PURPOSE: The purpose of this study was to retrospectively analyze the etiologic transition of the predisposing factors and organisms for septic arthritis of the knee. MATERIALS AND METHODS: Between January 1995 and December 2006, 122 cases of septic arthritis of the knee were retrospectively evaluated for the etiologic transition and causative organism with using the patients' medical records. We researched the incidence and causative factor of septic arthritis of the knee, which was diagnosed via the patients' symptoms, physical examinations, hematologic exams, culture studies & cytology of the joint fluid. We assessed the correlation of disease with age, the year the disease happened, the causative factors and the incidence. RESULTS: Septic arthritis of the knee was increased after 40 years old, and it also increased after 1998. The most common predisposing factor was intra-articular injection of the knee joint. Even though there were no detected organisms in 79 cases (64.8%), the most common causative organism was S. aureus (20.5%). CONCLUSION: The most common etiologic factor of septic arthritis of the knee was an intra-articular injection. We should be prudent for using good aseptic technique and the correct procedure to reduce the secondary infection that's recently due to increased invasive treatment of the knee joint.
Arthritis, Infectious ; Coinfection ; Incidence ; Injections, Intra-Articular ; Joints ; Knee ; Knee Joint ; Medical Records ; Physical Examination ; Retrospective Studies

We evaluated retrospectively the clinical characteristics of 16 consecutive exotropia patients over 10PD following surgery for esotropia, the patients were differentiated into nonoperative and operative group. The nonoperative group comprised of 11 patients with exodeviation 10PD through 20PD(mean 12.9PD) and the orthphoria through 15PD(mean 10.5PD) at final visit. The operative group of 5 patients with exodeviation of 10PD through 30PD(mean 21PD) at postoperatively 2 weeks and 20PD through 35PD(mean 24PD) before operation of consecutive exotropia. In the second operatio, 3 patients with adduction limitation were operated with advancement of medial rectus or recession of lateral rectus of same eye. Four patients showed orthotropia at postoperatively 2 weeks, and 2 patients revealed orthotropia at the final visit. The results suggest that the degree of deviation and adduction limitation will influence the choice of therapy and second operation method.
Esotropia ; Exotropia ; Humans ; Retrospective Studies

We evaluated retrospectively the clinical characteristics of 16 consecutive exotropia patients over 10PD following surgery for esotropia, the patients were differentiated into nonoperative and operative group. The nonoperative group comprised of 11 patients with exodeviation 10PD through 20PD(mean 12.9PD) and the orthphoria through 15PD(mean 10.5PD) at final visit. The operative group of 5 patients with exodeviation of 10PD through 30PD(mean 21PD) at postoperatively 2 weeks and 20PD through 35PD(mean 24PD) before operation of consecutive exotropia. In the second operatio, 3 patients with adduction limitation were operated with advancement of medial rectus or recession of lateral rectus of same eye. Four patients showed orthotropia at postoperatively 2 weeks, and 2 patients revealed orthotropia at the final visit. The results suggest that the degree of deviation and adduction limitation will influence the choice of therapy and second operation method.
Esotropia ; Exotropia ; Humans ; Retrospective Studies

PURPOSE: To assess the efficacy and toxicity of a new protocol that consists of CHOP- Bleo alternated with a new regimen of Cyclophosphamide, methotrexate, etoposide, and dexamethasone(CMED) for aggressive Non-Hodgkin's Lymphoma(NHL). PATIENTS AND METHODS: Between January 1991 and December 1996, forty-six patients with Ann Arbor stages II-IV aggressive NHL were treated with alternating cycles of CHOP-Bleo and CMED for a total of 12 cycles. All eligible patients were evaluated for response, disease-free survival, and overall survival. RESULTS: Twenty-two patients(47.8%) achieved a complete response and overall response rate was 83.9%. The range of survival duration was 1-68+months and the median survival time was 42 months. Overall 3-year survival rate was 54%. The range of disease-free survival time was 6-63+months and 3-year disease-free survival rate was 61%. The most common hematologic toxicity was leukopenia and the incidence of severe leukopenia(<1,000/mm3) was 11%. And alopecia(84.8%) was the most common non-hematologic toxicity. CONCLUSION: The results of CHOP-Bleo/CMED alternating chemotherapy for patients with aggressive Non-Hodgkin's Lymphoma is not superior to other results of previous studies. Therefore further study will be warranted to determine clinical effectiveness of alternating chemotherapy.
Cyclophosphamide ; Disease-Free Survival ; Drug Therapy* ; Etoposide ; Hodgkin Disease* ; Humans ; Incidence ; Leukopenia ; Lymphoma, Non-Hodgkin ; Methotrexate ; Survival Rate

With the widespread use of the obstetrical ultrasound, identification of a fetal suprarenal mass becomes more common. Most of these masses prove to be congenital neuroblastomas (CNB) postnatally. However, the diagnosis is often confused with other benign lesions and the post-natal management remains controversial. The medical records of 13 patients that underwent primary surgical excision for an antenatally detected adrenal CNB, between January 1995 and April 2009, were reviewed retrospectively. The clinical, radiological, surgical, and pathological data on the suprarenal mass were collected. Staging evaluation was performed after histological confirmation of the CNB. Most of the CNBs were stage I (N=11), with 1 stage IV and 1 stage IV-S. Four patients (3 stage I and 1 stage IV-S) had N-myc gene amplification. The stage I patients were cured by surgery alone, and stage IV patients underwent 9 cycles of adjuvant chemotherapy and currently have no evidence of disease after 39 months of follow-up. The patient with stage IV-S is currently receiving chemotherapy. There were no post-operative complications. For early diagnosis and treatment, surgical excision should be considered as the primary therapy for an adrenal CNB detected before birth. The surgery can be safely performed during the neonatal period and provides a cure in most cases. Surgical diagnosis and treatment of CNB is recommended in neonatal period.
Adrenal Glands ; Chemotherapy, Adjuvant ; Early Diagnosis ; Follow-Up Studies ; Genes, myc ; Humans ; Medical Records ; Neuroblastoma ; Parturition ; Prenatal Diagnosis ; Retrospective Studies

PURPOSE: To correlate clinical results of arthroscopic debridement of degenerative knee with preoperative factors. MATERIALS AND METHODS: A retrospective survey of 61 patients (81 knees) with degenerative arthritis of knee treated with arthroscopic debridement from June 1995 to June 1997 was conducted. The average follow-up period was 22.7 months (12-35 months). There were 6 male and 55 female patients. The average age was 61.1 years. The arthroscopic procedure included excision of osteophytes, removal of loose body, meniscal trimming, synovectomy and irrigation of the knee joint. Statistical analysis was done for parameters such as knee alignment, joint space narrowing, flexion contracture, meniscal tear, articular cartilage degeneration, age, follow-up period and preoperative Insall knee score. RESULTS: A statistically significant difference in clinical results was noted in the separate subgroups for radiographic alignment (chi-square test, P=0.007) and degree of cartilage degeneration (P=0.006). Those patients with joint space narrowing, flexion contracture, meniscal tear or low Insall knee score had poor results after arthroscopic surgery. CONCLUSIONS: Though the result of arthroscopic debridement of degenerative knee is known to be unpredictable, some preoperative factors are correlated with poor outcomes, and arthroscopic treatment should be carefully selected.
Arthroscopy ; Cartilage ; Cartilage, Articular ; Contracture ; Debridement ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee* ; Male ; Osteoarthritis ; Osteophyte ; Retrospective Studies

PURPOSE: The Injury Severity Score (ISS) has limited predictive power and is difficult to calculate. We used the New Injury Severity Score (NISS) and compared it to the ISS. The purpose of this study was to give a prognosis and predict the mortality for trauma patients by using the ISS and the NISS and to compare Trauma and Injury Severity Score (TRISS) method using NISS with the TRISS method using ISS. METHODS: A retrospective study of 100 trauma victims who visited the emergency room of Kyungpook National University Hospital from September 2000 to May 2001 was made using the ISS, the NISS, and the TRISS methods. RESULTS: A comparison between survivors and nonsurvivors showed differences in the revised trauma score (RTS), ISS, NISS, and TRISS Ps-1 by using RTS and the ISS and TRISS Ps-2 by using RTS and NISS (p<0.01). We found that the NISS was more predictive of survival than the ISS. A receiver operating curve analysis and Hosmer Lemeshow statistics showed that both the NISS and the ISS provided a good fit throughout its entire range of prediction. CONCLUSION: By comparing the ISS with the NISS, we concluded that the NISS better separated survivors from nonsurvivors. The NISS predicted survival better and was easier to calculate than the ISS. The results of the TRISS method using NISS were satisfactory, and we expect to use this method in quality assessment with further study and modification.
Emergency Service, Hospital ; Gyeongsangbuk-do ; Humans ; Injury Severity Score ; Mortality ; Prognosis ; Retrospective Studies ; Survivors

PURPOSE: Gastric cancer is the most common malignacy in Korea, However, standard systemic combination chemotherapy regimen has not been settled for advanced gastric cancer. 5-FU, Cisplatin, and Pirarubicin combination chemotherpay regimen has been tried to evaluate the response rate and toxicity in advanced gastric cancer patients. MATERIALS AND METHODS: Elligibility included biopsy proven inoperable or relapsed adenocarcinoma of stomach with adequate bone marrow, hepatic, and renal functon. Thirty seven patients with histologically confinned locally advanced or metastatic gastric cancer were treated with cisplatin 15 mg/m2 IV day 1~5, pirarubicin 60 mg/m2 day 1, 5-fluorouracil 750 mg/m2 day 1~5 as a continuous intravenous infusion. RESULTS: Twenty nine patients had measurable disease, 5 had received prior chemotherapy. Performance status was 0~1 in 24 and 2 in 13. There was 1 complete response and 13 partial response with an overall response rate of 48.3%(95% confidence interval 29.9~67.1%). The median survival is 7 months(95% confidence interval 5.4~8.6 months) and median response duration is 6 months. 19 patients experienced severe(WHO grade 3~4) leucopenia, 7 was thrombocytopenia, 13 was nausea and vomiting during chemotherapy. 11 patients experienced chemotherapy dose reduction or chemotherapy time delay due to severe hematologic or non-hematologic toxicities. There was no clinically recognizable cardiac toxicities. CONCLUSION: We experienced 48.3% overall response rate, 7 months median survival, and 51.3% severe hematologic toxicities with 5-fluorouracil, pirarubicin and cisplatin combination chemotherapy regimen in advanced or metastatic gastric cancer patients.
Adenocarcinoma ; Biopsy ; Bone Marrow ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Fluorouracil* ; Humans ; Infusions, Intravenous ; Korea ; Nausea ; Stomach ; Stomach Neoplasms* ; Thrombocytopenia ; Vomiting

Background/Aims: Patients with pancreatic cancer (PC) generally have poor clinical outcomes. Early determination of their prognosis is crucial for developing a therapeutic strategy. Recently, various inflammatory markers have been validated as prognostic indicators for many cancers, including PC. However, few studies have evaluated these markers together. Thus, the purpose of this study was to comprehensively evaluate the value of inflammatory markers as prognostic indicators in patients with advanced PC treated with gemcitabine-based chemotherapy as the first line regimen. Methods: This was a single-center retrospective study evaluating 302 patients with advanced PC who began first line treatment between November 2004 and August 2016. These patients were monitored until June 2017. Survival rates were assessed with univariate and multivariate analyses. Continuous variables were separated using the normal range or ideal cut-off levels determined by receiver operating curve analyses. Results: Among inflammatory markers evaluated, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and C-reactive protein (CRP) to albumin ratio (CRP-albumin ratio) were independent predictors of overall survival (hazard ratio, 1.712, 1.345, and 1.454, respectively). Difference in survival rates was significant (p < 0.001) among three groups divided by the number of marker-related risks. Conclusions Baseline inflammatory markers including NLR, PLR, and CRP-albumin ratio are useful in predicting survival rates in patients with PC. Combining these three markers is proven to be valuable.

Spontaneous hemo-pneumothorax, a hemothorax that occurs without trauma, is a very rare condition; however, as a result of excessive bleeding, it can be lethal. Also, if the bleeding is scanty, the physician might recognize hemothorax in case of performing invasive procedures, such as chest tube insertion, and may misunder stand as a complication of the procedure. For this reason, acknowledgement of the spontaneous hemo-pneumothorax in the emergency department is very important. We report on a case of a spontaneous hemo-pneumothorax in a healthy 18-year-old male presenting with chest pain who developed a spontaneous pneumothorax with a profuse amount of hemothorax.
Chest Pain ; Chest Tubes ; Emergencies ; Hemorrhage ; Hemothorax ; Humans ; Male ; Pneumothorax