PURPOSE: This retrospective study was conducted to evaluate the value of adminstration of IV gadopentetate dimeglumine for MR imaging of tuberculous spondylitis. MATERIALS AND METHODS: The authors reviewed MR images both with and without contrast enhancement of 22 patients with tuberculous spondylitis. Evaluation of signal characteristics, enhancement patterns, and difference of delineation between pre- and postcontrast enhancement was made on 4 compartments the vertebral body, intervertebral disc, paravertebral space, and extradural space. RESULTS: The spinal tuberculous lesions revealed relatively low or isosignal intensity on T1-weighted image and high signal intensity on T2-weighted image. The tuberculous lesions of vertebral body showed enhancement of mixed pattern, and rim enhancement pattern was predominant in the other 3 compartment, suggesting abscess. The contrast enhanced MR image showed better demarcation of the extents of tuberculous lesions comparing with noncontrast image, especially at the vertebral body and intervertebral disc. The nature of tuberculous involvement was better visualized at the extradural space and paravertebral space on postcontrast image. CONCLUSION: We conclude Gd-DTPA enhanced MR image can give informations for more detailed delineation, extents, and nature of involvement in the tuberculous spondylitis.
Abscess ; Gadolinium DTPA ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging* ; Retrospective Studies ; Spondylitis*

The incidence of hypercalcemia in terminal cancer patients is rare but if it is not treated, the consequence is dismal. Hydration, diuretics, corticosteroids are not so effective for the treatment of hypercalcemia in this situation. Pamidronate (synthetic bisphosphonate analogue of pyrophosphonate) decreases the activity and the life span of the osteoclasts. It results in decrease in resorption of bone mineral, directly and indirectly. There are only a few reports on the usage of pamidronate in children. We experienced a case with hypercalcemia in patient with Wilms tumor who was treated with pamidronate. A 5-year-old male patient was admitted to Ajou University Hospital due huge abdominal mass. Abdominal CT revealed a huge mass originating from right kidney (size: 18 11 8 cm) with lung metastasis. The chemotherapy according to National Wilms Tumor Study (NWTS)-4 was started but there was no response after 4 months. Right nephrectomy with mass removal was done and the pathologic finding revealed diffuse anaplastic type. The serum calcium level increased to be 16.7 mg/dL at 7 days after operation which was not responsive to hydration and furosemide. Pamidronate was given at the dose of 1 mg/kg and the serum calcium decreased to 8.0 mg/dL 24 hours later. The pulmonary lesion progressed and the patient died 4 months after operation but the serum calcium level remained within normal range thereafter.
Adrenal Cortex Hormones ; Calcium ; Child ; Child, Preschool ; Diuretics ; Drug Therapy ; Furosemide ; Humans ; Hypercalcemia* ; Incidence ; Kidney ; Lung ; Male ; Neoplasm Metastasis ; Nephrectomy ; Osteoclasts ; Reference Values ; Tomography, X-Ray Computed ; Wilms Tumor*

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

PURPOSE: Paragonimiasis is infectious disease occurred by Paragonimus Westermani, which invades into human body as a final host. Habitual eating the freshwater crab or crawfish unboiled is one of the reason of infection. Paragonimiasis raged in 1970s in Korea, Japan, China and other Asian countries but the incidence decreased rapidly. Once people eat infected second host, parasite penetrates the duodenal wall and migrates to the lung. During this migration period, the parasite can migrate to other organ, such as brain, spinal cord, liver and subcutaneous tissue, but the cases are rarely reported. The objective of our study is to present our experience of the ectopic migration of parasite to the subcutaneous tissue of the abdomen, which was easily treated with excision and Praziquantel medication. METHODS: A 59-year-old woman who likes eating unboiled freshwater crab was diagnosed as Paragonimiasis 15 months ago. Her symptoms were fever and cough, and she was treated with Praziquantel medication. 3 months after discharge, she visited our hospital with left pleuritic chest pain, cough with fever, and palpable mass formation on left lower quadrant of the abdomen. Wedge resection of the left lung and Praziquantel medication was maintained for a week. Nevertheless, fever persisted after the treatment. The patient received total excision of the abdominal soft tissue mass, and the fever was relieved. RESULTS: Pathologic findings of the mass showed multiple cyst and abscess formation with crystal structure which is suspicious parts of the parasite or calcified egg shells. Uncontrolled fever was relieved after the operation, and there was no evidence of recurrent Paragonimiasis and ectopic migration for 1 year follow up period. CONCLUSION: Ectopic migration of Paragonimus is rare, but multiple organ can be involved. Patient with Paragominiasis who was refractory in fever control after Praziquantel medication or surgical evaluation of the lung should be considered as ectopic migration of the Paragonimiasis.
Abdomen ; Abscess ; Animals ; Asian Continental Ancestry Group ; Brain ; Chest Pain ; China ; Communicable Diseases ; Cough ; Eating ; Egg Shell ; Female ; Fever ; Follow-Up Studies ; Fresh Water ; Human Body ; Humans ; Incidence ; Japan ; Korea ; Liver ; Lung ; Middle Aged ; Paragonimiasis ; Paragonimus ; Paragonimus westermani ; Parasites ; Praziquantel ; Rage ; Spinal Cord ; Subcutaneous Tissue

OBJECTIVES: To compare the diagnostic and prognostic performance of amniotic fluid white blood cell(AF WBC) count and amniotic fluid culture for the prenatal diagnosis of intrauterine infection and the prediction of neonatal outcomes in patients with preterm labor and intact membranes. Methods: Amniocentesis was performed in 75 patients with preterm labor and intact membranes, who delivered preterm neonates within 72 hours after amniocentesis. AF WBC was determined and amniotic fluid was cultured for aerobic and anaerobic bacteria as well as mycoplasma. The relations among placental histologic findings, perinatal outcome, AF WBC count, and AF culture were examined. Student t test, Mann Whitney U test, lamda2 test, Fisher's exact test, modified t test, and logistic regression analysis were used for statistical analysis. RESULTS: Microbial invasion of the amniotic fluid was more frequent in the patients with histologic chorioamnionitis than patients without histologic chorioamnionitis (28.9% vs 5.4%, p<0.05), and patients with histologic chorioamnionitis had significantly higher amniotic fluid white blood cell counts than those patients without such lesion (median 99, range 0-3024 cells/mm3 vs median 1, range 0-180 cells/mm3, p<0.01). Amniotic fluid white blood cell count (> or = 50cell/mm3) had a sensitivity of 55.3%(21/38) and a specificity of 94.6%(35/37) for the diagnosis of histologic chorioamnionitis and a sensitivity of 47.5%(19/40) and specificity of 90.9%(30/33) for the prediction of significant neonatal morbidity (defined as neonatal sepsis, respiratory distress syndrome, pneumonia, intraventricular hemorrhage, bronchopulmonary dysplasia, or necrotizing enterocolitis). These sensitivities were significantly higher than those of amniotic fluid culture (for histologic chorioamnionitis, 55.3% vs 28.9% ; for significant neonatal morbidity, 47.5% vs 25.0%, p<0.01 for each). CONCLUSION: Amniotic fluid WBC count is a more sensitive test for the prenatal diagnosis of intrauterine infection and for the prediction of significant neonatal morbidity than amniotic fluid culture in the patients with preterm labor and intact membranes.
Amniocentesis ; Amniotic Fluid* ; Bacteria, Anaerobic ; Bronchopulmonary Dysplasia ; Chorioamnionitis ; Diagnosis ; Female ; Hemorrhage ; Humans ; Infant, Newborn ; Leukocyte Count* ; Leukocytes* ; Logistic Models ; Membranes* ; Mycoplasma ; Obstetric Labor, Premature* ; Pneumonia ; Pregnancy ; Prenatal Diagnosis* ; Sensitivity and Specificity ; Sepsis

This paper is presented to report the results of urinary quantitative culture and sensitivity tests of certain antibiotics. Studies were done on 331 cases from the Department of Urology. Woo Sok University Medical College Hospital during the period from May 1962 up to September 1970. 1) Urine specimens from 331 cases were cultured and, of these, 115 cases grew micro-organism while the remaining 216 cases showed no growth. Among the 115 cases, 84 cases(73%) revealed significant bacteriuria with counts over 10s/ml. colonies in urine while 31 cases(27%) were below 10(5)/ml. 2) Only 74 cases(88. 1%) among the 84 cases with significant bacteriuria could the bacteria be identified after centrifuging the specimens and doing a smear and Gram stain. 68 cases(81%) of the total 84 significant bacteriuria cases had shown urinary leukocyte count of more than 4/HPF while 16 cases(19%) were below 4/HPF. 3) 77 cases(92%) of the total 84 cases with significant bacteriuria had Gram negative bacilli while 4 cases had Gram positive cocci by direct smear. 4) There were no significant differences between male and female patients in colony counts except the female group revealed some preponderance of E. coli. 5) In the sensitivity testing if the cultured significant bacteriuria in the group with Gram negative bacilli, 36 cases(49.3%) were sensitive to Kanamycin and 22 cases(30.1%) were resistant, while all cases were resistant to leucomycin and only one case was sensitive to penicillin among the total 73 cases of Gram negative bacilli cultured.
Anti-Bacterial Agents ; Bacteria ; Bacteriuria ; Female ; Gram-Positive Cocci ; Humans ; Kanamycin ; Kitasamycin ; Leukocyte Count ; Male ; Penicillins ; Urology

Simultaneoulsy carpometacarpal fracture and dislocation is known to be uncommon past days. But Fisher1 reported that it is quite common injury of hand in 1984. Also high energy injury causes carpometacarpal joint fracture and dislocation, the result of treatment has wide spectrum of prognosis, so early diagnosis and treatment is essential. We reported 2 patients who had the fourth and fifth carpometacarpal fracture and dislocation.
Carpometacarpal Joints ; Dislocations ; Early Diagnosis ; Hand ; Humans ; Prognosis

OBJECTIVES: Our purpose was 1) to determine whether elevated maternal serum alpha- fetoprotein(MSAFP) predict increased risk of spontaneous preterm delivery and indicated preterm delivery; 2) to determine whether elevated maternal serum human chorionic gonadotropin(MSHCG) predict increased risk of preterm delivery. Methods: Between September 1995 and April 1998, 945 of 2105 pregnant women who received midtrimester MSAFP screening were identified and evaluated. 81 women with MSAFP levels of 2.0 MoM or more were included in the study group while 864 women with levels less than 2.0 MoM served as controls. Pregnancy outcome were obtained from hospital records and statistical analysis were performed. RESULTS: Women with elevated MSAFP levels showed an increased risk for preterm delivery(p<0.05), fetal growth restriction(p<0.05) and hypertensive disorders(p<0.05), but not for preterm premature rupture of membrane, fetal death in utero. There was a strong association between unexplained elevated MSAFP levels and spontaneous preterm delivery(p<0.05) but our study does not support an association between unexplained elevated MSAFP levels and indicated preterm delivery. There was no association between elevated MSHCG levels and preterm delivery regardless of MSAFP levels. CONCLUSION: We concluded that unexplained elevated levels of midtrimester MSAFP were associated with an elevated risk of spontaneous preterm delivery but not with a risk of indicated preterm delivery. Elevated MSHCG levels were not associated with a risk of preterm delivery and spontaneous preterm birth.
alpha-Fetoproteins* ; Chorion ; Extraembryonic Membranes ; Female ; Fetal Development ; Hospital Records ; Humans ; Mass Screening ; Obstetric Labor, Premature ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second* ; Pregnant Women ; Premature Birth* ; Rupture

Animals ; Bone and Bones ; Dogs ; Finite Element Analysis ; Mandible ; Osseointegration ; Osteogenesis