PURPOSE: In this study we tried to look at the spreading, duration of colonization, and acquisition of new streptococci which were obtained in one geographical area, as well as the bacteriologic and molecular epidemiology of normal school children carrying group A streptococci and their clonal relationship through the combined application of the serotype of T antigen and Pulsed Field Gel Electrophoresis(PFGE). METHODS: A total of 88 strains of group A streptococci were isolated from 396 normal school children. All isolates were classified in groups by Streptex and serotyped by T. agglutination. Restriction enzyme digestion of DNA was taken using Sma I. DNA fragments were separated by PFGE. RESULTS: A total of 33 strains were allocated their epidemiologic characteristics. Four out of 33 strains were not restricted by enzyme(Sma I). Twenty nine strains out of 33 strains showed 12 subtypes with 8-12 fragments between 40kbp and 500kbp of DNA fragments on PFGE. Eight strains of NT and T6 war same fragment patterns on PFGE, respectively. Three strains out of 4 strains of T8/25 were not restricted and the other one showed different, unique patterns. One strain out of 8 stains of T12 was not restricted, and the others were classified as 5 different subtypes. Two strains of Tl were different patterns from each other, and 2 strains of T4 showed the samefragment pattern CONCLUSION: T serotypes with PFGE will be useful as a screening and molecular epidemiologic method in a country where anti-M antisera is not available, after recognizing the advantages and disadvantages of M and T serotyping.
Agglutination ; Antigens, Viral, Tumor ; Child* ; Colon ; Coloring Agents ; Digestion ; DNA ; Epidemiologic Methods ; Epidemiologic Studies* ; Humans ; Immune Sera ; Mass Screening ; Molecular Epidemiology ; Serotyping* ; Streptococcus pyogenes* ; Streptococcus*

OBJECTIVE: Pulmonary metastasis from carcinoma of the uterine cervix is relatively rare, and their clinical outcomes are not still remain unknown. This study is to evaluate survival and prognostic factors in recurrent cervical cancer patients showing lung metastasis. METHODS: From Jan. 1993 to Dec. 1996, 53 recurrent cervical cancer patients showing lung metastasis, registered in Korea Cancer Center Hospital, were retrospectively evaluated with respect to their clinical characteristics, response rate to salvage therapy, survival and prognostic factors. RESULTS: Median age of patients at recurrence was 58 years, and median interval of initial diagnosis to recurrence was 17 months. The most common histologic type was squamous cell carcinoma(82%), followed by adenocarcinoma(6%), adenosquamous(6%), and others(6%). Response rate to salvage therapy was 47%(complete response rate 23.5%, partial response rate 23.5%), and median survival was 10 months(range 1-39). 3 year survival rate was 18%. Age, initial stage, initial tumor size, interval of recurrence and type of chemotherapeutic regimen were not significant prognostic factors, but squamous cell carcinoma antigen(SCC) level at recurrence and response to salvage therapy was significant(p=0.0087, p=0.0104). CONCLUSION: Survival of recurrent cervical cancer patients with lung metastasis was poor despite salvage therapy. Those patients who showed low SCC level at recurrence and good response to salvage therapy had favorable outcomes.
Carcinoma, Squamous Cell ; Cervix Uteri ; Diagnosis ; Female ; Humans ; Korea ; Lung* ; Neoplasm Metastasis* ; Prognosis ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Survival Rate ; Uterine Cervical Neoplasms*

Aggressive angiomyxoma is a rare neoplasm occurring in the female pelvic cavity or perineum, and tends torecur. The radiographic findings of angiomyxoma have not been previously reported in Korea ; we describe a case ofaggressive angiomyxoma in the female pelvic cavity, with emphasis on the pathologic and radiologic findings, andreview the literature.
Female* ; Humans ; Korea ; Myxoma* ; Perineum

Dental implantation in the mandibular anterior region is considered a safe and reliable surgical procedure. On the other hand, several articles have reported that inadvertent hemorrhage of the sublingual artery can result in life-threatening airway obstruction. Surgical ligation under intubation or tracheostomy is the most widely used approach for controlling mouth floor bleeding in this highly vascular region. Nonetheless, surgically exploring the bleeding focus is difficult because of anatomical distortion followed by widespread edema and swelling. Since swelling of the mouth floor advances quickly, timely management is essential for favorable postoperative outcome. This paper reports a case of immediate hemorrhage control with angiographic embolization to perform rapid hemostasis before the ongoing swelling causes airway obstruction. Less invasive, angiographic embolization can prevent neurovascular damage during a surgical exploration of injured vascular structures on the mouth floor.
Airway Obstruction ; Angiography ; Arteries ; Dental Implantation ; Dental Implants ; Edema ; Hand ; Hemorrhage ; Hemostasis ; Intubation ; Ligation ; Mouth Floor ; Tracheostomy

Dental implantation in the mandibular anterior region is considered a safe and reliable surgical procedure. On the other hand, several articles have reported that inadvertent hemorrhage of the sublingual artery can result in life-threatening airway obstruction. Surgical ligation under intubation or tracheostomy is the most widely used approach for controlling mouth floor bleeding in this highly vascular region. Nonetheless, surgically exploring the bleeding focus is difficult because of anatomical distortion followed by widespread edema and swelling. Since swelling of the mouth floor advances quickly, timely management is essential for favorable postoperative outcome. This paper reports a case of immediate hemorrhage control with angiographic embolization to perform rapid hemostasis before the ongoing swelling causes airway obstruction. Less invasive, angiographic embolization can prevent neurovascular damage during a surgical exploration of injured vascular structures on the mouth floor.
Airway Obstruction ; Angiography ; Arteries ; Dental Implantation ; Dental Implants ; Edema ; Hand ; Hemorrhage ; Hemostasis ; Intubation ; Ligation ; Mouth Floor ; Tracheostomy

OBJECTIVES: To investigate clinicopathologic findings of patients with small cell carcinoma of uterine cervix, and to evaluate the recurrence pattern and prognosis of patients with small cell carcinoma of the uterine cervix. Methods: From Jan. 1990, to Dec. 1997, 23 patients with small cell carcinoma of the uterine cervix were registered and followed-up at Korea Cancer Center Hospital. Clinical characteristics, survival of these patients were studied retrospectively. RESULTS: Among the 23 cases of small cell carcinoma of uterine cervix, 17 cases(74%) were of the neuroendocrine type (NE group), and 6 cases(26.0%) of the squamous cell type (SCC group). The median age, FIGO stage, and treatment modality were not significant difference between two groups. Pelvic lymph node metastases were found 53% in NE group, and 33% in SCC group, but there were not significant difference between two groups(p>0.05). Three patients showed distant metastases in NE group(bone 18%, bladder 9%), but there was no distant metastasis in SCC group. The 3 year survival rate was 50.0% in SCC group and 32.1% in NE group, but there were not statistical significance(p>0.05). Six patients showed recurrence after treatment (4/17 cases in NE group, 2/6 cases in SCC group). Recurrence sites were liver (3/6, 50%), and lung (2/6, 33%), brain (2/6, 33%), retroperitoneum (1/6, 17%), and axillae lymph node (1/6, 17%). CONCLUSION: This study showed neuroendocrine small cell carcinoma may have more aggressive than squamous small cell carcinoma, but there were not significant difference in prognosis between the two groups. Because of limitation of number of patients, further large scaled multicenter studies are needed.
Axilla ; Brain ; Carcinoma, Small Cell* ; Cervix Uteri* ; Female ; Humans ; Korea ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate ; Urinary Bladder ; Uterine Cervical Neoplasms

PURPOSE: To determine results of treatment according to the guidelines of the Vancouver classification in periprosthetic femoral fractures after total hip arthroplasty. MATERIALS AND METHODS: Among 44 cases of periproshtetic femoral fractures after hip arthroplasty treated between Aug. 1991 and Feb. 2008, thirty-two cases with minimum follow-up greater than one year were included. Outcomes were evaluated using the Beals and Tower's critieria. RESULTS: Outcomes were excellent in 27 cases, and poor in 5 cases. Four of 5 cases with poor result were due to non-union. Three cases were treated with internal fixation and 1 case was treated with a conservative method. One case with a poor result was due to loosening of the cemented stem of a Vancouver type B1 fracture. Loosening of the stem after mid to long term follow up occurred in an additional 4 cases (3 cases with a cemented stem in a type B1 fracture, 1 case with a cemented stem of a type C fracture). Loosened stems were revised with a long revision stem. CONCLUSION: For type B1 periprosthetic fractures around a cementless stem, and for type B2, type B3 periprosthetic fractures, treatment according to the guidelines of the Vancouver classification showed excellent results. However, type B1 periprosthetic fractures around a cemented stem showed poor results with non-union or stem loosening. Hence, more rigid fixation using a bone graft or revision of the stem is needed. In type C periprosthetic fractures in osteoporotic patients, closer attentions is needed to avoid complications.
Arthroplasty ; Attention ; Femoral Fractures ; Follow-Up Studies ; Hip ; Humans ; Periprosthetic Fractures ; Transplants

Arm ; Facial Hemiatrophy ; Humans ; Skeleton

Varicella-zoster virus (VZV) infection is common in HIV seropositive patients, but disseminated VZV infection with pneumonia is rare in adult HIV seropositive patients. We report a case of disseminated VZV infection in a 28 year-old female patient with acquired immunodeficiency syndrome. The patient presented with dyspnea and disseminated cutaneous lesions. Chest radiograph showed multiple patchy lesions on the whole lung field. VZV was isolated from vesicular fluid of the cutaneous lesions. The patient was successfully treated with intravenous acyclovir.
Acquired Immunodeficiency Syndrome ; Acyclovir ; Adult ; Dyspnea ; Female ; Herpesvirus 3, Human* ; HIV ; Humans ; Lung ; Pneumonia* ; Radiography, Thoracic

OBJECTIVE: To investigate the efficacy of ultrasonography (US)-guided injections in patients with low lumbar facet syndrome, compared with that in patients who received fluoroscopy (FS)-guided injections. METHOD: Fifty-seven subjects with facet syndrome of the lumbar spine of the L4-5 and L5-S1 levels were randomly divided into two groups to receive intraarticular injections into the facet joint. One group received FS-guided facet joint injections and the other group received US-guided facet joint injections. Treatment effectiveness was assessed using a visual analogue scale (VAS), physician's and patient's global assessment (PhyGA, PaGA), and the modified Oswestry Disability Index (MODI). All parameters were evaluated four times: before injections, and at a week, a month, and three months after injections. We also measured, in both groups, how long it took to complete the whole procedure. RESULTS: Each group showed significant improvement from the facet joint injections on the VAS, PhyGA, PaGA, and MODI (p<0.05). However at a week, a month, and three months after injections, no significant differences were observed between the groups with regard to VAS, PhyGA, PaGA, and MODI (p>0.05). Statistically significant differences in procedure time were observed between groups (FS: 248.7+/-6.5 sec; US: 263.4+/-5.9 sec; p=0.023). CONCLUSION: US-guided injections in patients with lumbar facet syndrome are as effective as FS-guided injections for pain relief and improving activities of daily living.
Activities of Daily Living ; Fluoroscopy ; Humans ; Injections, Intra-Articular ; Spine ; Treatment Outcome ; Zygapophyseal Joint