The proper concentrations of dextrose and lidocaine in regenerative injection therapy: in vitro study

Background@#Prolotherapy is a proliferation therapy as an alternative medicine. A combination of dextrose solution and lidocaine is usually used in prolotherapy. The concentrations of dextrose and lidocaine used in the clinical field are very high (dextrose 10%-25%, lidocaine 0.075%-1%). Several studies show about 1% dextrose and more than 0.2% lidocaine induced cell death in various cell types. We investigated the effects of low concentrations of dextrose and lidocaine in fibroblasts and suggest the optimal range of concentrations of dextrose and lidocaine in prolotherapy. @*Methods@#Various concentrations of dextrose and lidocaine were treated in NIH-3T3. Viability was examined with trypan blue exclusion assay and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Migration assay was performed for measuring the motile activity. Extracellular signal-regulated kinase (Erk) activation and protein expression of collagen I and α-smooth muscle actin (α-SMA) were determined with western blot analysis. @*Results@#The cell viability was decreased in concentrations of more than 5% dextrose and 0.1% lidocaine. However, in the concentrations 1% dextrose (D1) and 0.01% lidocaine (L0.01), fibroblasts proliferated mildly. The ability of migration in fibroblast was increased in the D1, L0.01, and D1 + L0.01 groups sequentially. D1 and L0.01 increased Erk activation and the expression of collagen I and α-SMA and D1 + L0.01 further increased. The inhibition of Erk activation suppressed fibroblast proliferation and the synthesis of collagen I. @*Conclusions@#D1, L0.01, and the combination of D1 and L0.01 induced fibroblast proliferation and increased collagen I synthesis via Erk activation.

The proper concentrations of dextrose and lidocaine in regenerative injection therapy: in vitro study

Background@#Prolotherapy is a proliferation therapy as an alternative medicine. A combination of dextrose solution and lidocaine is usually used in prolotherapy. The concentrations of dextrose and lidocaine used in the clinical field are very high (dextrose 10%-25%, lidocaine 0.075%-1%). Several studies show about 1% dextrose and more than 0.2% lidocaine induced cell death in various cell types. We investigated the effects of low concentrations of dextrose and lidocaine in fibroblasts and suggest the optimal range of concentrations of dextrose and lidocaine in prolotherapy. @*Methods@#Various concentrations of dextrose and lidocaine were treated in NIH-3T3. Viability was examined with trypan blue exclusion assay and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Migration assay was performed for measuring the motile activity. Extracellular signal-regulated kinase (Erk) activation and protein expression of collagen I and α-smooth muscle actin (α-SMA) were determined with western blot analysis. @*Results@#The cell viability was decreased in concentrations of more than 5% dextrose and 0.1% lidocaine. However, in the concentrations 1% dextrose (D1) and 0.01% lidocaine (L0.01), fibroblasts proliferated mildly. The ability of migration in fibroblast was increased in the D1, L0.01, and D1 + L0.01 groups sequentially. D1 and L0.01 increased Erk activation and the expression of collagen I and α-SMA and D1 + L0.01 further increased. The inhibition of Erk activation suppressed fibroblast proliferation and the synthesis of collagen I. @*Conclusions@#D1, L0.01, and the combination of D1 and L0.01 induced fibroblast proliferation and increased collagen I synthesis via Erk activation.

11 Cases of Idiopathic Tumoral Calcinosis: A Single Center Experience / 대한피부과학회지

Background@#Tumoral calcinosis is characterized by the deposition of calcific masses around major joints, and it often causes significant impairment of joint function. Dermatologists sometimes encounter patients with a subcutaneous hard mass around the joint. However, there are few studies about tumoral calcinosis in the dermatologic literature, especially in Korea. @*Objective@#The aim of this study was to determine the clinical characteristics of tumoral calcinosis. @*Methods@#We reviewed the clinical photographs, medical records, and biopsy specimens of 11 cases of tumoral calcinosis seen at our clinic in 10 years. @*Results@#All 11 patients were female, and the mean age at onset was 58.5 years. The mean duration of the disease was 7.1 years. Most patients (9, 81.8%) presented with an asymptomatic subcutaneous hard mass around the iliac crest. None of the patients had a family history, or abnormal serum calcium, phosphorus, and parathyroid hormone levels. All patients underwent surgery for treatment. @*Conclusion@#Tumoral calcinosis can occur sporadically without metabolic disease. Therefore, careful history taking and biochemical work-up involving the metabolism of calcium and phosphorus should be performed. If there is no peculiarityon examination, the lesion is cured by resection. Although the sample size of this study is small, it can be inferred that the characteristics of tumoral calcinosis in Korea can be described by its predominant sex preponderance and location, that is, the female sex and the iliac crest, respectively.

A Case of Poromatosis Related to Chemotherapy / 대한피부과학회지

A poroma is a benign adnexal neoplasm originating from the sweat gland duct. It usually presents clinically as a soft erythematous or flesh-colored papule, plaque, or nodule on the palms and soles. In most cases, poromas manifest as a solitary lesion, but rarely, multiple lesions have been reported and are defined as poromatosis.Although the pathogenesis is unclear, poromatosis is known to be associated with actinic damage, human papillomavirus infection, radiation therapy, or polychemotherapy. Herein, we describe a 53-year-old woman who had multiple erythematous papules on her feet for a year. She had a medical history of acute lymphoblastic leukemia and had undergone polychemotherapy with stem cell transplantation. To our knowledge, poromatosis related to chemotherapy is a rare entity, and our case could be attributed to the theory that using polychemotherapy can induce poromatosis.

Anti-apoptotic and myocardial protective effects of ethyl pyruvate after regional ischaemia/reperfusion myocardial damage in an in vivo rat model

<p><b>INTRODUCTION</b>The integration of reactive oxygen species is strongly associated with important pathophysiological mechanisms that mediate myocardial ischaemia/reperfusion (I/R) damage. Pyruvate is an efficacious scavenger of reactive oxygen species and a previous study has shown that ethyl pyruvate (EP) has a myocardial protective effect against regional I/R damage in an in vivo rat model. The purpose of this study was to determine whether the myocardial protective effect of EP is associated with anti-apoptosis.</p><p><b>METHODS</b>Rats were allocated to receive EP dissolved in lactated Ringer's solution or lactated Ringer's solution alone, via intraperitoneal infusion one hour before ischaemia. They were exposed to 30 minutes of ischaemia followed by reperfusion of the left coronary artery territory over two hours. Anti-apoptotic effects were checked using several biochemical parameters after two hours of reperfusion. Apoptosis was analysed using measured caspase-3 activity, Western blotting of B-cell lymphoma 2 (Bcl-2) family protein cleaved by caspase-3, and assessment of DNA laddering patterns and the terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) staining test.</p><p><b>RESULTS</b>In ischaemic myocardium, EP increased Bcl-2 expression, but reduced Bcl-2-associated X protein and cleaved caspase-3 expressions. EP reduced the expression of DNA laddering and the number of myocardial I/R-damaged TUNEL-positive cells.</p><p><b>CONCLUSION</b>This study demonstrated that EP has an anti-apoptotic effect after regional I/R damage in an in vivo rat heart model. The myocardial protective effect of EP may be related to its anti-apoptotic effect.</p>

Lipofundin(R) MCT/LCT 20% increase left ventricular systolic pressure in an ex vivo rat heart model via increase of intracellular calcium level / 대한마취과학회지

BACKGROUND: Lipid emulsions have been used to treat various drug toxicities and for total parenteral nutrition therapy. Their usefulness has also been confirmed in patients with local anesthetic-induced cardiac toxicity. The purpose of this study was to measure the hemodynamic and composition effects of lipid emulsions and to elucidate the mechanism associated with changes in intracellular calcium levels in myocardiocytes. METHODS: We measured hemodynamic effects using a digital analysis system after Intralipid(R) and Lipofundin(R) MCT/LCT were infused into hearts hanging in a Langendorff perfusion system. We measured the effects of the lipid emulsions on intracellular calcium levels in H9c2 cells by confocal microscopy. RESULTS: Infusion of Lipofundin(R) MCT/LCT 20% (1 ml/kg) resulted in a significant increase in left ventricular systolic pressure compared to that after infusing modified Krebs-Henseleit solution (1 ml/kg) (P = 0.003, 95% confidence interval [CI], 2.4-12.5). Lipofundin(R) MCT/LCT 20% had a more positive inotropic effect than that of Intralipid(R) 20% (P = 0.009, 95% CI, 1.4-11.6). Both lipid emulsion treatments increased intracellular calcium levels. Lipofundin(R) MCT/LCT (0.01%) increased intracellular calcium level more than that of 0.01% Intralipid(R) (P < 0.05, 95% CI, 0.0-1.9). CONCLUSIONS: These two lipid emulsions had different inotropic effects depending on their triglyceride component. The inotropic effect of lipid emulsions could be related with intracellular calcium level.

Comparison of meperidine and nefopam for prevention of shivering during spinal anesthesia / 대한마취과학회지

BACKGROUND: Shivering is a frequent event during spinal anesthesia and meperidine is a well-known effective drug for prevention and treatment of shivering. Nefopam is a non-opiate analgesic and also known to have an anti-shivering effect. We compared nefopam with meperidine for efficacy of prevention of shivering during spinal anesthesia. METHODS: Sixty five patients, American Society of Anesthesiologists physical status I or II, aged 20-65 years, scheduled for elective orthopedic surgery under spinal anesthesia were investigated. Patients were randomly divided into two groups, meperidine (Group M, n = 33) and nefopam (Group N, n = 32) groups. Group M and N received meperidine 0.4 mg/kg or nefopam 0.15 mg/kg, respectively, in 100 ml of isotonic saline intravenously. All drugs were infused for 15 minutes by a blinded investigator before spinal anesthesia. Blood pressures, heart rates, body temperatures and side effects were checked before and at 15, 30, and 60 minutes after spinal anesthesia. RESULTS: The incidences and scores of shivering were similar between the two groups. The mean arterial pressures in Group N were maintained higher than in Group M at 15, 30, and 60 minutes after spinal anesthesia. The injection pain was checked in Group N only and its incidence was 15.6%. CONCLUSIONS: We conclude that nefopam can be a good substitute for meperidine for prevention of shivering during spinal anesthesia with more stable hemodynamics, if injection pain is effectively controlled.

Epidural Blood Patch for the Treatment of Abducens Nerve Palsy due to Spontaneous Intracranial Hypotension: A Case Report

Intracranial hypotension is characterized by a postural headache which is relieved in a supine position and worsened in a sitting or standing position. Although less commonly reported than postural headache, sixth nerve palsy has also been observed in intracranial hypotension. The epidural blood patch (EBP) has been performed for postdural puncture headache, but little is known about the proper timing of EBP in the treatment of sixth nerve palsy due to intracranial hypotension. This article reports a case of sixth nerve palsy due to spontaneous intracranial hypotension which was treated by EBP 10 days after the onset of palsy.

Comparison of the Incidence and Clinical Characteristics of Gram-positive and Gram-negative Surgical Site Infections after Gastric Surgery

BACKGROUND: Surgical site infection (SSI) is prominent among the total incidence of healthcare-associated infections, and is a major contributing factor in the trend of increasing medical costs. There have been numerous efforts to analyze the conditions and causes of SSI for the purpose of prevention. In this study of SSI development after gastric surgery, we evaluated the prevalence of specific pathogens and compared the clinical characteristics observed between gram-positive (GPB) and gram-negative bacteria (GNB). MATERIALS AND METHODS: We conducted a retrospective study of patients who developed SSI within 30 days after gastric surgery at 13 clinics in Korea, between January 2007 and December 2008. Only those cases of SSI which included confirmed pathogen were included in this study. RESULTS: Among the 121 patients who developed SSI, GPB were observed in 32 patients and 36 cases, and GNB were isolated in 32 patients and 36 cases. Methicillin resistant Staphylococcus aureus (MRSA) was the most frequently isolated pathogen in this analysis. There were no differences observed between the GPB and GNB group in terms of baseline characteristics, patient or procedure related risk factors, or factors associated with prophylactic antibiotics. CONCLUSIONS: In the previous studies of the occurrence of SSI after gastric surgery, it was reported that the majority of observed pathogens were enteric GNB. Further studies of the incidence of SSI after gastric surgery, particularly those related to MRSA infection, are necessary.

Accuracy of the epidural catheter position during the lumbar approach in infants and children: a comparison among L2-3, L3-4, and L4-5 approaches / 대한마취과학회지

BACKGROUND: The aim of this study was to compare the accuracy of the position of the epidural catheter inserted from three different lumbar intervertebral spaces, L2-3, L3-4, and L4-5, in infants and children. METHODS: Seventy-five children were randomly allocated to 3 groups according to the epidural catheter insertion site (L2-3, L3-4, and L4-5). The epidural catheter tip was identified using 50% diluted Iohexol and fluoroscopy. The incidence of correct position was compared among the groups and between infants and children. RESULTS: The incidence of correct position was significantly higher in the L2-3 group as compared to the L3-4 and L4-5 groups (P = 0.023 and P = 0.046 respectively). The incidence of correct position was higher in infants compared to children (P = 0.017). CONCLUSIONS: The L2-3 intervertebral space is preferable during epidural catheter insertion in children older than 1 year, but a low lumbar level should be considered in infants because they have a higher risk of neural damage.

Evaluation of the Contaminant Bacteria Isolated from Humidifiers Used in the Intensive Care Unit / 병원감염관리

BACKGROUND: This study aims to obtain basic data regarding the proper maintenance and potential role of humidifiers in the development of nosocomial pneumonia. We investigated into a spectrum of bacteria that grew after disinfection in humidifiers that were used in intensive care units (ICUs). The bacteria were isolated at different time points after disinfection. METHODS: We randomly selected 6 humidifiers that were used in an ICU and conducted a series of bacterial culture studies at 24 hr, 48 hr, 72 hr and 168 hr after disinfecting the six humidifiers. The fluid from the humidifider was cultured in the same manner as the dialysate. RESULTS: No bacteria were isolated in most of the 6 humidifiers 24 hr after the disinfection of the instruments. Gram-negative bacilli such as Acinetobacter baumannii, Burkholderia cepacia, and Stenotrophomonas maltophilia were cultured at 48 hr after disinfection. CONCLUSION: Regular and thorough disinfection of humidifiers is necessary to prevent possible spread of infection via humidifiers in the ICU.

Effect of various anesthetic induction agents on blood magnesium and calcium concentration / 대한마취과학회지

BACKGROUND: Decrease in blood magnesium and calcium concentration is associated with an increase in the incidence of arrhythmia, especially during the induction period. Therefore, it is important to evaluate the effects of propofol, pentothal sodium, and sevoflurane on calcium and magnesium concentration. METHODS: Thirty-six premedicated, ASA grade I patients were selected and randomly allocated into 3 groups. Six percent sevoflurane inhalation (sevo group), propofol 1.5 mg/kg (propofol group), and 5 mg/kg of pentothal sodium (pento group) were administered for anesthetic induction and anesthetic maintenance was done with end-tidal sevoflurane concentration at 3.5%. Blood sampling was performed during the pre-induction period (pre-induction), just before tracheal intubation (pre-intubation), and 2 min after intubation (post-intubation). pH corrected ionized magnesium and calcium were calculated and analyzed simultaneously. RESULTS: Both total calcium and magnesium concentrations decreased significantly in all groups during the pre-intubation and post-intubation periods compared with the pre-induction period. Ionized calcium only decreased significantly during pre-intubation and post-intubation in the pento group, and did not change throughout the study period in the sevo and propofol groups. Ionized magnesium did not change throughout the study period in any of the groups. pH corrected ionized calcium decreased significantly only at post-intubation in the pento group. CONCLUSIONS: All anesthetic induction agents administered in this study can be used safely in terms of magnesium-associated arrhythmia. However, ionized calcium concentration decreased in the pento group, but all values were within normal limits. This finding indicated that it is safe to use propofol, pentothal sodium, and sevoflurane for anesthetic induction

The Expression of the Ca++ Channel alpha2delta Subunit and TRPM8 in the Dorsal Root Ganglion of Sympathetically Maintained Pain and Sympathetic Independent Pain Rat Models / 대한통증학회지

BACKGROUND: Peripheral nerve injury induces up-regulation of the calcium channel alpha2delta (alpha2delta) subunit and TRPM8 in the dorsal root ganglion (DRG) which might contribute to allodynia development. We investigated the expression of the alpha2delta subunit and TRPM8 in the DRG of sympathetically maintained pain (SMP) and sympathetic independent pain (SIP) rat model. METHODS: For the SMP model, the L5 and L6 spinal nerves were ligated tightly distal to the DRG. For the SIP model, the tibial and sural nerves were transected, while the common peroneal nerve was spared. After a 7 day postoperative period, tactile and cold allodynia were assessed using von Frey filaments and acetone drops, respectively. Expression of the alpha2delta subunit and TRPM8 in the L5 and L6 DRG were subsequently examined by a Western blot. RESULTS: There were no significant differences between the two models for the thresholds of tactile and cold allodynia. Expression of the alpha2delta subunit in the ipsilateral DRG to the injury was increased as determined on a Western blot as compared to that in the contralateral or sham-operated DRG of the SMP model, but there was no difference in expression seen with the use of the SIP model. There was no difference in the expression of TRPM8 in the ipsilateral DRG to the injury and the contralateral or sham-operated DRG of either model. CONCLUSIONS: Up-regulation of the alpha2delta subunit in injured DRG may play a role that contributes to tactile allodynia development in SMP, but not TRPM8 to cold allodynia after peripheral nerve injury.

Prognosis Factors of Clostridium difficile Associated Diarrhea

BACKGROUND: Clostridium difficile associated diarrhea (CDAD) has a wide range of clinical manifestations. The prognostic factors of CDAD are not fully understood. MATERIALS AND METHODS: A retrospective cohort study of 115 patients with CDAD from Aug. 2002 to Dec. 2003 was conducted to evaluate prognostic factors of CDAD. Bacteriologic factors were determined by detecting the binary toxin gene, tcd A, tcd A rep and tcd B gene. Poor prognosis was defined as diarrhea more than 10 days even with classic treatment, recurrence, death, and moribund discharge. RESULTS: Approximately 79% of isolated strains were toxin A+/B+ strains and 21% were toxin A-/B+ strains. There was no difference in prognosis between toxin A+ and toxin A- strains. 39 (33.9%) cases showed poor prognosis and 76 (66.1%) cases showed good prognosis. Univariate analyses revealed that the poor prognostic factors were old age over 70 years old, male, the number of antibiotics used after onset of symptom, the administration of carbapenems, aminoglycosides, glycopeptides after onset of symptom, history of DM and stroke, and high Charlson comorbidity index. Multiple logistic regression analysis identified old age over 70 years old (odds ratio=3.378, P=0.009) and the administration of carbapenems after onset of symptom (odds ratio 7.210, P< 0.001) as the independent poor prognostic factors. CONCLUSION: Old age over 70 and the administration of carbapenems after onset of symptom were the poor prognostic factors for CDAD caused by none-binary toxin producing strains.

A Case of Brucellar Spondylitis with Multiple Spine Involvement

Brucellosis, a zoonosis with world wide distribution, is a systemic infection that affects several organs and has protean presentation. Although spondylitis is universally the most common complication of brucellosis and difficult to treat, there is no consensus on the preferred combination of antibiotics use. The authors report a case of a 58-year-old male patient with brucellar spondylitis involving several vertebrae. Diagnosis was made by positive blood culture and magnetic resonance imaging. The authors use a combination method of doxycycline, ciprofloxacin and streptomycin for a period of 3 months. The systemic symptoms were improved after treatment.

Therapeutic Response of HAART and Analysis of Related Factors in Korean HIV-infected Persons

BACKGROUND: Recently, 2.1 persons per day are reported to be HIV infected and totally more than 4,500 HIV infected persons have been officially reported until 2006 in Korea. We started highly active antiretroviral therapy (HAART) for HIV patients from 1997. Data on the efficacy of antiretroviral therapy are limited in Korea. MATERIALS AND METHODS: HIV infected patients treated with HAART for more than 1 year were included. We studied the therapeutic response of antiretroviral therapy in patients with AIDS and without previous antiretroviral therapy who were treated until Dec 2005 in Severance hospital. RESULTS: More than 450 were diagnosed as HIV infected in Severance hospital. Among these HIV infected patients, 141 patients including 14 females were included. 121 of the 141 patients (85.8%) were treated with PI based regimen, and 20(14.2%) were treated with NNRTI based regimen. The initial mean CD4 T cell count was 207/mm3 (IQR 73-299) and the mean HIV RNA level was 70,800 copies/mL. After 6 months of HAART, 103 patients (73%) had fewer than 400 copies of HIV RNA copies/mL. After 12 months of HAART, 90 patients (63.8%) had fewer than 50 copies of HIV RNA copies/mL. The mean increase in the CD4 T cell count from baseline to 12 months was 143 cells/mm3. After 12 months, 96 patients (68.1%) had increased more than 100 cells/mm3. CONCLUSION: This report the therapeutic response of HAART in Korea which the prevalence of HIV infection is now increasing. Overall, the outcomes are similar to those in other developed countries. Further large scale prospective cohort study is needed.

Epidemiology of HIV/AIDS in East Asia

BACKGROUND: Recent predictions of catastrophic epidemic surge of HIV infection in East Asia concern experts and governmental organizations. As in many other areas, countries in East Asia show diversities in their HIV epidemics, both geographically and temporally. However, they have similar regional, cultural and racial characteristics which allow them to have certain common factors. Having a clear picture of the current extent and feature of HIV/AIDS in this region is a very difficult task largely due to the fast pacing of expending epidemic and difficulty in data-sharing among countries in the region. Hence, we decided to study the epidemiologic feature of HIV/AIDS in East Asia through East Asia Network on HIV (EAN-HIV). MATERIALS AND METHODS: The epidemiological patterns of HIV/AIDS in East Asian countries were investigated by collecting data through EAN-HIV. RESULTS: The HIV/AIDS epidemic in East Asia started relatively late at mid 1980s. Since then, the number of newly infected HIV/AIDS cases has been steadily increasing with stiffer escalation in recent years. In China and Taiwan, IDU plays an important part in the swiftly growing HIV epidemics; however, in other regions like Korea, Japan, and Hong Kong, MSM (men who have sex with men) seems to be more of a problem. The major subtypes of HIV in East Asia are subtype B, C, and CRF01_AE, and rapidly evolving circulating recombinant forms (CRF) between subtypes such as CRF07_BC give dynamic change to the current status. CONCLUSION: The incidence of HIV/AIDS is rapidly increasing in East Asia. The epidemic pattern has undergone dynamic changes over time. China seems to be the leading source of HIV/AIDS epidemic in East Asia due to its large population and rapidly growing epidemics.

Prognosis Factors of Clostridium difficile Associated Diarrhea

BACKGROUND: Clostridium difficile associated diarrhea (CDAD) has a wide range of clinical manifestations. The prognostic factors of CDAD are not fully understood. MATERIALS AND METHODS: A retrospective cohort study of 115 patients with CDAD from Aug. 2002 to Dec. 2003 was conducted to evaluate prognostic factors of CDAD. Bacteriologic factors were determined by detecting the binary toxin gene, tcd A, tcd A rep and tcd B gene. Poor prognosis was defined as diarrhea more than 10 days even with classic treatment, recurrence, death, and moribund discharge. RESULTS: Approximately 79% of isolated strains were toxin A+/B+ strains and 21% were toxin A-/B+ strains. There was no difference in prognosis between toxin A+ and toxin A- strains. 39 (33.9%) cases showed poor prognosis and 76 (66.1%) cases showed good prognosis. Univariate analyses revealed that the poor prognostic factors were old age over 70 years old, male, the number of antibiotics used after onset of symptom, the administration of carbapenems, aminoglycosides, glycopeptides after onset of symptom, history of DM and stroke, and high Charlson comorbidity index. Multiple logistic regression analysis identified old age over 70 years old (odds ratio=3.378, P=0.009) and the administration of carbapenems after onset of symptom (odds ratio 7.210, P< 0.001) as the independent poor prognostic factors. CONCLUSION: Old age over 70 and the administration of carbapenems after onset of symptom were the poor prognostic factors for CDAD caused by none-binary toxin producing strains.

A Case of Brucellar Spondylitis with Multiple Spine Involvement

Brucellosis, a zoonosis with world wide distribution, is a systemic infection that affects several organs and has protean presentation. Although spondylitis is universally the most common complication of brucellosis and difficult to treat, there is no consensus on the preferred combination of antibiotics use. The authors report a case of a 58-year-old male patient with brucellar spondylitis involving several vertebrae. Diagnosis was made by positive blood culture and magnetic resonance imaging. The authors use a combination method of doxycycline, ciprofloxacin and streptomycin for a period of 3 months. The systemic symptoms were improved after treatment.

Therapeutic Response of HAART and Analysis of Related Factors in Korean HIV-infected Persons

BACKGROUND: Recently, 2.1 persons per day are reported to be HIV infected and totally more than 4,500 HIV infected persons have been officially reported until 2006 in Korea. We started highly active antiretroviral therapy (HAART) for HIV patients from 1997. Data on the efficacy of antiretroviral therapy are limited in Korea. MATERIALS AND METHODS: HIV infected patients treated with HAART for more than 1 year were included. We studied the therapeutic response of antiretroviral therapy in patients with AIDS and without previous antiretroviral therapy who were treated until Dec 2005 in Severance hospital. RESULTS: More than 450 were diagnosed as HIV infected in Severance hospital. Among these HIV infected patients, 141 patients including 14 females were included. 121 of the 141 patients (85.8%) were treated with PI based regimen, and 20(14.2%) were treated with NNRTI based regimen. The initial mean CD4 T cell count was 207/mm3 (IQR 73-299) and the mean HIV RNA level was 70,800 copies/mL. After 6 months of HAART, 103 patients (73%) had fewer than 400 copies of HIV RNA copies/mL. After 12 months of HAART, 90 patients (63.8%) had fewer than 50 copies of HIV RNA copies/mL. The mean increase in the CD4 T cell count from baseline to 12 months was 143 cells/mm3. After 12 months, 96 patients (68.1%) had increased more than 100 cells/mm3. CONCLUSION: This report the therapeutic response of HAART in Korea which the prevalence of HIV infection is now increasing. Overall, the outcomes are similar to those in other developed countries. Further large scale prospective cohort study is needed.