To define the effectiveness of C-reactive protein (CRP) as indicator for early detection of the post-operative infection, it is essential to exclude possible normal changes of CRP influenced by surgery itself. We analyzed 44 patients who had done orthopaedic surgeries without any evidence of infection preoperative and postoperatively from May to Aug. 1995 at Dongsan medical center, Keimyung University. We checked the levels of Erythrocyte sedimentation rate (ESR) and CRP levels at preoperative and postoperative 1, 3, 5, 7, 9, 11, 13, 15, 17, 19 and 21st day in all cases. In all cases, ESR increased up to 60mm/hr maximally and CRP increased to more than 10mg/dl at least one occasion within the first 3 weeks postoperatively. However CRP showed more rapid changes than ESR. The mean value of the CRP was increased maximally (7.2mg/dl) at 3 day after operation and then decreased rapid until 11 day. ESR was also increased at 3 day after operation, but it sustained high level until 21 day after operation. CRP appears to be more sensitive and rapid indicator as an acute phase reactant for the operation itself because CRP revealed more earlier and accentuated change after the operation. The changes of CRP showed same pattern regardless of operation time, use of tourniquet, use of transfusion and gender. In conclusion, within 3 day after operation, the high titer of CRP can not to be an indicator for early detection of the infection, because normal high titer can be developed by surgery itself. If there notes persistent high titer or more increasing pattern of CRP after postoperative 3 day or abnormal high titer of CRP after 11 day postoperatively, infection may be highly suspicious.
Blood Sedimentation ; C-Reactive Protein ; Humans ; Tourniquets

OBJECTIVE: To evaluate whether co-culture of oocytes on vero cell monolayers from Day 0 (Day 0 group) after egg retrieval results in an increase in developmental capacity such as fertilization rate, embryo quality, blastulation and clinical pregnancy rate compared with co-culture of oocytes from Day 1 (Day 1 group). METHODS: Sperms were treated with Hams F-10 supplemented with 10% human follicular fluid (hFF). Vero cells for co-culture were prepared in TCM-199 with 10% FBS. Oocytes were co-cultured from Day 0 and fertilized oocytes were co-cultured from Day 1 on vero cell monolayers in DMEM with 10% and 20% hFF, respectively after egg retrieval. On day 1, 2 and 5, fertilization rate and grade of embryos and blastocysts were evaluated. Results (fertilization rate, cleavage rate, grade of embryos and blastocysts and pregnancy rate) were considered statistically significant when p value was less than 0.05 using t-test and ci2. RESULTS: In sibling oocytes of same cycles, no differences were found in fertilization rate (94.6 vs. 91.4%), cleavage rates (94.6 vs. 91.4%), embryo grade (on day 2 and 3) and blastulation (65.6 vs. 57.0%) and their grade. In different oocytes of different cycles (patients), no differences were found in fertilization (79.8 vs. 78.3%), cleavage rates (77.7 vs. 76.4%) and blastulation (56.0 vs. 45.3%), but pregnancy rate was higher in the Day 0 group than in the Day 1 group (60.0 vs. 42.9%). CONCLUSIONS: This study revealed that the embryonic development capacities were not affected by the different co-culture time in the sibling oocytes of same cycles. Although no statistical significance, because of small size of study, there was a trend for higher pregnancy rates in Day 0 group compared to Day 1 group in different oocytes of different cycles.
Blastocyst ; Coculture Techniques* ; Embryonic Development* ; Embryonic Structures ; Female ; Fertilization ; Follicular Fluid ; Humans ; Oocytes* ; Ovum ; Pregnancy ; Pregnancy Rate ; Siblings ; Spermatozoa ; Vero Cells

We report here a case of maternal 3-methylcrotonyl-coenzyme A carboxylase (3-MCC) deficiency in a Korean woman. Her 2 infants had elevated 3-hydroxyisovalerylcarnitine (C5-OH) on a neonatal screening test by liquid chromatography-tandem mass spectrometry (LC-MS/MS), but normal results were found on urine organic acid analysis. The patient was subjected to serial testing and we confirmed a maternal 3-MCC deficiency by blood spot and breast milk spot test by LC-MS/MS, serum amino acid analysis, urine organic acid and molecular genetic analysis that found c.838G>T (p.Asp280Tyr) homozygous mutation within exon 9 of the MCCB gene. Especially, we confirmed marked higher levels of C5-OH on breast milk spot by LC-MS/MS, in the case of maternal 3-MCC deficiency vs. controls.
Breast* ; Exons ; Female ; Humans ; Infant ; Infant, Newborn ; Mass Spectrometry ; Milk, Human* ; Molecular Biology ; Neonatal Screening

No abstract available.
Animals ; Hypothermia* ; Rats*

BACKGROUND: Cytokines play a key role in the regulation of cells of the immune system and also have been implicated in the pathogenesis of malignant disease. Usually malignant cells secreted various types of cytokine, and the cytokine levels have been shown to be potential for diagnosis of malignant disease. To differentiate the ovarian cancer from other benign diseases, the levels of cytokine in peritoneal fluid have been revealed more effect than those in blood. METHODS: The levels of interferon-gamma, tumor necrosis factor-alpha, interleukin-1 beta, interleukin-5, interleukin-6 and interleukin-10 in peritoneal fluid from 31 cases of ovarian cyst, 14 cases of ovarian cancer, and 20 cases of endometriosis were determined by enzyme-linked immunosorbent assay(Endogen Inc., USA). RESULTS: The mean level of interleukin-1 beta, interleukin-6, and interleukin-10 in the patients of in ovarian cancer were 10.49+/-17.44 pg/mL, 705.79+/-236.06 pg/mL and 231.56+/-145.43 pg/mL, respectively, which were significantly higher than in ovarian cyst(2.00+/-2.04 pg/mL, 103.42+/-154.49 pg/mL and 27.90+/-23.20 pg/mL, respectively)(P<0.05). The mean concentration of interferon-gamma, tumor necrosis factor-alpha, and interleukin-5 in patients of ovarian cancer were not significantly different from the benign group. CONCLUSIONS: The cytokine levels of peritoneal fluid in ovarian cancer were significantly higher than ovarian cyst and endometriosis. So, the measurement of cytokine level in neoplastic effusion could be useful to differentiate malignant from ovarian cyst.
Ascitic Fluid* ; Cytokines ; Diagnosis ; Diagnosis, Differential* ; Endometriosis ; Female ; Humans ; Immune System ; Interferon-gamma ; Interleukin-1 ; Interleukin-10 ; Interleukin-1beta ; Interleukin-5 ; Interleukin-6 ; Ovarian Cysts ; Ovarian Diseases* ; Ovarian Neoplasms* ; Tumor Necrosis Factor-alpha

Electrocochleography(ECoG) is used to evaluate the cochlear function in patients with Meniere's disease. Endolymphatic hydrops is widely accepted as the underlying pathological finding in Meniere's disease and may cause the elevation of the ratio of summating potential amplitude to action potential amplitude. So, SP/AP amplitude ratio has been suggested as a diagnostic indicator for Meniere's disease. A variety of electrode locations have been employed to record the precise cochlear potentials better. In this study, we peformed extratympanic ECoG with an electrode(TIP trode(R)) that was placed in contact with the ear canal wall in normal subjects and Meniere's patients. The SP/AP amplitude ratio and the SP amplitude measured in the ears of patients with bilateral Meniere's disease and in the involved ear of patients with unilateral Meniere's disease were significantly larger than in the ears of normal subjects. In the contralateral ear of patients with unilateral Meniere's disease, the SP/AP amplitude ratio was significantly larger than in the ears of normal subjects; however, it was below the level for the diagnostic criteria of endolymphatic hydrops in Meniere's disease. This study suggests that ECoG can be a useful tool for the diagnosis of Meniere's disease and the early detection of incipient Meniere's disease in the contralateral ear of a patient with unilateral Meniere's disease.
Action Potentials ; Audiometry, Evoked Response* ; Diagnosis ; Ear ; Ear Canal ; Electrodes ; Endolymphatic Hydrops ; Humans ; Meniere Disease

A 66-year-old female who had undergone surgery for a herniated disc at the L5-S1 level at another hospital 3 months earlier was admitted with persistent back and leg pain. She was diagnosed with spondylodiscitis at the L5-S1 level by magnetic resonance imaging. A biopsy was performed, and Candida parapsilosis and Enterococcus faecium were isolated from the excised material. We report herein a case of successful treatment of polymicrobial spondylodiscitis in accordance with accurate microbiological diagnosis. Based on this case, we hope to encourage physicians to perform biopsies more aggressively or repeatedly to improve the diagnostic yield.
Aged ; Biopsy ; Candida ; Coinfection ; Diagnosis ; Discitis* ; Enterococcus faecium ; Female ; Hope ; Humans ; Intervertebral Disc Displacement ; Leg ; Magnetic Resonance Imaging

Aspergillus fumigatus is the most common pathogen causing invasive aspergillosis. Although invasive aspergillosis mainly involves lung, brain, and sinus, Aspergillus fumigatus osteomyelitis of the spine has been reported very rarely. We experienced a case of vertebral Aspergillus osteomyelitis and report it with a review. A 70-year-old women was admitted due to progressive lower back pain, which had begun 1 month before admission. Although she had diabetes and hypertension, no other underlying disease or immune dysfunction was found. MRI of spine showed severely destroyeded lumbar spines. Debridement and bone graft was done for correction of unstable spine, and Aspergillus fumigatus was grown from surgical specimen. Amphotericin B was given up to total 2 g, and was switched to oral itraconazole maintenance therapy. She is well until now, 120 days after operation. On the other hand, anthracofibrosis due to Mycobacterium tuberculosis was found through bronchoscopic study, which was done because of atelectasis in left lower lobe of lung. Therefore she was treated with anti-tuberculous agents also.
Aged ; Amphotericin B ; Aspergillosis ; Aspergillus fumigatus* ; Aspergillus* ; Brain ; Debridement ; Female ; Hand ; Humans ; Hypertension ; Itraconazole ; Low Back Pain ; Lung ; Magnetic Resonance Imaging ; Mycobacterium tuberculosis ; Osteomyelitis* ; Pulmonary Atelectasis ; Spine ; Transplants

BACKGROUND: Iodine is an intrinsic element of thyroid hormone, which is essential for childhood growth and development. The Ideal Breast Milk (IBM) cohort study aims to evaluate the effects of maternal iodine status during pregnancy and lactation on maternal thyroid function, offspring growth and development, and offspring thyroid function. METHODS: The IBM cohort study recruited pregnant women from Seoul National University Hospital between June 2016 and August 2017, followed by enrollment of their offspring after delivery. For the maternal participants, iodine status is evaluated by urinary iodine concentration (UIC) and dietary records in the third trimester and at 3 to 4 weeks and 12 to 15 months postpartum. For the child participants, cord blood sampling and UIC measurements are performed at birth. At 3 to 4 weeks of age, UIC and breastmilk iodine concentrations are measured. At 12 to 15 months of age, growth and development are assessed and measurements of UIC, a thyroid function test, and ultrasonography are performed. RESULTS: A total of 198 pregnant women in their third trimester were recruited. Their mean age was 35.1±3.5 years, and 78 (39.4%) of them were pregnant with twins. Thirty-three (16.7%) of them had a previous history of thyroid disease. CONCLUSION: Korea is an iodine-replete area. In particular, lactating women in Korea are commonly exposed to excess iodine due to the traditional practice of consuming brown seaweed soup postpartum. The study of the IBM cohort is expected to contribute to developing guidelines for optimal iodine nutrition in pregnant or lactating women.
Breast* ; Child ; Cohort Studies* ; Cordocentesis ; Diet Records ; Female ; Growth and Development* ; Humans ; Infant ; Iodine* ; Korea ; Lactation* ; Milk, Human* ; Parturition ; Postpartum Period ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Prospective Studies* ; Seaweed ; Seoul ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland* ; Twins ; Ultrasonography

BACKGROUND: Vancomycin-resistant enterococci (VRE) have become one of the important nosocomial pathogens. VRE infections are difficult to treat because few antibiotics are effective currently. Since 1998, VRE have been increasingly isolated in a tertiary care hospital with 1253 beds in Korea. To prevent endemic stage of VRE in the hospital, early intervention with intensive infection control strategies was implemented and the efficacy was evaluated. METHODS: Infection control team monitored VREisolated patients prospectively for 8 months (Mar-Oct, 2000). Infection control strategies including contact precaution of patients were applied for the first three months (the 1st phase :Mar~May). Rectal cultures were done to identify rectal colonization of VRE from all of the VRE-isolated patients and from their roommates. Health care workers' (HCW) hands and environments related with VRE patients were cultured to identify contaminations or colonizations. More intensive infection control strategies including strict isolation of patients were applied for the following 5 months (the 2nd phase : Jun~Oct). Pulsed field gel electrophoresis (PFGE) was done to document genetic relatedness of isolated VRE. RESULTS: Total 26 strains of VRE were isolated from 26 patients during study period. Isolation of VRE had decreased from 1.78 cases per 10,000 patients-days before the study to 1.49 cases during the 1st phase (P=0.4) and to 0.75 cases during the 2nd phase (P=0.02). Rectal colonization rate for VRE isolated patients was 40.9% (9/22); for roommates, 17.1% (12/70). Contamination rate of HCW's hands was 2.3 % (4/ 172) and environmental contamination rate was 8.4% (38/455). Six different PFGE patterns were identified with 43 isolates and 67.6% (29/43) showed the same PFGE patterns. CONCLUSIONS: It was supposed that single clonal epidemic strain had been probably transmitted between the patients, the environments, and the HCW's hands in the hospital. Intensive VRE infection control strategies including strict isolation were very effective to decrease the VRE isolation rate.
Anti-Bacterial Agents ; Colon ; Delivery of Health Care ; Early Intervention (Education) ; Electrophoresis, Gel, Pulsed-Field ; Enterococcus ; Hand ; Humans ; Infection Control ; Korea ; Prospective Studies ; Tertiary Healthcare* ; Vancomycin Resistance ; Vancomycin*