No abstract available.
Foreign Bodies* ; Pneumonia, Aspiration*

Femoral head and neck fractures during the course of avascular necrosis are rare with only few reports in the English literature. Moreover, there are very few reports on an analysis of the patterns of these fractures. Four cases of femoral head fracture caused by minor trauma, which were quite different from the crescent fractures during the course of avascular necrosis were analyzed in regard to the underlying disease, causes, sites, types, directions, pattern of fractures and the injury mechanism of the fractures. The results are reported with special regard to the pattern of the stress fracture of the femoral head and neck during the course of avascular necrosis.
Fractures, Stress ; Head* ; Neck* ; Necrosis*

PURPOSE: This study was performed to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. METHODS: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. RESULTS: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean 2.8+/-2.2). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was 21,000+/-5,600/uL; ESR, 60+/-23 mm/hr; CRP, 17+/-10 mg/dl. Pyuria was noted in every patient and persisted for 10.5+/-7.8 days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial (99m)Tc-DMSA scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was 11.8+/-6.3 days(pre-admission, 4.0+/-3.0; post-admission, 7.8+/-5.5 days) and the patients needed hospitalization for 17.2+/-8.1 days. CONCLUSION: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.
Abdominal Pain ; Age Distribution ; Anti-Bacterial Agents ; Child* ; Chills ; Early Diagnosis ; Female ; Fever ; Follow-Up Studies ; Hospitalization ; Humans ; Kidney ; Leukocyte Count ; Male ; Nephritis* ; Pyuria ; Ultrasonography ; Vesico-Ureteral Reflux

PURPOSE: Although neonatal pulmonary hemorrhage is rare, it is associated with high mortality. We aimed to evaluate the risk factors associated with pulmonary hemorrhage in preterm infants and to describe the clinical course, including neonatal morbidity, of infants who developed pulmonary hemorrhage. METHODS: We performed a retrospective case-control study of 117 newborn infants aged less than 37 gestational weeks admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 1995 and December 2008. Control group infants without pulmonary hemorrhage were matched according to the gestational age, duration of mechanical ventilation, and birth weight range (< or =100 g). Pulmonary hemorrhage was defined as the presence of hemorrhagic fluid in the trachea and severe respiratory decompensation. RESULTS: Pulmonary hemorrhage occurred in 17 cases of very low birth weight infants (VLBW; birth weight < 1,500 g; median age, 3 days) and 22 cases of low birth weight infants (LBW; 1,500 g < or = birth weight < 2,500 g; median age, 1 day). Antenatal maternal glucocorticoid treatment significantly reduced the incidence of pulmonary hemorrhage in VLBW infants. Low APGAR score (< or =3 at 1 min) and acidosis at birth were associated with significantly high incidence of pulmonary hemorrhage in LBW infants. CONCLUSION: Antecedent factors and timing of pulmonary hemorrhage of LBW infants were different from those of VLBW infants. The mortality rates of VLBW and LBW infants were 88.2% and 45.5%, respectively. Pulmonary hemorrhage was the principal cause of death in 66.6% VLBW infants and 40.0% LBW infants.
Acidosis ; Aged ; Apgar Score ; Birth Weight ; Case-Control Studies ; Cause of Death ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Parturition ; Prognosis ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Trachea

BACKGROUND: Severe respiratory variations of systolic arterial and central venous pressure (CVP) may increase the risk of embolic event in orthopedic patient. As airway obstruction during sedation can cause this respiratory variation, we evaluated the degree of variations of systolic blood (SBP) and CVP during airway obstruction period. METHODS: Fifteen females who had obstructed airway during total knee replacement (TKR) were included for the study. After regional anesthesia were established, SBP and CVP variations were analyzed according to the three periods; baseline, obstruction, and airway, respectively. Calculated CVP variables were similar to SBP variables as below: DeltaSBP = Expmax (maximal value at expiration) - Inspnadir (minimal value at inspiration), %DeltaSBP = (DeltaSBP/ Exp(max)) x 100. The frequencies of pulsus paradoxus (PP) and negative inspiratory CVP (NIC) were also measured. RESULTS: At obstruction period, DeltaSBP was 21.7 mmHg and 93.3% of patient had PP. Also, DeltaCVP was 19.3 mmHg and 100% of patient showed NIC. %DeltaCVP (140%) was larger than %DeltaSBP (16%). And DeltaCVP was inversely correlated with baseline and obstruction SBP and %DeltaCVP was also inversely correlated with baseline CVP at obstruction period. CONCLUSIONS: During airway obstruction in sedated TKR patients, variations of CVP are larger than those of SBP. So we have to monitor CVP continuously as well as SBP so as not to increase the possible risk of respiratory of variation.
Airway Obstruction ; Anesthesia, Conduction ; Arthroplasty, Replacement, Knee ; Central Venous Pressure ; Female ; Humans ; Organothiophosphorus Compounds ; Orthopedics

PURPOSE: To report a rare case of primary mucinous adenocarcinoma arising from a sweat gland in the eyelid. CASE SUMMARY: A 68-year-old male presented to our hospital with a painless, superficial nodular lesion over the skin of the right lateral canthus that had slowly grown over the past two years. The patient had a history of surgical excision for three nodular lesions at the same site 5 years ago, and an excisional biopsy was mucinous adenocarcinoma with a positive margin. A systemic evaluation, including whole-body Positron Emission Tomography scan (PET), chest computerized tomography, gastrointestinal endoscopy, and colonoscopy, revealed no other abnormal lesions. Therefore, the eyelid lesion was considered a primary mucinous adenocarcinoma of the skin. CONCLUSIONS: Primary mucinous adenocarcinoma of the eyelid can rarely metastasize. Therefore, a systemic examination is warranted to discriminate primary and metastatic adenocarcinoma and also to monitor the long-term follow-up for the evaluation of local recurrence.
Adenocarcinoma ; Adenocarcinoma, Mucinous ; Aged ; Biopsy ; Colonoscopy ; Endoscopy, Gastrointestinal ; Eyelids ; Humans ; Male ; Mucins ; Organothiophosphorus Compounds ; Positron-Emission Tomography ; Recurrence ; Skin ; Sweat Glands ; Thorax

Hantaan (HTN) virus and Seoul (SEO) virus, two murid rodent-borne hantaviruses harbored by the striped-field mouse (Apodemus agrarius) and the Norway rat (Rattus norvegicus), respectively, were known to cause hemorrhagic fever with renal syndrome (HFRS). After inoculation of HTN and SEO viruses into suckling mice intracerebrally, mice became ill and were morbibund by 15 or 16 days postinfection. Viral antigens were present in brain, heart, lung, liver, kidney, spleen, pituitary gland, thymus, lymph nodes, adrenal, pancreas, salivary glands, trigeminal ganglia, adipose tissue, intestine and muscle. Moreover, the time period appearing illness and morbidity were gradually decreased from 15 or 16 days to 8 or 9 days postinfection increasing the passage number. Therefore to evaluate the relationship between these adaptation process and genomic change of HTN and SEO viruses, we sequenced corresponding regions of the 3' G1 and 5' G2 encoding M genomic segments of two HTN and six SEO virus strains, and compared the nucleotide changes between the original stocks and five to nine passed virus strains in suckling mice brains. There was no nucleotide changes in HTN virus strains and zero to four nucleotide changes in SEO virus strains. However, only one base change resulted in amino acid change at the position 1691 (Gln to Glu) of 5' G2 encoding M genomic segment. This amino acid change didn't effect any conformational change in the beta-sheet, hydrophilicity, antigenicity and surface probability of protein structure of G2 glycoprotein. Our present data suggested that the genomic changes in the 3' G1 and 5' G2 encoding M genomic segment was not related with adaptation process of HTN and SEO viruses passed in suckling mice brains.
Adipose Tissue ; Animals ; Antigens, Viral ; Base Sequence* ; Brain* ; Glycoproteins ; Hantavirus ; Heart ; Hemorrhagic Fever with Renal Syndrome ; Hydrophobic and Hydrophilic Interactions ; Intestines ; Kidney ; Liver ; Lung ; Lymph Nodes ; Mice* ; Muridae ; Norway ; Pancreas ; Pituitary Gland ; Rats ; Salivary Glands ; Seoul virus* ; Seoul* ; Spleen ; Thymus Gland ; Trigeminal Ganglion

Hereditary spastic paraplegia is a familial disorder which is inherited by autosomal dominant, autosomal recessive or sex linked pattern. We experienced a family who has hereditary spastic paraplegia with mental retardation and extrapyramidal symptom that is thought inherited by autosomal dominant inheritance pattern. A review of literatures was made briefly.
Humans ; Inheritance Patterns ; Intellectual Disability ; Spastic Paraplegia, Hereditary*

Hereditary spastic paraplegia is a familial disorder which is inherited by autosomal dominant, autosomal recessive or sex linked pattern. We experienced a family who has hereditary spastic paraplegia with mental retardation and extrapyramidal symptom that is thought inherited by autosomal dominant inheritance pattern. A review of literatures was made briefly.
Humans ; Inheritance Patterns ; Intellectual Disability ; Spastic Paraplegia, Hereditary*

PURPOSE: To report a rare case of a painless mass on the lower lid, histologically diagnosed as primary signet ring cell carcinoma of the eyelid. CASE SUMMARY: A 74-year-old male presented with a painless mass on the right lower lid which had developed seven months prior to presentation. Incisional biopsy of the mass and attached lower lid skin was performed, revealing signet ring cell carcinoma. A systemic evaluation, including whole body positron emission tomography-computed tomography (PET-CT), chest CT, abdomen and pelvis CT, gastrointestinal endoscopy, and colonoscopy, revealed no other abnormal lesions. Therefore, the eyelid lesion was considered primary signet ring cell carcinoma of the skin and was treated with radiotherapy of 6600 cGy in 33 fractions over 7 weeks. CONCLUSIONS: Herein, the authors report a rare case of primary signet ring cell carcinoma of the eyelid with no evidence of tumor recurrence or metastasis for 5 years after radiotherapy.
Abdomen ; Aged ; Biopsy ; Carcinoma, Signet Ring Cell* ; Colonoscopy ; Electrons ; Endoscopy, Gastrointestinal ; Eyelids* ; Humans ; Male ; Neoplasm Metastasis ; Pelvis ; Radiotherapy ; Recurrence ; Skin ; Tomography, X-Ray Computed