methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center.METHODS: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed.RESULTS: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found.CONCLUSION: The only method to increase the survival rate is to ‘suspect’ the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.]]>
Abdomen ; Allografts ; Amputation ; Burn Units ; Burns ; Cellulitis ; Communicable Diseases ; Debridement ; Electronic Health Records ; Fascia ; Fasciitis, Necrotizing ; Female ; Foot ; Fournier Gangrene ; Heart ; Hip ; Humans ; Hypertension ; Infection Control ; Injections, Intramuscular ; Inpatients ; Korea ; Leg ; Male ; Medical Records ; Methods ; Mortality ; Nutritional Support ; Sepsis ; Skin ; Stroke ; Survival Rate ; Toes ; Wounds and Injuries ; Wounds, Stab

Adult ; Botulinum Toxins ; administration & dosage ; pharmacology ; Humans ; Injections, Intramuscular ; Male ; Muscle Spasticity ; chemically induced ; diagnosis ; Neuromuscular Agents ; administration & dosage ; pharmacology ; Transcranial Magnetic Stimulation ; methods

OBJECTIVETo investigate the application of facial liposuction and fat grafting in the remodeling of facial contour.

METHODSFrom Nov. 2008 to Mar. 2014, 49 cases received facial liposuction and fat grafting to improve facial contours. Subcutaneous facial liposuction with tumescent technique and chin fat grafting were performed in all the cases, buccal fat pad excision of fat in 7 cases, the masseter injection of botulinum toxin type A in 9 cases, temporal fat grafting in 25 cases, forehead fat grafting in 15 cases.

RESULTSMarked improvement was achieved in all the patients with stable results during the follow-up period of 6 - 24 months. Complications, such as asymmetric, unsmooth and sagging were retreated with acceptance results.

CONCLUSIONCombination application of liposuction and fat grafting can effectively and easily improve the facial contour with low risk.

Adipose Tissue ; transplantation ; Botulinum Toxins, Type A ; administration & dosage ; Chin ; Face ; surgery ; Forehead ; Humans ; Injections, Intramuscular ; Lipectomy ; adverse effects ; methods ; Masseter Muscle ; Neuromuscular Agents ; administration & dosage

OBJECTIVE: To explore the effects of different analgesia methods after UPPP. METHOD: Ninety cases of patients uvulopalatopharyngoplasty were divided into 3 groups randomly, and 30 cases in each group. The group A was the blank control group without any analgesia measures. The cases in group B were treated with intramuscular injection of parecoxib sodium 40 mg after surgery immediately, and continued injecting 40 mg after 12 hours, 24 hours and 36 hours respectively. 100 mg tramadol replaced 40 mg parecoxib sodium in group C. The VAS scoring was performed after surgery 12, 24, 36, 48, 72, 96 hours in 3 groups, and we observed adverse reaction such as lethargy, nausea, vomiting, dizziness, skin rash and so on. RESULT: The group B and C reduced the pain significantly compared with blank control group. The pain scores in group B were significantly decreased than that in group C (P<. 05). CONCLUSION The analgesic effect of parecoxib sodium after UPPP is significant and better than tramadol. It is worthy to use widely in clinical due to its better effect and less side effect.
Analgesia ; methods ; Analgesics ; therapeutic use ; Humans ; Injections, Intramuscular ; Isoxazoles ; therapeutic use ; Pain Measurement ; Pain, Postoperative ; Palate ; surgery ; Pharynx ; surgery ; Tramadol ; therapeutic use ; Uvula ; surgery

PURPOSE: To investigate the therapeutic effectiveness of ultrasound (US)-guided trigger point injection for myofascial trigger points (MTrPs) in the internal rotator muscles of the shoulder in post-mastectomy patients. MATERIALS AND METHODS: This pilot study was a non-controlled, prospective, clinical trial. Nineteen post-mastectomy patients with a diagnosis of at least one active MTrP in the subscapularis and/or pectoralis muscles were included. We performed trigger point injections into the subscapularis muscle deep behind the scapula as well as the pectoralis muscle for diagnostic and therapeutic purpose by the newly developed US-guided method. RESULTS: Visual analogue scale and range of motion of the shoulder for external rotation and of abduction showed significant improvement immediately after the first injection and 3 months after the last injection compared with baseline (p<0.05 for both). Duration from onset to surgery and duration of myofascial pain syndrome in the good responder group were significantly shorter than in the bad responder group (p<0.05). Patients did not report any complications related to the procedure or serious adverse events attributable to the treatment. CONCLUSION: In post-mastectomy patients with shoulder pain, US-guided trigger point injections of the subscapularis and/or pectoralis muscles are effective for both diagnosis and treatment when the cause of shoulder pain is suspected to originate from active MTrPs in these muscles, particularly, the subscapularis.
Adult ; Aged ; Anesthetics, Local/administration & dosage/therapeutic use ; Female ; Humans ; Injections, Intramuscular/methods ; Lidocaine/administration & dosage/therapeutic use ; Mastectomy ; Middle Aged ; Muscle, Skeletal/drug effects/ultrasonography ; Myofascial Pain Syndromes/drug therapy ; Pectoralis Muscles/drug effects/*ultrasonography ; Trigger Points/*ultrasonography

This study aimed to evaluate the efficacy of fructose-1,6-bis phosphate aldolase (SMALDO) DNA vaccination against Schistosoma mansoni infection using different routes of injection. The SMALDO has been cloned into the eukaryotic expression vector pcDNA3.1/V5-His TOPO-TA and was used in injecting Swiss albino mice intramuscularly (IM), subcutaneously (SC), or intraperitoneally (IP) (50 microg/mouse). Mice vaccinated with non-recombinant pcDNA3.1 served as controls. Each group was immunized 4 times at weeks 0, 2, 4, and 6. Two weeks after the last booster dose, all mice groups were infected with 80 S. mansoni cercariae via tail immersion. At week 8 post-infection, animals were sacrificed for assessment of parasitological and histopathological parameters. High anti-SMALDO IgG antibody titers were detected in sera of all vaccinated groups (P<0.01) compared to the control group. Both the IP and SC vaccination routes resulted in a significant reduction in worm burden (46.2% and 28.9%, respectively, P<0.01). This was accompanied by a significant reduction in hepatic and intestinal egg counts (41.7% and 40.2%, respectively, P<0.01) in the IP group only. The number of dead eggs was significantly increased in both IP and IM groups (P<0.01). IP vaccination recorded the highest significant reduction in granuloma number and diameter (54.7% and 29.2%, respectively, P<0.01) and significant increase in dead miracidia (P<0.01). In conclusion, changing the injection route of SMALDO DNA vaccination significantly influenced the efficacy of vaccination. SMALDO DNA vaccination via IP route could be a promising protective and anti-pathology vaccine candidate against S. mansoni infection.
Animals ; Antibodies, Helminth/blood ; Disease Models, Animal ; Female ; Fructose-Bisphosphate Aldolase/genetics/*immunology ; Histocytochemistry ; Immunoglobulin G/blood ; Injections, Intramuscular ; Injections, Intraperitoneal ; Injections, Subcutaneous ; Mice ; Parasite Load ; Schistosoma mansoni/enzymology/genetics/*immunology ; Schistosomiasis mansoni/immunology/parasitology/pathology/*prevention & control ; Vaccination/methods ; Vaccines, DNA/administration & dosage/genetics/*immunology ; Vaccines, Synthetic/administration & dosage/genetics/immunology

To control coccidiosis without using prophylactic medications, a DNA vaccine targeting the gametophyte antigen Gam56 from Eimeria maxima in chickens was constructed, and the immunogenicity and protective effects were evaluated. The ORF of Gam56 gene was cloned into an eukaryotic expression vector pcDNA3.1(zeo)+. Expression of Gam56 protein in COS-7 cells transfected with recombinant plasmid pcDNA-Gam56 was confirmed by indirect immunofluorescence assay. The DNA vaccine was injected intramuscularly to yellow feathered broilers of 1-week old at 3 dosages (25, 50, and 100 microg/chick). Injection was repeated once 1 week later. One week after the second injection, birds were challenged orally with 5x10(4) sporulated oocysts of E. maxima, then weighed and killed at day 8 post challenge. Blood samples were collected and examined for specific peripheral blood lymphocyte proliferation activity and serum antibody levels. Compared with control groups, the administration of pcDNA-Gam56 vaccine markedly increased the lymphocyte proliferation activity (P<0.05) at day 7 and 14 after the first immunization. The level of lymphocyte proliferation started to decrease on day 21 after the first immunization. A similar trend was seen in specific antibody levels. Among the 3 pcDNA-Gam56 immunized groups, the median dosage group displayed the highest lymphocyte proliferation and antibody levels (P<0.05). The median dosage group had the greatest relative body weight gain (89.7%), and the greatest oocyst shedding reduction (53.7%). These results indicate that median dosage of DNA vaccine had good immunogenicity and immune protection effects, and may be used in field applications for coccidiosis control.
Animals ; Antibodies, Protozoan/blood ; Antigens, Protozoan/genetics/*immunology ; Cell Proliferation ; Chickens ; Coccidiosis/immunology/pathology/*prevention & control ; Disease Models, Animal ; Eimeria/genetics/*immunology ; Injections, Intramuscular ; Lymphocytes/immunology ; Protozoan Vaccines/administration & dosage/genetics/*immunology ; Vaccination/methods ; Vaccines, DNA/administration & dosage/genetics/*immunology

OBJECTIVETo study the pharmacokinetics of matrine (MT) intramuscular administration in rat.

METHODPlasma concentration of matrine was determined by HPLC under the following conditions: column (Shim-pack VP-ODS, 4. 6 mm x 150 mm, 5 m); eluent (acetonitrile-0.02 mol ammonium acetate buffer-triethylamine 30: 70: 0.04); flow rate was 1 mL x min(-1) and ultraviolet detection wavelength was set at 220 nm; column temperature 40 degrees C; aliquot injected 20 microL. All data of concentration-time of matrine were treated with pharmacokinetics program DAS 2. 1. 1.

RESULTA simple, sensitive and reliable method for determining matrine in rat plasma by HPLC was established. The plasma concentration time profiles of MT fitted in with two-compartment models well, and the main pharmacokinetic parameters found for MT after i. m. infusion were as follows: C(max) = 21.113 9 mg x L(-1), t(max) = 0.75 h, t1/2alpha 1.34 h, t1/2beta = 3.509 h, AUC(0-t) = 90.984 mg x h(-1) x L(-1), AUC(0-infinity) = 100.346 mg x h(-1) x L(-1).

CONCLUSIONCompare with oral administration, the matrine is absorbed well and distributes fast with intramuscular administration; the absolute bioavailability of matrine is higher. According to this, the pharmacological action is also stronger and duration is longer.

Alkaloids ; administration & dosage ; pharmacokinetics ; Animals ; Chromatography, High Pressure Liquid ; methods ; Female ; Injections, Intramuscular ; Male ; Quinolizines ; administration & dosage ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

INTRODUCTIONInfection-related complications after transrectal ultrasound guided prostatic biopsy (TRPB) could be life threatening. Our centre observed sepsis after TRPB despite prophylactic oral ciprofloxacin. We reviewed all cases of post-TRPB sepsis with their bacteriology and evaluated if the addition of intramuscular (I/M) gentamicin to standard prophylaxis before TRPB could reduce its incidence.

MATERIALS AND METHODSIn a single urological centre, we performed an interventional study that compared a prospective group with retrospective control. The latter is known as the "cipro-only" group included consecutive patients who underwent TRPB between 1 September 2003 and 31 August 2004. The addition of I/M gentamicin 80 mg half an hour before TRPB started on 1 September 2004. All subsequent patients who underwent TRPB until 31 August 2005 were included in the "cipro+genta" group. Patients who did not receive the studied antibiotics were excluded.

RESULTSThere were 374 patients in the "cipro+genta" group and 367 patients in the "cipro-only" group with comparable profiles. There were 12 cases of post-TRPB sepsis in the "cipro-only" group and 5 cases in the "cipro+genta" group. Ciprofloxacin-resistant Escherichia coli (E. coli) was the only pathogen isolated in both groups. In the "cipro-only" group, 9 patients had positive blood cultures and 8 were sensitive to gentamicin. In the "cipro+genta" group, the only positive E. coli was gentamicin-resistant. One patient in the "cipro+genta" group was admitted to the intensive care unit with septicaemia.

CONCLUSIONThe addition of I/M gentamicin to oral ciprofloxacin is a safe and effective prophylactic antibiotic regime in reducing the incidence of post-TRPB sepsis.

Administration, Oral ; Adult ; Aged ; Antibiotic Prophylaxis ; methods ; Biopsy ; Ciprofloxacin ; administration & dosage ; therapeutic use ; Drug Resistance, Bacterial ; Escherichia coli ; drug effects ; isolation & purification ; Gentamicins ; administration & dosage ; Humans ; Injections, Intramuscular ; Male ; Middle Aged ; Prospective Studies ; Prostate ; diagnostic imaging ; pathology ; Rectum ; Ultrasonography

A sensitive and selective liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed and validated for the determination of betamethasone in human plasma. The analyte was isocratically eluted on a Venusil XBP C8 column (200 mm x 3.9 mm ID, 5 microm) with methanol-water mol x L(-1) ammonium formate) (80:20) at a flow rate of 0.4 mL x min(-1), and detected (containing 5 mmol x L(-1) ammonium formate) (80:20) at a flow rate of 0.4 mL x min(-1), and detected with a triple quad LC-MS/MS using ESI with positive ionization. Ions monitored in the multiple reaction monitoring (MRM) mode were m/z 393.3-->355.2 for betamethasone and m/z 361.3-->343.2 for prednisolone (IS). Betamethasone was extracted from 0.5 mL human plasma with ethyl acetate. The average recovery is 88.24% and the low limit of quantitation (LLOQ) was 0.5 ng x mL(-1). The 3-day validation study demonstrated excellent precision and accuracy across the calibration range of 0.5-80.0 ng x mL(-1). The method was successfully applied to the pharmacokinetic study of compound betamethason injection in healthy Chinese volunteers.
Anti-Inflammatory Agents ; blood ; pharmacokinetics ; Area Under Curve ; Betamethasone ; blood ; pharmacokinetics ; Chromatography, Liquid ; methods ; Humans ; Injections, Intramuscular ; Male ; Spectrometry, Mass, Electrospray Ionization ; methods ; Tandem Mass Spectrometry ; methods ; Young Adult