1.Risk Factors for Failure to Eradicate Infection after Single Arthroscopic Debridement in Septic Arthritis of a Native Knee Joint
Junwoo BYUN ; Min JUNG ; Kwangho CHUNG ; Se-Han JUNG ; Hyeokjoo JANG ; Chong-Hyuk CHOI ; Sung-Hwan KIM
Yonsei Medical Journal 2025;66(5):295-301
Purpose:
To identify the risk factors and effect of empirical glycopeptide on the failure of single arthroscopic debridement for septic knee arthritis in a native knee joint.
Materials and Methods:
Patients who underwent arthroscopic debridement for septic knee arthritis from March 2005 to December 2022 at one institution were included in this study. Demographic data, comorbidities, preoperative factors including history of previous surgery, history of injection, laboratory data including preoperative C-reactive protein (CRP) and white blood cell (WBC) count, isolated pathogens from synovial fluid culture, and Gachter stage were analyzed. Statistical analyses using univariate and logistic regression were performed.
Results:
Out of 132 patients, 17 patients (12.9%) had more than one additional arthroscopic debridement. History of diabetes mellitus (DM) (p<0.001), previous injection (p=0.041), isolated Staphylococcus aureus in synovial fluid (p=0.010), and high Gachter stage (p=0.002) were identified as risk factors, whereas age, history of previous knee surgery at the affected knee, CRP level, preoperative WBC, and preoperative neutrophil count of synovial fluid had no significant relation. Logistic regression analysis showed significant increase of risk in patients with DM [odds ratio (OR) 12.002, 95% confidence interval (CI) 3.243–44.418, p<0.001], previous injection history (OR 4.812, 95% CI 1.367–16.939, p=0.017), and isolation of Staphylococcus aureus in synovial fluid (OR 4.804, 95% CI 1.282–18.001, p=0.031) as independent risk factors for failure of infection eradication after single arthroscopic debridement.
Conclusion
Comorbidity of DM, history of previous injection, isolated Staphylococcus aureus in synovial fluid, and high Gachter stage were associated with a higher risk of failure to eradicate infection with a single arthroscopic procedure. Empirical glycopeptide administration also showed no significant benefit in reducing the risk of additional surgical procedures for infection control, suggesting against the routine administration of glycopeptide.
2.Risk Factors for Failure to Eradicate Infection after Single Arthroscopic Debridement in Septic Arthritis of a Native Knee Joint
Junwoo BYUN ; Min JUNG ; Kwangho CHUNG ; Se-Han JUNG ; Hyeokjoo JANG ; Chong-Hyuk CHOI ; Sung-Hwan KIM
Yonsei Medical Journal 2025;66(5):295-301
Purpose:
To identify the risk factors and effect of empirical glycopeptide on the failure of single arthroscopic debridement for septic knee arthritis in a native knee joint.
Materials and Methods:
Patients who underwent arthroscopic debridement for septic knee arthritis from March 2005 to December 2022 at one institution were included in this study. Demographic data, comorbidities, preoperative factors including history of previous surgery, history of injection, laboratory data including preoperative C-reactive protein (CRP) and white blood cell (WBC) count, isolated pathogens from synovial fluid culture, and Gachter stage were analyzed. Statistical analyses using univariate and logistic regression were performed.
Results:
Out of 132 patients, 17 patients (12.9%) had more than one additional arthroscopic debridement. History of diabetes mellitus (DM) (p<0.001), previous injection (p=0.041), isolated Staphylococcus aureus in synovial fluid (p=0.010), and high Gachter stage (p=0.002) were identified as risk factors, whereas age, history of previous knee surgery at the affected knee, CRP level, preoperative WBC, and preoperative neutrophil count of synovial fluid had no significant relation. Logistic regression analysis showed significant increase of risk in patients with DM [odds ratio (OR) 12.002, 95% confidence interval (CI) 3.243–44.418, p<0.001], previous injection history (OR 4.812, 95% CI 1.367–16.939, p=0.017), and isolation of Staphylococcus aureus in synovial fluid (OR 4.804, 95% CI 1.282–18.001, p=0.031) as independent risk factors for failure of infection eradication after single arthroscopic debridement.
Conclusion
Comorbidity of DM, history of previous injection, isolated Staphylococcus aureus in synovial fluid, and high Gachter stage were associated with a higher risk of failure to eradicate infection with a single arthroscopic procedure. Empirical glycopeptide administration also showed no significant benefit in reducing the risk of additional surgical procedures for infection control, suggesting against the routine administration of glycopeptide.
3.The Effect of Nerve Growth Factor on Cartilage Fibrosis and Hypertrophy during In Vitro Chondrogenesis Using Induced Pluripotent Stem Cells
Se In JUNG ; Si Hwa CHOI ; Jang-Woon KIM ; Jooyoung LIM ; Yeri Alice RIM ; Ji Hyeon JU
International Journal of Stem Cells 2025;18(1):59-71
Nerve growth factor (NGF) is a neurotrophic factor usually involved in the survival, differentiation, and growth of sensory neurons and nociceptive function. Yet, it has been suggested to play a role in the pathogenesis of osteoarthritis (OA). Previous studies suggested a possible relationship between NGF and OA; however, the underlying mechanisms remain unknown. Therefore, we investigated the impact of NGF in chondrogenesis using human induced pluripotent stem cells (hiPSCs)-derived chondrogenic pellets. To investigate how NGF affects the cartilage tissue, hiPSC-derived chondrogenic pellets were treated with NGF on day 3 of differentiation, expression of chondrogenic, hypertrophic, and fibrotic markers was confirmed. Also, inflammatory cytokine arrays were performed using the culture medium of the NGF treated chondrogenic pellets. As a result, NGF treatment decreased the expression of pro-chondrogenic markers by approximately 2∼4 times, and hypertrophic (pro-osteogenic) markers and fibrotic markers were increased by approximately 3-fold or more in the NGF-treated cartilaginous pellets. In addition, angiogenesis was upregulated by approximately 4-fold or more, bone formation by more than 2-fold, and matrix metalloproteinase induction by more than 2-fold. These inflammatory cytokine array were using the NGF-treated chondrogenic pellet cultured medium.Furthermore, it was confirmed by Western blot to be related to the induction of the glycogen synthase kinase-3 beta (GSK3β) pathway by NGF. In Conclusions, these findings provide valuable insights into the multifaceted role of NGF in cartilage hypertrophy and fibrosis, which might play a critical role in OA progression.
4.Risk Factors for Failure to Eradicate Infection after Single Arthroscopic Debridement in Septic Arthritis of a Native Knee Joint
Junwoo BYUN ; Min JUNG ; Kwangho CHUNG ; Se-Han JUNG ; Hyeokjoo JANG ; Chong-Hyuk CHOI ; Sung-Hwan KIM
Yonsei Medical Journal 2025;66(5):295-301
Purpose:
To identify the risk factors and effect of empirical glycopeptide on the failure of single arthroscopic debridement for septic knee arthritis in a native knee joint.
Materials and Methods:
Patients who underwent arthroscopic debridement for septic knee arthritis from March 2005 to December 2022 at one institution were included in this study. Demographic data, comorbidities, preoperative factors including history of previous surgery, history of injection, laboratory data including preoperative C-reactive protein (CRP) and white blood cell (WBC) count, isolated pathogens from synovial fluid culture, and Gachter stage were analyzed. Statistical analyses using univariate and logistic regression were performed.
Results:
Out of 132 patients, 17 patients (12.9%) had more than one additional arthroscopic debridement. History of diabetes mellitus (DM) (p<0.001), previous injection (p=0.041), isolated Staphylococcus aureus in synovial fluid (p=0.010), and high Gachter stage (p=0.002) were identified as risk factors, whereas age, history of previous knee surgery at the affected knee, CRP level, preoperative WBC, and preoperative neutrophil count of synovial fluid had no significant relation. Logistic regression analysis showed significant increase of risk in patients with DM [odds ratio (OR) 12.002, 95% confidence interval (CI) 3.243–44.418, p<0.001], previous injection history (OR 4.812, 95% CI 1.367–16.939, p=0.017), and isolation of Staphylococcus aureus in synovial fluid (OR 4.804, 95% CI 1.282–18.001, p=0.031) as independent risk factors for failure of infection eradication after single arthroscopic debridement.
Conclusion
Comorbidity of DM, history of previous injection, isolated Staphylococcus aureus in synovial fluid, and high Gachter stage were associated with a higher risk of failure to eradicate infection with a single arthroscopic procedure. Empirical glycopeptide administration also showed no significant benefit in reducing the risk of additional surgical procedures for infection control, suggesting against the routine administration of glycopeptide.
5.Medical accident compensation systems in obstetrics: a comparison among Korea, Japan, and Taiwan, with suggestions for Korea
Kyong-No LEE ; Sang Hyun KIM ; Se Jin LEE ; Wook JANG ; Sunghun NA ; So Yun KIM
Journal of the Korean Medical Association 2025;68(3):148-156
Korea’s medical accident compensation system is a vital national initiative designed to create a stable environment for both mothers and healthcare professionals. This article examines how Korea's neighboring countries, Taiwan and Japan, operate their obstetric compensation systems to draw lessons and implications for Korea's approach.Current Concepts: Korea's medical malpractice compensation system is fully funded by the government, and the amount is determined by the Compensation Review Committee, which considers the type of accident and, in cases of cerebral palsy, the degree of impairment, with awards reaching up to 30 million won. Japan experienced severe declines in birth rates, a shortage of obstetricians, and the closure of maternity hospitals due to increasing medical litigation. In response, the government ,in 2009, introduced a no-fault obstetric compensation system that covers cerebral palsy cases regardless of negligence. Taiwan faced a surge in medical disputes, particularly in obstetrics and gynecology, with maternal lawsuits comprising 14% of all cases. In 2016, the government introduced the Childbirth Accident Emergency Relief Act, achieving a 93.9% compensation approval rate Discussion and Conclusion: Observing these challenges, young doctors are increasingly dissuaded from pursuing careers in obstetrics and gynecology doctor, thereby accelerating the decline of maternity care services. To maintain a stable medical environment, compensation amounts should be adjusted to reflect actual medical costs, and reimbursement rates for obstetric procedures should be re-evaluated. Drawing on the successful implementations in Japan and Taiwan, South Korea must establish a sustainable and protective obstetric care system at the national level.
6.Assessing Trainee Needs for Developing Response Scenarios and Training Manuals for Unknown Infectious Diseases: Insights From a Focus Group Interview
Wooyoung JANG ; Jinnam KIM ; Dabin EOM ; Yeseul NA ; Choseok YOON ; Se Yoon PARK ; Bongyoung KIM
Journal of Korean Medical Science 2025;40(3):e81-
This study employed focus group interviews (FGIs) to evaluate the preparedness and training requirements for an emerging infectious disease response system in the Republic of Korea.Based on the FGIs, the critical role of interdepartmental cooperation in responding to emerging infectious diseases was identified, with agencies such as public health centers, police, and fire services playing key roles in scene control, decontamination, and patient transport. Frequent staff turnover and a lack of trained personnel at local government levels were significant challenges, necessitating the development of training materials for unskilled workers. Civil complaints, common during outbreaks, require public officials to be educated on legal frameworks and the management of patients’ rights. The absence of standardized procedures for managing patients, such as bed assignments considering underlying conditions and sample collection, underscores the need for comprehensive guidelines.Interviewees emphasized cross-departmental training, detailed manuals, and legal education to improve infectious disease response capabilities.
7.Assessing Trainee Needs for Developing Response Scenarios and Training Manuals for Unknown Infectious Diseases: Insights From a Focus Group Interview
Wooyoung JANG ; Jinnam KIM ; Dabin EOM ; Yeseul NA ; Choseok YOON ; Se Yoon PARK ; Bongyoung KIM
Journal of Korean Medical Science 2025;40(3):e81-
This study employed focus group interviews (FGIs) to evaluate the preparedness and training requirements for an emerging infectious disease response system in the Republic of Korea.Based on the FGIs, the critical role of interdepartmental cooperation in responding to emerging infectious diseases was identified, with agencies such as public health centers, police, and fire services playing key roles in scene control, decontamination, and patient transport. Frequent staff turnover and a lack of trained personnel at local government levels were significant challenges, necessitating the development of training materials for unskilled workers. Civil complaints, common during outbreaks, require public officials to be educated on legal frameworks and the management of patients’ rights. The absence of standardized procedures for managing patients, such as bed assignments considering underlying conditions and sample collection, underscores the need for comprehensive guidelines.Interviewees emphasized cross-departmental training, detailed manuals, and legal education to improve infectious disease response capabilities.
8.The Effect of Nerve Growth Factor on Cartilage Fibrosis and Hypertrophy during In Vitro Chondrogenesis Using Induced Pluripotent Stem Cells
Se In JUNG ; Si Hwa CHOI ; Jang-Woon KIM ; Jooyoung LIM ; Yeri Alice RIM ; Ji Hyeon JU
International Journal of Stem Cells 2025;18(1):59-71
Nerve growth factor (NGF) is a neurotrophic factor usually involved in the survival, differentiation, and growth of sensory neurons and nociceptive function. Yet, it has been suggested to play a role in the pathogenesis of osteoarthritis (OA). Previous studies suggested a possible relationship between NGF and OA; however, the underlying mechanisms remain unknown. Therefore, we investigated the impact of NGF in chondrogenesis using human induced pluripotent stem cells (hiPSCs)-derived chondrogenic pellets. To investigate how NGF affects the cartilage tissue, hiPSC-derived chondrogenic pellets were treated with NGF on day 3 of differentiation, expression of chondrogenic, hypertrophic, and fibrotic markers was confirmed. Also, inflammatory cytokine arrays were performed using the culture medium of the NGF treated chondrogenic pellets. As a result, NGF treatment decreased the expression of pro-chondrogenic markers by approximately 2∼4 times, and hypertrophic (pro-osteogenic) markers and fibrotic markers were increased by approximately 3-fold or more in the NGF-treated cartilaginous pellets. In addition, angiogenesis was upregulated by approximately 4-fold or more, bone formation by more than 2-fold, and matrix metalloproteinase induction by more than 2-fold. These inflammatory cytokine array were using the NGF-treated chondrogenic pellet cultured medium.Furthermore, it was confirmed by Western blot to be related to the induction of the glycogen synthase kinase-3 beta (GSK3β) pathway by NGF. In Conclusions, these findings provide valuable insights into the multifaceted role of NGF in cartilage hypertrophy and fibrosis, which might play a critical role in OA progression.
9.Assessing Trainee Needs for Developing Response Scenarios and Training Manuals for Unknown Infectious Diseases: Insights From a Focus Group Interview
Wooyoung JANG ; Jinnam KIM ; Dabin EOM ; Yeseul NA ; Choseok YOON ; Se Yoon PARK ; Bongyoung KIM
Journal of Korean Medical Science 2025;40(3):e81-
This study employed focus group interviews (FGIs) to evaluate the preparedness and training requirements for an emerging infectious disease response system in the Republic of Korea.Based on the FGIs, the critical role of interdepartmental cooperation in responding to emerging infectious diseases was identified, with agencies such as public health centers, police, and fire services playing key roles in scene control, decontamination, and patient transport. Frequent staff turnover and a lack of trained personnel at local government levels were significant challenges, necessitating the development of training materials for unskilled workers. Civil complaints, common during outbreaks, require public officials to be educated on legal frameworks and the management of patients’ rights. The absence of standardized procedures for managing patients, such as bed assignments considering underlying conditions and sample collection, underscores the need for comprehensive guidelines.Interviewees emphasized cross-departmental training, detailed manuals, and legal education to improve infectious disease response capabilities.
10.Medical accident compensation systems in obstetrics: a comparison among Korea, Japan, and Taiwan, with suggestions for Korea
Kyong-No LEE ; Sang Hyun KIM ; Se Jin LEE ; Wook JANG ; Sunghun NA ; So Yun KIM
Journal of the Korean Medical Association 2025;68(3):148-156
Korea’s medical accident compensation system is a vital national initiative designed to create a stable environment for both mothers and healthcare professionals. This article examines how Korea's neighboring countries, Taiwan and Japan, operate their obstetric compensation systems to draw lessons and implications for Korea's approach.Current Concepts: Korea's medical malpractice compensation system is fully funded by the government, and the amount is determined by the Compensation Review Committee, which considers the type of accident and, in cases of cerebral palsy, the degree of impairment, with awards reaching up to 30 million won. Japan experienced severe declines in birth rates, a shortage of obstetricians, and the closure of maternity hospitals due to increasing medical litigation. In response, the government ,in 2009, introduced a no-fault obstetric compensation system that covers cerebral palsy cases regardless of negligence. Taiwan faced a surge in medical disputes, particularly in obstetrics and gynecology, with maternal lawsuits comprising 14% of all cases. In 2016, the government introduced the Childbirth Accident Emergency Relief Act, achieving a 93.9% compensation approval rate Discussion and Conclusion: Observing these challenges, young doctors are increasingly dissuaded from pursuing careers in obstetrics and gynecology doctor, thereby accelerating the decline of maternity care services. To maintain a stable medical environment, compensation amounts should be adjusted to reflect actual medical costs, and reimbursement rates for obstetric procedures should be re-evaluated. Drawing on the successful implementations in Japan and Taiwan, South Korea must establish a sustainable and protective obstetric care system at the national level.

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