We experienced a case of congenital tuberculosis infected in utero, who had been found to have massive ascites and pleural effusion on routine ultrasonography at the 39 weeks' gestation. The emergency C-section delivered a male neonate weighing 2,050 g with poor condition and in severe respiratory distress. He was the first child born of a 27-year-old woman, who was diagnosed as having tuberculous pleurisy after delivery. Detection of acidfast bacilli in gastric aspirates obtained from the newborn as well as the clinical features and maternal history confirmed the diagnosis of congenital tuberculosis. Though rare, congenital tuberculosis requires early detection and treatment because of its severity and high mortality. A brief review of the relevant literature was made.
Adult ; Ascites* ; Child ; Diagnosis ; Emergencies ; Female ; Humans ; Infant, Newborn ; Male ; Mortality ; Pleural Effusion* ; Pregnancy ; Tuberculosis* ; Tuberculosis, Pleural ; Ultrasonography

OBJECTIVES: This study was conducted to find the relationship between oral health conditions of elderly people and closures of public dental health clinics in rural areas. METHODS: Oral examinations and surveys were conducted in 2011 from May 11 through November 4 on 383 seniors over 65-years and under 74 years old. RESULTS: The results of this study were as follows: 1. The results of comparative analysis of the usage behaviors of health clinics of subjects in relation to the closures of public dental clinics within the area showed that the usage level and frequency of public health agencies in areas with public dental clinics were high, and that the trend of influence on personal oral health conditions and improvement in prevention was high. When compared to 3 years ago, there was an 11.6 percentage point reduction in areas without public dental clinics (24.4%) compared to areas with public dental clinics (12.8%). 2. The results of comparative analysis of the oral health conditions and behaviors of subjects in relation to the closures of public dental clinics showed that the level of dental caries was high in areas with no public dental clinics, and the number of toothbrush usage and oral health supplemental product usage were shown to be high in areas with public dental clinics. CONCLUSION: The closures of public dental clinics were found to affect oral health behavior and conditions of elderly people in rural areas.
Aged* ; Dental Care for Aged ; Dental Caries ; Dental Clinics* ; Diagnosis, Oral ; Humans ; Oral Health* ; Public Health* ; Rural Health Services

PURPOSE: To analyze the clinical and radiological results of hip arthroplasty following the failed internal fixation of intertrochanteric fractures of the femur. MATERIALS AND METHODS: We analyzed the reasons for failure in 29 cases of hip arthroplasty from January 1997 through December 2008 in which the hip arthroplasty was necessary due to failed internal fixation of an intertrochanteric fracture of the femur. Furthermore, we tried to find pitfalls encountered when performing the operations. We assessed those patients and drew both clinical (Harris hip score, HHS) and radiological results. The follow-up period was 34.2 months(12-96 months), on average. RESULTS: The average operating time was 174 min.(115-205 min.) and the mean amount of perioperative bleeding was 1,335 ml(759-2,450 ml). The amount of packed RBC transfusion was 2.8 units(0-10 units) on average. We could see prolonged operation time and a large amount of blood loss as we performed both the removal of the previously fixed implant and reduction of the displaced bone fragment simultaneously. The mean Harris hip score of the patients was improved from the preoperative score of 43 to the postoperative score of 85.7. No cases showed any radiological signs of loosening of acetabular cups or femoral stems, although an articular dislocation and a postoperative joint infection occurred. CONCLUSION: Although hip arthroplasties performed because of a failure in internal fixation could provide relatively satisfactory outcomes, as they result in extended surgery time and greater blood loss, a requirement for higher-level surgical skills, and greater consideration required for the systemic conditions of patients before performing surgery.
Arthroplasty ; Dislocations ; Femur ; Follow-Up Studies ; Hemorrhage ; Hip ; Hip Fractures ; Humans ; Joints

PURPOSE: The present study was undertaken to assess whether the results of cerebrospinal fluid (CSF) culture are related to prognosis. METHODS: Subjected to this study were 51 cases admitted to our department who had been diagnosed as bacterial meningitis. They were divided into two groups, Group l (20) with positive CSF culture and Group ll (31) with negative outcome, then both groups were compared. RESULTS: Group l cases tended to be younger than Group ll cases. The male/female ratio was 1.2 in Group l and 1.6 in Group ll. Laboratory findings of CFS were not significantly different in either groups, except for the glucose level, which was markedly lower in Group l than in Group ll. The causative organisms identified from CSF culture were E. coli (5), group B Streptococcus (4) and S. aureus (1) among the 10 cases aged under 2 months. On the other hand, S. pneumoniae were isolated in 7 and H. influenzae in 3 among the 10 older cases. Mortality rate and the incidence of complications were higher in Group l than in Group ll. Mortality rate as related to the causative organism was highest with E. coli, followed by group B Streptococcus, H. influenzae. CONCLUSION: Bacterial meningitis cases with positive CSF culture have significantly lower glucose concentration in the CSF, and also higher rates of mortality and incidence of serious complications than those with negative culture.
Cerebrospinal Fluid* ; Glucose ; Hand ; Incidence ; Influenza, Human ; Meningitis, Bacterial* ; Mortality ; Pneumonia ; Prognosis* ; Streptococcus

PURPOSE: We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. MATERIALS AND METHODS: We have made an analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom,statistically. We also reviewed CT findings in 15 study groups. RESULTS: The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p <0.01) CONCLUSION: The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.
Congenital Abnormalities* ; Spondylolisthesis*

Pheochromocytoma is a rare endocrine tumor arising from the chromaffin tissue, and it is able to produce and secrete catecholamines. Lymph nodes, liver, lung and bone are the most frequent sites of metastasis. We report here on a case of pheochromocytoma arising from the dura in a patient who was surgically treated for bilateral pheochromocytoma five years previously.
Catecholamines ; Humans ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Pheochromocytoma*

A retrospective study of 46 patients with primary superficial bladder tumor was performed to identify the prognostic parameters which affect tumor recurrence. We examined 4 parameters such as stage, grade, size and number of tumor and each parameter was compared with recurrence rate respectively. The recurrence rate of stage Ta and T1 within 2 years was 33.3 % and 71% (p<0.05) and that of grade I, II and III was 40%, 60% and 100% respectively(p<0.05). Tumor recurrence was observed in 44% of patients with single tumor, 76.2% of those with multifocal tumors(p>0.05) and tumor size had no effect on tumor recurrence(p>0.06). Early recurrence rate within 1 year of grade I, II and III was 20%, 32% and 100% respectively(p< 0.01 ) but stage, number of tumor and tumor size were not correlated significantly with early recurrence rate within 1 year. A separate evaluation of the 4 parameters showed that stage and grade have a significant influence on tumor recurrence. Therefore more aggressive therapy and intensive follow-up should be considered for patients with high stage and high grade tumors.
Follow-Up Studies ; Humans ; Recurrence* ; Retrospective Studies ; Urinary Bladder Neoplasms* ; Urinary Bladder*

The vast majority of foreign bodies (FBs) that enter the stomach pass through the gastrointestinal tract spontaneously. When the FB enters the small bowel-beyond the reach of conventional endoscopy-daily radiographs are needed to ensure its safe passage. However, endoscopic intervention is an appropriate management strategy for a sharp-pointed FB, because sharp FBs have a higher risk of intestinal perforation. We describe here a case in which a 1.5-cm, sharp-pointed screw nail in the proximal jejunum was removed successfully by double-balloon enteroscopy from a 19-year-old-male with autism. This case adds to the growing body of evidence demonstrating the value of therapeutic double-balloon enteroscopy in the field of FB ingestion
Autistic Disorder ; Double-Balloon Enteroscopy* ; Eating ; Foreign Bodies ; Gastrointestinal Tract ; Intestinal Perforation ; Jejunum* ; Stomach

PURPOSE: Childhood headache is different from adulthood headache and according to their age in clinical aspects. This study investigated the clinical differences of primary headache according to ages of children and adolescents. METHODS: A 300 children who did not show abnormalities on neurologic examination or brain CT or MRI were classified into two groups according to their ages. RESULTS: The percentage of those in the migraine group (24.2% vs. 35.9% in Groups 1 and 2 respectively) was higher in Group 2, but it was not statistically significant. In relation to the duration of headache, pain lasting for less than one hour accounted for 59.8% and 40% in Groups 1 and 2, respectively (P=0.001). In relation to the location headaches developed, the frontal region (40.2%) and temporal region (48.1%) were the most common in Groups 1 and 2, respectively (P<0.001). In relation to the nature of the headaches, tightening sensation accounted for the highest percentage in both groups; however, pulsating sensation were more common in Group 2 than in Group 1 (16.2% vs. 8.3%, P=0.038). In relation to the severity of headaches, severe to profound headaches accounted for 35.5% and 61.1% in Groups 1 and 2, respectively (P<0.001). In relation to laterality, unilateral headaches accounted for 12.4% and 26.7% in Groups 1 and 2, respectively (P=0.002). In relation to accompanying symptoms, the incidence of photophobia was higher in Group 2 than in Group 1 (P=0.047). CONCLUSION: Age factors should be considered in the diagnosis of childhood headaches. Also, we consider that there may be a need to establish diagnostic criteria specifically for childhood headaches separately from those for adulthood headaches.
Adolescent ; Age Factors ; Brain ; Child ; Headache ; Headache Disorders, Primary ; Humans ; Hydroxamic Acids ; Incidence ; Migraine Disorders ; Neurologic Examination ; Photophobia ; Sensation

The preferred site of spontaneous intracerebral hemorrhage(SICH) is the supratentorial area, especially the basal ganglia. Large hematomas frequently spread into the ventricle, and in the case of intraventricular hematomas, varying degrees of fresh blood are found within the subarachnoid space. Cases in which SICH of the basal ganglia ruptures the insular cortex and causes thick subarachnoid hemorrhage(SAH) in the basal cisterns, are, however, rare. The authors report a rare case of putaminal SICH with intraventricular hemorrhage(IVH) and SAH in the basal cisterns. This 58-year-old female was stuporous on admission. Neurological examination revealed Glasgow coma scale score 7, left hemiparesis, positive Babinski's sign and neck stiffness. Brain CT showed a large intracerebral hematoma in the right basal ganglion and associated intraventricular hematoma and SAH in the basal cistern. Cerebral angiography demonstrated a small saccular aneurysm at the right M1. Right pterional and trans-sylvian approach revealed thick SAH in the sylvian fissure and a small unruptured aneurysm at the early bifurcation of the middle cerebral artery. The putaminal hematoma had ruptured into the sylvian fissure through a natural opening at the insular cortex between M2 branches. This case illustrates that hypertensive SICH should be included in the differential diagnosis of basal cistern SAH associated with SICH.
Aneurysm ; Basal Ganglia ; Brain ; Cerebral Angiography ; Diagnosis, Differential ; Female ; Ganglion Cysts ; Glasgow Coma Scale ; Hematoma ; Humans ; Middle Aged ; Middle Cerebral Artery ; Neck ; Neurologic Examination ; Paresis ; Putaminal Hemorrhage* ; Reflex, Babinski ; Rupture ; Stupor ; Subarachnoid Hemorrhage* ; Subarachnoid Space