• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.52-58
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• 2019

Purpose: Fungal periprosthetic joint infection (PJI) is a rare but devastating complication following total knee arthroplasty (TKA). On the other hand, a standardized procedure regarding an accurate treatment of this serious complication of knee arthroplasty is lacking. The clinical progress of staged reimplantation in patients who had fungus-related PJI after TKA was reviewed retrospectively. Materials and Methods: Ten patients who had a fungal related PJI after TKA between 2006 and 2017 using staged reimplantation surgery were reviewed. These patients were compared with 119 patients who had a PJI in the same period. The failure rate of infection control, intravenous antimicrobial using the period, and the clinical results were evaluated by comparing the range of motion and Korean knee score (KKS) between pre-staged reimplantation and the last follow-up. Results: In the fungal infection group, 7 out of 10 cases (70.0%) had failed in infection control using staged reimplantation and in the non-fungal group, 7 out of 119 cases (5.9%) had failed (p=0.04). In the non-fungal group, the mean duration of antibiotics was 6.2 weeks. In the fungus group, the mean duration of antibiotics was 15.3 weeks, which was 9.1 weeks longer (p<0.001). The range of motion of the knee was increased in the two groups (p=0.265). At the last follow-up, the KKS was 71.01 points in the non-fungal group and 61.3 points in the fungal group (p=0.012). Erythrocyte sedimentation rate and C-reactive protein (CRP) decreased in the two groups, but the CRP was significantly different in the two groups (p=0.007). Conclusion: The treatment of fungus-related PJIs using staged reimplantation showed uneven clinical progress and unsatisfactory clinical improvements compared to non-fungal PJI. Therefore, it is necessary to consider the use of an antifungal mixed cement spacer at resection arthroplasty and oral antifungal agent after reimplantation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.422-430
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• 2010

Purpose: The aim of this study is that we evaluate the change of the White Blood Cell(WBC) count, Absolute Neutrophil Count (ANC), Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP) values, and try to make standardization for postoperative sequels before and after the oral cancer resection and reconstructive surgery. Materials and Methods: The study was comprised of 34 patients (male 15, female 19) who were diagnosed as an oral cancer and had performed ablation and reconstructive surgery at Dankook university dental hos-pital. Each blood specimen was collected from patients and estimated WBC count, Neutrophil count, ESR, CRP on first, third, fifth, seventh day efore and after surgery and analyzing inter relationship between each value. Classifying Group I (resection with reconstructive surgery patients) and Group II (resection without reconstructive surgery patients). Also classifying group A (below 4 hours of operation time), Group B (4 to 8 hours of operation time), Group C (above 8 hours of operation time), each group was analyzed and compared. The Following results were induced. Results: (1) In coefficient of correlation, the CRP and WBC has highest value except WBC count and Neutrophil count. (2) There was no significant difference any lapse in the progress between Group I and II of WBC count, Neutrophil count, but the CRP shows statistically higher level in group I than group II at immediate postoperative day, and 1 to 5 days after surgery. (3) There is no significant difference any lapse in the progress between Group A, B, C of WBC count, Neutrophil count, but CRP shows statistically significant difference in 1 day, 3 days after surgery Conclusion: It should be suggested that, determination of CRP is most valuable parameter for postopera-tive management and determination of postoperative clinical changes than other parameter such as WBC count, neutrophil count, and ESR values in oral cancer patient after resection and reconstructive surgery, based on the results of this study.

• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.856-867
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• 2020

Objectives: The purpose of this case study was to report the effect of Korean Medicine treatment on a patient diagnosed with nontuberculous mycobacterial lung disease. Methods: A 61-year-old female patient with nontuberculous mycobacterial lung disease was admitted to the clinic from October 15th, 2018 to November 7th, 2018. The patient was treated using Korean medical treatments of Jinhae-tang-gami, Ssanghwa-tang-gami, Haeyeol-tang, Jinhae-tang plus Ssanghwa-tang-gami, and Jinhae-tang plus Bojungikgi-tang-gami. We evaluated the improvement of symptoms by a numeric rating scale (NRS) score, C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and body temperature. Results: After Korean medicine treatment, the patient's cough and sputum amounts were decreased as measured by the NRS score. CRP levels and ESR were also decreased and fever was relieved. Conclusion: This study suggested that Korean medicine treatment might be effective in treating patients diagnosed with nontuberculous mycobacterial lung disease.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.159-166
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• 2015

Purpose: The aim of the present study was to investigate the risk factors for the development of coronary artery lesions (CALs) and to determine whether hyponatremia is associated with CALs in children with Kawasaki disease (KD). Methods: We retrospectively analyzed the data of 105 children with KD who were admitted to Ilsan Hospital between January 2000 and July 2011. Results: Erythrocyte sedimentation rate (P = 0.013), total bilirubin levels (P = 0.017) were higher and serum sodium levels (P = 0.027) were lower in KD children with CALs than those without. White blood cell (WBC) counts (P = 0.006), neutrophil counts (P = 0.003) were higher and albumin levels (P = 0.009) were lower in KD children with hyponatremia than those without. On multiple logistic regression analysis, hyponatremia (P = 0.024) and intravenous immunoglobulin-resistance (P = 0.024) were independent risk factors for CALs in KD. Furthermore, serum sodium levels were correlated negatively with WBC counts (P = 0.004), neutrophil counts (P < 0.001), total bilirubin levels (P = 0.005) and positively with albumin levels (P = 0.009). Conclusion: Our study indicates that hyponatremia may reflect severe inflammation in children with KD.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.414-423
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• 1998

Metal fume fever has been known as an occupational disease is induced by intense inhalation of fresh metal fume with a particle size smaller than $0.5{\mu}m\;to\;1{\mu}m$. The fumes originate from heating metals beyond their boiling point, as happens, for example, in welding operations. Oxidation usually accompanies this process. In most cases, this syndrome is due to exposure to zinc oxide fumes; however, other metals like copper, magnesium, cadmium, manganese, and antimony are also reported to produce such reactions. Authors report a case of metal fume fever suspected to be associated with copper fume inhalation. The patient was a 42-year-old male and was a smoker. He conducted inert gas tungsten arc welding on copper-coated materials without safety precautions such as a protective mask and adequate ventilation. Immediately after work, he felt metallic taste in his mouth. A few hours after welding, he developed headache, chilling sensation, and chest discomfort. He also complained of myalgia, arthralgia, feverish sensation, thirst, and general weakness. Symptoms worsened after repeated copper welding on the next day and subsided gradually following two weeks. Laboratory examination showed a transient increase of neutrophil count, eosinophilia, elevated erythrocyte sedimentation rate, and positive C-reactive proteinemia. Blood and urine copper level was also increased compared to his wife. Before this episode, he experienced above complaints several times after welding with copper materials but welding of other metals did not produce any symptoms. It was suggested that copper fume would have induced metal fume fever in this case. Further investigations are needed to clarify their pathogenic mechanisms.

• Journal of Korean Neurosurgical Society
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• v.40 no.6
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• pp.412-418
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• 2006

Objective : The safety of titanium metal cages in tuberculous spondylitis has not been investigated. We evaluated the outcome and complications of titanium mesh cages for reconstruction after thoracolumbar vertebrectomy in the tuberculous spondylitis. Methods : There were 17 patients with 18 operations on the tuberculous spondylitis in this study. Sixteen patients were operated with anterior corpectomy and reconstruction with titanium mesh cage followed by posterior transpedicular screw fixations on same day, two pateints were operated by either anterior or posterior approach only. After the affected vertebral body resection and pus drainage from the psoas muscle, titanium mesh cage, filled with morselized autogenous bone, was inserted. All the patients had antituberculosis medication for 18 months. The degree of kyphosis correction and the subsidence of cage were measured in the 15 patients available at a minimum of 2 years. Outcome was assessed with various cross-sectional outcome measures. Recurrent infection was identified by serial ESR[Erythrocyte Sedimentation Rate] and CRP[Cross Reactive Protein]. Results : There was no complication from the use of a titanium mesh cage. Recurrent infection was not detected in any case. Average preoperative of $9.2^{\circ}$ was reduced to $-2^{\circ}$ at immediate postoperative period, and on final follow up period kyphotic angle was measured to be $4.5^{\circ}$. Postoperatively, subsidence was detected in most patients especially at ambulation period, however further subsidence was prevented by the titanium mesh cage. Osseous union was identified in all cases at the final follow-up. Conclusion : The cylindrical mesh cage is a successful instrument in restoring and maintaining sagittal plane alignment without infection recurrence after vertebrectomy for tuberculous spondylitis.

• Journal of Korean Neurosurgical Society
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• v.58 no.3
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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.

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.231-240
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• 2005

Objectives: In order to investigate the efficacy and safety of the newly developed herbal medicine Jetongdan, a placebo­controlled, randomized clinical trial of patients with osteoarthritis of the knee was undertaken. Methods: Data were obtained from 80 patients with OA of the knee. After enrollment, they were asked to answer a disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index) and analyzed with the erythrocyte sedimentation rate (ESR) in order to evaluate the efficacy of Jetongdan, and analyzed for aspartate transaminase (AST) level, alanine transaminase (ALT) level, blood mea nitrogen (BUN) level, and creatinine (Cr) level in order to evaluate the safety of Jetongdan. Results: The liver function and renal function did not deteriorate after treatment with Jetongdan. Composite WOMAC score and physical function subscale was improved, but pain subscale, stiffness subscale, and ESR were not improved by. This was possibly because the baseline characteristics of the two groups were not homogenized after randomization. Conclusions: Jetongdan could be a promising treatment option for osteoarthritis of the knee. Further study in a larger population with appropriate severity grades is recommended.

• Clinical and Experimental Pediatrics
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• v.59 no.3
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• pp.139-144
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• 2016

Purpose: Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a useful marker to predict APN or vesicoureteral reflux (VUR). Methods: We retrospectively evaluated 298 pediatric patients ($age{\leq}36months$) with febrile UTI from January 2010 to December 2014. Conventional infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and NLR were measured. Results: WBC, CRP, ESR, and NLR were higher in APN than in lower UTI (P<0.001). Multiple logistic regression analyses showed that NLR was a predictive factor for positive dimercaptosuccinic acid (DMSA) defects (P<0.001). The area under the receiver operating characteristic (ROC) curve was high for NLR (P<0.001) as well as CRP (P<0.001) for prediction of DMSA defects. NLR showed the highest area under the ROC curve for diagnosis of VUR (P<0.001). Conclusion: NLR can be used as a diagnostic marker of APN with DMSA defect, showing better results than those of conventional markers for VUR prediction.

• Clinical and Experimental Pediatrics
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• v.56 no.1
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• pp.13-18
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• 2013

Purpose: Kawasaki disease (KD) is a systemic vasculitis and affects many organ systems. It often presents sterile pyuria, microscopic hematuria, and proteinuria due to renal involvement. The aims of this study were to define clinical characteristics of acute KD patients with pyuria and to analyze meaning of pyuria in KD. Methods: The medical records and laboratory findings including serum and urine test of 133 patients with KD admitted to Yeungnam University Hospital from March 2006 to December 2010 were reviewed retrospectively. Results: Forty patients had sterile pyuria and their clinical characteristics including age, gender and body weight were not significantly different with those who did not have pyuria. Fever duration after treatment was significantly longer in KD patients with pyuria. Erythrocyte sedimentation rate, C-reactive protein and serum concentration of alanine aminotransferase were significantly higher in patients with pyuria. Hyponatremia and coronary artery lesion were seen more often in patients with pyuria but there was no significant difference. Also serum blood urea nitrogen was significantly higher in KD patients with pyuria. Urine ${\beta}_2$-microglobulin was elevated in both patients groups and showed no difference between two groups. Conclusion: We found more severe inflammatory reaction in KD patients with pyuria. We also found elevation of some useful parameters like ${\beta}_2$-microglobulin that indicate renal involvement of KD through the urine test. Careful management and follow up will need for KD patients with pyuria and it is necessary in the future to study the specific parameters for renal involvement of KD.