• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.271-275
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• 2015

Objective : This study was designed to evaluation the diagnostic value of procalcitonin (PCT) in patients with spinal infection, compare to the classical biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count. Methods : All patients who were diagnosed as a spinal infection between January, 2013 and July, 2014 were included in this study. Serum PCT, CRP, ESR, and WBC count were checked at initial hospital visit and once a week serially until they were discharged. Patient's medical history, causes and pathogens of spinal infection were reviewed. Results : Total 34 (16 men, 18 women) patients were included in this study. Mean age of the patients was 65.6 year-old. Causes of spinal infection were pain block procedure (14, 41.2%) and post-operation (5, 14.7%). Out of 25 patients who showed elevated initial serum PCT level, 20 patients (80%) had a combined systemic infection. 14 patients (6.7%) had a sepsis, 3 patients (14.2%) had a urinary tract infection and 2 (9.6%) had a pneumonia. 14 patients (41.2%) showed elevation of serum PCT level during treatment. Among them, 9 patients (64.3%) had a combined infection such as sepsis and urinary tract infection. Conclusion : Serum CRP showed more sensitivity compared to serum PCT in patients with spinal infection. Patients with spinal infection who showed elevated serum PCT level should be investigated for combined infection and proper antibiotics should be applied.

• Clinical and Experimental Pediatrics
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• 제60권1호
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• pp.10-16
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• 2017

Purpose: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. Methods: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth. Newborns with proven bacterial (blood culture positive for bacteria) or suspicious infection (presence of C-reactive protein expression or leukocytosis/leukopenia) were excluded. Various neonatal conditions were analyzed to identify the factors influencing increased PCT level. Results: Among 292 newborns with a gestational age of $35.2{\pm}3.0$ weeks and a birth weight of $2,428{\pm}643g$, preterm newborns (n=212) had higher PCT levels than term newborns (n=80). Of the newborns, 7.9% had increased PCT level (23 of 292) on the firstday; 28.3% (81 of 286), on the third day; and 3.3% (7 of 121), on the seventh day after birth. The increased PCT level was significantly associated with prenatal disuse of antibiotics (P=0.004) and surfactant administration (P<0.001) on the first day after birth, postnatal use of antibiotics (P=0.001) and ventilator application (P=0.001) on the third day after birth, and very low birth weight (P=0.042) on the seventh day after birth. Conclusion: In newborns without bacterial infection, increased PCT level was significantly associated with lower gestational age and respiratory difficulty during the first week of life. Further studies are needed for clinical applications.

• Journal of Korean Neurosurgical Society
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• 제49권1호
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• pp.43-48
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• 2011

Objective: Classical markers of infection cannot differentiate reliably between inflammation and infection after neurosurgery. This study investigated the dynamics of serum procalcitonin (PCT) in patients who had elective spine surgeries without complications. Methods: Participants were 103 patients (47 women, 56 men) who underwent elective spinal surgery. Clinical variables relevant to the study included age, sex, medical history, body mass index (BMI), site and type of surgery, and surgery duration. Clinical and laboratory data were body temperature, white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and PCT, all measured preoperatively and postoperatively on days 1, 3, and 5. Results: PCT concentrations remained at <0.25 ng/mL during the postoperative course except in 2 patients. PCT concentrations did not correlate with age, sex, DM, hypertension, BMI, operation time, operation site, or use of instrumentation. In contrast, CRP concentrations were significantly higher with older age, male, DM, hypertension, longer operation time, cervical operation, and use of instrumentation. Conclusion: PCT may be useful in the diagnosing neurosurgical patients with postoperative fever of unknown origin.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.683-686
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• 2014

Objective: The purpose of the study was to evaluate clinical value of dual-phase $^{18}F$-FDG SPECT with serum procalcitonin (PCT) in identifying cancers in patients with fever of unknown origin (FUO). Methods: PCT test and dual-phase $^{18}F$-FDG SPECT were sequentially performed on 50 consecutive patients with FUO. Two radiologists evaluated all $^{18}F$-FDG SPECT data independently. A consensus was reached if any difference of opinions existed. Final diagnosis was based on a comprehensive analysis of results for the PCT test, dual-phase $^{18}F$-FDG SPECT and bacterial cultivation, regarded as a gold standard. Results: Among 50 patients, 34 demonstrated PCT ${\geq}0.5{\mu}g/L$. Coincidence imaging showed in 37 patients with inflammatory lesions, and 13 with malignancy. Finally, 36 bacterial, 1 fungal and 1 viral infections, as well as 12 cancerous fevers were confirmed by dual-phase $^{18}F$-FDG SPECT with PCT, combined with bacterial cultivation and clinical follow-up. Conclusion: Our study demonstrated that dual-phase $^{18}F$-FDG SPECT in association with PCT could be a valuable tool for diagnosis in tumor patients with FUO.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.337-346
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• 2018

Objectives: Serum procalcitonin (PCT) is a specific biomarker that rises after bacterial infection, and levels of PCT are known to correlate with the severity and mortality of patients with pneumonia and sepsis. However, the usefulness of PCT levels in acute pyelonephritis is unknown. This study aimed to evaluate the effectiveness of using the PCT level as a predictive test for bacteremia in acute pyelonephritis. Methods: Between January 2012 and June 2013, 140 patients diagnosed with acute pyelonephritis were admitted to Haeundae Paik Hospital. Serum PCT, C-reactive protein (CRP), and white blood cell (WBC) levels at pre- and post- treatment were measured. Blood and urine cultures were obtained from all patients. The levels of PCT, CRP, and WBCs were each compared between the blood culture-positive and blood culture-negative groups to assess their effectiveness in predicting bacteremia. Results: Pre-treatment PCT level was 0.77 ng/mL (95% CI: 0.42-1.60 ng/mL) in the blood culture-negative group and 4.89 ng/mL (95% CI: 2.88-9.04 ng/mL) in the blood culture-positive group, and the increase between the two groups was statistically significant. The area under the receiver operating characteristic curve of PCT level for prediction of bacteremia was 0.728. A cut-off value of 1.23 ng/mL indicated a sensitivity of 79.0 % and specificity of 60.0 % for PCT level. Conclusions: Serum PCT level is a useful predictive test for bacteremia in acute pyelonephritis. Through the early detection of bacteremia, serum PCT level can help estimate the prognosis and predict complications such as sepsis.

• Tuberculosis and Respiratory Diseases
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• 제70권6호
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• pp.490-497
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• 2011

Background: It is difficult but important to differentiate between bacterial and viral infections, especially for respiratory infections. Hence, there is an ongoing need for sensitive and specific markers of bacterial infections. We investigated novel biomarkers for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infections. Methods: This was a prospective, observational study of patients with community acquired bacterial pneumonia, 2009 H1N1 Influenza A infection, and healthy controls. Serum samples were obtained on the initial visit to the hospital and stored at $-80^{\circ}C$. We evaluated CRP (C-reactive protein), PCT (procalcitonin), LBP (lipopolysaccharide-binding protein) and copeptin. These analytes were all evaluated retrospectively except CRP. Receiver operating characteristic curve (ROC) analyses were performed on the resulting data. Results: Enrolled patients included 27 with community acquired bacterial pneumonia, 20 with 2009 H1N1 Influenza A infection, and 26 who were healthy controls. In an ROC analysis for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection, areas under the curve (AUCs) were 0.799 for CRP (95% Confidence interval [CI], 0.664~0.934), 0.753 for PCT (95% CI, 0.613~0.892) and 0.684 for LBP (95% CI, 0.531~0.837). Copeptin was not different among the three groups. Conclusion: These findings suggest that serum CRP, PCT and LBP can assist physicians in discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection.

• 대한임상검사과학회지
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• 제54권1호
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• pp.15-22
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• 2022

프로칼시토닌(procalcitonin, PCT)은 세균성과 바이러스성의 감염을 구별하기 위한 과학적 근거와 진단상의 중요한 단서를 제공한다. 프로칼시토닌이 높은 환자의 임상적 특성과 예후를 조사하고 임상적 진단을 향상시키고자 한다. 프로칼시토닌이 일반적인 집단에서 패혈증의 유병률과 연관성이 있는지를 결정한다. 이에 본 연구는 1년 동안 프로칼시토닌을 검사한 외래 환자(127명)의 C-반응성단백과 혈구산정검사의 결과를 기반으로 후향적 조사연구이다. 분석에 사용된 데이터는 프로칼시토닌, C-반응 단백 그리고 혈구산정검사이다. PCT의 결과가 높은 군의 CRP와 WBC의 양성율은 정상군보다 높게 나타났다(P<0.05). 프로칼시토닌 수준의 특이성과 민감도는 C-반응단백과 백혈구 수준보다 높게 나타났다(P<0.05). 또한. 프로칼시토닌의 결과값을 삼분위한 그룹의 분석에서는 낮은 군과 중간군의 값에 비해 높은 군의 값이 평균보다 높은 것으로 나타났다(P<.001). 상관분석에서는 프로칼시토닌은 C-반응단백, 백혈구(호중구, 림프구 포함)에서 양의 상관성을 보였다(P<.001). 이 연구의 주된 발견은 높은 프로칼시토닌은 C-반응성단백, 백혈구들의 수준에서 높은 연관성을 보이며 진단적 가치를 확인하였다. 따라서 이러한 관련 인자들은 환자의 감염진단과 항생제 치료에 중요한 진단적 및 치료적 영향을 미칠 것으로 사료된다.

• 대한화상학회지
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• 제22권2호
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• pp.38-44
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• 2019

Purpose: The immature granulocyte count has been reported to be a marker of infection and sepsis. The difference in leukocyte subfractions (delta neutrophil index, DNI) in ADVIA 2120 reflects the fraction of circulating immature granulocytes in the blood. This study evaluated the clinical utility of DNI as a severity and prediction marker in critically ill patients with burn sepsis. Methods: One hundred and sixty nine patients admitted to the burn care unit were studied. DNI (the difference in leukocyte subfractions identified by myeloperoxidase and nuclear lobularity channels) was determined using a specific blood cell analyzer. Results: Seventy one patients (42 %) were diagnosed with burn sepsis. DNI was significantly higher in patients with burn sepsis than in patients without (P<0.01). Delta neutrophil index was a better indicator of burn sepsis than C-reactive protein, lactate, white blood cell count, HCO3, base excess, lactate, procalcitonin (odds ratio, 6.31; confidence interval 2.36~16.90; P<0.01). And the receiver operating characteristic curves showed that delta neutrophil index, AUC 0.795 (95% confidence interval, 0.721~0.869; P<0.05) was a better predictor of burn sepsis than lactate, procalcitonin, white blood cell, base excess and abbreviated burn severity index. Conclusion: Delta neutrophil index may be used as a early marker of patients with burn sepsis.

• Pediatric Infection and Vaccine
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• 제16권2호
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• pp.142-149
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• 2009

목 적: 6개월 미만의 열이 있는 영아에서 세균성 감염을 진단하는 데 있어서 C-반응 단백질(CRP), 전백혈구 수치(WBC)와 비교하여 혈청 procalcitonin (PCT)가 진단적 가치가 있는지 알아보고자 연구를 시행하였다. 방 법 : 전향적인 연구방법을 채택해 2008년 7월부터 9월까지 분당차병원 소아청소년과에 발열을 주소로 내원한 6개월 미만의 영아를 대상으로 하였다. 내원 당시 체온, 흉부방사선 검사, 뇨분석검사 및 배양검사와 함께 말초 혈액에서 WBC를 포함한 전혈구 검사, CRP, PCT, 혈액배양검사를 진행하였고, 임상 증상과 이학적 검사에 따라서 대변검사와 복부방사선 검사, 수막염 진단을 위한 뇌척수액 검사도 진행하였다. 결 과: 총 71명의 영아가 연구에 포함되었고 이 중에서 26명(36.6%)이 요로감염을 진단받았으며, 22명(31.0%)이 바이러스성 수막염을 진단받았다. 다른 질환으로는 급성 인두염과 포진성 구협염이 각각 1명씩 진단되었고, 상부 호흡기 감염증 7명, 급성 세기관지염 8명, 급성 위장관염 4명, 균혈증 2명이 진단되었다. 요로감염군과 바이러스성 수막염군을 비교했을때, WBC와 CRP수치는 요로감염군에서 통계적으로 유의하게 더 높은 수치를 보였으나, PCT수치는 두 군 사이에서 통계적으로 유의한 차이를 보이지 않았다. ROC 곡선 분석에 의해 산출한 곡선 아래 면적은 WBC 0.792 (95% CI, 0.65-0.896), CRP 0.77 (95% CI, 0.626-0.879), PCT 0.568 (95% CI, 0.417-0.710)로 측정되었으며, 다중 로지스틱 회귀분석에 의해 WBC가 11,920/${\mu}L$보다 큰 경우와 CRP가 1.06g/dL보다 큰 경우는 요로감염을 진단하는 데 있어서 진단적 가치가 있음을 확인하였다. 결 론: 6개월 미만의 발열을 주소로 내원한 영아에서 세균성 감염을 예측하기 위한 인자로서 혈청 PCT수치에 대한 연구가 부족하고 진단적 기준 역시 명확하지 않으므로 단독으로 해석함에 있어서 주의를 기울여야 한다.

• Tuberculosis and Respiratory Diseases
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• 제61권1호
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• pp.20-25
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• 2006

배 경 : 중환자실에서 발열은 가장 흔한 임상 상황이며 그 원인을 감염성 또는 비감염성으로 감별하는 것은 적절한 치료와 예후 측면에서 매우 중요하다. Procalcitonin(PCT)는 최근 여러 감염 질환의 뛰어난 표식자로 보고되고 있다. 연구자 등은 중환자실 발열 환자에서 혈청 PCT의 측정이 감염성과 비감염성 원인을 감별하는 데 도움이 되는지 알아보기 위해 연구를 시행하였다. 방 법 : 2005년 3월부터 8월까지 내과 중환자실에서 치료받은 환자 중 $38^{\circ}C$ 이상의 발열이 있는 환자를 대상으로 백혈구, CRP, PCT, IL-6, $TNF-{\alpha}$를 측정하였고 원인을 규명하기 위한 검사를 시행하였다. 감염성과 비감염성 원인의 감별은 배양 검사 결과와 임상적인 경과에 의존해 판단하였다. 감염성 발열 환자, 비감염성 발열 환자, 발열이 없는 중환자 및 건강 성인에서 각각의 값을 비교하였다. 결 과 : 1) 총 42명의 환자를 대상으로 46 예의 발열에 대해 평가하였다. 감염성으로 생각된 경우는 26 예, 비감염성은 13 예, 7예는 원인이 명확하지 않았다. 2) 감염성과 비감염성 원인의 발열의 정도, 백혈구 수, CRP, IL-6, $TNF-{\alpha}$는 유의한 차이가 없었다. 3) 감염성 원인과 비감염성 원인의 혈청 PCT는 각각 $15.1{\pm}32.57ng/mL$, $2.68{\pm}3.63ng/mL$로 감염성 원인이 높았으나 통계적인 유의성은 없었다(p=0.06). 4) 발열이 있는 환자의 혈청 PCT은 $10.94{\pm}27.15ng/mL$로, 발열이 없는 중환자의 $0.45{\pm}0.49ng/mL$에 비해 의미 있게 높았다(p=0.02). 결 론 : 중환자실 발열 환자에서 혈청 PCT의 측정은 감염성 원인과 비감염성 원인을 감별하는 데 도움이 되지 않을 것으로 사료된다.