A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factor in neonatal sepsis, localized infection in neonate, causative organism in nosocomial infection and the most common causative organism in neonatal sepsis in Korea. Clinical and bacteriological data were collected from thirty seven neonatal units through retrospective review of the medical records of the newborn infants who were confirmed as neonatal sepsis by isolating organisms from blood culture during one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997 and 20,869 neonates were admitted to the neonatal units. During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1 and 303 cases(42.1%) were born prematurely. The main pathogens of early onset sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative Staphylococcus( 14.4%). Gram negative bacilli including Enterobacter spp (7.2%), E.coli(5.1%), Klepsiella(4.5%), Pseudomonas(3.7%) Enterobacter faecium(3.6%) constitute 24.1%. Only two cases of group B beta-hemolytic Streptococcus were isolated. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases (1.0%) of Candida sepsis. Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%). S. epidermidis(22.0%) and S. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.
Candida ; Coagulase ; Cross Infection ; Enterobacter ; Female ; Focal Infection ; Humans ; Infant, Newborn ; Korea ; Male ; Medical Records ; Retrospective Studies ; Risk Factors ; Sepsis* ; Streptococcus ; Urinary Tract

Operations on the inner aspect of the pelvis are often necessary for irreducible fracture of the ilium, irreducible fracture of superior and medial portion of the acetabulum, tumors and infections involving iliac fossa, and fracture-dislocation and infection of the sacro-iliac joint. Until now Letournel and Judet's ilioinguinal and iliofemoral approaches provided access to anterior column of the pelvis by elevating muscle layer on inner aspect of the pelvis. We used modified iliofemoral approach using ASIS(anterior superior iliac spine) osteotomy to gain better access to anterior column, the pelvlc brim, and in some occasions as far as anterior sacroiliac joint while avoiding injury to the structures in the inguinal ligament and lateral femoral cutaneous nerve and reported six cases treated with this approach. In conclusion, a modified iliofemoral approach using ASIS osteotomy is a useful approach which can obtain an excellent exposure in the inner pelvis.
Acetabulum ; Ilium ; Joints ; Ligaments ; Osteotomy ; Pelvis ; Sacroiliac Joint

No abstract available.
Incontinentia Pigmenti*

Bordetella (B.) bronchiseptica is a causative agent of swine atrophic rhinitis that promotes colonization of the mucous membrane of the swine nasal cavity by Pasteurella (P.) multocida. Mixed infection with B. bronchiseptica and P. multocida leads to growth inhibition of pigs, resulting in significant economic loss. There are many commercial vaccines for atrophic rhinitis, including B. bronchiseptica as a killed vaccine antigen (Ag). However, the immunogenicity of killed B. bronchiseptica Ag has not yet been elucidated; therefore, this study was conducted to investigate the immunogenicity of killed B. bronchiseptica Ag and the type of immune response it induces. In vitro assays using mouse spleen cells and flow cytometry revealed that B. bronchiseptica Ag induced high proliferation capability of lymphocytes, especially B lymphocytes, and the proliferating cells showed a significant response to interleukin (IL)-2. B. bronchiseptica Ag also enhanced the production of IL-12, a representative cytokine for cell-mediated immunity. In vivo experiments using mice showed that the injection of B. bronchiseptica Ag markedly induced Ag-specific antibody. Taken together, these results indicate that B. bronchiseptica Ag has high immunogenicity by itself.
Animals ; B-Lymphocytes ; Bordetella ; Bordetella bronchiseptica* ; Coinfection ; Colon ; Flow Cytometry ; Immunity, Cellular ; Interleukin-12 ; Interleukins ; Lymphocytes ; Mice ; Mucous Membrane ; Nasal Cavity ; Pasteurella ; Rhinitis, Atrophic ; Spleen ; Swine ; Vaccines

Because the tongue is superficially located and the initial manifestation of most diseases occurring there is mucosal change, lingual lesionscan be easily accessed and diagnosed without imaging analysis. Some lingual neoplasms, however, may manifest as a submucosal bulge and be located in a deep portion of the tongue, such as its base; their true characteristics and extent may be rec-ognized only on cross-sectional images such as those obtained by CT or MRI. Some uncommon tongue neoplasms may have characteristic radiologic fea-tures, thus permitting quite specific radiologic diagnosis. Lipomas typically manifest at both CT and MR imaging as homogeneous nonenhancing lesions. Relative to subcutaneous fat they are isoattenuating on CT images, and all MR sequences show them as isointense. Due to the paramagnetic properties of melanin, metastases from melanotic melanoma usually demonstrate high signal intensity on T1-weighted MR images and low signal intensity on T2-weighted images. Although the radiologic findings for other submucosal neoplasms are nonspecific, CT and MR imaging can play an important role in the diagnostic work-up of these unusual tumors. Delineation of the extent of the tumor, and recognition and understanding of the spectrum of imaging and the pathologic features of these lesions, often help narrow the differential diagnosis.
Carcinoma, Adenoid Cystic/diagnosis ; Carcinoma, Mucoepidermoid/diagnosis ; Hemangioma/diagnosis ; Human ; Lipoma/diagnosis ; Lymphoma/diagnosis ; Magnetic Resonance Imaging ; Myoepithelioma/diagnosis ; Neurilemmoma/diagnosis ; Tomography, X-Ray Computed ; Tongue Neoplasms/*diagnosis/secondary

Because the tongue is superficially located and the intial manifestation of most diseases occurring there is mucosal change, lingual these lesions can be easily accessed and diagnosed without imaging analysis. Most congenital lesions of the tongue, however, can manifest as a submucosal bulge and be located in a deep portion of that organ such as its base; their true characteristics and extent may be recognized only on cross-sectional images such as those obtained by CT or MRI. In addition, because it is usually difficult to differentiate congenital lesions from other submucosal neoplasms on the basis of imaging findings alone, clinical history and physical examination should always be taken into consideration when interpretating CT and MR images of the tongue. Although the radiologic findings for congenital lesions are nonspecific, CT and MR imaging can play an important role in the diagnostic work-up of these unusual lesions. Delineation of the extent of the tumor, and recognition and understanding of the spectrum of imaging and the pathologic features of these lesions, often help narrow the differential diagnosis.
Bronchogenic Cyst/diagnosis ; Epidermal Cyst/diagnosis ; Human ; Magnetic Resonance Imaging ; Thyroglossal Cyst/diagnosis ; Tomography, X-Ray Computed ; Tongue/*abnormalities ; Tongue Diseases/*congenital/*diagnosis ; Veins/abnormalities

PURPOSE: Diagnosis of diabetic foot infection is sometimes difficult, since the classical inflammatory signs and leukocytosis may be absent due to the decreased host immune response in diabetics. Therefore inflammatory blood markers, such as white blood cell(WBC) count, erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP) have been commonly needed to confirm the diagnosis of infection. The purpose of this study is to evaluate the diagnostic usefulness of WBC, ESR and CRP for detection of diabetic foot infection. METHODS: Peripheral blood samples were taken from 113 patients with diabetic foot ulcers admitted from June 2007 to April 2009. Diabetic foot infection was diagnosed according to the microbiological culture from soft tissue and bone specimens. Reference values of tests were 4500-11000/microliter for WBC count, 0-20mm/hr for ESR, and 0-5 mg/L for CRP(13,14). Sensitivities, specificities, positive and negative predictive values of laboratory tests were calculated and analysed. Receiver-operator characteristic (ROC) curve was also created. RESULTS: There was a significant difference in WBC, ESR, and CRP between infectious group and noninfectious group(p<0.05). The sensitivity of WBC>11,000/microliter ESR >20 mm/hr, and CRP > 5mg/L was 30%, 96%, and 84%. The specificity was 86%, 14%, and 50% for WBC, ESR, and CRP, respectively. Positive predictive value was 88%, 78%, and 84%, and negative predictive value was 28%, 50%, and 50% respectively. The areas under the ROC curve for WBC, ESR and CRP were 0.72, 0.75, and 0.78 respectively. CONCLUSION: Based on the results of this study, we conclude that CRP is more useful method in predicting and diagnosing infection than WBC, ESR in diabetic foot ulcer patients.
C-Reactive Protein ; Diabetic Foot ; Erythrocyte Count ; Humans ; Leukocyte Count ; Leukocytes ; Leukocytosis ; Reference Values ; ROC Curve ; Sensitivity and Specificity ; Ulcer

The characteristic pathological lesions in ankylosing spondylitis are vertebral body osteoporosis, ankylosis of the apophyseal joints, intervertebral disc calcification, and ligamentous ossification. Calcification of the annulus fibrosis reduces the movement and elasticity of the intervertebral disc, causing this point to be the site of least resistance when the spine is subjected to trauma. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. The ligamentous fragility and multiple fused vertebral segments cause the fractured ankylosing spondylitic spine to resemble a long-bone fracture. In ankylosing spondylitis patient who have sustained minor trauma, a complete radiological study of the entire spine and not just the symptomatic region must be performed for an accurate diagnosis, so that any fracture possible along the spine can be detected and thus prevent any medicolegal problems. The authors report 4 cases of ankylosing spondylitis including 2 cases with severe neurological abnormalities that had occurred after minor trauma.
Ankylosis ; Diagnosis ; Elasticity ; Fibrosis ; Humans ; Intervertebral Disc ; Joints ; Ligaments ; Osteoporosis ; Spinal Fractures ; Spine ; Spondylitis, Ankylosing*

A sciatic nerve injury can arise from a penetrating injury of the thigh, a longstanding malposition or after hip arthroplasty. However, it rarely occurs after a subtrochanteric fracture of the femur. We report a case of sciatic nerve entrapment associated with a subtrochanteric fracture of the femur, which was aggravated after skeletal traction.
Arthroplasty ; Femur ; Hip ; Sciatic Nerve* ; Thigh ; Traction

Background: This study aimed to evaluate the annual trends of transfusion rates and utilization of blood management agents in total knee arthroplasty (TKA) based on the operation type and to analyze the risk factors of transfusion after TKA. Methods: Using the Korean National Insurance claims database of 797,106 primary and revision TKAs between January 2008 and October 2019, data on the patients’ characteristics, comorbidities, utilization of transfusion, and blood management agents were collected. The patients were categorized into three groups based on the operation type: primary, revision, and simultaneous bilateral TKA. The transfusion rate and utilization of blood management agents (intraoperative tranexamic acid [TXA] and preoperative iron supplements) were compared, and the risk factors for transfusion were evaluated. Results: After excluding the inaccurate data, 730,554 arthroplasties (636,292 primary, 10,540 revision, and 41,861 simultaneous bilateral TKAs) were identified. The transfusion rates of primary, revision, and simultaneous bilateral TKAs in 2019 were 64.0%, 67.7%, and 68.9%, respectively, which were significantly decreased compared with 83.2%, 88.0%, and 92.5% in 2008, respectively (p < 0.001). Conversely, the utilization of intraoperative TXA and preoperative iron supplements was significantly increased from 4.6% and 13.8%, respectively, in 2008 to 52.4% and 27.0%, respectively, in 2019 (p < 0.001). The utilization of intraoperative TXA and preoperative iron supplements significantly lowered the risk of transfusion after TKA (odds ratio [OR], 0.20; p < 0.001 and OR, 0.71; p < 0.001). Conclusions The transfusion rate after TKA decreased gradually from 83.5% to 64.5% between 2008 and 2019 in South Korea corresponding with the increased utilization of blood management agents. Therefore, consistent attention to patient blood management should be emphasized to reduce the transfusion rate after TKA.