The clincal experience of thirteen patients with proven acute osteomyelitis under twelve years of age treated by surgical exprolation such as immediate decompression followed by continuous suction-irrigation. Five patients of them who had short duration from the onset improved while three patients who had long duration from the onset had persisting inflammatory change of the bone in spite of the regimen. The causating organisms were mostly staphylococcus aureus in bacterial cultures. The combination of gentamycin, minocin and penclox were the antibiotics of choice. Early diagnosis and early operation is advocated to attain good results in the treatment of acute osteomyelitis in the children.
Anti-Bacterial Agents ; Child ; Decompression ; Early Diagnosis ; Gentamicins ; Humans ; Minocycline ; Osteomyelitis ; Staphylococcus aureus

Esophageal cancer is still a virulent disease that leads to death. Surgery has been regarded as the treatment of choice in patients suffering this type of cancer and recent improvements in surgical techniques and perioperative management have significantly increased the resection rate and reduced the operative mortality. Nevertheless, long-term survival rates remain poor. The poor prognosis reflects the fact that the disease is usually advanced at the time of diagnosis. Therefore, a combination of chemotherapy and radiotherapy has recently been developed as a treatment for advanced esophageal cancer patients. Chemoradiation therapy is based on the concept of the biochemical modulation effects and radiosensitizing effects of the chemotherapeutic agents. How ever, the optimal choice of chemotherapeutic agents and their doses, as well as the chemotherapy and radiotherapy regimens have not been precisely established. We report a case of concurrent chemoradiation protocol by which a complete response was achieved. 5-FU (1,800 mg/body/day) was continuously infused over 24 hours and cisplatin (45 mg/ body/day) was administered 1 hour before radiotherapy for 3 days. This chemotherapy course was repeated once more after 4 weeks. The radiotherapy (180 cGy/day) was scheduled for 5 consecutive days, followed by a 2-day withdrawal, and a total dose of 5,940 cGy within 7 weeks. Our concurrent chemoradiation therapy is deemed rational, effective and safe because an endoscopically and pathologically complete response was achieved 1 year after chemoradiation therapy without any severe side effects. Therefore, we believe that our concurrent chemoradiation therapy can be recommended as a treatment for advanced esophageal cancer patients.
Cisplatin ; Diagnosis ; Drug Therapy ; Esophageal Neoplasms* ; Fluorouracil ; Humans ; Mortality ; Prognosis ; Radiation-Sensitizing Agents ; Radiotherapy ; Survival Rate

Since the introduction of Percutaneous Endoscopic Gastrostomy(PEG) into clinical practice by Ponsky in 1980, the endoscopic procedure for the placement of a gastrostomy feeding tube has been markedly developed in the world. In l986, PEG was first described in Korea, thereafter it is widely used in many Korean institutions. But until recently the clinical studies of the long term efficacy of PEG has almost not been reported. (continue...)
Gastrostomy* ; Korea

No abstract available.
Pancreatitis*

PURPOSE: This study sought to evaluate the treatment modality, morbidity and mortality after surgery, the method of nutritional support and the survival rate for patients with cancer of the hypopharynx, larynx and cervical esophagus. METHODS: A retrospective review was undertaken of 17 hypopharyngeal, laryngeal and cervical esophageal carcinoma patients who had undergone surgical treatment in the Department of Surgery and Otorhinolaryngology, Yonsei University, College of Medicine, from January 1995 to April 2000. All patients underwent transhiatal esophagectomy in order to avoid pulmonary complications. Outcome measures were calculated using the Kaplan-Meier estimator. RESULTS: The 17 consecutive patients included 11 cases of hypopharyngeal cancer, 3 glottic cancers, 2 cervical esophageal cancers and one thyroid cancer with invasion of the trachea and esophagus. Fifteen patients (88%) presented with an advanced tumor stage. As for nutritional support following surgery, 12 underwent feeding jejunostomy, 4 a nasoenteric tube feeding and the other recieved total parenteral nutrition. Nine patients (53%) developed complications following surgery. One of the patients who had surgery died postoperatively. The mean survival time was 26 months and the 2-year and 4-year overall survival rates were 69.5% and 53.0%, respectively. CONCLUSION: Reconstruction of the hypopharynx and esophagus using stomach was low mortality and low severe morbidity. A total pharyngolaryngoesophagectomy with gastric transposition and primary hypopharyngogastric anastomosis offers the best chance for cure or palliation with acceptable morbidity and degree of function for selected patients with advanced hypopharyngeal, laryngeal and cervical esophageal carcinomas.
Enteral Nutrition ; Esophageal Neoplasms ; Esophagectomy ; Esophagus* ; Head and Neck Neoplasms ; Humans ; Hypopharyngeal Neoplasms ; Hypopharynx* ; Jejunostomy ; Larynx ; Mortality ; Nutritional Support ; Otolaryngology ; Outcome Assessment (Health Care) ; Parenteral Nutrition, Total ; Retrospective Studies ; Stomach* ; Survival Rate ; Thyroid Neoplasms ; Trachea