Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi . Although early diagnosis and appropriate antibiotic therapy improve the prognosis for the majority of patients, life-threatening complications are not uncommon. Here, we present a case of successful veno-veno-type extracorporeal membrane oxygenation for scrub typhus-induced complications, including acute respiratory distress syndrome, myocarditis and multi-organ dysfunction. To our knowledge, this is the first case report of successful extracorporeal membrane oxygenation in complicated scrub typhus in Korea.
Communicable Diseases ; Early Diagnosis ; Extracorporeal Membrane Oxygenation* ; Humans ; Korea ; Myocarditis ; Orientia tsutsugamushi ; Prognosis ; Respiratory Distress Syndrome, Adult ; Scrub Typhus*

PURPOSE: In contracted bladder of various etiologies, if many of conservative managements fail, a surgical treatment seems to be the only therapeutic approach. We tried to evaluate the long term results of aug mentation cystoplasty including the postoperative complication and the degree of satisfaction in patients. MATERIALS AND METHODS: From 1989 to 1988, augmentation cystoplasties had been performed in 11 patients with contracted bladder of various etiologies. We reviewed the patients' medical records including the result of urodynamic examinations, retrospectively. Postoperative follow-up periods were 9 to 114months (mean:61months). Patients were interviewed by telephone. RESULTS: Urinary frequency, nocturia, dysuria and suprapubic pain were improved in all patients, but dysuria persisted in one patient with tuberculous cystitis. Clean intermittent catheterization (CIC) was done in there of 11 patients due to large volume of residual urine. The volume of residual urine was 200-300ml in one with hyperreflexic neurogenic bladder, and 100-200ml in two with interstitial cystitis. Self voiding was possible in 8 patients with residual urine volume less than 90ml. Almost all patients were very satisfied symptomatically in the telephone survey. There were no significant complications which required surgical revision. CONCLUSIONS: It is concluded that augmentation cystoplasty could be an excellent method of treatment for selective patients with contracted bladder, who have not improved symtomatically by medication or conservative management.
Cystitis ; Cystitis, Interstitial ; Dysuria ; Follow-Up Studies ; Humans ; Intermittent Urethral Catheterization ; Medical Records ; Nocturia ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Telephone ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urodynamics

BACKGROUND: Hepatitis C virus (HCV) infection is frequent in hemophilia patients treated with non-viral inactivated factor concentrates. In Korea, solvent/detergent method was introduced in 1989 and majority of hemophila patients treated before 1989 were infected with HCV. A number of studies have described the identification of virus genotypes in different geographical regions and racial groups. In order to clarify the characteristics of HCV infection in Korean hemophiliacs, we investigated the HCV genotypes in 125 hemophilia patients infected with HCV. METHODS: The HCV infection was confirmed by anti-HCV test and HCV-RNA detection method. To analyze the HCV genotypes, we used the reverse hybridization line probe assay (INNO LiPA HCV II, Innogenetics N.V., Belgium). RESULTS: Among 125 hemophilia patients, ten (8.0%) patients were infected with type 1a, 56 (44.8%) type 1b, 38 (30.4%) ambiguous type 2a/2c, eight (6.4%) type 2b, four (3.2%) type 3a, two (1.6%) type 4. And seven (5.6%) patients had mixed infection (four 1b+2a/2c, one 1a+2a/2c, one 2b+2a/2c, one 1a+2b+2a/2c). CONCLUSION: In Korean hemophiliacs, HCV genotype 1b was the most predominant and 2a/2c the second.
Coinfection ; Genotype ; Hemophilia A ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Korea

Sixty amputees who had traumatic amputations due to industrial accidents were examined on their phantom limb and phantom pain phenomena and the following results were obtained. 1. Fifty-three (93%) of sixty amputees experienced phantom limb and twenty-four (40%) experienced phantom pain. The incidence of phantom pain in the lower limb amputation (59%) is greater than that of upper limb amputation (29%). 2. Amputees with asthenic body status gave higher incidence (56%) of phantom pain than those with muscular body status (20%). None of amputees with obese body status experienced phantom pain. 3. The sensation of strong current and cramping were most predominant sensations in the phantom pain. 4. Twenty-eight (93%) of thirty amputees had experienced painless phantom limb longer than four months. 5. Six (55%) of eleven upper limb amputees with phantom pain experienced pain sensation at the tips of fingers and nine (69%) of thirteen lower limb amputees with phantom pain experienced pain at the great toe. 6. Fifty-three (88%) of sixty amputees experienced telescoping of the lost limb and twenty-three (38%) of sixty amputees experienced jerking movement of the stump. 7. In fifty-four (90%) of sixty amputees, trigger zones triggering pain in the phantom limb were found in the healthy part of the body. 8. Twenty-two (40%) of fifty-five male amputees experienced burning sensation in the phantom limb associated with urination, defecation or ejaculation. 9. Cold temperature was predominant, aggrevating factor of the phantom pain. Fitting prosthesis and alcohol intake were predominant, relieving factor of the phantom pain.
Accidents, Occupational ; Amputation ; Amputation, Traumatic ; Amputees ; Burns ; Cold Temperature ; Defecation ; Ejaculation ; Extremities ; Fingers ; Humans ; Incidence ; Lower Extremity ; Male ; Muscle Cramp ; Phantom Limb ; Prostheses and Implants ; Sensation ; Toes ; Upper Extremity ; Urination

The incidence and risk factors for hypercalciuria were studied in 23 sick preterm (Group I), 36 well preterm (Group II), 16 sick term(Group III)and 41 well term(Group IV) neonates who were admitted to NICU and nursery of Ewha Woman's University Hospital from May 1988 to February 1992. The results were as follws: 1) The incidences of hypercalciuria were 73.9% in sick preterm (Group I) and 56.3% in sick term (Group III) which were significantly higher than 13.9% of control preterm (Group II) and 7.3% of control term (Group IV). Maximal urinary Ca/Cr ration were 0.63+/-0.503 in group I and 0.50+/-0.513 in group III, significantly higher than 0.19+/-0.142 of control term and 0.17+/-0.131 of control term. 2) In sick neonates with hypercalcuria, birth wight and gestational age were significantly lower and the frequencies of frosemide and intravenous calcium therpy were significantly higher than those of sick neonates without hypercalciuria. 3) In sick neonates, furosemide increased the incidence of hypercalciuria to 90.9%, significantly higher than 57.1% in neonates without furosemide. Maximal urine Ca/Cr ratio 24 hour urine calcium were also significantly higher in neonates with furosemide than those of neonates without furosemide. 4) In sick neonates, intravenous calcium gluconate increased the incidence of hypercalciuria to 86.6%, significantly higher than 54.2% in neonates without intravenous calcium. Maximal urine Ca/Cr ratio and 24 hour urine calcium were also significantly higher in neonates treated with IV calcium than those of neonates without IV calcium. 5) Calcium intake and maximal random urine Ca/Cr ratio were positively correlated (r=0.46, p=o.037). In conclusion, the majority of sick newborns in our intensive care unit were hypercalciuric. Sick condition, premature, furosemide and intravenous calcium gluconate were the risk factors that could lead to hypercalciuria. Use of these agents in sick neonates especially preterm neonates requires careful monitoring of urine calcium excretion.
Calcium ; Calcium Gluconate ; Furosemide ; Gestational Age ; Humans ; Hypercalciuria* ; Incidence ; Infant, Newborn* ; Intensive Care Units ; Nurseries ; Parturition ; Risk Factors

Conservative or surgical methods have been used for the treatment of fracture of mandibular subcondyle, but consensus has not been reached in regard to the proper management of this injury. Several problems related to the surgical procedure have led many surgeons to avoid surgical management of condylar fractures in favor of closed reduction and intermaxillary fixations. However, luxation of the condyle may lead to various long-term complications such as open bite on the contralateral side, dysfunction, deviation in opening and closing movements, as well as bone apposition leading to ankylosis. As a consequence, open reduction is preferable when the condyle is displaced. Various methods-for example, direct wiring technique, simple bone plating, dynamic compression plating-have been advocated for the treatment of fracture of mandibular subcondyle. Of such methods, a functionally-stable osteosynthesis can be achieved by compression osteosynthesis methods. Lag screw osteosynthesis is essentially a form of compression osteosynthesis in which the bone fragments are bound to one another as a result of traction from the screw. An advantage of compression osteosynthesis is that the end of a fractured bone can be maintained in an opposed position under pressure, and then primary bone healing occurs by direct osteoblastic activity within the fracture. As well, it obviates or reduces the need for maxillomandibular fixation, as well as the morbidity associated with conventional treatment methods such as facial nerve injury and bone resorption due to wide dissection. We have treated 9 cases of displaced subcondylar fractures of the mandible with the lag screw fixation system which is marketed by the Martin corporation. Mobilization and guidance of the jaw was begun from 7 or 10 days postoperatively. The radiologic and clinical evaluations showed good repositioning of the fragments and good occlusion postoperatively The disadvantage is that surgical procedures are relatively compound, and an additional procedure - removal of lag screw - is necessary after complete bone union. Lag screw osteosynthesis can be added as a another valid armament for plastic surgeons in the management of mandibular subcondyle fractures.
Ankylosis ; Bone Resorption ; Consensus ; Facial Nerve Injuries ; Jaw ; Jaw Fixation Techniques ; Mandible ; Open Bite ; Osteoblasts ; Traction

No abstract available.
Fetus* ; Humans*

The propose of this study was to propose for protection of childhood injury or accident and to provide safety measures. Data was collected from 2,052 who visited emergency room of E University Hospital during 1 year period form January to December, 1996. The results were as follows : 1. The most common type of accident was fall down (53.4%). 2. Male patients outnumbered female by the ratio of 1.68 : 1. 3. The highest incidence rate of accidents were observed in children between 1-3 years age group(34.9%). 4. Accidents were seasonally more frequent in spring(28.2%). 5. Accidents mainly took place at home(63%). 6. The time of accidental occurrence appeared to be predominantly high during a day 8:00 PM to 0:00 AM(35.1%). 7. The most frequent involved part of body was head and face(74%). 8. Most patients discharged from the hospital in good condition(85.4%). Though clinical analysis, in the relation to accident, there were statistically significant difference in sex, age, season, injury place(all=0.000).
Child ; Emergency Service, Hospital ; Female ; Head ; Humans ; Incidence ; Male ; Seasons ; Child Health

No abstract available.
Cafe-au-Lait Spots ; Nevus*

The nucleolus of human cell is a morphologically well recognizable nuclear organelle and the argyrophilic NORs (AgNORs) are nucleic acid-argyrophilic nonhistone protein complex in the nucleoli and the silver staining allows their identification and enumeration at the light microscopic level. The AgNOR counts are in parallel with mitotic activity and vary in different phase of cell cycle. It has been reported that human cells have one AgNOR during interphase and S-phase. However, the correlation between the number of AgNORs and S-phase markers is still controversial and they have never been studied simultaneously. In this study, AgNOR and PCNA were stained simultaneously to find out the relationship of AgNOR counts with cell cycle (S-phase) in human palatine tonsil, gastric carcinoma, liver and brain tissues. S-phase cells (PCNA-positive) were found predominantly in lymphoid follicles in palatine tonsil but gastric carcinoma showed diffuse immunoreactivity for PCNA. The AgNOR counts varied according to the type and locus of tissue. More than one AgNOR were identified in S-phase cells and some of hepatocytes and neurons in the brain which were not in S-phase contained two or more AgNORs. The above results suggest that the number of AgNOR is a characteristic feature of each type of cells and can be more than one even in S-phase.
Brain ; Cell Cycle ; Hepatocytes ; Humans* ; Interphase ; Liver ; Neurons ; Organelles ; Palatine Tonsil ; Proliferating Cell Nuclear Antigen ; Silver Staining