No abstract available.
Talus*

No abstract available.
Chondrocalcinosis*

The author studied 62 consecutive patients with spontaneous cerebellar hemorrhage and 38 patients with spontaneous pontine hemorrhage, diagnosed by computerized tomography scanning from May 1983 to December 1994 and assessed the relationship of outcome of initial GCS score, CT findings, and treatment modality. In cerebellar hemorrhage, good outcome was achieved in patients with high initial GCS score(>13), small hematoma, patent quadrigeminal cistern, absent hydroceohalic change, and the location of the hemorrhage in the hemisphere. Although the size of hematoma was an impotant prognostic factor, it had no constant bearing on the level of consciousness, degree of quadrigeminal cistern obliteration, and outcome. Absence of quadrigeminal cistern obliteration predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved darly. However, partial obliteration of the quadrigeminal cistern was a predictor of good outcome if the hematoma was evacuate d within 48 hours after the onset of hemorrhage. Total obliteration of the quadrigeminal cistern inevitably predicted an unfavorable outcome. In pontine hemorrhages, a good outcome was achieved in patients with high initial GCS score(>13), small size hematoma(<5cc) and patent quadrigeminal cistern. Especially, the size of the hematoma was an important prognostic factor and guideline for the determination of surgical candidates. Small hematomas(<5cc) responded more positively to conservative management than to surgery. However, early hematoma evaculation(<48hr) had improved the outcome in moderate sized hematomas(5-10cc). Large hematomas(>10cc) inevitably showed an unfavorable outcome.
Consciousness ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus

We present a case report of primary middle ear lipoma diagnosed in right ear of a 25-month-old girl with right otitis media. We identified injection and retraction at right ear drum. Impedance tympanometry of right ear was type B and temporal bone CT was suggestive of a congenital cholesteatoma. During the tympanoplasty, a mass of tissue obstructing the eustachian tube orifice was noted in the middle ear. We have treated a case of a lipoma that originated from the middle ear; only 5 such cases have been reported worldwide.
Acoustic Impedance Tests ; Cholesteatoma ; Ear ; Ear, Middle ; Electric Impedance ; Eustachian Tube ; Lipoma ; Otitis Media ; Preschool Child ; Temporal Bone ; Tympanoplasty

Background: Periprosthetic infection after total knee arthroplasty is a challenging problem, and physicians should identify risk factors to decrease recurrence. However, risk factors for reinfection with two-stage reimplantation have not yet been well established. The purpose of this study was to assess treatment outcomes of subsequent twostage knee reimplantation and identify risk factors for uncontrolled periprosthetic knee joint infections. Methods: We retrospectively reviewed 70 knees diagnosed with a periprosthetic knee joint infection treated with two-stage reimplantation between September 2011 and October 2016 at our institution. Patients in the controlled infection group (group C) required no further medication or surgical treatment within 2 years after reimplantation.Patients in the uncontrolled infection group (group U) displayed symptoms of active infection after resection arthroplasty or were reinfected after two-stage reimplantation. We compared group C and group U, and analyzed potential risk factors for uncontrolled prosthetic joint infection (PJI). Results: Of 70 knees included in this analysis, 53 (75.7%) were clinically deemed free from infection at the latest follow-up. The remaining 17 knees (24.3%) required additional surgical procedures after two-stage reimplantation.Demographics were not statistically significantly different between the two groups. Wound complications were statistically more frequent in group U (p = 0.030). Pre-reimplantation C-reactive protein (CRP) was statistically different between groups C and U (0.44 and 1.70, respectively, (p = 0.025). Among the cultured microorganisms, fungus species were statistically more frequently detected in group U compared with group C ((p = 0.031). Conclusions The reinfection rate of our two-stage reimplantation protocol was 24.3% in the included cases.Wound complications, higher pre-reimplantation CRP levels, and fungus species were statistically more common in group U compared with group C. Our findings will help in counseling patients and physicians to understand that additional caution may be required when treating PJI if the aforementioned risk factors are present.Level of evidence: IV, case series.

The aim of this study was to investigate the association of colorectal polyps with carcinoma of the colon and rectum. METHODS: Between January 1995 and December 1998, 203 consecutive patients with 423 colorectal polyps retrospectively documented at the Department of General Surgery and College of Medicine in Dongguk University. RESULTS: The peak age group of the colorectal polyp was in the fifth decades (33.5%). The proportions of malignant polyps were as follows: for size, 5.2% of polyps less than 1.0 cm and 19.5% of polyps larger than 1 cm (P<0.05); for morphology, 2.6% in polyps of Yamada type I, II and 18.5% in polyps of Yamada type III, IV (P<0.05); for location, 13.4% of the polyps located in rectum and sigmoid colon and 7.6% of the polyps located in descending to ascending colon (P>0.05); for number of polyp, 4.5% in cases of single polyp and 25.0% in cases of multiple polyps (P<0.05); for underlying histology, 9.2% in cases of tubular adenoma and 19.2% in cases of villous adenoma (p<0.05). The presence of distal adenomatous polyp was increased the risk of presence of the proximal adenomas (59.7%), whereas the presence of hyperplastic polyp did not (16.7%). CONCLUSIONS: The malignant potential of colorectal polyps are correlated with size, histologic type, morphologic shape, multiplicity and distal location. The presence of hyperpalstic polyp should not be indication for colonoscopy because they are not associated with proximal adenoma when adjusting for patient characteristics and presence of distal adenoma.
Adenoma ; Adenoma, Villous ; Adenomatous Polyps ; Colon ; Colon, Ascending ; Colon, Sigmoid ; Colonoscopy ; Humans ; Polyps* ; Rectum ; Retrospective Studies

OBJECTIVES: Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. METHODS: We performed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we performed rectal swabs on the cattle raised by the household of the index patient. RESULTS: We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. CONCLUSIONS: We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.
Animals ; Cattle ; Diarrhea ; Enterohemorrhagic Escherichia coli* ; Family Characteristics ; Grandparents ; Hemolytic-Uremic Syndrome ; Humans ; Korea* ; Mothers ; Shiga Toxin 2 ; Zoonoses

BACKGROUND: In 2000~2001 there was a nationwide outbreak of measles in the Republic of Korea. Since supplementary vaccination program was implemented in 2001, the control strategy of this measles outbreak has been stepped up from the control phase to the elimination phase. We here present the result of survey for the epidemiologic characteristics of the nationwide outbreak of measles in 2000~2001. METHODS: Using the data based on the sheet of epidemiologic investigation, incidences rates per 100,000 population and distributions of cases with vaccination history were investigated by the age. The seasonal or regional distribution were also studied with the onset days of cases. RESULTS: In 2000~2001, a measles outbreak occurred with 52,897 reported cases. The incidence rate per 100,000 population of measles was 111.9 cases and that of geopolitical unit (province) was high nationwide, 35.9~386.3 cases. The incidence rates were very high in less than 12 months and 10 years of age, 954.4 and 714.9, respectively. The 1st vaccination rate of measles/mumps/rubella (MMR) in 1~3 years old was 26.3~77.1%, and especially, that of 1 year old showed very low coverage, 26.3%. However, there was no special propensity in the 1st vaccine coverage in the age of 7~15 years, which had 87.7~91.4%. On the other hand, the 2nd MMR vaccination rate of the cases was very low, 17.7% at the age of 7~10 years. From the 21st May, 2001 a mass catch-up campaign with measles/rubella (MR) vaccine was launched, resulting in prominent reduction in the incidence of measles case. CONCLUSION: This survey showed that the measles outbreak in 2000~2001 had a high incidence nationwide from October 2000 to April 2001 and in less than 12 month and 10 years of age. Our results also showed that no routine immunization made the age group under 1 year vulnerable to measles infection. In cases of school-age group after 7 years of age, some cases with vaccination history were also infected. The characteristics of recent outbreaks indicates the need for the introduction of a specific vaccination programme at that age group. This survey was helpful to establish the effective vaccination strategy and it would be used as reference data on survey continuously for the epidemiologic characteristics of measles case for elimination of indigenous measles transmission in Republic of Korea.
Disease Outbreaks ; Epidemiology ; Hand ; Humans ; Immunization ; Incidence ; Korea* ; Measles* ; Republic of Korea ; Seasons ; Vaccination

BACKGROUND: This study reports the incidences of measles in Koea and the epidemiologic characteristics for the incidence reported for the period 1980~1999. It provides the epidemeologic adta for measles before implementing the catch-up campaign in 2001. METHODS: We obtained information for the survey from the data for the incidence reported from health centers. Incidences per 100,000 population were calculated for the 1963~1999. And the following variables were studied: seasonal or regional distribution for the 1980~1999. RESULTS: The incidence rate of measles declined after the systemic immunization in 1990, the outbreak of measles occurred periodically and incidences per 100,000 population increased from 8.4 cases in 1990 to 17.7 in 1994. In 1990 and 1994, measles cases centered around the 5~6th month. On the other hand, in non-epidemic year measles cases were scattered around the year. The incidence rates of measles by the province were greatly defferent whenever the outbreak of measles occurred. CONCLUSION: In 1990s, the outbreak of measles occurred periodically at the interval of 4 years until 1994. The seasonal distribution may be caused by Iimitation of transmission due to the increased measles immunity in outbreak region. Our results showed that the measles outbreak did not occur in the specific province, but it occurred nationwide whenever measles outbreak occurred, even though the incidence rates of the provinces were different.
Epidemiology ; Hand ; Immunization ; Incidence* ; Korea* ; Measles* ; Seasons

Despite improvements in the surgical treatment of gastric adenocarcinomas, the recurrence rates remain high in patients with advanced-stage disease. Most of the recurrence occurs within 3 years of the surgical resection, and nearly 90% of the patients with recurrence die within 2 years of the diagnosis of recurrence. A recent study analyzed recurrence patterns for patients who had undergone a potentially curative gastrectomy. For those patients, 33% of the recurrences involved locoregional sites, 44% the peritoneum, and 38% distant sites. A 51-year-old female patient was diagnosed with stomach cancer and underwent a total gastrectomy with D2 lymph node dissection during Oct. 1999. The pathologic report indicated a T3N1M0 tumor. We performed immunochemotherapy for 2 years with regular follow up. A gastrofiberscopic examination done during Sep. 2004, cancer recurrence was found at the *Kim's tie site of the jejunual loop. We did an abdominal exploration and a segmental resection of cancer site with pathologically negative resection margins. After the operation, we started secondary chemotherapy with TS-1.
Adenocarcinoma ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Gastrectomy* ; Humans ; Jejunum* ; Lymph Node Excision ; Middle Aged ; Peritoneum ; Recurrence ; Stomach Neoplasms*