Primary subacute pyogenic osteomyelitis is defined as a bone infection of insidious onset lasting for more than several weeks without any acute systemic toxic reactions and is known to have the problem of diagnosis because there is no inflammatory symptoms or signs and X-ray findings are similar to various bone tumors. Authors reviewed 29 cases of primary subacute pyogenic osteomyelitis of long bones admitted at Fatima hospital during the years between 1976 and 1984. The osteomyelitis of infants and the osteomyelitis modified by antibiotics were excluded. The diagnosis of the cases was confirmed by bacteriological examination and/or tissue examination. The results were as follows. 1. The cases were 18 males and 11 females and 19 adults and 10 children. Male predominence was noted in children. 2. The involved bones were 11 tibias, 10 femurs and all other long bones. The involved sites were 18 metaphysis and 11 shafts. 3. All of the cases has insidious onset of local pain without any acute systemic symptoms and most of the cases has local tenderness but local deep swelling noted in about half of the cases. 4. There were many cases with elevated ESR and a few cases of slight leukocytosis. 5. The confirmed infecting organism was all staphylococcus in 16 cases of the cultures from the 25 lesions. 6. The X-ray findings were Brodies abscess in 10, illdefined cavity in 3, diffuse bones absorption in 5, diaphyseal lesion of adult with localized cortical sclerosis in 5 and with localized medullary abscess in 3 and diaphyseal lesion of children with localized medullary abscess and periosteal reaction in 3 cases. 7. All of the cases cured rapidly with rare recurrence after treatment by simple local excision in 4 and curettage in 22 cases combined with antibiotic therapy and local immobilization.
Abscess ; Absorption ; Adult ; Anti-Bacterial Agents ; Child ; Curettage ; Diagnosis ; Female ; Femur ; Humans ; Immobilization ; Infant ; Leukocytosis ; Male ; Osteomyelitis ; Recurrence ; Sclerosis ; Staphylococcus ; Tibia

BACKGROUND: Among the various mechanisms of Myocardial reperfusion injuries, neutrophil is thought to be one of them. Endogenous coronary vasodilator adenosine is known to have myocardial protective effect through variable pharmacologic action, influencing the function of several cell types involved in the pathogenesis of myocardial reperfusion injury. This study was designed to determine the beneficial effect of adenosine on the left ventricular function during reperfusion and whether this effect is due to the adenosine on the role of neutrophil. METHODS: 27 open-chest cats were randomly divided into 3 groups. 6 cats received ischemic injury without reperfusion(group 1). 21 cats were subjected to 60 minutes of proximal left anterior descending coronary artery occlusion followed by a 60-minute reperfusion. 11 of 21 cats received intravenous adenosine(0.15mg/Kg/min) infusion starting 5 minutes before reperfusion throughout the entire period(group 3). 10 cats received equal volume of saline instead of adenosine(group 2). RESULTS: 1) During the experimental period, significant decrease of heart rate, blood pressure, RPI, negative dP/dT and increase of LVEDP were noted in group 2 and 3 with no difference between the two groups. The reduction of positve dP/dT was more significant in group 2 at 30 and 60 minute of reperfusion than the preocclusion value(1404+/-111, 1631+/-161 vs 1832+/-169mmHg/sec at baseline, p<0.05). In contrast, positive dP/dT in group 3 at 30 and 60 minute of reperfusion were similar to baseline values(1890+/-92, 2052+/-112 vs 2025+/-227mmHg/sec at baseline, p=NS). These were significantly higher(p<0.05) than untreated group 2. 2) Infarct size was significantly reduced in adenosine-treated group 3, when expressed as a percentage of the area at risk(28.4+/-3.3% vs 44.5+/-3.2% of group 2, p<0.05). The significant increase in myeloperoxidase activity observed after reperfusion was not detected in adenosine treated group 3.(0.18+/-0.05 vs 0.46+/-0.09 unit/100mg wet tissue weight, p<0.05). A significant correlation was present between infarct size (% of left ventricle) and myeloperoxidase activity(r=0.72, p<0.01). 3) Light microscopic examination demonstrated the decreased acute interstitial and intra vascular inflammatory infiltration and capillary plugging together with decreased tendency of incidence of contraction band necrosis in adenosine treated group 3. CONCLUSION: These findings suggest that intravenous administration of adenosine during the early reperfusion period significantly reduces infarct size, improving the early recovery of global ventricular function. The probable cause is the effect of adenosine on neutrophil as one of the various protective mechanisms of adenosine in feline heart model subjected to coronary occlusion and reperfusion, 60 minutes each.
Adenosine* ; Administration, Intravenous ; Animals ; Blood Pressure ; Capillaries ; Cats ; Coronary Occlusion ; Coronary Vessels ; Heart Rate ; Heart* ; Incidence ; Myocardial Reperfusion Injury* ; Myocardial Reperfusion* ; Necrosis ; Neutrophils ; Peroxidase ; Reperfusion ; Reperfusion Injury ; Ventricular Function ; Ventricular Function, Left

Clinical observations were made on 349 cases of acute drug intoxication who were visited to emergency room of Yeungnam University Hospital during recent 7 years from January 1984 to December 1990. The following results were obtained. 1) Total number of cases of acute drug intoxication was 349 which was 0.39% of the total patients of the emergency room during the same period. 2) The ratio of male to female was 1.1:1. The age incidence was highest in the third decade (26.7%). The monthly incidence was highest in May. Higher frequency was observed in summer season. 3) The most common drug of the intoxication was pesticides and herbicides (71.9%), the remainders were miscellaneous drugs (11.2%), sedatives (7.7%), rodenticides (6.3%) and unknown drug (3.2%) in orders. 4) The most common cause of drug intoxication was suicide (69.1%) and the others were accident, unknown cause, intention in orders. 5) Main clinical manifestations were the impairment of consciousness, nausea, vomiting and convulsion. Physical examination revealed increased pulses, increased blood pressure, miosis of the pupil and sweating. Above symptoms and signs were more prominent in pesticide intoxication. Leukocytosis, glycosuria and abnormal LFT were common findings in acute intoxications. 6) The complications were developed in 18.3% among 349 cases and the most common complication was respiratory failure, pneumonia, cardiovascular collapse and pulmonary edema in orders. 7) Overall mortality rate was 8.3% of total cases and mortality rate was highest in herbicide intoxication (22.2%).
Blood Pressure ; Consciousness ; Emergency Service, Hospital ; Female ; Glycosuria ; Herbicides ; Humans ; Hypnotics and Sedatives ; Incidence ; Intention ; Leukocytosis ; Male ; Miosis ; Mortality ; Nausea ; Pesticides ; Physical Examination ; Pneumonia ; Pulmonary Edema ; Pupil ; Respiratory Insufficiency ; Rodenticides ; Seasons ; Seizures ; Suicide ; Sweat ; Sweating ; Vomiting

The present study was performed to evaluate histomorphological difference in various surface-treated implants in beagle. Implants(Implantium(R), Dentium Co. Korea) with pure titanium machined surface, acid treated surface, and Al2O3(50~100micrometer)blasted with acid treated surface were used in this study. All mandibular premolars of 1.5~2 year old male beagle dogs were extracted. At 3 months after extraction, the implants(phi 4mm, l6mm) were installed. The beagle were sacrificed at 1, 3 months after installation and then tissues including implants were prepared for non-decalcified specimens. These specimens were analyzed comparatively under light microscope. The results of this study were as follow 1. Higher rate of osseointegration were showed in the Al2O3(50~100micrometer)blasted with acid-treated surface. 2. Increased osseointegration were showed in the Al2O3(50~100micrometer)blasted with acidtreated surface with time. 3. Higher maturation of integration were showed in the Al2O3(50~100micrometer)blasted with acid-treated surface. In conclusion, surface treatment of Al2O3blasted with acid might be considered to shorten healing time and improve success rate as increasing contact of implant and bone.
Animals ; Bicuspid ; Dogs ; Humans ; Male ; Osseointegration* ; Titanium

PURPOSE: There diagnostic modalities have been commonly used to detect prostate cancer to date: digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasonography(TRUS). We evaluated the diagnostic values of these three modalities in the early detection of prostate cancer. MATERIALS AND METHODS: We analysed 215 patients with low urinary tract symptoms who had pathologic diagnosis for prostatic cancer was possible by biopsy or transurethral resection. Transectal ultrasonography guided sextant biopsies were performed if the PSA level was greater than 4.0 ng/ml or DRE was suspicious, even if TRUS revealed no ateas suspicious for cancer. TURP were performed without TRUS or biopsies if the PSA level was lesser than 4.0 ng/ml and DRE was negative. RESULTS: Of the 215 patients, 36 (16.7%) revealed prostate cancer. Positive predictive value, sensitivity and specificity was 37.0%. 83.3%. 71.5% for DRE, 30.0%, 91.7%, 58.3% for PSA and 27.6% 58.3%. 43.3% for TRUS respectively. Positive findings on serum PSA or DRE or both tests detected significantly more tumors(97.2%, 35of 36 cancers) than only PSA (91.7%, 33 for 36 cancers), DRE (83.3%, 30 of 36 cancers) and TRUS (60.0%, 21 of 35 cancers) alone. CONCLUSIONS: These result shows that DRE is more valuable and cost effective method for detection of prostate cancer than serum PSA and the use of DRE in conjunction with serum PSA enhances prostate cancer detection.
Biopsy ; Diagnosis ; Digital Rectal Examination* ; Humans ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Sensitivity and Specificity ; Transurethral Resection of Prostate ; Ultrasonography* ; Urinary Tract

No abstract available.
Diagnosis* ; Female ; Pregnancy ; Pregnancy, Ectopic* ; Ultrasonography*

A lymphangioma is comparatively rare in the elimentary tract, and is a benign tumor of the lymphatic system. A duodenal lymphangioma is especially rare, and has an obscure etiology. Clinically, and in the laboratory the are non-specific, and are incidentally found by endoscopy, and their treatment is total excision. Recently, the authors experienced a 45 year-old woman, who had a duodenal lymphangioma, but with no symptom. An endoscopic examination revealed a single, about 2 cm, polypoid lesion below the ampulla. The lesion was successfully excised after a duodenotomy.
Duodenum ; Endoscopy ; Female ; Humans ; Lymphangioma* ; Lymphatic System ; Middle Aged

BACKGROUND: Korean mistletoe (Viscum album) extract has been found to posses immunostimulatory activity. In this study, Korean mistletoe extract, M11C (non-lectin components), was used to know whether this extract might activate mouse peritoneal macrophages to produce interleukin 1 beta (IL-1 beta). METHODS: Hemagglutination assay was carried out to examine whether M11C contained a lectin or not . To know the effect of M11C on the production of IL-1 beta, the macrophages were treated by the M11C, and then collected the supernatant (M11C stimulated macrophages-conditioned media; MMCM). MMCM was analyzed for the IL-1 beta quantification and mRNA expression by means of ELISA and RT-PCR, respectively. RESULTS: Maximum effective dose and time of M11C on IL-1 beta production from macrophages were 20 micro gram/ml and 8 hours, respectively . This ELISA data was reconfirmed by immunoblotting assay . indicating that M11C is a good candidate for an immunomodulator. The dose and time dependent effect s of M11C on the expression of IL-1 beta mRNA from macrophages was also shown in expression of mRNA detected by RT-PCR. Treatment dose and time for the maximum expression of IL-1 beta mRNA were 20 micro gram/ml and 4 hours, respectively . Maximum gene expression of IL-1 beta was much earlier than maximum production of it. CONCLUSION: As results, Korean mistletoe extract, M11C, may be used for an immunomodulator. This will be able to make up for and solve the problems caused by existent immunoagent with many adverse effects through many other studies in future including one molecule extraction.
Animals ; Enzyme-Linked Immunosorbent Assay ; Gene Expression ; Hemagglutination ; Immunoblotting ; Interleukin-1beta ; Macrophages* ; Macrophages, Peritoneal ; Mice ; Mistletoe* ; RNA, Messenger

PURPOSE: Acute appendicitis is one of the most common causes of abdominal emergency. Children, under age of 5 years, are unable to give an accurate history, but other nonspecific abdominal pain is more common at this age. Because diagnosis is often delayed and progression of appendicitis is faster, incidence and perforation rate is higher than those of adults. Abdominal US and CT are helpful in diagnosis of acute appendicitis. METHODS: Between July, 1997 and April, 2004, 39 patients below 5-year-old were participated, but 2 (Negative) patients were excluded. This study was done retrospectively based on medical charts. For statistical analysis, Chi-squre test was used. RESULTS: All patients undergone emergency operations, in which male to female ratio was 1.79: 1, with its mean age of 4.05. 19 patients (49%) were perforated and fever developed more frequently in perforating group, but leukocytosis was not significant. Delayed preoperative duration was associated with perforation rate significantly. All complications were occurred in perforating group. CONCLUSION: To decrease perforation rate and complications, early diagnosis and management are necessary to avoid delaying preoperative time.
Abdominal Pain ; Adult ; Appendicitis* ; Child* ; Child, Preschool ; Diagnosis ; Early Diagnosis ; Emergencies ; Female ; Fever ; Humans ; Incidence ; Leukocytosis ; Male ; Retrospective Studies

OBJECTIVE: This study was performed to elucidate the technical and patient-specific risk factors for postoperative ischemia in patients undergoing temporary arterial occlusion (TAO) during the surgical repair of their aneurysms. METHODS: Eighty-nine consecutive patients in whom TAO was performed during surgical repair of an aneurysm were retrospectively analyzed. The demographics of the patients were analyzed with respect to age, Hunt and Hess grade on admission, Fisher grade of hemorrhage, aneurysm characteristics, timing of surgery, duration of temporary occlusion, and number of temporary occlusive episodes. Outcome was analyzed at the 3-month follow-up, along with the occurrence of symptomatic and radiological stroke. RESULTS: In overall, twenty-seven patients (29.3%) had radiologic ischemia attributable to TAO and fifteen patients (16.3%) had symptomatic ischemia attributable to TAO. Older age and poor clinical grade were associated with poor clinical outcome. There was a significantly higher rate of symptomatic ischemia in patients who underwent early surgery (p = 0.007). The incidence of ischemia was significantly higher in patients with TAO longer than 10 minutes (p = 0.01). In addition, patients who underwent repeated TAO, which allowed reperfusion, had a lower incidence of ischemia than those who underwent single TAO lasting for more than 10 minutes (p = 0.011). CONCLUSION: Duration of occlusion is the only variable that needs to be considered when assessing the risk of postoperative ischemic complication in patients who undergo temporary vascular occlusion. Attention must be paid to the patient's age, grade of hemorrhage, and the timing of surgery. In addition, patients undergoing dissection when brief periods of temporary occlusion are performed may benefit more from intermittent reperfusion than continuous clip application. With careful planning, the use of TAO is a safe technique when used for periods of less than 10 minutes.
Aneurysm ; Brain Ischemia ; Craniotomy ; Demography ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm ; Ischemia ; Reperfusion ; Retrospective Studies ; Risk Factors ; Stroke ; Troleandomycin