Mass Infection Analysis of COVID-19 Using the SEIRD Model in DaeguGyeongbuk of Korea from April to May, 2020

Background@#The novel coronavirus (coronavirus disease 2019 [COVID-19]) outbreak began in China in December last year, and confirmed cases began occurring in Korea in mid-February 2020. Since the end of February, the rate of infection has increased greatly due to mass (herd) infection within religious groups and nursing homes in the Daegu and Gyeongbuk regions. This mass infection has increased the number of infected people more rapidly than was initially expected; the epidemic model based on existing studies had predicted a much lower infection rate and faster recovery. @*Methods@#The present study evaluated rapid infection spread by mass infection in Korea and the high mortality rate for the elderly and those with underlying diseases through the Susceptible-Exposed-Infected-Recovered-Dead (SEIRD) model. @*Results@#The present study demonstrated early infection peak occurrence (-6.3 days for Daegu and -5.3 days for Gyeongbuk) and slow recovery trend (= -1,486.6 persons for Daegu and -223.7 persons for Gyeongbuk) between the actual and the epidemic model for a mass infection region compared to a normal infection region. @*Conclusion@#The analysis of the time difference between infection and recovery can help predict the epidemic peak due to mass (or normal) infection and can also be used as a time index to prepare medical resources.

A Case of Steven-Johnson Syndrome after Live Bee Acupuncture (Bong-Chim)

Bee stings can cause various skin reactions that usually resolve over several days; however, in some patients the venom acts as an allergen, causing a severe immunological response such as anaphylaxis. Bee stings can also induce chronic inflammation because the barbed stinging apparatus and venom sacs, along with the nerve plexus, can lodge in the skin. Chronic non-specific low back pain is the most common medical problem for which patients seek complementary and alternative medical treatment, including bee venom acupuncture. Bee venom acupuncture involves injecting diluted bee venom into acupoints and is used for arthritis, pain, and rheumatoid diseases. Here we report a 75-year-old man with acute urticaria and skin eruption with eosinophilia and interstitial pneumonia 6 weeks later after receiving 5 times bee venom acupuncture.

Development and Effect of a Metabolic Syndrome Prevention Program for University Students using Mobile Application

PURPOSE: The purpose of the study was to develop and evaluate the effect of a metabolic syndrome prevention program using mobile application for university students. METHODS: A pretest-posttest design with content analysis as a triangulation method was used. The participants were 49 university students. Data were analyzed using descriptive statistics, chi2-test, t-test and Fisher's exact test with the SPSS WIN 18.0 program. RESULTS: The application consisted of six main menus as follows: 'basic education', 'nutrition education', 'exercise education', 'meal diary', 'exercise checkup', and 'tips'. The experimental group had higher recognition about metabolic syndrome prevention than the control group (F=7.919, p=.007). Understanding of metabolic syndrome among participants was mostly related to chronic diseases such as obesity, hypertension and diabetes in relation to the importance of eating habits and exercising. CONCLUSION: The results indicate that metabolic syndrome prevention education using mobile application is necessary and would be useful for university students.

Surgical completeness of total thyroidectomy using harmonic scalpel: comparison with conventional total thyroidectomy in papillary thyroid carcinoma patients / 대한외과학회지

PURPOSE: The aim of this study was to compare the surgical completeness and outcome of total thyroidectomy in two patient groups: One treated by harmonic scalpel (HS) and one by conventional total thyroidectomy (CT). METHODS: Between March 2006 and December 2007, 104 patients had total thyroidectomy by HS and 108 patients underwent CT. We analyzed clinicopathological characteristics and stimulated serum thyroid-stimulating hormone (TSH), thyroglobulin (Tg), and anti-Tg antibodies at the time of ablation for both groups. RESULTS: Compared with the CT group, the HS group had shorter operating time and hospital stays and reduced postoperative drainage. At postsurgical ablation, mean serum TSH was 80.47 +/- 21.77 mU/L in the HS group and 69.74 +/- 21.17 mU/L in the CT group, with significant between-group differences (P < 0.001). Mean serum Tg levels after TSH stimulation were 1.57 +/- 3.17 and 3.95 +/- 10.14 ng/mL in the HS and CT groups, respectively, with significant between-group differences (P = 0.028). CONCLUSION: Total thyroidectomy with an HS is a relatively safe and effective technique for use in patients with PTC. The HS provides surgical completeness and has a beneficial effect on successful ablation.

Management of Facet Joint Fracture-Dislocation of the Lower Cervical Spine with Reduction Failure / 대한정형외과학회잡지

PURPOSE: This study examined the obstacles preventing a decrease in a facet joint fracture-dislocation of the lower cervical spine after skeletal traction to determine suitable treatment guidelines. MATERIALS AND METHODS: This study examined 19 fracture-dislocation cases of the facet joint in the lower cervical spine who failed closed reduction through skeletal traction. The following parameters were analyzed: obstacles preventing reduction, neurological recovery, complications and body to canal ratio of the injured site. RESULTS: The obstacles found on MRI were herniated discs in 17 cases and joint capsule in 2 cases. The surgical decision was based on an analysis of the size and location of the disc, the degree of spinal canal stenosis and damage of the posterior structures. Anterior reduction/fusion and posterior fusion after anterior reduction/fusion, anterior fusion after posterior reduction/fusion and posterior reduction/fusion was performed in 9, 2, 6 and 2 cases, respectively. There was significant neurological recovery at the final follow-up (p=0.000). The body to canal ratio also increased significantly after surgery (p=0.000). CONCLUSION: For the treatment of unreducible facet joint fracture-dislocation of the cervical spine, pre-reduction MRI is essential for a thorough evaluation of the various underlying pathologies. In addition the surgical methods should be determined according to not only the neurological status, obstacles and pathologic structures preventing reduction, but also the surgeon's experience.

Pretreatment Serum CEA as a Prognostic Factor for Rectal Cancer Treated with Preoperative Chemoradiotherapy

PURPOSE: Preoperative serum carcinoembryonic antigen (s-CEA) is well known to be a prognostic factor in patients with colorectal cancer. However, the prognostic effect of s-CEA in patients with rectal cancer treated with preoperative chemoradiotherapy (CRT) has not been well studied. The aim of this study is to evaluate the prognostic value of pretreatment s-CEA for rectal cancer treated with preoperative CRT. METHODS: This study analyzed the data of 436 patients who received preoperative CRT and underwent curative surgery for locally advanced rectal cancer from January 2002 to July 2007. Patients were categorized into two groups according to pretreatment CEA levels: 10 ng/mL. The disease-free survivals between the two groups were compared. RESULTS: The three-year disease-free survival rates of the CEA 10 ng/mL group were 80.4% and 67.3%, respectively (P=0.002). Multivariate analysis revealed the following independent risk factor for recurrence: pretreatment CEA >10 ng/mL (hazard ratio [HR] 1.616; 95% confidence interval [CI], 1.007 to 2.594; P=0.047), positive lymph node status (HR, 2.580; 95% CI, 1.625 to 4.094; P<0.001), and positive circumferential resection margin (HR, 1.889; 95% CI, 1.035 to 3.446; P=0.038). CONCLUSION: Pretreatment s-CEA (cutoff value 10 ng/mL) may be a prognostic factor for disease-free survival in rectal cancer patients treated with preoperative CRT and surgery.

Treatment of the Proximal Femoral Fractures with Proximal Femoral Nail Antirotation (PFNA)

PURPOSE: To analyze the clinical and radiologic results of treatments in proximal femoral fracture with Proximal Femoral Nail-Antirotation (PFNA). MATERIALS AND METHODS: We retrospectively reviewed the results of 21 cases of proximal femoral fracture treated with PFNA from September 2006 to October 2007 which could be followed up for minimum of more than a year. The mean age was 61.5 (20~88) years old. Male were involved in 12 cases, female in 9 cases. The mean follow up was 14.3 (12~18) months. The Garden alignment index, Cleveland index, tip apex distance were evaluated by post-operative radiologic evaluation and complications of bone union, failure of internal fixation and deformity were evaluated by follow up radiologic findings. Clinical results were assessed by social function score of Jensen and mobility score of Parker and Palmer at last follow up. RESULTS: All fractures were united and the mean time to bone union was 15.7 (13~18) weeks. Garden alignment index showed good results of above 'good' in 15 cases (71.4%), Cleveland index showed 14 cases (66.4%) positioning in zone 5 and tip apex distance showed 17.81 (+/-5.65~27.52) mm in radiologic findings. The mean sliding of blade was 1.32 (0.34~2.94) mm in follow up radiologic findings and fracture of distal locking screw area was found in 1 case as a complication. Among 21 cases, the function before injury was completely recovered in 15 cases (71.4%) which were assessed by social function score of Jensen and 13 cases (61.9%) by mobility score of Parker and Palmer. CONCLUSION: We think that PFNA is effective osteosynthetic device for proximal femur fracture with satisfactory radiologic and clinical outcomes.

Anterior Cervical Fusion with Autogenous Iliac Bone Graft with or without Plate Fixation for Degenerative Cervical Spinal Disorders / 대한정형외과학회잡지

PURPOSE: This study compared the results of anterior cervical discectomy and fusion with autogenous bone graft (AFA) with or without plate fixation through a retrospective review of one or two-level degenerative cervical disorder, and the average follow-up was 6 years. MATERIALS AND METHODS: Group A (n=40) underwent one-level (A-1/26) or two-level (A-2/14) fusion and AFA alone. Group B (n=36) underwent one-level (B-1/24) or two-level (B-2/12) fusion and AFA with plate construct. The following parameters were analyzed: the fusion rate, the change of Cobb's angle, the adjacent level degeneration (ALD), the clinical outcome and the rate of complications. RESULTS: There was a significant difference in the fusion rate between group A and B (p=0.028). Group B had a significant increase in the change of Cobb's angle compared to groups A (p=0.004). ALD were developed in 16 of 40 cases (40%) in group A, and in 4 of 36 cases (11%) in group B. There was a significant difference in ALD between group A and group B (p=0.004). CONCLUSION: We think that plate augmentation is necessary for the maintenance of lordosis, for reducing the pseudarthrosis and adjacent level degeneration, and to improve the clinical outcome after treatment of degenerative cervical disorders.

Effect of Adrenomedullin on Proliferation and Mitogen-Activated Protein Kinase Activity in Osteosarcoma Cell Lines (MG63, U2OS) / 대한정형외과학회잡지

PURPOSE: The aims investigated how how human osteosarcoma cell proliferation and the MAP kinases cascade are regulated, in the MG63 and U2OS human osteosarcoma cell lines after stimulating them with adrenomedullin (AM) with particular focus on extracellular signal-regulated kinase 1/2 (ERK 1 and 2) activation. MATERIALS AND METHODS: A cell proliferation assay was used to examined the effects of AM on the osteosarcoma cell lines (MG63 and U2OS). The effects of AM on ERK1/2 were examed by Western blot analysis. The roles of ERK 1/2 in the AM-induced proliferative signaling pathways in the two cell types were examed using PD98059, a selective inhibitor of the mitogen activated protein-ERK kinase (MEK) pathway. RESULTS: The addition of AM to the medium containing the osteosarcoma MG63 and U2OS cells induced proliferation in a dose-dependent manner. AM strongly activated ERK 1/2 mediated cell proliferation signaling, which was prevented using PD98059. CONCLUSION: These results suggest that AM plays an important role in the proliferation of human osteosarcoma MG63 and U2OS cells, and ERK kinase pathway plays a signal transduction role in AM treated human osteosarcoma MG63 and U2OS cell lines.

Esophageal Fistula Formation by MetalLoosening following Anterior Cervical Arthrodesis: A Case Report / 대한정형외과학회잡지

An esophageal injury after an anterior cervical discectomy and fusion with plating is a well known but a fatal complication. If the diagnosis is delayed, inflammation can spread out into the neighboring main organs resulting in a very poor prognosis despite vigorous treatment. We report a case of esophageal fistula formation as a result of infected metal loosening after an anterior cervical discectomy and fusion with plating, which was treated successfully with a satisfactory clinical outcome.

Clinical Efficacy of Implant Removal after Posterior Spinal Arthrodesis with Pedicle Screw Fixation for the Thoracolumbar Burst Fractures / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical efficacy of implant removal by analyzing the radiological changes after posterior spinal stabilization in patients with thoracolumbar burst fractures. MATERIALS AND METHODS: Fifty-eight patients, who received surgical treatment after a thoracolumbar burst fracture with at least a two year follow-up, were enrolled in this study. An evaluation of the clinical results was based on the VAS score to examine degree of pain and discomfort. The evaluation of the radiological results was performed by measuring the changes in the kyphotic angle of the fractured vertebral bodies and the severity of the collapse of the anterior vertebral height taken after the injury, after fusion and after metal removal on the plain lateral radiograph. RESULTS: The VAS score on pain and discomfort after removing the implants showed a significant decrease from 6.5 to 3.2 and from 5.6 to 2.8, respectively. Overall, the kyphotic angle after removing the implants increased by 3.7 degrees, whereas the anterior height of the fractured vertebral body after removing the implant decreased by 1.5% in correction. CONCLUSION: The removal of implants after posterior arthrodesis in thoracolumbar burst fractures can be performed effectively to relieve the pain and restore flexibility but can result in the progression of kyphosis. However careful consideration should be made before removing an implant in cases of severe initial damage.

Treatment of O dontoid Fractures with Single Anterior Screw Fixation / 대한정형외과학회잡지

PURPOSE: To evaluate the availability and safety of single anterior screw fixation in the treatment of type II and III odontoid process fractures through an analysis of the treatment outcomes. MATERIALS AND METHODS: This study analyzed 16 patients who underwent surgery between May 1996 and Oct. 2003 by single anterior screw fixation for type II and III odontoid process fractures with at least a 1 year follow up. The radiographic findings such as the fusion rate, union time, changes in the fracture shape, and metal migration were evaluated. In addition, the Robinson modification criteria were used for the clinical assessment. RESULTS: There were 12 and 4 patients with Anderson and D'Alonzo type II and type III fractures, respectively. Of the 16 patients, 15 (93%) achieved bony union after an average of 13.8 weeks. There were 2 cases of malunion with a normal range of cervical motion, and 1 case requiring posterior fusion as a result of nonunion. A full range of cervical motion was maintained in 11 cases. Three cases had a limitation of less than 25% and 2 cases had a limitation greater than 25%. CONCLUSION: Single anterior screw fixation is an effective treatment modality with a high fusion rate and low complication rates. However, precise preoperative planning and technical experience is essential for preventing unwanted complications.

Results of Revision Surgery in the Lumbar Spine / 대한정형외과학회잡지

PURPOSE: This report examined the surgical treatment results and suggests proper treatment guidelines for revision surgery in the lumbar spine. MATERIALS AND METHODS: This study examined 97 patients, who underwent revision surgery from 1996 to 2004 with a follow-up of at least 1 year. The causes of revision surgery, treatment modalities and results of treatment were analyzed. The clinical results were evaluated using the Kirkaldy-Willis criteria. RESULTS: In the ninety-seven patients, recurred disc herniation (37 cases, 35 cases: same level, 2 cases: different level) was the leading cause of revision surgery. The other causes were spinal stenosis (17 cases), epidural fibrosis (9 cases), pseudoarthrosis (9 cases), junctional stenosis (9 cases), infection (8 cases), segmental instability (4 cases), metal failure (2 cases) and cyst (2 cases). Spinal fusion was performed in 91 patients, and decompression only was performed in the remaining 6 patients. The clinical results according to reasons for failure were good in cases of recurrent disc herniation. The results of spinal fusion were more successful than that of decompression only (p= 0.002). The results of short segment fusion were more satisfactory than those of long segment fusion (p=0.043). In the final follow-up results, excellent and good results according to Kirkaldy-willis criteria were found in 62 cases. CONCLUSION: Spinal arthrodesis is an effective treatment modality for revision surgery in the lumbar spine. However, long segment arthrodesis should be considered carefully because of the high level of disappointing results. In addition, selective arthrodesis of the pathologic level is recommended in revision surgery of the lumbar spine.

Ipsilateral femoral neck and shaft fracture / 대한정형외과학회잡지

No abstract available.