Clinical observation of thirty-eight cases of pyogenic osteomyelitis of the spine for the period of eleven years, from 1965, at Seoul National University Hospital was carried out with the following results. 1. The incidence of pyogenic osteomyelitis of the spine among total cases of the pyogenic osteomyelitis was 6.9% and the ratio between the spine tuberculosis and the pyogenic osteomyelitis of the spine was 1:0.067. 2. The sex ratio between male and female wss 3.8: 1 The incidence was higher ia the second and third decade and the average prevalent age was 30.8 years of age. 3. The site of infection was in the lumbar vertebrae in 25 cases(66%), thoracic in seven(19%), lumbosacral in three, sacral in two and cervical in one. In the region of a vertebra, the vertebral body was affected in 33 cases (87%) and the neural arch and processes in other 5 cases (13%) 4. The causative micro-organism was isolated in 27 cases from the diseased focus; coagulase positive staphylococcus in 18 cases (67%), streptococcus in one, salmonella in one and the mixed infection in two. 5. Frequent clinical symptoms and signs were back pain, tenderness, muscle spasm, fever and chillness, and limited motion of the spine. 6. The roetgenographic findings were in order of disc space narrowing, destruction of the vertebral body, kyphosis or loss of lordosis, erosion, bony bridging or spur formation, sclerosis and paravertebral abscess. 7. The conservative treatment was performed in 14 cases. Among 7 cases in which the follow-up was possible, only 3 cases obtained the satisfactory result, four cases were readmitted for the recurrence and two cases among them needed the operative treatment later. The operative treatment was peformed in 26 cases; The focal curettage with anterior interbody fusion through anterior approach was carried out in 13 cases with the satisfactory result in almost all cases. 8. The advantages of the operative treatment were that the isolation of the offending organism was efficient and the definite diagnosis was feasible, and especially in cases of anterior spinal fusion the healing and union of the infected spine was better clinically and roetgenographically in comparision with those of conservative treatment, in which the expected spontaneous fusion was not found in any case and the recurrence was also frequent.
Abscess ; Animals ; Back Pain ; Coagulase ; Coinfection ; Curettage ; Diagnosis ; Female ; Fever ; Follow-Up Studies ; Humans ; Incidence ; Kyphosis ; Lordosis ; Lumbar Vertebrae ; Male ; Myalgia ; Osteomyelitis ; Recurrence ; Salmonella ; Sclerosis ; Seoul ; Sex Ratio ; Spasm ; Spinal Fusion ; Spine ; Staphylococcus ; Streptococcus ; Tuberculosis

Osteoradionecrosis is one of the most serious complication after heavy irradiation of bone and most particularly following treatment of cancers within the head and neck. The irradiated bone has the decreased vascularity and is easily infected. As a result, the spread of infection may cause a nonhealing wound that is very difficult to be treated. A comprehensive prophylactic dental care as well as proper blocking of the radiation field before radiotherapy must be considered to reduce the risk of osteoradionecrosis. We present three cases of osteoradionecrosis which developed after extraction of teeth in irradiated patients.
Dental Care ; Head ; Humans ; Jaw* ; Neck ; Osteoradionecrosis* ; Radiotherapy ; Tooth ; Tooth Extraction ; Wounds and Injuries

Inflammatory pseudotumor was originally described in the lung, but recently has been recognized to occur in various sites. A 56-year-old female was referred to our department with a painless swelling of the right midfacial area since 3 months ago. Clinical examination showed non-specific intraoral findings, but asymmetric facial appearance and numbness of the right midfacial area. Plain radiographs and CT images showed aggressive destruction and irregular thickening of the right maxillary sinus wall, increased antral opacification, and destruction of the zygomatic arch. A relatively well-defined soft tissue mass occupied the right maxillary sinus, nasal cavity, zygoma, and infraorbital region. The soft tissue mass showed mild enhancement on CT. Radiographically, this lesion presented a rapidly enlarging mass demonstrating aggressive behavior, mimicking a malignant tumor. Histopathologic examinations showed plasma cells and inflammatory cells in variable fibrotic tissues and demonstrated positive reactivity for vimentin. No malignent changes could be found.
Female ; Granuloma, Plasma Cell* ; Humans ; Hypesthesia ; Lung ; Maxillary Sinus ; Middle Aged ; Nasal Cavity ; Plasma Cells ; Vimentin ; Zygoma

Inflammatory pseudotumor was originally described in the lung, but recently has been recognized to occur in various sites. A 56-year-old female was referred to our department with a painless swelling of the right midfacial area since 3 months ago. Clinical examination showed non-specific intraoral findings, but asymmetric facial appearance and numbness of the right midfacial area. Plain radiographs and CT images showed aggressive destruction and irregular thickening of the right maxillary sinus wall, increased antral opacification, and destruction of the zygomatic arch. A relatively well-defined soft tissue mass occupied the right maxillary sinus, nasal cavity, zygoma, and infraorbital region. The soft tissue mass showed mild enhancement on CT. Radiographically, this lesion presented a rapidly enlarging mass demonstrating aggressive behavior, mimicking a malignant tumor. Histopathologic examinations showed plasma cells and inflammatory cells in variable fibrotic tissues and demonstrated positive reactivity for vimentin. No malignent changes could be found.
Female ; Granuloma, Plasma Cell* ; Humans ; Hypesthesia ; Lung ; Maxillary Sinus ; Middle Aged ; Nasal Cavity ; Plasma Cells ; Vimentin ; Zygoma

Two cases of cavernous hemangioma of the cauda equina are presented. Cavernous hemangioma of the cauda equina is rare vascular malformation. This is the fifth and sixth case of cavernous hemangioma of the cauda equina in the literature. These cases are female patients. MRI is more sensitive method than spinal myelography and CT in diagnosis of cavernous hemangioma of the cauda equina. Total removal was possible without immediate post-operative complication.
Cauda Equina* ; Diagnosis ; Female ; Hemangioma, Cavernous* ; Humans ; Magnetic Resonance Imaging ; Myelography ; Vascular Malformations

PURPOSE: To evaluate displacement and morphologic changes of the temporomandibular joint (TMJ) disc in patient with internal derangement using magnetic resonance imaging (MRI). MATERIALS AND METHODS: One hundred and forty five MR images of TMJs in 73 patients were evaluated. Positional and morphologic changes of the TMJ discs were assessed. Lateral or medial disc displacement was also evaluated on coronal images. RESULTS: Among 63 discs with anterior disc displacement, 37 discs were assessed as a biconcave disc and 21 as a deformed disc. Rotational disc displacement was observed in 35 discs. Anteromedial disc displacement was observed in 29 discs, and anterolateral direction in 6 discs. Among 35 rotational displacement, 5 biconcave discs and 21 deformed discs were observed. CONCLUSION: Rotational and sideways displacement of TMJ discs were found to be common and an important aspect of internal derangement. This study also suggests that sagittal and coronal images of the TMJ have complementary abilities for an assessment of joint abnormality.
Humans ; Joints ; Magnetic Resonance Imaging* ; Temporomandibular Joint Disc* ; Temporomandibular Joint Disorders ; Temporomandibular Joint*

Metastatic tumors to the jaw bones are uncommon. The most common metastatic tumors to the jaw bones are the breast, lung and kidney. In the jaw bones, the common location of the lesions is the mandible, and the posterior area of the mandible is more commonly affected. The radiographic appearance is quite variable. In this report, a very rare case of metastatic gastric adenocarcinoma to the mandible is presented. The patient had undergone a gastrectomy 3 years ago.
Adenocarcinoma* ; Breast ; Gastrectomy ; Gingival Neoplasms ; Humans ; Jaw ; Kidney ; Lung ; Mandible* ; Neoplasm Metastasis ; Stomach Neoplasms

PURPOSE: To characterize the effects of 2-deoxy-D-glucose (2DG) and quercetin (QCT) on cytokine secretion of IL-6, TGF-beta and gene expression of Col I in irradiated MC3T3-E1 cells. MATERIALS AND METHODS: The MC3T3-E1 cells were cultured in an alpha-MEM supplemented with 5 mM 2DG or 10 mM QCT and then the cells were incubated 12h before irradiation with 2, 4, 6, and 8 Gy X-ray using a linear accelerator delivered at a dose rate of 1.5 Gy/min. Level of IL-6 and TGF-beta was determined by ELISA. Also expression of Col I was examined by RT-PCR. RESULTS: In accordance with the radiation dose, the amount of TGF-beta was not different in RA+QCT, but it showed a peak value in control and RA+2DG at 4Gy on the 3rd day. However, all groups showed a decreasing tendency dose-dependently in RA+QCT on the 7th day (p< 0.01). In accordance with the radiation dose, the amount of IL-6 increased dose-dependently in all groups on the 3rd day. On the 7th and 21st day, all groups showed peak values at 4Gy. RA+QCT showed a slightly increased amount of IL-6 at 2 Gy, but it showed a slightly decreased amount at 4, 6, and 8 Gy. In accordance with the period of culture after irradiation, the expression of Col I increased dosedependently in RA+QCT. CONCLUSIONS: The result showed that QCT acted as radiosensitizer in the secretion of TGF-beta and gene expression of Col I during differentiation in irradiated MC3T3-E1 cells at the cellular level.
Collagen Type I* ; Deoxyglucose* ; Enzyme-Linked Immunosorbent Assay ; Gene Expression* ; Interleukin-6 ; Osteoblasts* ; Particle Accelerators ; Quercetin* ; Transforming Growth Factor beta

PURPOSE: To investigate the in vitro response of MC3T3-E1 osteoblastic cells to X-ray in the presence and absence of 2 deoxy-D-glucose (2-DG) and quercetin (QCT). MATERIALS AND METHODS: The MC3T3-E1 cells were cultured in an alpha-MEM supplemented with 5 mM 2-DG or 10 micrometer QCT and then the cells were incubated for 12 h prior to irradiation with 2, 4, 6, and 8 Gy using a linear accelerator (Mevaprimus, Germany) delivered at a rate of 1.5 Gy/min. At various times after the irradiation, the cells were processed for the analyses of proliferation, viability, cytotoxicity, and mineralization. RESULTS: Exposure of the cells to X-ray inhibited the tritium incorporation, 3-(4, 5-dimethylthiazol-2yl-)-2, 5- diphenyl tetrazolium bromide (MTT)-reducing activity, and alkaline phosphatase (ALP) activity, and caused cytotoxicity and apoptosis in a dose-dependent manner of the X-ray. This effect was further apparent on day 3 and 7 after the irradiation. RA+2-DG showed the decrease of DNA content, cell viability, and increase of cytotoxicity rather than RA. ALP activity increased on day 7 and subsequently its activity dropped to a lower level. 2-DG suppressed the calcium concentration, but visual difference of number of calcified nodules between RA and RA+2-DG was not noticed. RA+QCT showed the increase of DNA content, cell viability, but decrease of cytotoxicity and subG1 stage cells in the cell cycle, and increased calcified nodules in von Kossa staining rather than the RA. ALP activity showed significant increases on day 7 and subsequently its activity dropped to a lower level. CONCLUSION: The results showed that the 2-DG acted as a radiosensitizing agent and QCT acted as a radioprotective agent respectively in the irradiated MC3T3-E1 osteoblast-like cells.
Alkaline Phosphatase ; Apoptosis ; Calcium ; Cell Cycle ; Cell Survival ; Deoxyglucose* ; DNA ; Osteoblasts* ; Particle Accelerators ; Quercetin* ; Tritium

Hemolytic uremic syndrome (HUS) is characterized clinically by classic triad of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The illness is uncommon and various agents have been associated with HUS, such as infectious, genetic, environmental and phamacological factor. We experienced a case of hemolytic uremic syndrome in a eighty-year old man with a evidence for recent Epstein-barr virus infection. He developed hemolytic anemia, thrombocytopenia, hypertension and azotemia. His renal dysfunction was recovered by hemodialysis, plasmapheresis, warfarin and dypiridamole. We present this case with a review of the literature.
Acute Kidney Injury ; Anemia, Hemolytic ; Azotemia ; Disseminated Intravascular Coagulation ; Hemolytic-Uremic Syndrome* ; Herpesvirus 4, Human ; Hypertension ; Plasmapheresis ; Renal Dialysis ; Thrombocytopenia ; Warfarin