The authors did a clincal analysis of 95 cases of the osteomyelitis. Among them 72 were hematogenous in origin: 12 were secondary to open fracture: 6 were direct extension from adjascent soft tissue infection: 5 were complicated after open reduction of fracture, who were treated at Dept. of Orthopedics of Catholic Medical College for past 3 years from 1968 to 1971. Through this study following result were obtained: 1. Most of the patient were under age of 16 Years, In acute hematogenous osteomyelitis, over 80% of patient were under age of 12 years. Males were more frequently affected than females. 2. Generally, femur, tibia and humerus were most frequently affected than the others. In acute osteomyelitis, distal femur and proximal tibia were the most frequent site of involvement. 3. In acute osteomyelitis, early decompression, like drilling or fenestration operation gave more satisfactory result than the simple soft tissue drainage. Immediate surgical intervention with massive antibiotics administration is stressed without hesitation when diagnosis is made. The group treated within a week after onset gave relatively good result in this series. 4. Primary closure of the wound in acute osteomoelitis were considered not to be the good method which is usually adopted as procedure in the chronic type. 5. In the chronic osteomyelitis, continuous tube irrigation after saucerization was adopted when the bony defect is large. Primary closure of the wound were adopted in the case when surgical defect is small in size less than 4cm in diameter. 6. Treatment of the osteomyelitis complicated after open reduction of the fracture were generally treated with focal curettage and removal of fixative device when clinical union is evident, also fixative devices were out even in the group which were not united clinically but redisplacement is expected not to take place. In this group external support was given until fracture healing. Bony window was also made for drainage when cavitary change develped around the tip of nail.
Anti-Bacterial Agents ; Curettage ; Decompression ; Diagnosis ; Drainage ; Female ; Femur ; Fracture Healing ; Fractures, Open ; Humans ; Humerus ; Male ; Methods ; Orthopedics ; Osteomyelitis ; Soft Tissue Infections ; Tibia ; Wounds and Injuries

The superficial sural artery flap is supplied by the superficial sural artery that accompanies the sural nerve. The superficial sural artery connects distally with a peroneal artery septocutaneous perforator via a suprafascial network of vessels that permits the flap to be raised on its distal pedicle. We treated 10 patients who showed soft tissue defect of the lower third of the leg, around the ankle and the hindfoot with this flap. The causes of the soft tissue defect were trauma in 6 cases, pressure sore in 2 cases, squamous cell carcinoma in 1 case and osteomyelitis in 1 case. The sites of the soft tissue defect were the lower third of the leg in 5 cases, around the ankle in 2 cases and the hindfoot in 3 cases. The size of the soft tissue defect was from 5x6 cm to 8xl2 cm. All 10 flaps survived. Two flaps showed slight venous congestion which cleared in a few days. The time for flap dissection was 15 minutes in average. The results of our cases show that the distally based superficial sural artery flap is useful for the soft tissue coverage of the lower third of the leg, around the ankle and the hindfoot. The advantages of the flap are that the blood supply is reliable, elevation is easy and quick, the major arteries are not sacrificed and the donor site morbidity is negligible.
Ankle ; Arteries* ; Carcinoma, Squamous Cell ; Humans ; Hyperemia ; Leg ; Lower Extremity ; Osteomyelitis ; Pressure Ulcer ; Sural Nerve ; Tissue Donors

No abstract available.
Humans ; Mothers*

No abstract available.
Hemorrhage*

Patients with atypical or incomplete Kawasaki disease are at same risk for development of coronary artery complications as typical Kawasaki disease. In this communication we report six patients with unusual presentation of Kawasaki disease complicated by coronary artery aneurysms, in whom correct diagnosis were not made in time for proper treatment. One of these patients died from massive myocardial ischemia due to giant aneurysms along the entire coronary artery system. These patients had either less than enough number of diagnostic criteria at initial presentation or diagnostic signs which occurred over an extended period of time, resulting in difficulty in diagnosis during the acute phase. As a result, none of these patients received intravenous gamma globulin treatment. Thus strict adherence to currently accepted criteria for diagnosis of Kawasaki disease may lead to failure to recognize atypical form of this illness with potential sequelae of myocardial ischemia or sudden death. We would like to emphasize from this experience that clinicians must be aware of the wide variations in clinical presentation of Kawasaki disease and take an aggressive approach in making correct diagnosis by obtaining early cardiac evaluation in order to initiate prompt treatment with intravenous gamma globulin.
Aneurysm ; Coronary Aneurysm* ; Coronary Vessels ; Death, Sudden ; Diagnosis ; gamma-Globulins ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia

Rett syndrome is progressive neurodegenerative disorder in female patients, characterized by autistic behavior, mental retardation, loss of purposeful hand skills, stereotypic hand movement, breathing dysfunction, severely impaired language, ataxia, and seizure. The diagnosis of Rett syndrome is based on its characteristic clinical manifestation and course. The electroencephalographic (EEG) findings of Rett syndrome are nonspecific, but a progressive deterioration in the EEG, characterized by a slowing of background activity and spike sharp wave discharges, may be observed. We experienced one case of Rett syndrome in a 5 year old girl having mental retardation, loss of purposeful hand skills, stereotypic hand movements (clapping, washing, hand-to-mouth), breathing dysfunction (hyperventilation/apnea). Her EEG findings on Video-EEG monitoring are excessive slowing waves during awake state and frequent spike discharges from left or centrotemporal area during sleeping. We report a case of Rett syndrome with brief review of related literatures.
Ataxia ; Child, Preschool ; Diagnosis ; Electroencephalography ; Female ; Hand ; Humans ; Intellectual Disability ; Neurodegenerative Diseases ; Respiration ; Rett Syndrome* ; Seizures

No abstract available.
Ameloblastoma*

PURPOSE: We report the results of embolization in 42 cases of brain arteriovenous malformation and discuss the technical problems. MATERIALS AND METHODS: Flow-guided microcatheter for the superselection of the feeding arteries and nbutyl cyanoacrylate as an embolic agent were used. Wire guided microcatheter and microparticle were used in two exceptional cases. As preembolization functional evaluation, 30--50mg of thiopental sodium solution was injected into the feeding arteries through superselected microcatheters in 40 cases with supratentorial lesions. RESULTS: There was no local arterial complication by injection of thiopental solution. Embolization caused a permanent neurologic deficit(mild to moderated hemiparesis) in 2 patients (4.8%) by a reflux of embolic agent or probable spasm of main arterial trunk. In 8 patients(19%), the AVMs were completely obliterated and 25 patients(60%) showed anglographic obliterations of 50--90% of the lesions. Embolization induced venous occlusion was demonstrated at post-embolization angiography in 6 patients, and 3 patients of them showed delayed and transient neurologic deficits. CONCLUSION: Embolization of cerebral AVM can be performed effectively and safely by a superselective method and appropriate functional evaluation. Superselective thiopental sodium injection is a safe and reliable test for the evaluation of local brain function before embolization.
Angiography ; Arteries ; Arteriovenous Malformations ; Brain* ; Cyanoacrylates ; Humans ; Neurologic Manifestations ; Spasm ; Thiopental

No abstract available.
Lung Injury* ; Lung* ; Paraquat*

No abstract available.
Cerebral Infarction* ; Craniocerebral Trauma* ; Head* ; Humans ; Oxygen*