Stump neuroma is a common cause of pain from disorganized proliferation of nerve fascicles occurring after limb amputation. Ultrasound guided alcohol injection in painful stump neuroma has been tried as a new treatment approach. Herein, we report 2 male patients, who had traumatic amputation and claimed severe and diffuse burning pain in the stump area. Neuroma at the distal end of an amputated nerve was clearly identified on sonography. The patients gradually developed increasing severe pain that could not be managed with conservative care. They were treated with neurolysis using alcohol solution. Using ultrasonographical guidance, 1.2 ml of 100% dehydrated alcohol was injected into the nerves proximal to neuroma. No complications occurred. The patients were initially pain free. After a few months, however, their stump pain recurred slightly. Repeat neurolysis was performed using 0.3 ml of 100% dehydrated alcohol. During the three months follow-up period, mild stump pain occurred but the patients did not require any analgesics.
Amputation ; Amputation, Traumatic ; Analgesics ; Burns ; Extremities ; Follow-Up Studies ; Humans ; Male ; Neuroma

Candida species inhabit the skin and mucous membranes of healthy individuals with low virulence, and osteomyelitis due to candida is very rare. However, the incidence of invasive candidal infection caused by intravenous drug use, broad-spectrum antibiotics, and indwelling central venous catheter is increasing. A 73-year old man visited the outpatient clinic complaining of right shoulder pain that radiated to the right acromioclavicular joint. He had undergone multiple injection procedures followed by nonsteroidal anti-inflammatory drug therapy for several weeks. The ultrasonographic findings showed a heterogeneous mass around the right acromioclavicular joint, while the right shoulder MRI and the overall findings of the body bone scan were suggestive of osteomyelitis. Pathologic findings of ultrasonographically guided joint aspiration fluid showed acute and chronic nonspecific inflammation, while the tissue culture and staining revealed Candida parapsilosis.
Acromioclavicular Joint ; Ambulatory Care Facilities ; Anti-Bacterial Agents ; Arthritis, Infectious ; Candida ; Central Venous Catheters ; Incidence ; Inflammation ; Joints ; Mucous Membrane ; Osteomyelitis ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Skin

No abstract available.
Anesthesia, Spinal* ; Cesarean Section* ; Emergencies* ; Female ; Humans ; Neurofibromatosis 1* ; Pre-Eclampsia* ; Pregnancy

The purpose of this research was to investigate whether pulsed electromagnetic field (PEMF) stimulation applied to the rabbit cranial defects grafted with beta-tricalcium phosphate (beta-TCP) could affect the new bone formation. With 16 New Zealand white rabbits under the same condition, bilateral calvarial bone defects were formed around the sagittal suture line. The defect on the left side was grafted with beta-TCP, while on the right side was grafted by harvested autogenous bone. PEMF was applied to 8 rabbits for 8 hours per day. The bony specimen were divided into 3 groups, the group 1 was autogenous bone grafted specimen, the group 2 was beta-TCP grafted with PEMF, and the group 3 was beta-TCP grafted without PEMF. We investigated the bone regeneration and growth factor expression at 2, 4, 6, and 8 weeks. As a result, BMP 2 was expressed in the group 1 from 2 weeks, the group 2 from 4 weeks, and the group 3 from 6 weeks. BMP 4 was expressed in the group 1 from 2 weeks, in the group 2 and the group 3 from 4 weeks. 4. There was no significant difference in expression pattern of BMP 7, PDGF, VEGF, and TGF-beta1 during grafted bone regeneration in group 1, 2, and 3. According to our results, PEMF stimulation could be effective on the new bome formation in animal study, and have a feasibility of clinical use.
Animals ; Bone Regeneration ; Electromagnetic Fields* ; Magnets* ; Osteogenesis ; Rabbits ; Sutures ; Transforming Growth Factor beta1 ; Transplants* ; Vascular Endothelial Growth Factor A

OBJECTIVE: The Purpose of the study was to investigate the bone morphogenic protein expression of rhBMP-2(recombinant human bone morphogenic protein-2) as singnaling molecule and beta-TCP(Tricalcium phosphate) as a bone substitute and carrier medium of rhBMP-2. MATERIALS AND METHODS: 16 rabbits divided into 2 group of each 8 rabbit. Two standardized bone defect, round bilateral defect was made in the cranium of the 8 rabbit of first group, and was grafted with 150~500micrometer diameter beta-TCP 0.25g in one side, which was soaked with rhBMP-2, and autogenous bone was grafted on another side as a positive control. Second group of 8 rabbit, only beta-TCP was grafted with same size and same manner. After 2, 4, 8, and 12 weeks, specimen was taken for microscopic immunohiostochemical and histomorphometric analysis. RESULT: Grafting beta-TCP with rhBMP show the early formation of the bone regenerative factor (BMP-4) and more quantity of new bone formation than only use of beta-TCP (8,12 week), even show less new bone formation than autogenous bone. CONCLUSION: The experimental study result that beta-TCP graft combination with rhBMP-2 as a delivery system is an effective with osteoinductive capacity and biodegradable properties, so that provide clinical availibility of composite use in reconstruction of bony defect.
Bone Substitutes ; Calcium Phosphates ; Humans ; Immunohistochemistry ; Osteogenesis ; Rabbits ; Skull ; Transplants

Animal Experimentation ; Animals ; Bone Regeneration ; Intercellular Signaling Peptides and Proteins ; Osteogenesis ; Platelet-Rich Plasma ; Rabbits ; Transforming Growth Factor beta1 ; Transforming Growth Factor beta2 ; Transplants ; Vascular Endothelial Growth Factor A

Brucellosis is a systemic, infectious disease caused by the bacterial genus Brucella and a common zoonosis that still remains a major health problem in certain parts of the world such as the Mediterranean region, the Middle East, and Latin America. It may involve multiple organs and tissues. Osteoarticular involvement is the most frequent complication of brucellosis, in which the diagnosis of brucellar spondylitis is often difficult since the clinical presentation may be obscured by many other conditions. There are only a few reports on brucellar spondylitis in Korea. Here, we report a case of spondylitis due to brucella in an elderly male.
Aged ; Back Pain ; Brucella ; Brucellosis ; Communicable Diseases ; Humans ; Korea ; Latin America ; Lumbosacral Region ; Male ; Mediterranean Region ; Middle East ; Spondylitis

BACKGROUND: To characterize the ictal electrocorticographic features in relation to surgical outcome in nonlesional neocortical epilepsy (NE). METHODS: Seventeen patients with intractable NE underwent surgeries after chronic subdural recordings. All patients did not have any lesions on brain MRI, which was confirmed by pathology postoperatively. One hundred and eighty one ictal EEGs recorded from subdural electrodes were analyzed. Surgical outcome was determined by seizure reduction rate, and free or more than 75% reduction was defined as favorable outcome. The mean duration of follow-up was 55+/-8.7 months. RESULTS: Reproducible ictal onset zone (IOZ) in more than a half of seizures (p=0.002), and persistent ictal discharges in IOZ from the onset to the end of seizure were found more frequently in the patients with good outcome (p=0.004). Ictal onset patterns consisting of low voltage fast or high amplitude beta spikes predicted a good surgical outcome while rhythmic sinusoidal activity or rhythmic spike/sharp wave were predictive of poor outcome (p=0.01). The ictal onset rhythm consisted of gamma or beta frequencies was more prevalent in the favorable group (p=0.003). CONCLUSIONS: The presence of stable ictal circuit suggested by the consistent earliest activation in more than 50% of seizures and the active participation of IOZ throughout the attack were valuable prognostic factors in addition to the morphology and frequency of ictal onset rhythm.
Brain ; Electrodes ; Electroencephalography ; Epilepsy* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Pathology ; Prognosis ; Seizures

BACKGROUND: Since 2001, the Korean Red Cross has performed malaria antibody test for blood donors in malaria-risk areas to prevent transfusion-transmitted malaria. However, due to insufficient sensitivity and specificity the malaria antibody assay is not considered an efficient screening method. Therefore, we have considered discontinuing malaria antibody testing for blood donors. METHODS: We analyzed the results of malaria antibody test from 2001 to 2014 utilizing data from the Blood Information Management System of the Korean Red Cross. RESULTS: Among 16,650,812 donations tested from 2001 to 2014, 50,143 donations (0.30%) showed positive results. However, there was no truly infected case at the time of donation. The positive rate among blood donations was between 34 and 39 per 10,000 in 2001, but between 9 and 10 per 10,000 in 2014. There was no interregional disparity in the positive rate of blood donations. CONCLUSION: Korea is in a malaria elimination phase and malaria antibody testing in limited areas is not effective, therefore we propose discontinuing the malaria antibody test.
Blood Donors* ; Humans ; Information Management ; Korea ; Malaria* ; Mass Screening* ; Red Cross ; Sensitivity and Specificity

PURPOSE: We aimed to compare the prognosis and the recurrence patterns of sporadic primary colon cancers according to the location of the cancer. METHODS: One thousand four-hundred eighty-three (1,483) stage II, III colon cancer patients who had undergone a consecutive curative resection between January 1989 and December 2003 were analyzed. Hereditary, synchronous, metachronous, and recurrent colon cancers were excluded. The right colon was defined as being from the cecum to the transverse colon, and the left colon was defined as being from the splenic flexure colon to the rectosigmoid colon. The median follow-up time was 63 (3-228) mo. RESULTS: Poorly differentiated and mucinous cell type tumors were more frequent in the right colon. T3 tumors were more frequent in the right colon. Lymph-node-positive tumors were more frequent in the left colon. The recurrence rate was higher in the left colon, but the patterns of recurrence were not different according to the tumor's location. By univariate analysis, age, preoperative serum CEA level, T-stage, N-stage, lymphovascular invasion, postoperative chemotherapy, and tumor location were significant prognostic factors associated with recurrence. By multivariate analysis, sex, preoperative serum CEA level, T-stage, N-stage, postoperative chemotherapy, and tumor location were significant prognostic factors associated with recurrence. The 5-yr disease-free survival rates were 84.0% for right colon cancer and 77.1% for left colon cancer (P=0.005). The recurrence rates for cancers in the sigmoid colon and the rectosigmoid colon were higher than those for cancers in the cecum and the ascending colon. CONCLUSION: The tumor's location was an independent prognostic factor for recurrence, but the pattern of recurrence did not vary with the tumor's location.
Cecum ; Colon ; Colon, Ascending ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Mucins ; Multivariate Analysis ; Prognosis ; Recurrence