STUDY DESIGN: The authors analysed the recovery of clinical symptoms after percutaneous drainage and irrigation in pyogenic vertebral osteomyelitis. OBJECTIVES: To determine the role of percutaneous drainage and irrigation in pyogenic vertebral osteomyelitis. SUMMARY OF LITERATURE REVIEW: Pyogenic vertebral osteomyelitis is a relatively rare condition but its incidence is recently increasing due to common use of intravenous access devices and resultant nosocomial bacteremia. Management of the disease is not uniform and is controversial regarding the role of surgery and duration of use of antibiotics. At present, the role of percutaneous drainage of involved spines in treatment of pyogenic vertebral osteomyelitis is not well-known. MATERIALS AND METHODS: We report 3 cases of pyogenic vertebral osteomyelitis which were treated by continuous drainage with automated percutaneous lumbar discectomy device(APLD device) and draining tube after they haute failed to conservative treatment. APLD device, fluoroscopic guide, contrast media and continuous percutaneous draining tubes were used for this procedure. The percutaneous draining tubes were maintained for 7 to 11 days and each case was followed up for 6 to 10 weeks under admission. RESULTS: Symptoms were relieved 3 to 5 weeks after this procedure. The patients were followed up to 12 to 39 months and experienced no recurrence. CONCLUSIONS: Percutaneous drainage and irrigation with APLD device brought prompt and marked clinical recovery. It is indicated as a supplementary method to conservative treatment or in case of high operative risk patient due to poor general conditions. It has minimal invasiveness, short clinical course and low recurrence rate.
Anti-Bacterial Agents ; Bacteremia ; Contrast Media ; Diskectomy ; Drainage* ; Humans ; Incidence ; Osteomyelitis* ; Recurrence ; Spine

No abstract available.
Erythrocytes*

The purpose of this paper is to study the effects of anti-inflammatory agents on the blood-aqueous-berrier in experimentally induced uveitis. 10% solution of sodium fluorescein was injection intravenously in the ear vein of rabbits (0.25 ml/kg) and fluorescein curve was drawn after the method of Amsler and Huber. Experimental uveitis was induced by the injection of 0.2 ml of human serwn into the vitreous body. After uveitis had been induced. three kinds of anti-inflammatory agents-Prednisolone, Benzyron and Methotrexate-were Biven oralIy. In control animals in which no uveitis was induced, no changes in fluorescein curve were demonstrated before and after the administrations of drugs. In animals with uveitis, maked increases of the blood-aqueous barrier were noted. When Benoyron and Prednisolone were given to these animals, normaliration of the fluorescein curves were demonstrated. Methotrexate had no effects on the fluorescein curves in uveitis animals, showing no improvements in the permeability of uveal vessela. This ineffectiveness seemed to be due to the resistance of rabbits to methotrexate.
Animals ; Anti-Inflammatory Agents ; Blood-Aqueous Barrier ; Ear ; Fluorescein ; Humans ; Methotrexate ; Permeability ; Prednisolone ; Rabbits ; Uveitis* ; Veins ; Vitreous Body

No abstract available.
Erythrocytes*

No abstract available.
Erythrocytes*

Ischemic stroke is a serious neurological complication of infective endocarditis. Intravenous tissue plasminogen activator (t-PA), which has only been approved for treatment of hyperacute stroke, has been excluded as an ischemic stroke treatment due to infective endocarditis according to current expert consensus guidelines. Here, we describe a case of a hyperacute stroke patient treated with intravenous t-PA, who was later diagnosed with infective endocarditis.

A global increase in the incidence of tuberculosis has prompted the need for earlier diagnosis, treatment, and isolation of the disease. In tuberculosis, concomitant tuberculous meningitis and vascular complications such as intracranial aneurysms and subarachnoid hemorrhage are very rare. Because of the poor prognosis of tuberculous meningitis as well as intracranial aneurysm and subarachnoid hemorrhage, early diagnosis and management are crucial. We present the case of a 76-year-old woman who had two intracranial aneurysms complicated by subarachnoid hemorrhage, who had concomitant tuberculous meningitis. She remained well with medical management.

Background & Objective: Sex differences in cerebral atherosclerosis and subsequent stroke have not been thoroughly investigated and conflicting data exist. The aim of this study was to investigate sex differences in the risk factors and distribution of large artery atherosclerotic stroke in a Korean population. Methods: We included consecutive acute ischemic stroke patients with symptomatic extracranial atherosclerosis (ECAS) or intracranial atherosclerosis (ICAS) based on brain and vascular imaging who presented at our hospital between January 2011 and December 2015. We then compared risk factor profiles and the proportion of symptomatic ECAS and ICAS between men and women. Results: Eight hundred and forty four patients were enrolled during the study period. The proportion of ECAS in men was notably higher than in women (19.4% in men vs. 9.3% in women; p < 0.001). A multiple regression analysis showed that male gender was a factor favoring ECAS (vs. ICAS, odds ratio [OR], 3.554; 95% confidence interval [CI], 2.175-5.808; p < 0.001). Age (OR, 1.051; 95% CI, 1.031-1.072; p = 0.001) and hyperlipidemia (OR, 2.330; 95% CI, 1.538-3.529; p < 0.001) were also factors favoring ECAS. However, after stratification by sex, the association was only significant in men. Conclusions: There is a sex difference in the distribution of atherosclerotic stroke. Sex may be an effect modifier of the association between atherosclerotic risk factors and atherosclerotic distribution.
Stroke

PURPOSE: The purpose of our study is to evaluate the diagnostic significance of clinical findings, WBC count, ESR, CRP, simple X-ray, ultrasonography and bone sanning in neonates. MATERIALS AND METHODS: From January 1995 to May 1998, we have experienced 14 cases of pyogenic osteomyelitis and pyogenic arthritis in neonates. The mean age of patients was 16.7 days and the involved sites were 6 cases of pyogenic arhtritis of hip, 5 cases of pyogenic arthritis of hip with proximal femur osteomyelitis, 2 cases of pyogenic arthritis of shoulder with proximal humerus osteomyelitis and 1 case of proximal tibia osteomyelitis. RESULTS: The most frequent clinical signs were local swelling and pseudoparalysis of involved extremity. Laboratory findings showed that elevated ESR was in 11/14 (79%), positive CRP in 6/8 (75%), leukocytosis in 6/14 cases (43%). Abnomal findings in simple X-ray was in 7/13 (54%), positive bone scanning findings in 3/8 (37.5%), positive ultrasonographic findings in 11/11 cases (100%). CONCLUSIONS: ITherefore we concluded that careful physical examination and ultrasonography were important for early diagnosis of bone or joint infection in neonates
Arthritis ; Diagnosis* ; Early Diagnosis ; Extremities ; Femur ; Hip ; Humans ; Humerus ; Infant, Newborn* ; Joints* ; Leukocytosis ; Osteomyelitis ; Physical Examination ; Shoulder ; Tibia ; Ultrasonography

PURPOSE: To evaluate and compare the diagnostic findings and usefulness of MRI and MR arthrogram in recurrent anterior dislocation of the shoulder. MATERIALS AND METHODS: MRI and MR arthrogram of thirty-two cases of thirty patients with recurrent anterior dislocation of the shoulder were retrospectively analyzed to evaluate glenohumeral ligaments, pattern of labral injury, bony Bankart lesion, capsular stripping, Hill-Sachs lesion, and loose body. RESULTS: Labral abnormalities was detected on MRI in 23 cases(72%) and MR arthrogram in 22 cases(69%) as labral tear, detachment, and deficiency. All cases involved anteroinferior labrum. On MR arthrogram, labral abnormalities was confined to anteroinferior portion in 4 cases(18%), extended into midglenoid level in 13 cases(59%), and that into anterosuperior portion in 5 cases(23%). Capsular stripping was noted on MRI in 6 cases(19%) and MR arthrogram in 12 cases(38%). Loose body was detected only on MR arthrogram in 5 cases (16%). Bony Bankart lesion and Hill-Sachs lesion was detected equally on MRI and MR arthrogram in 2 cases (6%) and 21 cases(66%) respectively. We obtained identical findings on both MR arthrogram and operation field in 6 patients. CONCLUSION: MRI with its excellent soft tissue contrast resolution and multiplanar imaging capafility helps detection of labral injury in recurrent anterior dislocation of the shoulder. MR arthrogram is slightly invasive, but shows good artatomic details of labral-ligamentous-capsular relationship and thus provides accurate detec- tion of pattern of labral injury, capsular stripping, and loose body.
Dislocations* ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Retrospective Studies ; Shoulder*