PURPOSE: Cerebral contusion is often associated with delayed edema, ischemia, demyelination, and secondary impairment in the neurological function. Early prediction of the outcome for patients with diverse critical illnesses has long been a concern of intensive care unit physicians. Recently, the systemic release of host-derived inflammatory mediators has been used for prognosis assessment in patients with multiple infections, burn injury, and systemic infection. Experimental investigations have revealed the importance of free radicals and calcium currents in cellular damage. Also experimental injuries have caused an early production of cytokines. This study was undertaken to analyze the production of interleukin-6 in the brain and in plasma following a brain contusion. METHODS: Sixty male Sprague-Dawley (SD) rats, each weighing 300-350 g were used in an experimental group following brain contusion, and 18 SD rats were used as a control group following a sham operation. Intracerebral IL-6 and plasma IL-6 were measured by using the ELISA method with a rat IL-6 kit at 3, 6, 24, 48, and 72 hours after the brain contusion. After contusion, the brains were fixed by perfusion via the carotid artery with 40% formaldehyde, glacial acetic acid, and 100% ethanol (1:1:8) at a flow rate of 25 ml/min and stained with hematoxylin and eosin for histologic examination. RESULTS: Brain IL-6 levels increased to reach a maximum of 160.23 pg/ml, at 6 hour after brain trauma. Plasma IL-6 levels increased to 70.02 pg/ml at 3 hour following brain contusion. CONCLUSION: The elevated brain IL-6 level in the injured rat does not seem to reflect a systemic inflammation. Although plasma IL-6 is detected in the sham-operated and the traumatized rats, the levels are too low to account for the increase observed in the brain cortex. This finding shows that the increase in brain IL-6 is related to the dynamics of brain contusion.
Acetic Acid ; Animals ; Brain Injuries* ; Brain* ; Burns ; Calcium ; Carotid Arteries ; Contusions ; Critical Illness ; Cytokines ; Demyelinating Diseases ; Edema ; Enzyme-Linked Immunosorbent Assay ; Eosine Yellowish-(YS) ; Ethanol ; Formaldehyde ; Free Radicals ; Hematoxylin ; Humans ; Inflammation ; Intensive Care Units ; Interleukin-6* ; Ischemia ; Male ; Perfusion ; Plasma ; Prognosis ; Rats* ; Rats, Sprague-Dawley

PURPOSE: To establish the incidence of deep vein thrombosis among Koreans after primary total hip arthroplasty and the usefulness of color doppler ultrasonography for routine noninvasive screening for deep vein thrombosis. MATERIALS AND METHODS: We performed prospective, randomized routine venography and color doppler ultrasonography before and after operation in a consecutive series of 89 primary total hip arthroplasty in which no form of prophylaxis was used. RESULTS: Of the 89 cases, eleven (12.4%) were found to have deep vein thrombosis (three proximal veins and eight distal veins) by bilateral venography. Most of the thromboses except two were asymptomatic. No patient had a symptomatic pulmonary embolism. Statistical analysis of risk factors, age, gender, weight, height, fixation method, and duration of operation time, were performed and there was no statistical difference (P>0.05). The reliability of color doppler ultrasonography for detection of deep vein thrombosis was demonstrated. CONCLUSIONS: We found insufficient evidence to recommend routine thromboprophylaxis in primary total hip arthroplasty among Koreans. The authors recommend that routine bilateral color doppler ultrasonography screening be considered after primary total hip arthroplasty for detection of deep vein thrombosis
Arthroplasty, Replacement, Hip* ; Humans ; Incidence ; Mass Screening ; Phlebography ; Prevalence* ; Prospective Studies ; Pulmonary Embolism ; Risk Factors ; Thrombosis ; Ultrasonography, Doppler, Color ; Veins ; Venous Thrombosis*

PURPOSE: To evaluate the efficacy of open reduction and internal fixation for disrupted symphysis pubis in unstable pelvic injuries. MATERIALS AND METHODS: Eighteen symphyseal disruptions were treated by open reduction and internal fixation from 1994 to 1998. There were 12 Tile type B and six type C injuries. In 12 patients, anterior fixation was performed whereas six patients were treated by anterior and posterior fixation. The clinical and radiological results were reviewed retrospectively at a mean of 20.4 months (range, 12 to 44 months) . RESULTS: The average symphyseal displacement improved from a preoperative value of 37.3 mm (range, 10-87 mm) to a postoperative value of 6.5 mm (range, 2-14 mm) . Leg length discrepancy which averaged 11.8 mm (range, 4-30 mm) preoperatively was decreased to 2.3 mm (range, 0-7 mm) postoperatively. Open reduction and internal fixation was associated with a higher percentage of excellent results except in osteoporotic bone. Two patients with osteoporosis had a loss of fixation. Complications were infrequent. CONCLUSION: Open reduction and internal fixation are desirable techniques for symphyseal disruption. But the supplemental wire fixation with plate would be recommended for elderly patients who show obvious signs of osteoporosis.
Aged ; Humans ; Leg ; Osteoporosis ; Retrospective Studies

PURPOSE: To analyze the clinical and radiological results of open reduction and plate fixation through the anterior approach for sacroiliac joint separation in unstable pelvic fracture. MATERIALS AND METHODS: We retrospectively reviewed fifteen cases treated by open reduction and plate fixation through the anterior approach from January 1994 to July 2000. Cases were followed up for more than one year, and the radiological results were evaluated according to the largest displacement and leg length discrepancy. The clinical results were evaluated according to pain and functional disabilities. RESULTS: Ten patients had mild pain not requiring analgesics, and one patient had a slight limp. The average sacroiliac joint separation improved from a mean preoperative value of 13.5 mm (range, 10-23 mm) to a mean postoperative value of 4.8 mm (range, 3-6 mm). Leg length discrepancy, which averaged 11 mm (range, 3-28 mm) preoperatively, decreased to 3.5 mm (range, 0-6 mm) postoperatively. All patients attained anatomical reduction postoperatively and no patient experienced loss of fixation during the follow up period. CONCLUSION: Open reduction and plate fixation for unstable pelvic fracture through the anterior approach is a useful method, as evidenced by the satisfactory clinical and radiological results.
Analgesics ; Follow-Up Studies ; Humans ; Leg ; Retrospective Studies ; Sacroiliac Joint*

PURPOSE: This study was performed to evaluate clinical and radiographical results of treatment of chronic lateral ankle instability with modified Brostrom procedure. MATERIALS AND METHODS: This is a retrospective study of 22 cases in 22 patients treated with modified Brostrom procedure under the diagnosis of chronic lateral ankle instability from May 2000 to August 2004. Average age was 32.3 years. Average follow-up period was 23 months. Preoperative and postoperative radiographs of ankle anteroposterior view, lateral view and varus stress view were analyzed. The clinical evaluation was performed according to the Americal Orthopaedic Foot and Ankle Society scales. RESULTS: After the modified Brostrom procedure, Americal Orthopaedic Foot and Ankle Society scales score was improved by average 28 points. Among the 22 cases, 13 cases were excellent, 3 cases good, 4 cases fair, and 2 cases poor with satisfaction of 73%. Five cases had intermittent ankle pain of whom 3 cases had difficulty during competitive sports activity. Lateral tilting of talus improved by average 5.4 degrees on varus stress view. CONCLUSIONS: The modified Brostrom procedure is one of the most effective methods for treating of chronic lateral ankle instability.
Ankle* ; Diagnosis ; Follow-Up Studies ; Foot ; Humans ; Retrospective Studies ; Sports ; Talus ; Weights and Measures

We investigated the induction of resistance to Clonorchis sinensis infection by prior infection in rat and hamster models. Animals were challenged with C. sinensis metacercariae, then treated with praziquantel and reinfected. Worm recovery rate in reinfected animals was used to estimate resistance to reinfection. The determined resistance rates to reinfection in rats and hamsters were 97.7% and 10.3%, respectively. In rats, cure from the primary infection of C. sinensis increased resistant to reinfection, and the greatert the worm burden and the longer the duration of primary infection, the higher was the resistance rate. For primary infection doses of 10, 40 and 100 metacercariae per rat, the resistance rates were 87.4%, 93.8% and 98.4%, respectively. The resistance rates in rats after 2 or 8-week primary infection were 78.7% and 95.3%, respectively. All worms recovered from reinfected rats were immature. When cured rats were administered with methylprednisolone, resistance to reinfection became impaired. These findings indicate that rats develop a high degree of resistance to reinfection by C. sinensis after cure. The growths and maturations of reinfected worms were also impaired.
Animals ; Anthelmintics/administration & dosage/therapeutic use ; Anti-Inflammatory Agents/administration & dosage ; Clonorchiasis/*immunology/parasitology/*pathology ; Clonorchis sinensis/*pathogenicity ; Disease Models, Animal ; Female ; Hamsters ; Immunocompetence ; Immunosuppression ; Male ; Mesocricetus ; Methylprednisolone/administration & dosage ; Praziquantel/administration & dosage/therapeutic use ; Rats ; Rats, Sprague-Dawley ; Support, Non-U.S. Gov't

Wernicke's encephalopathy is a reversible but potentially critical disease caused by thiamine deficiency. Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion. Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand. We report a case of Wernicke's encephalopathy following hyperemesis gravidarum in a 36-year-old female at 20 weeks of pregnancy, who visited our hospital because of shock with vaginal bleeding. This case suggests that although the initial presentation may include atypical symptoms (e.g., shock or bleeding), Wernicke's encephalopathy should be considered, and thiamine replacement should be performed in pregnant women with neurologic symptoms and poor oral intake.
Acute Kidney Injury ; Adult ; Alcohol Drinking ; Ataxia ; Female ; Humans ; Hyperemesis Gravidarum* ; Neurologic Manifestations ; Ophthalmoplegia ; Pregnancy ; Pregnant Women ; Shock ; Thiamine ; Thiamine Deficiency ; Uterine Hemorrhage ; Wernicke Encephalopathy*

PURPOSE: This study attempted to investigate the frequency, duration, and risk factors of antibiotic-associated diarrhea (AAD) in infants hospitalized due to febrile urinary tract infection (UTI). This is a basic research on the probiotics used in the prevention and treatment of AAD in infants. METHODS: Medical records of the infants aged 3-6 months hospitalized in Gachon University Gil Hospital from January 2008 to September 2010 due to the febrile UTI were retrospectively reviewed. The episodes of loose or watery stool were investigated for frequency, onset, and duration. Those who had AAD and those who did not (non-AAD) were compared. The antibiotic regimens and the episodes of diarrhea were investigated in AAD group. RESULTS: Total 147 infants were included. Fifty-four (36.7%) showed AAD. Intravenous third-generation cephalosporin (3rd CS) single therapy was used for 102 patients (69.4%), the 3rd CS and non-3rd CS combination therapy for 24 (16.3%), and non-3rd CS combination therapy for 21 (14.3%). There was no significant difference in the dose of cefotaxime between AAD and non-AAD group (P=0.601). According to the antibiotic therapies above, in AAD group, there was no significant difference in the onset and duration of diarrhea respectively (P=0.717, P=0.830). Although the frequency of diarrhea was higher for the 3rd CS and non-3rd CS combination therapy subgroup with 9.25+/-5.30 times/day than the other two subgroups (7.58+/-2.97 times/day in 3rd CS single therapy subgroup, 6.75+/-4.40 times/day in non-3rd CS combination therapy subgroup), there was no statistical significance (P=0.078). CONCLUSION: AAD seems common to the infants aged 3-6 months with febrile UTI, regardless of regimen and amount of antibiotics in usual dosage. Further research on the effects of probiotics used in the prevention and treatment of AAD in infants is warranted.
Aged ; Anti-Bacterial Agents ; Cefotaxime ; Child ; Diarrhea ; Humans ; Infant ; Medical Records ; Probiotics ; Retrospective Studies ; Risk Factors ; Urinary Tract ; Urinary Tract Infections

Transfer of large quantities of fetal blood across the placental barrier to the maternal circulation is a rare occurrence which results in severe anemia in the newborn infants. This phenomenon is believed to occur most often during labor and delivery and apparently, is more frequent when abnormal obstetric conditions are present. However, fetal erythrocytes have been identified in the naternal circulation throughout most of pregnancy indicating some degree of constant or intermittent transplacental transfusion. We experienced a case of stillbirth due to large amount of fetomaternal transfusion. Acid elutionl test of maternal blood was positive and direct and indirect Coombs test was negative. Ultrasonographic finding on abdomen and cranium to rule out the internal hemorrhage was normal. We report a case of stillbirth due to fetomaternal transfusion with a brief review of related literatures.
Abdomen ; Anemia ; Coombs Test ; Erythrocytes ; Female ; Fetal Blood ; Fetomaternal Transfusion* ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Skull ; Stillbirth*

OBJECTIVES: Alexithymia has been regarded as the general personality of psychosomatic disease, but it's controversial. The object of the study is to find out the relationship between alexithymia and alopecia areata. METHODS: Thirty one alopecia areata patients were compared to 31 normal healthy persons in alexithymic tendency using TAS-20K. Also MMPI and SCL-90-R were checked in both groups. Psychiatric diseases were ruled out. RESULTS: The scores of F, K, Hs, D, Hy, Pd, Pa, Pt and Sc of MMPI in alopecia areata patients were different from those in normal healthy persons. The scores of SOM, O-C, I-S, DEP, ANX, HOT, PHOB, PAR, PSY, GSI, PSDI, and PST of SCL-90-R in alopecia areata patients were significantly higher than those in normal healthy persons. In TAS-20K, the scores of Factor 1 and Total in alopecia areata patients were higher than those in normal healthy persons. CONCLUSION: Our results suggest that alopecia areata patients are more alexithymic than normal healthy persons.
Affective Symptoms* ; Alopecia Areata* ; Alopecia* ; Humans ; MMPI