No abstract available.
Animals ; Female ; Menstrual Cycle* ; Mice* ; Zygote*

BACKGROUND: It has been documented that certain prognostic factors may affect the outcomes of the old aged victims by trauma. Considering that trauma is the sixth most common cause of death in people over the age of 65 years and there is a rapid growth of elderly population, it is paramount to understand the prognostic factors when dealing with geriatric trauma patients. Hypothesis and Goals : It can be hypothesized that the prognostic factors should be determined independently between populations being consisted of different races, countries, socio-economic states, cultures, or so on. Thus, study was designed to evaluate the factors affecting the outcomes of elderly Korean trauma patients. METHODS: One hundred forty six patients aged over 65 years were retrospectively reviewed, who visited the Emergency Canter of Korea University from January, 1997 to June, 1998. Of 146 patients, 7 were excluded due to discharge against advice or transfer to the other hospitals. Parameters analysed were age, sex, mechanism of injuries, body region injured, Injury Severity Score (ISS), previous medical illness, hospital morbidity, duration of hospital stay, and cost. Each patient was classified into improved or not-improved groups depending on the outcomes, and young-old or old-old group depending on the age. The factors affecting the hospital stay in improved patients were analyzed in the parameters of previous medical illness, hospital morbidity, multiple injuries, ISS, and age. All statistical tests were conducted with two-tailed levels of 0.05. RESULTS: Of 139 patients, the mean age was 74+/-7.1 years, mean ISS 9.3+/-7.26, mean hospital stay 27+/-27.1 days. Most commonly injured body region was the extremities due to fall from a level surface. Rate of previous illness showed 0.94 medical diseases per person and were aggravated after trauma in 39 patients (60.9%). Hospital morbidity rate was 0.46 incidents per person. There were no differences in age and duration of hospital stay between the improved and the not-improved group. Substantial differences were noted in affected body region, incidence of previous illness, and hospital morbidity between the groups (p=NS). Not-improved group had higher ISS (p<0.05). ISS, previous illness and hospital morbidity affected the duration of hospital stay in the improved group. Hospital stay was 40+/-25.1 days in patients with ISS over 6 while 6+/-8.6 days in those with ISS 5 (p<0.05). Hospital stay in the improved was 26+/-26.9 days while 31+/- 24.8 days in the improved old-old group (P=NS). Hospital stay in the young-old minor trauma (ISS5) patients with previous illness and hospital morbidity was 26+/-10.1 days while 4+/-7.3 days in those without previous illness and hospital morbidity (p<0.05). CONCLUSION: Previous medical illness and hospital morbidity, not age, are predictive of outcomes of geriatric trauma patients with respect to hospital stay. As most of the hospital morbidity was a trauma-induced aggravation of previous medical illness and hospital morbidity contributing poor outcomes can be potentially avoidable, routine aggressive care far the geriatric trauma patients with previous medical illnesses is needed.
Aged ; Body Regions ; Cause of Death ; Continental Population Groups ; Emergencies ; Extremities ; Humans ; Incidence ; Injury Severity Score ; Korea ; Length of Stay ; Multiple Trauma ; Retrospective Studies

PURPOSE: The purpose of this study was to define the factors affecting results in acute septic hip arthritis in children and to reduce the complications. MATERIALS AND METHODS: This is a retrospective study of 27 children with 28 hip joint infections, treated with arthrotomy and followed up for more than 12 months. Results were evaluated according to Merle D'Aubigne's clinical grade and Bennett's radiological grade, and correlated with the time between symptom onset and treatment, the existence of a causative organism, its species, concomitant osteomyelitis, age of onset and normalized time of C-reactive protein (CRP). We analysed results using the Pearson Chi Square method. RESULTS: A delay in treatment, concomitant osteomyelitis of the proximal femur and old age, were factors associated with poor prognosis. Normalized time of CRP, the existence of a causative organism and species were not correlated with the treatment results. CONCLUSION: Shorter duration of disease from clinical onset to the initiation of therapy and concomitant osteomyelitis of the proximal femur are the most important factors in the treatment of acute septic hip arthritis in children. When analysing results correlated with the age of onset, precise prospective study is required in many cases of acute septic hip arthritis in children.
Age of Onset ; Arthritis ; Arthritis, Infectious* ; C-Reactive Protein ; Child* ; Early Diagnosis ; Femur ; Hip Joint* ; Hip* ; Humans ; Osteomyelitis ; Prognosis ; Retrospective Studies

Sacral insufficiency fractures are unexpected causes of inguinal, lower back and buttock pain in elderly women with osteoporosis who have sustained unknown or only minimal trauma. Differential and radiological diagnoses of these fractures are often difficult. Bone scan remains the standard diagnostic tool, but computed tomography or magnetic resonance image may be required to differentiate insufficiency fracture from other diseases such as malignant bone lesion. The fracture usually extends vertically in the sacral ala, parallel to the sacroiliac joints. This distribution suggests that such fractures could be partially caused by weight-bearing transmitted through the spine. We report the treatment of insufficiency sacral fracture in one osteopenic patient who has been confirmed by computed tomography and treated with conservative method that convinced by follow up computed tomography.
Aged ; Buttocks ; Diagnosis ; Female ; Follow-Up Studies ; Fractures, Stress* ; Humans ; Osteoporosis ; Sacroiliac Joint ; Sacrum* ; Spine ; Weight-Bearing

PURPOSE: Vascular endothelial growth factor (VEGF) is a potent angiogenic factor in a number of cancers. The aim of this study was to evaluate the clinical significance of the serum level of VEGF in hepatocellular carcinoma (HCC) patients. METHODS: Serum VEGF was measured by an enzyme linked immunosorbent assay (ELISA) method. The correlation between serum VEGF level and clinico-pathological data of HCC patients were evaluated. RESULTS: The serum VEGF levels significantly increased with increasing tumor size and platelets count. The mean serum VEGF level in HCC patients with microvessel tumor invasion was higher than in those without microvessel tumor invasion. CONCLUSION: A high serum VEGF level may be an indicator of tumor progression and an important predictor of microvessel tumor invasion.
Angiogenesis Inducing Agents ; Carcinoma, Hepatocellular* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Microvessels* ; Vascular Endothelial Growth Factor A*

The simultaneous correction of the hypertelorism and exophthalmos combined with craniosynostosis is very rarely performed operative procedures in the world. The craniosynostosis is the congenital anomaly that designates premature fusion of one or more sutures in either cranial vault or cranial base. Hypertelorism is not a distinct clinical syndrome in itself, but is a physical finding secondary to facial and cranial maldevelopment and it is defined as a increase in the distance between the medial orbital walls. Exophthalmos can occur following the decrease in the size of the orbit in patients with developmental skeletal disorders such as craniofacial synostosis. The authors experienced 9-year-old male patient, who has complex cranio-facial abnormality. The craniosynostosis was oxycephaly type and primary fronto-orbital advancement surgery had been performed in other hospital. The abnormal cranial vault combined with hypertelorism and exophthalmos due to maldeveloped both orbital walls. Surgical correction was obtained by various cranio-fronto-orbital remodeling technique such as calvarial bone craniotomy, fronto-orbital advancement, paramedian resection, medial canthopexy, Tessier-Wolfe three wall orbital expansions. We achieved a quite satisfactory result both functionally and aesthetically in a complex cranio-facial deformity patient by combination and modification of previously developed various cranio-facial plasty technique and hereby report the case with brief discussion and review of literature.
Child ; Congenital Abnormalities ; Craniosynostoses ; Craniotomy ; Exophthalmos* ; Humans ; Hypertelorism* ; Male ; Orbit ; Skull Base ; Surgical Procedures, Operative ; Sutures ; Synostosis

BACKGROUND/AIMS: The QuantiFERON-TB Gold (QFT-G) and QuantiFERON-TB Gold in tube (QFT-IT) assays have been studied primarily for the use of diagnosing active pulmonary tuberculosis (TB) or latent TB. The clinical usefulness of these assays for the detection of active extrapulmonary (EP) TB has not been fully defined. The aim of this study was to compare the diagnostic value of these two interferon-gamma assays for EP-TB. METHODS: From June 2007 to August 2010, we evaluated the usefulness of QFT-G (n = 56) and QFT-IT (n = 48) in patients (n = 104) with suspected EP-TB. The diagnostic sensitivity, specificity, postive predictive value (PPV), and negative predictive value (NPV) of QFT-G and QFT-IT, and the cut-off value of QFT-IT were analyzed. RESULTS: EP-TB was diagnosed in 55 (53%) patients. The overall sensitivity, specificity, PPV, and NPV of the QFT-IT assay were 96%, 42%, 62%, and 91%, respectively, and those of the QFT-G test were 81%, 52%, 68%, and 68%, respectively. In subgroup analyses according to infection site, the sensitivity and NPV of QFT-IT were higher than those of QFT-G. Analysis confirmed that the manufacturer's recommended test cut-off value fell within our cut-off value range (0.30-0.45 IU/mL; 95.8% sensitivity, 41.7% specificity). CONCLUSIONS: The QFT-IT assay showed superior sensitivity and NPV, and equivalent specificity, as comparison with the QFT-G test for the detection of Mycobacterium tuberculosis infection. The logistic benefits of the QFT-IT test format should facilitate the diagnosis of EP-TB.
Humans ; Interferon-gamma ; Lymphadenitis ; Mycobacterium tuberculosis ; Sensitivity and Specificity ; Spondylitis ; Tuberculosis ; Tuberculosis, Pulmonary

Background: The type of footwear is one of several factors that affect foot pressure. Despite its usefulness in identifying pathology and preventing and treating foot-related diseases, the type of shoes has been investigated and compared in only a few studies. This study aimed to investigate differences in plantar pressure, induced by flat, running, and high-heeled shoes in healthy, young women. Methods: A total of 27 healthy women (27 feet) with a mean age of 21.5 ± 2.03 years were included in this study. Based on demographic data, radiologic measurements, clinical scores, temporal gait parameters, and kinematic parameters of gait, we confirmed the participants had normal feet. Then, pedobarographic data were measured by dividing each foot into seven regions to compare the three types of shoes. Peak plantar pressure and pressure-time integral were calculated using the Pedar-X system. The one-way analysis of variance and the Kruskal-Wallis test with Mann Whitney U-test were used for statistical analyses. Results: Regarding the 7 regions of the foot, flat shoes resulted in a significantly higher pressure than running shoes in the hallux and lesser toes and the highest pressure in the metatarsal head (MTH) 3–5 and the hindfoot. In contrast, in the MTH 1 and MTH 2 regions, the high-heeled shoes had the highest measured pressure, followed by the flat shoes. Lastly, there was no high pressure in running shoes in any region except for the midfoot compared to the other shoes. Conclusions It can be inferred from our findings that flat and high-heeled shoes can generate a considerable burden on specific parts of the foot, which will aid in choosing appropriate shoes. Also, wearing running shoes places less burden on the overall foot.

PURPOSE: To determine the concordance of transcutaneous CO2 (PtcCO2) versus arterial CO2 (PaCO2), end-tidal CO2 (PetCO2) versus PaCO2, and transcutaneous O2 (PtcO2) versus arterial O2 (PaCO2) among healthy adult volunteers, and to determine the normal values of the PtcCO2/PtcO2 and PtcO2/PaO2 that will be used as early signs of shock or as prognostic factors for critically ill patients. METHODS: We measured the PtcO2, PtcCO2, PetCO2, PaO2, and PaCO2 from 11 healthy volunteers while breathing room air or O2 at a flow rate of 6 L/min via nasal cannula. The PtcO2 and PtcCO2 were measured using a Radiometer's transcutaneous sensor that interfaced with the Solar 8000 patient monitor system. The PetCO2 was measured using a side stream capnometer that sampled air from a nasal catheter. The PaO2 and PaCO2 were measured from arterial blood samples. The concordances of the PtcCO2 versus the PaCO2, the PtcO2 versus the PaO2, and the PetCO2 versus the PaCO2 were analyzed using a Bland-Altman plot. We defined the normal values of the P(a-tc)CO2, PtcO2/PaO2, and PtcCO2/PtcO2. RESULTS: Twenty-two pairs of the PtcCO2 versus PaCO2, PtcO2 versus PaO2, and PetCO2 versus PaCO2 were obtained. The mean (+/-SD) values of the P(a-tc)CO2, P(atc) O2, and P(a-et)CO2 were 0(+/-2.2) mmHg, 35.4(+/-24.1) mmHg, and 1.4(+/-1.3) mmHg, respectively (p=0.947, p<0.001, and p<0.001 by paired t-test, respectively). The P(a-tc)CO2 and P(a-et)CO2 showed a high concordance of 95.5% within a range of +/-4 mmHg. The median (25~75%) values of the PtcCO2/PtcO2 and PtcO2/PaO2 at room air were 54.8%(46.8%~62.7%), respectively. CONCLUSION: The PtcCO2 and PetCO2 had a reliable concordance with the PaCO2. However, the PtcO2 was discordant with the PaO2 and this discordance was increased when inspiring O2. Therefore, the absolute values of the PtcO2 cannot be used as a surrogate measurement of the PaO2. However, because the O2 supply did not increase the PtcCO2, but rather the PtcO2, we can use the trend in the change in the PtcCO2/PtcO2 or PtcO2/PaO2 in shock patients.
Adult ; Blood Gas Monitoring, Transcutaneous ; Carbon ; Carbon Dioxide ; Catheters ; Critical Illness ; Humans ; Organothiophosphorus Compounds ; Oxygen ; Reference Values ; Respiration ; Rivers ; Shock

BACKGROUND: Linezolid, an oxazolidinone, has shown efficacy in the treatment of adults with nosocomial or community-acquired pneumonia, skin and soft tissue infections (SSTI), and infections due to methicillin-resistant Staphylococcus aureus. We have taken part in the study for evaluation of efficacy and safety of linezolid for the treatment of suspected or proven gram-positive SSTI in Asia. We sub-analyzed and reported the results of the study among Korean patients. MATERIALS AND METHODS: A total of 60 patients were enrolled in the study for evaluation of efficacy and safety of linezolid for the treatment of gram-positive SSTI at eight teaching hospitals in Korea. We investigated patients' medical history, physical examination and laboratory study. Patients were regularly followed up to evaluate clinical response, laboratory changes, and adverse event up to 4 weeks after treatment. When possible, we performed microbiological study before and after treatment. RESULTS: A total of 60 patients were enrolled. Average age of the patient was 50.9+/-15.3 years old with male to female ratio being 1.3:1. Cellulitis, open wound infection, skin abscess, and other clinical manifestations were observed in 47 (78.3%), 6 (10.0%), 2 (3.3%), and 5 (8.3%) patients, respectively. Forty two patients completed both follow-up and treatment and among them, treatment was successful in 38 patients (90.5%) and unsuccessful in 4 patients (9.5%). Microoranisms were isolated from seven patients and 14 isolates were documented; 11 S. aureus, 3 coagulase-negative staphylococcus. Among the seven patients, bacteria were eradicated in four patient and the organism proved to be colonization in three patients. The most frequent drug-related adverse events were gastrointestinal (21.7%), hematologic and biochemical (21.7%) and neurologic (3.3%), in decreasing order. Nausea (15%) was the most frequent symptom and there were no serious side effects related to linezolid. CONCLUSION: Linezolid was effective and safe in treatment of gram-positive SSTI.
Abscess ; Adult ; Asia ; Bacteria ; Cellulitis ; Colon ; Female ; Follow-Up Studies ; Hospitals, Teaching ; Humans ; Korea ; Linezolid ; Male ; Methicillin-Resistant Staphylococcus aureus ; Nausea ; Physical Examination ; Pneumonia ; Skin* ; Soft Tissue Infections* ; Staphylococcus ; Wound Infection