Idiopathic small bowel ulceration occurring beyond the duodenum is rare, and less than 5% of all the reported cases have occurred in children. In most of the cases, single ulcer of unknown cause is observed in jejunum or ileum. The diagnosis is difficult and usually made at the time of surgical exploration for the complications, such as perforation, hemorrhage or obstruction. We experienced a case of perforation of idiopathic ileal ulceration due to blunt abdominal trauma in a 11-year-old boy. The ileal segment including the lesion was resected and the pathologic findings were compatible with idiopathic small bowel ulceration. The clinical and pathological aspects are discussed, and the literatures were reviewed.
Child* ; Diagnosis ; Duodenum ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Ulcer*

Microsurgical reconstruction is necessary for children to correct severe trauma and congenital or acuqired deformity. The aim of this study was to evaluate whether or not microsurgical reconstruction is a safe and reliable operation in children and to analyze the differences of microsurgical reconstruction in children compared to adults. The study included 12 children who underwent 13 microsurgical reconstructions among a total of 251 cases of microsurgical reconstruction from May, 1986 to August, 1998. Their ages ranged from 24 months to 14 years and 8 months. There were 7 males and 6 females. The involved sites were 9 legs, 3 hands and 1 face. The causes of microsurgical reconstruction were 9 traumas, 2 congenital anomalies, 1 acquired deformity and 1 cancer. The applied flaps were 4 scapular flaps, 2 rectus abdominis muscle flaps, 1 de-epithelized groin flap, 1 lateral arm flap, 1 forearm tendocutaneous flap, 1 forearm tendocutaneous flap, 1 latissimus dorsi muscle flap, 1 fibula flap, 1 second toe transfer, and 1 wrap-around flap. All patients have had normal growth of the donor and recipient sites without specific complications during an average 2 years follow-up. We concluded that microvascular reconstruction is a very useful and reliable procedure in children if it is performed in consideration of each child's specific characteristics and conditions.
Adult ; Arm ; Child ; Congenital Abnormalities ; Female ; Fibula ; Follow-Up Studies ; Forearm ; Groin ; Hand ; Humans ; Leg ; Male ; Rectus Abdominis ; Superficial Back Muscles ; Tissue Donors ; Toes

Chronic eosinophilic pneumonia is a rare diasease characterized by chronic infiltration of the lung with ~eosinophils, usually associated with peripheral eosinophilia. In 65% of cases, the chest rad Ogroaph shows typiical nonsegmental air-space consolidation confined to the outer third of the lung and in 25)/0 of case "photographic negative of pulmonary edema". Typical lung manifestations with 'peripheral eosinophiliSa' tahrcharacteristic of chronic eosinophilic pneumonia. In the remaining cases, radiographic findings are nonspecific and require lung biopsy for confirmation. We repot a case of chronic eosinophilic pneumonia in which chest radiograph and CT scans revealed bilateral patchy or diffuse opacity with nodules scattered throughout the lungs.
Biopsy ; Eosinophilia ; Eosinophils* ; Lung ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

PURPOSE: Myocardial SPECT is an effective test for detecting coronary artery disease in the general population. But the diagnostic accuracy between sexes is not defined. The purpose of this study is to compare the diagnostic accuracy between males and females. MATERIALS AND METHODS: One hundred and seventy seven male and 98 female patients who underwent myocardial SPECT within 1 month of coronary angiography were studied. Myocardial SPECTs were considered abnormal if fixed or reversible perfusion defects were detected. Stenosis severity of > or = 50% luminal diameter reduction of any artery defined coronary artery disease (CAD). RESULTS: Overall sensitivity for detection of CAD was 98% in men and 97% in women (p=not significant). However, specificities, accuracies, and positive predictive values (PPV) in men and women were 49% vs 31% (p<0.05), 81% vs 57% (p<0.01), 78% vs 48% (P<0.01), respectively Diagnostic accuracies for detection of right coronary artery disease were not different in both sexes, however, accuracies for detection of left anterior descending artery disease and left circumflex artery disease were significantly lower in female (p<0.05). CONCLUSION: A significant difference of diagnostic accuracy between sexes, especially in LAD and LCx disease, was noted. Artifacts from breast attenuation might be a cause for the lower diagnostic accuracy in female.
Arteries ; Artifacts ; Breast ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Humans ; Male ; Perfusion* ; Phenobarbital ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: This study investigated the effectiveness of reinforced contact precautions and active surveillance cultures (ASCs) in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections (HAIs). METHODS: A before- and after-experimental study was performed at the intensive care unit (ICU) in a university-affiliated hospital. Reinforced contact precautions were applied to all patients, and ASCs for MRSA were performed for newly admitted patients at the time of admission and once a week thereafter. The HAIs were investigated in accordance with the National Nosocomial Infections Surveillance (NNIS) definitions and compared before and after the interventions. The data were analyzed using descriptive statistics. RESULTS: The number of HAIs caused by MRSA decreased from 2.2 to 0.5 per 100 patients discharged (P=0.02) and from 3.6 to 1.0 per 1,000 patient-days (P=0.032). The number of overall HAIs decreased from 7.6 to 4.0 per 100 patients discharged (P=0.011) and from 12.7 to 7.3 per 1,000 patient-days (P=0.034). The invasive device-associated infections caused by MRSA and other pathogens decreased, but the decrease was not statistically significant. CONCLUSION: Reinforced contact precautions and ASCs were effective in decreasing both MRSA infections and overall HAIs in the ICU. Further, it was assumed that the incidence of device-associated infections would have decreased if the intervention period was extended.
Cross Infection ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus

BACKGROUND: This study aimed to assess the status of infection control during influenza A pandemic (H1N1) 2009. METHODS: A questionnaire survey was conducted in November 2009 at the 100 hospitals designated by the Korea Centers for Disease Control and Prevention (KCDC) as influenza A pandemic (H1N1) 2009-treatment institutions. RESULTS: In 32.3% of the hospitals, the ventilation system of the influenza A pandemic (H1N1) 2009 isolation ward was separated from the hospital's ventilation system. With regard to wearing personal protective equipment while caring for patients with H1N1 infection, during usual patient contact, masks were always worn by all medical staff at all the hospitals; however, medical staff at 38.7% and 51.6% of the hospitals did not wear gloves and gowns, respectively. During aerosol-generating procedures, some medical staff wore surgical masks, whereas medical staff at 10% and 23.3% of the hospitals did not wear gowns and protective goggles, respectively. In all, 64.5% of the hospitals responded that the contents of the guidelines established by the KCDC were insufficient for reference purposes in actual practice. CONCLUSION: Some of influenza A pandemic (H1N1) 2009-treatment institutions are believed to be inadequate in facilities, infection control during patient treatment, and administrative measures among their efforts to prevent transmission in hospital. In preparation against the outbreak of similar diseases in the future, the government needs to establish guidelines highly applicable by medical staff, to secure exclusive spaces and personnel for treating infectious disease patients, and to develop personal protective gear support and management systems.
Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Delivery of Health Care ; Eye Protective Devices ; Humans ; Infection Control ; Influenza, Human ; Korea ; Masks ; Medical Staff ; Pandemics ; Ventilation ; Surveys and Questionnaires

No abstract available.

We report a false positive case of I-131 scan due to a sialolithiasis in right submandibular gland. I-131 images showed not only remnant thyroid tissues and functional metastases in the anterior neck but also a hot uptake near right submandibular gland. We confirmed the sialolithiasis by radiologic studies. Sialolithiasis should be regarded as a false positive cause when I-131 scan shows a hot spot near salivary bed.
Neck ; Neoplasm Metastasis ; Salivary Gland Calculi* ; Submandibular Gland ; Thyroid Gland* ; Thyroid Neoplasms*

We report a case of a patient with cystic subdural hygroma who underwent pre-operative Tc-99m DTPA cistrenoscintigraphy to determine the course of operation. A 68-year-old female was admitted to the department of neurosurgery because of acute subarachnoid hemorrhage. After emergency ventricular drainage, the hydrocephalus and cystic subdural hygroma in the right fronto-temporal area developed. She underwent Tc-99m DTPA cisternoscintigraphy to evaluate the type of hydrocephalus, which revealed obstructive communicating hydrocephalus and the communication between the subdural hygroma and the subarachnoid space. As a result of these findings, she underwent the ventriculo-peritoneal shunt operation without removal of the subdural hygroma. Post-operative brain CT showed nearly normalized shape and size of the right ventricle and disappearance of subdural hygroma. We recommend the pre-operative cisternoscintigraphy in patients with complex hygroma to evaluate the communication between subdural hygroma and the subarachnoid space.
Aged ; Brain ; Decision Making* ; Drainage ; Emergencies ; Female ; Heart Ventricles ; Humans ; Hydrocephalus ; Lymphangioma, Cystic ; Neurosurgery ; Pentetic Acid ; Subarachnoid Hemorrhage ; Subarachnoid Space ; Subdural Effusion* ; Ventriculoperitoneal Shunt

Tufted hair follliculitis is a localized, inflammatory and exudative disease of the scalp characterized by a tufted appearance of the scalp hairs emerging from single follicular openings, and may result in permanent and irreversible scarring alopecia. We report two cases of tufted hair folliculitis in a 53-year-old woman and a 47-year-old man. They had several areas of scarring alopecia with multiple bundles of hairs emerging from single follicular orifices. Histopathologic findings were typical for tufted hair folliculitis. The patients were treated successively with oral antibiotics and with topical application of clindamycin.
Alopecia ; Anti-Bacterial Agents ; Cicatrix ; Clindamycin ; Female ; Folliculitis* ; Hair* ; Humans ; Middle Aged ; Scalp