Cnical analysis of pyogenic hip in children was made on 18 patients, who had been admitted in the dept. of orthopedic surgery, Seoul Red Cross Hospital from Jan. 1972 to Dec. 1976. The following results were obtained: 1. The incidence of the pyogenic hip was slightly higher in male than female as 11 versus 7 and it was higher in the age group of 5~7 years and 11~13 years. 2. The most of the etiological microorganism was coagulase positive stap hylococcus aureus. 3. Penicillin was resistant to staphylococcus aureus in about 75% of cases, and orbenin and Lincocin were most sensitive in 58.2% of cases. 4. All cases treated with arthrotomy and irigation or drainage, but prognosis was different by method of surgical approach and method of treatment. 5 In reference with progoosis early hospitalization, early diagnosis and early treatment were counted to be imperative as known.
Child ; Coagulase ; Drainage ; Early Diagnosis ; Female ; Hip ; Hospitalization ; Humans ; Incidence ; Lincomycin ; Male ; Methods ; Orthopedics ; Penicillins ; Prognosis ; Red Cross ; Seoul ; Staphylococcus aureus

Narcolepsy is characterized by excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucinations. Only a few studies have focused on non-rapid eye movement (NREM) and REM parasomnias in narcolepsy. We report a narcolepsy without cataplexy patient presenting parasomnia as an initial symptom. A 18-year-old boy was admitted to hospital for abnormal behavior of sitting up during sleep over 2 years. He had a symptom of lethargy without cataplexy and subjective excessive daytime sleepiness, but his family found him often asleep during daytime. He underwent 3 times of polysomnography (PSG) including 1 multiple sleep latency test (MSLT) after the last PSG. The last PSG showed 1 episode of abrupt sitting. Three sleep REM onset period was observed in MSLT which was not detect in PSG. Parasomnia as an initial symptom of narcolepsy is a rare clinical entity. The MSLT may be useful in the evaluation of patients with parasomnia and unexplained hypersomnia.
Adolescent ; Cataplexy ; Disorders of Excessive Somnolence ; Eye Movements ; Hallucinations ; Humans ; Lethargy ; Male ; Narcolepsy ; Parasomnias ; Polysomnography ; Sleep Arousal Disorders ; Sleep Paralysis

PURPOSE: To investigate the learning curve and outcomes of robot-assisted laparoscopic radical prostatectomy (RALP) performed by a relatively lower volume surgeon at a secondary training hospital. MATERIALS AND METHODS: The medical records and the surgery video recordings of 100 patients who underwent RALP by a single surgeon between March 2010 and January 2013 were reviewed. The first 10 cases were grouped into period 1, cases 11 to 40 into period 2, cases 41 to 70 into period 3, and cases 71 to 100 into period 4. The interval between the operations, the operative time for each step of the surgery, the total console time, and the operative outcomes were investigated. RESULTS: The mean interval between surgeries was 10.6+/-9.3 days. The console time decreased progressively after the first 10 cases and reached under 3 hours after 75 cases. The time taken to begin dissection of the dorsal vein complex, for the division of the bladder neck, for lateral dissection with neurovascular bundle preservation, and for apex dissection decreased significantly with experience, although the time for vesicourethral anastomosis did not. The margin-positive rate of stage T2 patients was 27.4% (20/73), and the transfusion rate was 50% in period 1 patients and 3.3% in period 4 patients. No major complications occurred. CONCLUSIONS: It is difficult to shorten the learning curve of surgeons in secondary training hospitals owing to the smaller number of cases and the irregular surgical intervals. Although the operation time was relatively longer, the surgical outcome and complication rates were comparable with those of surgeons at larger hospitals.
Humans ; Learning Curve ; Medical Records ; Neck ; Operative Time ; Prostatectomy ; Prostatic Neoplasms ; Robotics ; Urinary Bladder ; Veins ; Video Recording

Massive pneumopritoneum developing immediately following initiation of artificial ventilation is an unusual sign of lung barotrauma and must be distinguished from pneumoperitoneum following rupture of a hollow abdominal viscus. Besides, pneumoperitoneum occurring in a mechanically ventilated asthmatic patient can present a diagnostic dilemma as the usual signs of an intestinal perforation may be masked by steroid therapy, sedation or paralysis, or combination of all three. We report a case of massive pneumoperitoneum after initiation of mechanical ventilation in a child with severe asthmatic attack.
Asthma* ; Barotrauma ; Child* ; Humans ; Intestinal Perforation ; Lung ; Masks ; Paralysis ; Pneumoperitoneum* ; Respiration, Artificial* ; Rupture ; Ventilation

OBJECTIVE: The purpose of this study was to analyze in detail the relationship between outcome and time course of effect in medically refractory primary cervical dystonia (CD) with phasic type that was treated by bilateral globus pallidus internus (Gpi) deep brain stimulation (DBS). METHODS: Six patients underwent bilateral implantation of DBS into the Gpi under the guide of microelectrode recording and were followed for 18.7 +/- 11.1 months. The mean duration of the CD was 5.8 +/- 3.4 years. The mean age at time of surgery was 54.2 +/- 10.2 years. Patients were evaluated with the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and relief scale using patient self-reporting. RESULTS: The TWSTRS total scores improved by 64.5%, 65.5%, 75.8%, and 76.0% at 3, 6, 12 months, and at the last available follow-up after surgery, respectively. Statistically significant improvements in the TWSTRS scores were observed 3 months after surgery (p = 0.028) with gradual improvement up to 12 months after surgery, thereafter, the improvement was sustained. However, there was no statistically significant difference between the scores at 3 and 12 months. Subjective improvement reported averaged 81.7 +/- 6.8% at last follow-up. Mild dysarthria, the most frequent adverse event, occurred in 3 patients. Conclusions: Our results show that the bilateral Gpi-DBS can offer a significant therapeutic effect from 3 months postoperatively in patients with primary CD with phasic type, without significant side effects.
Deep Brain Stimulation ; Dysarthria ; Follow-Up Studies ; Globus Pallidus ; Humans ; Microelectrodes ; Torticollis

OBJECTIVES: This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. METHODS: For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale (NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). RESULTS: At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. CONCLUSIONS: More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.
Anxiety ; Appetite ; Depression ; Hand Strength ; Hostility ; Humans ; Muscles ; National Institutes of Health (U.S.) ; Neurologic Manifestations ; Stroke

OBJECTIVE: This study aimed to (1) evaluate the effects of maxillary second and third molar eruption status on the distalization of first molars with a modified palatal anchorage plate (MPAP), and (2) compare the results to the outcomes of the use of a pendulum and that of a headgear using three-dimensional finite element analysis. METHODS: Three eruption stages were established: an erupting second molar at the cervical one-third of the first molar root (Stage 1), a fully erupted second molar (Stage 2), and an erupting third molar at the cervical one-third of the second molar root (Stage 3). Retraction forces were applied via three anchorage appliance models: an MPAP with bracket and archwire, a bone-anchored pendulum appliance, and cervical-pull headgear. RESULTS: An MPAP showed greater root movement of the first molar than crown movement, and this was more noticeable in Stages 2 and 3. With the other devices, the first molar showed distal tipping. Transversely, the first molar had mesial-out rotation with headgear and mesial-in rotation with the other devices. Vertically, the first molar was intruded with an MPAP, and extruded with the other appliances. CONCLUSIONS: The second molar eruption stage had an effect on molar distalization, but the third molar follicle had no effect. The application of an MPAP may be an effective treatment option for maxillary molar distalization.
Crowns ; Finite Element Analysis* ; Molar* ; Molar, Third

BACKGROUND: Oxidative stress contributes to vascular diseases in patients with diabetes. As the mechanism of development and progression of diabetic vascular complications is poorly understood, this study was aimed to assess the potential role of hyperglycemia-induced oxidative stress and to determine whether the oxidative stress is a major factor in hyperglycemia-induced migration of vascular smooth muscle cells (VSMCs). METHODS: We treated primary cultured rat aortic smooth muscle cells for 72 hours with medium containing 5.5 mM D-glucose (normal glucose), 30 mM D-glucose (high glucose) or 5.5 mM D-glucose plus 24.5 mM mannitol (osmotic control). We measured the migration of VSMCs and superoxide production. Immunoblotting of PKC isozymes using phoshospecific antibodies was performed, and PKC activity was also measured. RESULTS: Migration of VSMCs incubated under high glucose condition were markedly increased compared to normal glucose condition. Treatment with diphenyleneiodonium (DPI, 10 micromol/L) and superoxide dismutase (SOD, 500 U/mL) significantly suppressed high glucose-induced migration of VSMCs. Superoxide production was significantly increased in high glucose condition and was markedly decreased after treatment with DPI and SOD. High glucose also markedly increased activity of PKC-delta isozyme. When VSMCs were treated with rottlerin or transfected with PKC-delta siRNA, nitro blue tetrazolium (NBT) staining and NAD(P)H oxidase activity were significantly attenuated in the high glucose-treated VSMCs. Furthermore, inhibition of PKC-delta markedly decreased VSMC migration by high glucose. CONCLUSION: These results suggest that high glucose-induced VSMC migration is dependent upon activation of PKC-delta, which may responsible for elevated intracellular ROS production in VSMCs, and this is mediated by NAD(P)H oxidase.
Acetophenones ; Animals ; Antibodies ; Benzopyrans ; Diabetic Angiopathies ; Glucose ; Humans ; Immunoblotting ; Isoenzymes ; Mannitol ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; NADPH Oxidase ; Onium Compounds ; Oxidative Stress ; Oxygen ; Protein Kinase C ; Rats ; RNA, Small Interfering ; Superoxide Dismutase ; Superoxides ; Vascular Diseases

Atopic dermatitis (AD) is a common inflammatory skin disorder mediated by inflammatory cells, such as macrophages and mast cells. Rifampicin is mainly used for the treatment of tuberculosis. Recently, it was reported that rifampicin has anti-inflammatory and immune-suppressive activities. In this study, we investigated the effect of rifampicin on atopic dermatitis in vivo and in vitro. AD was induced by treatment with 2, 4-dinitrochlorobenzene (DNCB) in NC/Nga mice. A subset of mice was then treated with rifampicin by oral administration. The severity score and scratching behavior were alleviated in the rifampicin-treated group. Serum immunoglobulin E (IgE) and interleukin-4 (IL-4) levels were also ameliorated in mice treated with rifampicin. We next examined whether rifampicin has anti-atopic activity via suppression of mast cell activation. Rifampicin suppressed the release of β-hexosaminidase and histamine from human mast cell (HMC)-1 cultures stimulated with compound 48/80. Treatment with rifampicin also inhibited secretion of inflammatory mediators, such tumor necrosis factor-α (TNF-α) and prostaglandin D₂ (PGD₂), in mast cells activated by compound 48/80. The mRNA expression of cyclooxygenase 2 (COX-2) was reduced in the cells treated with rifampicin in a concentration-dependent manner. These results suggest that rifampicin can be used to treat atopic dermatitis.
Administration, Oral ; Animals ; Cyclooxygenase 2 ; Dermatitis, Atopic ; Histamine ; Humans ; Immunoglobulin E ; Immunoglobulins ; In Vitro Techniques* ; Interleukin-4 ; Macrophages ; Mast Cells ; Mice ; Necrosis ; Rifampin* ; RNA, Messenger ; Skin ; Tuberculosis

Atopic dermatitis (AD) is a common inflammatory skin disorder mediated by inflammatory cells, such as macrophages and mast cells. Rifampicin is mainly used for the treatment of tuberculosis. Recently, it was reported that rifampicin has anti-inflammatory and immune-suppressive activities. In this study, we investigated the effect of rifampicin on atopic dermatitis in vivo and in vitro. AD was induced by treatment with 2, 4-dinitrochlorobenzene (DNCB) in NC/Nga mice. A subset of mice was then treated with rifampicin by oral administration. The severity score and scratching behavior were alleviated in the rifampicin-treated group. Serum immunoglobulin E (IgE) and interleukin-4 (IL-4) levels were also ameliorated in mice treated with rifampicin. We next examined whether rifampicin has anti-atopic activity via suppression of mast cell activation. Rifampicin suppressed the release of β-hexosaminidase and histamine from human mast cell (HMC)-1 cultures stimulated with compound 48/80. Treatment with rifampicin also inhibited secretion of inflammatory mediators, such tumor necrosis factor-α (TNF-α) and prostaglandin D₂ (PGD₂), in mast cells activated by compound 48/80. The mRNA expression of cyclooxygenase 2 (COX-2) was reduced in the cells treated with rifampicin in a concentration-dependent manner. These results suggest that rifampicin can be used to treat atopic dermatitis.
Administration, Oral ; Animals ; Cyclooxygenase 2 ; Dermatitis, Atopic ; Histamine ; Humans ; Immunoglobulin E ; Immunoglobulins ; In Vitro Techniques* ; Interleukin-4 ; Macrophages ; Mast Cells ; Mice ; Necrosis ; Rifampin* ; RNA, Messenger ; Skin ; Tuberculosis