Acute bacterial infection of bone and joint presents a real challenge to orthopedist because early diagnosis and treatment are difficult and also essential. In almost all practices, fever and erythrocyte sedimentation rate(ESR) are widely used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses. However, interpreting body temperature is difficult and ESR is nonspecific, is not not sensitive, normalizes slowly. Otherwise, C-reactive protein(CRP) is very sensitive and normalizes fast. CRP, body temperature, and ESR were sequentially measured until a normal value was reached in twenty seven patients in whom acute osteomyelitis (17 patients), acute exacerbation of chronic osteomyelitis(4 patients), and septic arthritis(6 patients) had been diagnosed by positive bacterial culture at Kyungpook National University Hospital from June 1984 to May 1985. The results were as follows: 1. CRP normalized within 8.8 days on average. 2. Fever lasted 4.5 days on average. 3. ESR normalized within 41.6 days on average. 4. Initial mean value of CRP was 4.2 positive in acute in acute osteomyelitis and septic arthritis and 3.5 positive in acute exacerbation of chronic osteomyelitis, therefore CRP can be considered as a very sensitive indicator for early detection of acute bacterial infection of bone and joint. Also sequential CRP determination can be used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses.
Arthritis, Infectious ; Bacterial Infections ; Blood Sedimentation ; Body Temperature ; C-Reactive Protein ; Early Diagnosis ; Fever ; Gyeongsangbuk-do ; Humans ; Joints ; Osteomyelitis ; Reference Values

PURPOSE: To evaluate the dose under lung block as a function of depth and the effectiveness of a block as a function of block width. MATERIALS AND METHODS: Field size of mantle field was 22.8 x 32.4 cm2 . Dose distribution of the mantle field was measured with two dimensional water phantom system. To analyze the effectiveness of the lung block, central axis plane, 5cm off-axis plane, and 10cm off-axis plane were studied. RESULTS: The dose under the lung block was recorded with maximum at the depth between , 5cm and 10cm . In the central axis plane, dosimetric block width was 10-15% les than physical block width. In the 5cm off-axis plane. Dosimetric block width was 4-9% less than physical block width. In the 10cm off-axis plane, dosimetric block width was 2% less than physical block width. CONCLUSION: Depth dependence of the dose under the lung block was founded. Also, block width dependence of the lung block was founded. To induce the accurate relation between the physical block width and the "effective" block width, it needs more detailed understanding of the variables involved.
Axis, Cervical Vertebra ; Lung* ; Water

No abstract available.
Cervix Uteri* ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Follicular Fluid* ; Humans* ; Spermatozoa* ; Spouses*

A rare case of chronic pain of entrapment neuropathy of the sciatic nerve successfully relieved by surgical decompression is presented. A 71-year-old male suffered a chronic right buttock pain of duration of 7 years which radiating to the right distal leg and foot. His pain developed gradually over one year after underwenting drainage for the gluteal abscess seven years ago. A cramping buttock and intermittently radiating pain to his right foot on sitting, walking, and voiding did not respond to conventional treatment. An MRI suggested a post-inflammatory adhesion encroaching the proximal course of the sciatic nerve beneath the piriformis as it emerges from the sciatic notch. Upon exploration of the sciatic nerve, a fibrotic tendinous scar beneath the piriformis was found and released proximally to the sciatic notch. His chronic intractable pain was completely relieved within days after the decompression. However, thigh weakness and hypesthesia of the foot did not improve. This case suggest a need for of more prompt investigation and decompression of the chronic sciatic entrapment neuropathy which does not improve clinically or electrically over several months.
Abscess ; Aged ; Buttocks ; Chronic Pain ; Cicatrix* ; Decompression* ; Decompression, Surgical ; Drainage ; Foot ; Humans ; Hypesthesia ; Leg ; Magnetic Resonance Imaging ; Male ; Muscle Cramp ; Pain, Intractable ; Sciatic Nerve* ; Thigh ; Walking

Since 1980, 18 patients(12 males, 6 females) with intractable perineal and perianal pain caused by uncontrolled malignant neoplastic disease, were surgically treated with sacral rhizotomy. Patients ranged in age from 33 to 74 years ; the duration of symptoms ranged from 2 months to 17 months. The primary site of the malignancies were as follows : prostate cancer(3 cases), cervix cancer(5), colorectal cancer(10). All patients underwent preoperative psychological test, drug assessment, cystometry and trial block. The present criteria for selection were : 1) All patients should have uncontrolled malignant disease with metastasis. 2) The pain should be limited to the perineal or the perianal region. 3) The pain should be severe and refractory to medical and psychological management. 4) The pain should be of least 3 months. 5) Estimated life expectancy should be at least 3 months. 6) All patients should have had a previous colostomy. 7) The operative modification should be made according to the urinary disturbance. If there is no voluntary urination, the operation should include both S2 roots ; but, if the bladder is still functioning normally, the S2 root should be preserved in the least painful side. Postoperative results of pain control were no pain in 14 patients(78%), good in three(16%), and poor in one(6%). After reviewing the results, the authors believe that if the patients are selected properly, according to the criteria outlined, sacral rhizotomy is worthwhile, simple and relatively successful method of treating intractable perineal and perianal cancer pain.
Cervix Uteri ; Colostomy ; Female ; Humans ; Life Expectancy ; Male ; Neoplasm Metastasis ; Prostate ; Psychological Tests ; Rhizotomy* ; Urinary Bladder ; Urination

PURPOSE: Glomus tumors are uncommon benign neoplasms arising from the neuromyoarterial apparatus, usually seen in the nail bed of fingers. Most of this mass presents typical symptoms such as severe pain, point tenderness and hypersensitivity to cold like neuroma, gout or causalgia. Concerning about the origin, there were few written reports about extra-digit glomus tumor, especially that occurred in the skeletal muscule. METHODS: A 48-year-old female complained of painful tender mass in her right calf aggravated several months ago. Her MRI and femoral angiogram showed a well defined hypervascular tumor such as hemagioma or hemagioendothelioma in the right calf. Surgical treatment was performed, and it proved glomus tumor in soleus muscle histologically. RESULTS: After the operation, patient didn't complain of her symptoms any more and there was no evidence of recurrence during 1 year follow-up period. CONCLUSION: Authors have found only eight cases of intramuscular glomus tumor reported in the literature and present here the ninth case of an intramuscular glomus tumor and first case of soleus muscle.
Causalgia ; Female ; Fingers ; Follow-Up Studies ; Glomus Tumor* ; Gout ; Humans ; Hypersensitivity ; Magnetic Resonance Imaging ; Middle Aged ; Muscle, Skeletal* ; Neuroma ; Recurrence

BACKGROUND: The awareness and knowledge of stroke among general population has been poorly estimated in our country. METHODS: Well-trained personnel asked to randomly selected 985 residents in Ansan City with questionnaire concerning stroke. The results of questionnaire were analyzed in terms of demographic factors. RESULTS: Only 55.4% of the subjects answered that stroke is cerebrovascular disease. As risk factors of stroke, hypertension (70.4%) and mental stress (59.7%) were considered to be important. But the risk of cigarette smoking(18.7%), diabetes mellitus(14.5%), and heart disease(14.5%) were underappreciated. This awareness pattern did not show no statistical significance between those with and without risk factors(p>0.05). The more than half of subjects(65.2%) chose western medicine and 26.8% of subjects chose oriental medicine for the treatment of stroke. Forty four percent of the subjects perceived motor paralysis as a primary symptom of stroke. Broadcasting was the most important source of information about stroke. CONCLUSIONS: The misinformation about stroke is common among general population in Ansan City. To provide proper management for stroke by neurologists, public health education should be focused especially on those who have risk factors and are the elderly and less educated. Because primary physician play a crucial role in spreading information about stroke, special education program for them is needed.
Aged ; Demography ; Education ; Education, Special ; Gyeonggi-do* ; Health Education ; Heart ; Humans ; Hypertension ; Medicine, East Asian Traditional ; Paralysis ; Public Health ; Surveys and Questionnaires ; Risk Factors ; Stroke* ; Tobacco Products

PURPOSE: We evaluated the prognostic significance of p53 and proliferating cell nuclear antigen(PCNA) in stage III gastric carcinoma to determine the correlation between the p53 and PCNA expression and various clinicopathological parameters. MATERIALS AND METHODS: The expression of p53 and PCNA were studied immunohistochemically in 64 cases of stage III gastric carcinomas with paraffin-embedded tissue specimens which were obtained surgically at the department of surgery, Presbyterian Medical Center from 1991 to 1992. Both expression were compared with known factors of prognosis. Survival rate and other clinicopathological parameters were analysed. RESULTS: Expression rates of p53 and high PCNA group were 40.6% and 26.6%, respectively. There was no significant correlation between the p53 and PCNA expression and various clinicopathological variables such as age, sex, stage, histology, tumor depth, number of metastatic node, tumor size, site and method of operation. To analyse survival, we evaluated overall survival according to the extent of p53 and PCNA expression. No significant correlations between the p53 and PCNA expression and overall survival were found. CONCLUSION: These results suggest that the p53 and PCNA expression seems to be hard to use as a prognostic indicator in stage III gastric carcinoma.
Prognosis ; Proliferating Cell Nuclear Antigen* ; Protestantism ; Survival Rate

Tsutsugamushi disease is one of the acute febrile diseases caused by Orientia tsutsugamushi that is transmitted to human by the bite of larval-stage trombiculid mite (chigger). The clinical illness is characterized by abrupt onset of fever, headache, rashes, myalgia and eschar. Chest radiologic findings show reticulonodular infiltration, cardiomegaly, lymphadenopathy and in a minority, pleural effusion. About pleural effusion, it is supposed to be caused by tsutsugamushi disease itself in most cases and no case has been reported that the pleural effusion confirmed by pleural biopsy and revealed granulomatous lesions. We experienced a case of tsutsugamushi disease with pleural effusion which was also confirmed to granulomatous lesion by pleural biopsy. So we report this case with a brief review of literatures.
Biopsy ; Cardiomegaly ; Exanthema ; Fever ; Granuloma ; Headache ; Humans ; Lymphatic Diseases ; Myalgia ; Orientia tsutsugamushi ; Pleural Effusion* ; Scrub Typhus* ; Thorax ; Trombiculidae

The treatment of pathologic aerophagia has rarely been discussed in the literature. In this retrospective study, the authors investigated the effects of clonazepam on the management of pathologic childhood aerophagia (PCA) with psychological stresses (PS), but not with mental retardation. Data from 22 consecutive PCA patients with PS (aged 2 to 10 yr), who had been followed up for over 1 yr, were reviewed. On the basis of videolaryngoscopic views, the authors observed that the pathology of aerophagia was the result of reflex-induced swallowing with paroxysmal openings of the upper esophageal sphincter due to unknown factors and also observed that these reflex-induced openings were subsided after intravenous low dose benzodiazepine administration. Hence, clonazepam was administered to treat paroxysmal openings in these PCA patients with PS. Remission positivity was defined as symptom-free for a consecutive 1 month within 6 months of treatment. The results of treatment in 22 PCA patients with PS were analyzed. A remission positive state was documented in 14.3% of PCA patients managed by reassurance, and in 66.7% of PCA patients treated with clonazepam (p=0.032). Thus, clonazepam may produce positive results in PCA with PS. Future studies by randomized and placebo-controlled trials are needed to confirm the favorable effect of clonazepam in PCA.
Treatment Outcome ; Stress, Psychological/*complications/*drug therapy ; Retrospective Studies ; Male ; Injections, Intravenous ; Humans ; Female ; Clonazepam/*administration & dosage ; Child, Preschool ; Child ; Anticonvulsants/administration & dosage ; Aerophagy/*complications/*prevention & control