma, bleeding disorders, urinary tract infection or urinary tract obstruction. Gross hematuria followed by left flank pain occurred 1 day prior to admission. Although radiologic findings were suggestive of rupture of renal cyst into the calyx or calyceal diverticulum. exclusion of malignant disease or renal carbuncle was difficult. He was managed by partial nephrectomy. Microscopic findings revealed ruptured cyst lined with low cuboidal epithelium without evidence of malignancy.
Carbuncle ; Diverticulum ; Epithelium ; Flank Pain ; Hematuria ; Hemorrhage* ; Humans ; Nephrectomy ; Rupture ; Rupture, Spontaneous* ; Urinary Tract ; Urinary Tract Infections

A clinical observation was made on 31 partial nephrectomized patients in Department of Urology, Catholic Medical College, during the period from January 1976 to December 1980. The results were as follow: 1. The common age group in 3rd and 4th decades and the proportion of male to female was 1.4 : 1. 2. Among 31 cases, renal stone was 18 (58.0%). renal tuberculosis was 7 (22.6%), renal rupture was 2 (6.5%). double pelvis was 2 (6.5%), renal infarction was 1 (3.2%) and renal carbuncle was 1 (3.2%). 3. of 31 cases, partial nephrectomy was performed in 33 cases. As methods of the operation, Guillotine type with "U" shaped mattress suture was 19 cases (57.6%) and Renal Vessel Clamp type wag 14 cases (42.4%). 4. Postoperative complication were gross hematuria in 4 cases, temporary urine leakage in 4 cases, wound infection in 1 case, residual stone in 1 case, delayed bleeding in 1 case, septic condition in l case and death in 1 case.
Carbuncle ; Female ; Hematuria ; Hemorrhage ; Humans ; Infarction ; Male ; Nephrectomy ; Pelvis ; Postoperative Complications ; Rupture ; Sutures ; Tuberculosis, Renal ; Urology ; Wound Infection