One hundred and fifty two open wounds of extremities including open fractures were treated at the Kyoungpook Nstional Univ. Hospital from March 1977 to August 1977. Of 152 open wounds there were 32 cases (21.5%) of wound infection even though the initial wound culture revealed bacterial growth in 44 cases(28.9%). However, there were only 10 cases of infection among the cases with positive bacterial growth in the original culture and the same organisms were found in the 6 cases between the initial wound culture and post infection culture. Sensitivity studies of the organisms, the Cephalosqorines appeared to be most effective as a prophylactic antibiotics. It was sensitive to all gram positive organisms and majority of gram negative organisms including Escherichia coli. In bacterial culture and sensitivity studies of the 82 open fracture wounds 18 of them showed gram positive and gramnegative bacteria. The prominant organism were Staphylococcus, Escherichia coli, Streptococcus and Pseudomonas. The infection rate was lower in the cases whar the wound was managed within six hours from the time of injury than after six hours.
Anti-Bacterial Agents ; Bacteria ; Escherichia coli ; Extremities ; Fractures, Open ; Humans ; Pseudomonas ; Staphylococcus ; Streptococcus ; Wound Infection ; Wounds and Injuries

Gas producing infection accompanied by evidence of subcutaneous gas usually are diagnosed as clostridial gas gangrene. The occurrence of nonclostridial gas producing infection is thought to be relatively rare. Two cases of nonclostridial gas producing infection simulating clostridial gas gangrene in diabetes occurred. Gram stains of pus at the time of admission can isolate the E-coli and streptococcus, and can distinguish these two entities. Chief conplaints were swelling, pain and tenderness of right lower extremity by infection. Multiple incisions to free the tissues of gas and pus and the administration of antibiotics are the treatment of choice.
Anti-Bacterial Agents ; Coloring Agents ; Gas Gangrene ; Lower Extremity ; Streptococcus ; Suppuration

No abstract available.
Plasma* ; Spectrum Analysis* ; Trace Elements*

BACKGROUND: An increased frequency of the epsilon4 allele in Alzheimer's disease has been reported, which suggested a functional role of apolipoprotein E isoforms in pathophysiology of Alzheimer's disease. The aims of this study were to determine the frequency of ApoE genotypes in various types of dementia such as Alzheimer's disease, vascular dementia, and Parkinson's disease, to relate epsilon4 and assess risk factors for different types of dementia. METHODS: We assessed the frequency of Apolipoprotein E alleles in 29 patients with Alzheimer's disease, 10 patients with vascular dementia and 9 demented patients with Parkinson's disease. The Apolipoprotein E genotype was determined the polymerase chain reaction (PCR) with sequence-specific oligonuculeotide primers (SSOP) and reverse hybridiza- tion using the INNO-LiPA (Line Probe Assay) Apo E typing kit. RESULTS: Allele frequencies of epsilon2, epsilon3, and epsilon4 were : 0.5, 0.72, and 0.23 in Alzheimer's disease; 0, 0.65, and 0.35 in vascular dementia; 0.6, 0.83 and 0.11 in demented patients with Parkinson's disease. Conculsion : These results indicate that the apolipoprotein E4 allele is associated with not only Alzheimer's disease but also vascular dementia, however not associated with Parkinson's disease. No such an association was observed between the apolipoprotein E alleles and age.
Alleles ; Alzheimer Disease ; Apolipoprotein E4 ; Apolipoproteins E ; Apolipoproteins* ; Dementia ; Dementia, Vascular ; Gene Frequency ; Genotype* ; Humans ; Parkinson Disease ; Polymerase Chain Reaction ; Protein Isoforms ; Risk Factors

PURPOSE: To assess the biomechanical effects and effectiveness of an interspinous spinal spacer (ISS) on the intradiscal pressure using in vitro biomechanical tests. MATERIALS AND METHODS: Six calf spine specimens (less than 2 weeks of age, L1-L5) were divided to two groups the intact and the surgery groups (n=3 each). For the surgery group, an ISS made from PMMA (Greek pi=12-mm) were inserted into the space between the spinous processes of L3-L4. The intradiscal pressures at the various regions of the annulus (anterior, posterior, and posterolateral locations) and the nucleus pulposus were measured using the four pressure transducers under pure compression (700 N) and extension loads (700 N+7.5 Nm). RESULTS: An increase in pressure was observed from neutral to extension at the posterior and posterolateral annulus. After inserting the ISS, the changes in pressure at the adjacent disc levels (L2-L3, L4-L5) were negligible regardless of the loading conditions (p>0.05). However, at the implanted level (L3-L4) statistically significant changes in the pressure were found under extension loading at the nucleus pulposus, posterior and posterolateral regions of the annulus with a pressure drop from 1.48 MPa, 1.42 MPa, 1.71 MPa to 1.11 MPa, 0.961 MPa, 1.08 MPa, at the respective locations (p<0.05). The relative percentage decrease were 25%, 31.7%, and 36.8%. CONCLUSION: On the implanted level, these results showed that the insertion of the ISS with PMMA can effectively reduce the intradiscal pressures by at least 25% quite uniformly over the intravertebral disc during extension. More effective reduction was observed at the posterolateral location. The pressure changes at the adjacent levels were negligible in contrast to the abnormal pressure changes that are frequently reported after conventional rigid fusion. This suggests that the likelihood of adjacent level degeneration after surgery can be minimized using the ISS insertion.
Polymethyl Methacrylate ; Spinal Stenosis* ; Spine ; Transducers, Pressure

Although various studies on predictive markers in the use of PD-1/PD-L1 inhibitors are in progress, only PD-L1 expression levels in tumor tissues are currently used. In the present study, we investigated whether baseline serum levels of IL-6 can predict the treatment response of patients with advanced non-small cell lung cancer (NSCLC) treated with PD-1/PD-L1 inhibitors. In our cohort of 125 NSCLC patients, the objective response rate (ORR) and disease control rate (DCR) were significantly higher in those with low IL-6 (<13.1 pg/ml) than those with high IL-6 (ORR 33.9% vs. 11.1%, p=0.003; DCR 80.6% vs. 34.9%, p<0.001). The median progression-free survival was 6.3 months (95% confidence interval [CI], 3.9–8.7) in the low IL-6 group, significantly longer than in the high IL-6 group (1.9 months, 95% CI, 1.6–2.2, p<0.001). The median overall survival in the low IL-6 group was significantly longer than in the high IL-6 group (not reached vs. 7.4 months, 95% CI, 4.8–10.0). Thus, baseline serum IL-6 levels could be a potential biomarker for predicting the efficacy and survival benefit of PD-1/PD-L1 inhibitors in NSCLC.

Human chorionic gonadotropin (HCG) is one of the glycoproteins families synthesized by the placenta, and consists of 2 noncovalently joined subunits, namely, alpha and beta. The alpha and beta-subunits have a structural homology with the alpha and beta-subunits of TSH and LH. The thyrotropic action of HCG results from its structural similarity to TSH, so beta-HCG can bind to the TSH receptor in the thyroid gland. A high level of HCG, accompanied by an increased thyroid hormone level, can be observed in gestational trophoblastic diseases (GTD), such as a hydatidiform mole or a choriocarcinoma. However, the clinical symptoms of hyperthyroidism in GTD are rarely observed. A 27-years-old woman, admitted due to an amenorrhea of 11 weeks duration, with thyrotoxic symptoms, such as weight loss, palpitation, sweating, tremor, heat intolerance and anxiety, was evaluated. Her serum free T4 level was 8 times higher than normal, and her serum beta-HCG level was over 1,000,000IU/L. She had a curettage operation, with the pathological findings of a complete hydatidiform mole. These thyrotoxic symptoms developed due to a hydatidiform mole, and were accompanied with a highly increased serum beta-HCG level. After evacuation of the molar tissue, the thyroid hormone and thyrotoxic symptoms normalized. Here, this case is reported, with brief review of the literature.
Amenorrhea ; Anxiety ; Choriocarcinoma ; Chorionic Gonadotropin ; Curettage ; Female ; Gestational Trophoblastic Disease ; Glycoproteins ; Hot Temperature ; Humans ; Hydatidiform Mole* ; Hyperthyroidism ; Molar ; Placenta ; Pregnancy ; Receptors, Thyrotropin ; Sweat ; Sweating ; Thyroid Gland ; Thyrotoxicosis* ; Tremor ; Weight Loss

A 28-year-old woman was admitted due to fever, dyspnea, hematuria and acute renal insufficiency. 1 months ago, she had been diagnosed as having ventricular septal defect with mild dyspnea and chronic cough. Infective endocarditis (IE) was diagnosed by clinical findings including vegetation in echocardiography. A blood culture drawn during the hospitalization grew streptococcus sanguis. A renal biopsy showed IE-induced crescentic glomerulonephritis (GN). Antibiotic treatment alone was effective for fever, but not for gross hematuria and renal insufficiency. After the initiation of plasmapheresis, gross hematuria and acute renal insufficiency was dramatically improved. After clinical stability was achieved, closure of the ventricular septal defect was performed. This result suggests that plasmapheresis may be beneficial in the treatment infective endocarditis-induced crescent GN.
Acute Kidney Injury ; Adult ; Biopsy ; Cough ; Dyspnea ; Echocardiography ; Endocarditis* ; Female ; Fever ; Glomerulonephritis* ; Heart Septal Defects, Ventricular ; Hematuria ; Hospitalization ; Humans ; Plasmapheresis* ; Renal Insufficiency ; Streptococcus sanguis

Paragonimiasis is a parasitic infection that occurs following the ingestion of infectious Paragonimus metacercariae, which occurs as a result of eating raw or undercooked freshwater crabs or crayfish. Pulmonary paragonimiasis is the most common clinical manifestation of this infection. Human paragonimiasis occurs sporadically. We experienced a case of pulmonary paragonimiasis in a 35-year-old woman with left lower chest pain. The patient had hypereosinophilia and a pleural effusion. The diagnosis was confirmed by positive ELISA (Enzyme-linked immunosorbent assay) that detected Paragonimiasis westermani antibody in the serum. We treated the patient with praziquantel for two days at a daily dosage of 75 mg/kg. Left pleuritic pain and pleural effusion improved after treatment. However, similar symptoms and pleural effusion developed recurrently for the first 3 courses of treatment with praziquantel. Upon the fourth round of treatment, the patient made a full recovery.
Adult ; Astacoidea ; Chest Pain ; Eating ; Enzyme-Linked Immunosorbent Assay ; Female ; Fresh Water ; Humans ; Metacercariae ; Paragonimiasis ; Paragonimus ; Pleural Effusion ; Praziquantel ; Recurrence

We experienced a rare case of sinonasal sarcoidosis initially presenting as nasal cavitary mass. When the clinical course was different from that of typical tuberculosis, physician should think the possibility of sarcoidosis, and re-biopsy or retrospective review of pathological findings might be helpful.
Nasal Cavity ; Retrospective Studies ; Sarcoidosis ; Tuberculosis